The decision to sell your Occupational & Hand Therapy practice is one of the most significant of your career. The North Carolina market is currently experiencing intense demand, creating a powerful window of opportunity for owners. This guide provides a clear overview of the market, key factors to consider, and the steps involved in navigating a successful sale. Proper preparation and understanding your practice’s true worth are the first steps toward achieving your financial and personal goals.
Market Overview: A Seller’s Climate in North Carolina
The current environment for therapy practices is exceptionally strong. This is not just a general feeling; it is supported by clear data. Buyers, from private equity groups to larger strategic healthcare systems, are actively looking to acquire well-run practices.
Unprecedented Growth
Nationally, the field of occupational therapy is projected to grow 11% by 2033, much faster than the average for all occupations. The overall U.S. therapy market is expected to nearly double by 2032. This national trend fuels buyer confidence and increases their appetite for acquisitions. They are looking for established practices to build upon.
High Demand in the Tar Heel State
This growth is reflected directly in North Carolina. Projections show a 24% growth for physical therapists in the state through 2032, a strong indicator for the entire rehabilitation therapy sector. This high demand means that a well-positioned Occupational and Hand Therapy practice is a very attractive asset. Selling into a growing market gives you significant leverage.
Key Considerations for a Successful Sale
A strong market is a great start. But a successful sale depends on the specific details of your practice. Before you begin, you should have a clear picture of a few key areas. Thinking through these points now will save you time and prevent surprises later.
Here are three areas to focus on:
- Regulatory Compliance. Your practice operates under rules set by the North Carolina Occupational Therapy Practice Act. While there are no specific regulations for a sale, buyers will perform due diligence to ensure all licensing and professional standards are impeccable. Clean records are a must.
- Your Business Structure. Are you an LLC or an S-Corp? This is not just a legal detail. It has major implications for how a deal is structured and how your proceeds are taxed. Understanding this early helps you plan for the best possible financial outcome.
- Your Unique Value. What makes your practice special? Perhaps you have a high percentage of therapists with a Certified Hand Therapy (CHT) designation. Maybe you have a strong, consistent referral network from local surgeons. These are not just points of pride. They are tangible value drivers that increase your valuation.
Every practice sale has unique considerations that require personalized guidance.
Market Activity: What We Are Seeing Today
The theoretical opportunity in the market is translating into real transactions. We see private practice owners receiving strong interest from a variety of motivated buyers.
Buyer Appetite is Strong
Buyers are not just browsing. They are actively seeking to invest in the North Carolina therapy space. We have seen profitable OT/PT practices with over $500,000 in annual revenue attract multiple offers. In one recent example, a thriving hand therapy clinic was listed for $600,000, showing the premium placed on specialized services.
What Buyers are Looking For
Sophisticated buyers look past the basic numbers. They want to see a stable business with a clear path for growth. They are interested in your patient demographics, your payer mix, the quality of your staff, and the efficiency of your operations. A practice that can demonstrate consistent performance and a strong local reputation will always command the most attention.
Timing your practice sale correctly can be the difference between average and premium valuations.
The Sale Process: A Simple Roadmap
Selling your practice is a structured process, not a single event. When managed correctly, it unfolds in predictable stages. Understanding this path helps you feel in control and prepared for each step. At its core, the process is about telling your practice’s story to the right people in the right way.
| Stage | What It Means for You |
|---|---|
| 1. Preparation & Strategy | We work with you to define your goals, prepare your financial documents, and create a clear exit plan. This is where we build the foundation for a successful outcome. |
| 2. Confidential Marketing | Your practice is presented confidentially to a vetted pool of qualified buyers. We manage all communications to protect your staff and patient relationships. |
| 3. Managing Offers | We help you evaluate and negotiate offers to ensure the terms align with your financial goals and legacy objectives. |
| 4. Due Diligence | The buyer verifies all the information about your practice. This is a critical phase where a deal can encounter challenges, but with proper preparation beforehand, it can be a smooth confirmation of value. |
| 5. Closing | The final agreements are signed, and the transition to new ownership begins. |
The due diligence process is where many practice sales encounter unexpected challenges.
Uncovering Your Practice’s True Value
Many owners mistakenly believe their practice is worth little more than its physical assets. This is rarely the case. True value is driven by profitability and future potential. Getting an accurate valuation is the most important step you can take.
So what really determines your practice’s worth?
- True Profitability. Buyers value your practice based on a metric called Adjusted EBITDA. This is your earnings before interest, taxes, depreciation, and amortization, with key adjustments made for owner-specific expenses. Most practice owners are surprised to learn their Adjusted EBITDA is much higher than they thought.
- Clinical Reputation and Specialization. A strong brand, excellent patient outcomes, and specialized services like Certified Hand Therapy dramatically increase your valuation multiple. Buyers pay a premium for a practice that is a clinical leader in its community.
- Staff and Referral Networks. A stable, experienced team and a diverse, loyal base of referral sources reduce risk for a buyer. They see a business that can run smoothly and continue to grow after the transition, making it a more valuable investment.
A comprehensive valuation is the foundation of a successful practice transition strategy.
After the Sale: Planning Your Next Chapter
The moment the deal closes is not the end of the story. The structure of the sale has a lasting impact on your finances, your staff, and your legacy. Planning for this from the beginning is key to a transition you can feel good about.
Ensuring a Smooth Transition
A responsible buyer wants to protect the asset they just acquired. This means retaining your talented staff and ensuring continuity of care for your patients. A key part of our negotiation process is building in a transition plan that respects your team and gives you a defined role for as long as you wish to stay involved.
Structuring Your Financial Future
Your payout is not always a single check. Many of todays deals involve an “earn-out,” where you receive additional payments for hitting performance targets post-sale. Some owners also choose to “roll over” a portion of their equity, retaining ownership in the larger new company. This can provide a second, often larger, financial return when that company is sold again down the road. These advanced structures require careful planning to maximize your benefit.
Your legacy and staff deserve protection during the transition to new ownership.
Frequently Asked Questions
What is the current market demand for Occupational & Hand Therapy practices in North Carolina?
The market in North Carolina is highly favorable for sellers, with intense buyer demand. Buyers include private equity groups and strategic healthcare systems actively seeking well-run practices due to projected growth in occupational therapy and rehabilitation therapy sectors.
What key factors should I consider before selling my Occupational & Hand Therapy practice in North Carolina?
Key considerations include ensuring regulatory compliance with the North Carolina Occupational Therapy Practice Act, understanding the legal structure of your business (LLC, S-Corp), and identifying your practice’s unique value drivers such as specialized certifications and referral networks.
How is the value of my Occupational & Hand Therapy practice determined?
The value is primarily based on adjusted EBITDA (earnings before interest, taxes, depreciation, and amortization with adjustments), clinical reputation, specialization (e.g., Certified Hand Therapy), and the stability of staff and referral networks, all of which contribute to a higher valuation multiple.
What are the main stages involved in selling an Occupational & Hand Therapy practice?
The sale process includes: 1) Preparation & Strategy, 2) Confidential Marketing to qualified buyers, 3) Managing Offers and negotiation, 4) Due Diligence by the buyer, and 5) Closing and transition to new ownership.
What should I plan for after selling my Occupational & Hand Therapy practice?
Post-sale planning involves ensuring a smooth transition by retaining staff and maintaining patient care continuity, structuring financial terms such as earn-outs or equity rollovers, and protecting your legacy and staff during the transition.
