Post-Acute Healthcare Advisory Firm, 20-Year Compliance & Revenue Cycle Consultancy

$3.8M

Revenue

$1.0M

SDE

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Full Editorial Writeup

This is a healthcare consulting firm built around operational and compliance support for post-acute care providers: skilled nursing facilities, assisted living, home health agencies, hospice providers, rehab centers, and continuing care retirement communities across the US. The core work is advisory: helping care teams navigate regulatory guidance, improve clinical performance, and optimize revenue cycle. Over a 20-plus year operating history the firm has embedded itself deeply into client operations, which is exactly what you want to see in a services business that lives or dies on retention.

The financial profile is genuinely attractive for a consulting shop. Gross profit margins averaged 44.7% and adjusted EBITDA margins 34.1% from 2023 to 2025, and on roughly $3.78M of revenue the business threw off about $1.01M of EBITDA. More importantly, over 95% of annual revenue is recurring, structured through evergreen agreements with monthly billing. That is not typical for consulting, which usually reads as lumpy project work; here the revenue behaves more like a subscription book tied to ongoing regulatory and revenue cycle needs.

The firm operates from two small facilities in the Northeast and Southeast US, neither of which is included in the sale. Ownership is two partners on a 99/1 split, both seeking a full exit, with the majority owner willing to stay on temporarily to hand over relationships. The stated growth paths are logical extensions of the existing base: deepen legal-adjacent referral channels, expand the Southeast footprint, build in-house medical billing and coding to reclaim margin currently paid to third parties, and lean into M&A diligence work as post-acute consolidation continues.

Why we like it

Earnings quality is strong for a services firm, with 34.1% average adjusted EBITDA margins and about $1.01M of EBITDA on $3.78M of revenue. Over 95% of that revenue is recurring under evergreen monthly-billing agreements, so this reads more like a subscription book than lumpy project consulting. That combination of margin plus recurring structure is rare in the advisory world.
The moat is relationship depth and regulatory embeddedness built over a 20-plus year operating history. Clients rely on the firm for ongoing compliance, advisory, and revenue cycle services in a sector where getting regulation wrong carries real financial and licensure consequences. Switching costs are high when a provider has wired your team into its compliance and reimbursement workflow.
Post-acute care sits on top of durable demographic tailwinds as the population ages and skilled nursing, home health, and hospice utilization grows. Regulatory complexity in this segment only increases over time, which structurally expands the need for exactly the compliance and reimbursement support this firm sells. This is need-to-have spend for providers, not discretionary.
There is a clear operator playbook already scoped: build in-house billing and coding to reclaim margin paid to third parties, expand the Southeast presence through regional associations, and layer in M&A diligence work as the sector consolidates. These are extensions of an existing base rather than speculative new lines. A hands-on owner can convert them into margin and revenue without reinventing the business.

How to improve it

Bring medical billing and coding in-house to capture margin currently flowing to third-party providers. The listing flags this directly as an opportunity, and every dollar of billing spend retained drops toward EBITDA. Model the fully loaded cost of hiring certified coders against current outsourced spend before committing.
Push a structured Southeast expansion using the associations already named, FHCA, AHCA, and LeadingAge Southeast. The firm already has a Southeast facility and warm regional ties, so this is about disciplined business development rather than a cold market entry. Set concrete client-add targets tied to each association relationship.
Diversify the client base by building referral channels with legal practices handling post-acute disputes, compliance issues, and reimbursement litigation. This introduces higher-rate, project-based work that complements the recurring advisory base. It also creates a natural cross-referral loop back into the core compliance offering.
Formalize and scale the M&A due diligence service to ride continued post-acute consolidation. Buyers and lenders in this space need clinical and compliance diligence, and the firm already has the domain expertise to deliver it. Package it as a defined product with clear pricing rather than ad hoc engagements.
Reduce key-person and owner dependency by documenting the advisory methodology and client relationships before the transition period ends. With both owners exiting, the value hinges on whether relationships transfer to the team rather than walking out the door. Build a client success layer and named account owners inside the firm during the handover.
Introduce tiered service packages and annual price escalators into the evergreen agreements. Recurring contracts with monthly billing are an ideal vehicle for modest, consistent rate increases that compound to EBITDA. Audit which long-tenured clients are underpriced relative to the value delivered.
Invest in a lightweight technology layer to standardize deliverables, compliance tracking, and reporting across engagements. This improves consultant utilization and makes each client relationship less dependent on individual memory. Better tooling also strengthens the retention story for a future exit.

Diligence notes

Scrutinize the recurring revenue claim by pulling the actual evergreen contracts, cancellation terms, and historical churn. Evergreen and 95% recurring on paper still needs proof that clients renew and rarely leave, so request a client-by-client revenue history for the last three years. Confirm there are no auto-termination clauses or short notice periods that undercut the durability narrative.
Assess client concentration carefully, since a firm this size may lean on a handful of large post-acute accounts. Ask for revenue by client and tenure, and understand what percentage sits with the top five and top ten relationships. Concentration risk is the single biggest threat to the recurring-revenue thesis.
Dig into owner and key-person dependency given that both partners want a full exit. Determine which client relationships are owned by the majority partner personally versus the broader team, and how much revenue is at risk if those relationships do not transfer. The willingness to stay for a transition period is helpful but not a substitute for a retention plan.
Verify the margin bridge behind the 44.7% gross and 34.1% adjusted EBITDA figures, including what add-backs are being applied. Confirm the affiliated-entity lease on the Northeast facility is at market rate, since a related-party lease can distort reported earnings. Restate EBITDA on arms-length rents and a realistic post-sale management structure.
Confirm the regulatory and licensing exposure of the advisory work itself, including any liability tied to compliance guidance provided to clients. Review insurance coverage, past claims, and any indemnity obligations in client contracts. Reimbursement and compliance advice carries tail risk that needs to be understood before closing.

Source

Originally listed on BizBuySell. View original listing →