New Hampshire’s rapidly aging population creates a significant and growing demand for hospice and geriatric care. This makes your practice a valuable asset in today’s market. For owners considering their next steps, this presents a unique window of opportunity. Selling your practice is a major decision. Success depends on understanding market dynamics, proper valuation, and strategic timing. This guide provides insights to help you navigate the process.
Executive Summary
Selling your hospice or geriatric practice in New Hampshire is a timely consideration. The state’s demographic trends are driving strong buyer interest and premium valuations. This article outlines the current market landscape, key factors for a successful sale, and the strategic steps involved. Understanding these elements is the first move toward maximizing your practice’s value and securing your legacy. Proper preparation and expert guidance can make a significant difference in your final outcome.
Market Overview
The market for hospice and geriatric services in New Hampshire is not just stable. It is expanding rapidly. This growth is fueled by powerful demographic tailwinds, making it an attractive environment for sellers. Buyers, including private equity firms and strategic health systems, recognize this trend and are actively looking for well-run practices.
Here are the core drivers of this demand:
1. An Aging Population: With 20.8% of residents already over 65, New Hampshire’s population is aging faster than the national average. By 2030, older adults will outnumber children, guaranteeing a sustained need for your services.
2. Industry Growth: The state’s home care provider industry is projected to hit $568 million by 2025. The elderly and disabled services sector is forecast to reach $485.4 million in the same timeframe.
3. Infrastructure Demand: Forecasts show a need for 6,300 additional long-term care beds by 2030, signaling a system-wide expansion that creates opportunities for established practices to be acquired as platforms for growth.
Key Considerations
Beyond market statistics, selling a hospice or geriatric practice involves a unique set of human-centric factors. You have built a legacy based on trust and compassionate care. A successful transition must honor that legacy. For owners, this means finding a buyer who not only pays a premium price but also aligns with your clinical values and commitment to patient care.
Protecting Your Team
Your dedicated staff are crucial to your practice’s success and reputation. A key part of any sale is ensuring their future is secure. The right buyer will recognize their value and have a clear plan for retention and integration, preserving the culture you9ve built.
Ensuring Continuity of Care
The transition of care for vulnerable patients must be seamless. This requires careful planning and communication. We help you structure a deal that prioritizes this continuity, giving you peace of mind that your patients will remain in good hands.
Finding the Right Partner
Not all buyers are created equal. Some seek to slash costs, while others aim to invest in growth and enhance clinical capabilities. The goal is to find a partner who will continue your mission. This is where a structured, confidential process helps you vet potential buyers thoroughly.
Market Activity
The healthcare M&A market is dynamic. While deal activity saw a slower start in early 2025, volume steadied, and the underlying drivers for hospice and geriatric care remain incredibly strong. Private equity (PE) continues to be a major force, actively seeking platform practices in growing markets like New Hampshire. These sophisticated buyers are looking for well-managed businesses with a strong community presence and clear potential for expansion. This environment creates both opportunity and competition. Running a professional process is the only way to generate multiple offers and drive valuation to its peak.
| Market Reality | Your Opportunity |
|---|---|
| PE firms are the primary buyers. | They have capital and are willing to pay a premium for the right platform. |
| The market is selective. | A well-prepared practice with clean financials stands out significantly. |
| Buyers want proven growth. | Starting to prepare 203 years before a sale allows you to build that track record. |
The Sale Process
Selling your practice is a structured journey, not a single event. While every transaction is unique, a successful sale typically follows a clear pathway designed to maximize value and minimize disruption to you and your team. Getting this process right is the difference between an average outcome and a great one. We find that most owners start thinking about selling far too late. The best time to start preparing is two to three years before your target exit date.
Here are the four major phases:
1. Preparation and Valuation. This is the foundation. It involves a deep financial review to calculate your practice’s true earning power (Adjusted EBITDA), preparing marketing materials, and setting a data-backed valuation.
2. Confidential Marketing. We don’t just “list” your practice. We run a confidential, targeted process, discreetly approaching a curated list of qualified strategic and financial buyers who we know are a good fit.
