Largest Hospice in the U.S. Virgin Islands, 26-Year Medicare-Certified Provider

Full Editorial Writeup

This is the largest hospice provider in the U.S. Virgin Islands, Medicare-certified since 2000 and operating for 26 years. It runs a current patient census of 57, generating roughly $2.41M in annual revenue and $664K in seller discretionary earnings, which pencils to a 3.39x multiple at the $2.25M asking price. Hospice is a federally reimbursed, per-diem Medicare benefit, so the bulk of revenue comes through a predictable government payer rather than discretionary consumer spending.

The business serves terminally ill patients and their families across the territory, delivering end-of-life care that is medically necessary and almost entirely insulated from economic cycles. Its 26-year track record and Medicare certification create a meaningful regulatory moat: standing up a competing certified hospice in a small island market requires licensure, survey compliance, and clinical staffing that most entrants cannot quickly replicate.

The seller is screening hard, requiring hands-on hospice operating experience or a credible plan for experienced local leadership, plus proof of funds, with a stated preference for all-cash offers. That signals the key risk and the key value driver are the same thing: this is a clinically regulated operation where the quality of local leadership, staffing, and survey compliance determines whether the census and reimbursement hold after close.