3. Negotiation and Due Diligence. After vetting initial offers, you select a preferred partner. This leads to the due diligence phase, where the buyer verifies your financials and operations. This is where most deals fail, but with proper preparation, it becomes a smooth validation step.
4. Closing and Transition. The final phase involves legal documentation and executing the transition plan. The goal is a seamless handover that protects your legacy, your staff, and your patients.
Valuation
What is your practice actually worth? The answer is more complex than a simple formula. Sophisticated buyers don’t just look at your revenue. They look at your profitability and your future potential. A professional valuation is the foundation of a successful sale. It ensures you don’t leave money on the table.
It Starts with Adjusted EBITDA
The most important metric is Adjusted EBITDA (Earnings Before Interest, Taxes, Depreciation, and Amortization). We start with your net income and add back certain expenses like your personal auto lease, above-market salary, or other one-time costs. This reveals your practice’s true cash flow and is the baseline for its value. Many owners are surprised by how much higher their Adjusted EBITDA is compared to their reported profit.
The Multiple
Your Adjusted EBITDA is then multiplied by a number (the multiple) to determine your practice’s enterprise value. This multiple isn’t fixed. It depends on factors like your payer mix, your reliance on a single owner, and your growth history. For example, a multi-provider practice with a strong management team will receive a much higher multiple than a solo practice. Multiples for practices with over $1M in EBITDA often range from 5.5x to 7.5x or higher.
The Story
Buyers don’t just buy numbers. They buy a story of future growth. We help frame your practice’s unique story, highlighting its strategic position in the growing New Hampshire market. This narrative is often the key to achieving a premium valuation.
Post-Sale Considerations
The day you sign the closing documents is not the end of the journey. It is the beginning of your next chapter. Planning for what comes next is a critical part of the sale process itself. Your goals for the future should shape the structure of the deal today. Proper planning ensures you not only maximize your financial return but also achieve your personal and professional objectives.
Thinking about these things now will lead to a better outcome:
1. Your Future Role. You don’t necessarily have to walk away. Many owners choose to stay on for a defined period, focusing on clinical work without the administrative burdens. Some deals are structured with an “equity rollover,” where you retain a stake in the new, larger company. This gives you a potential second financial reward when that company is sold later.
2. Tax-Efficient Structures. How your deal is structured has massive implications for your net, after-tax proceeds. Planning for this in advance, rather than as an afterthought, can save you a significant amount of money.
3. Wealth Management. A successful sale will be a major liquidity event. Having a plan in place for managing your proceeds is a key component of securing your financial future for yourself and your family.
4. Legacy and Impact. The right deal structure ensures your practice’s mission continues. By choosing the right partner, you can ensure your legacy of care thrives and expands long after you have moved on.
Frequently Asked Questions
Why is New Hampshire a good market for selling a hospice or geriatric practice?
New Hampshire’s rapidly aging population drives strong demand for hospice and geriatric care. With 20.8% of residents over 65 and an expanding home care industry projected to hit $568 million by 2025, the market offers significant growth potential and buyer interest.
What should I consider when preparing to sell my hospice or geriatric practice?
Key considerations include understanding your practice’s valuation based on adjusted EBITDA, protecting your staff’s future employment, ensuring continuity of care for patients during the transition, and finding a buyer who aligns with your clinical values and commitment to compassionate care.
Who are the typical buyers for hospice and geriatric practices in New Hampshire?
Private equity firms and strategic health systems are the main buyers. They are actively searching for well-run practices with strong community presence and growth potential, often willing to pay a premium for established platforms in this expanding market.
How should I time the sale of my practice to maximize value?
The best time to start preparing for a sale is two to three years before your target exit date. This allows time to build a strong growth record, clean up financials, and position your practice to attract multiple qualified offers, ultimately driving up valuation.
What happens after I sell my hospice or geriatric practice?
Post-sale, many owners choose to stay on in some clinical capacity or retain equity stakes through an equity rollover. Planning your future role, tax-efficient deal structure, wealth management, and ensuring your practice’s legacy continues are important steps for a successful transition.
