Operator economics across the three post-acute settings: what facilities earn, how full they run, who operates them, and how buyers price them.
Six posts on what skilled-nursing facilities earn, how full they run, who operates them, and how buyers price them.
The median skilled-nursing facility runs a 9% EBITDAR margin and a breakeven operating line. From 12,000-plus Medicare cost reports: what SNFs earn, how wide the spread runs, and what moves it.
Median skilled-nursing occupancy is 83.8% nationally, but it runs from 62% in Oklahoma to 95% in North Dakota. Texas has the most SNFs and one of the lowest occupancies. What the state spread signals for a deal.
The average skilled-nursing bed traded near $83,800 in 2024, but a per-bed rule of thumb hides the real inputs. How buyers normalize EBITDAR, read revenue per day and occupancy, and build a defensible comp set.
EBITDAR is EBITDA with rent added back. Why lease-heavy post-acute operators are measured on it, a worked example from the median SNF, and how to use it in a benchmark.
Skilled-nursing occupancy is patient-days over available bed-days. Why the denominator makes reported rates vary, and the three adjustments that make occupancy comparable across facilities.
The largest skilled-nursing operator runs about 2.4% of US beds, and a third of operators run just one facility. The biggest chains by footprint and the fragmentation behind the roll-up thesis.
Three posts on the richest margins in post-acute, who is buying, and the census figure the sector runs on.
The median hospice operates at a 10.2% EBITDA margin, the highest in the post-acute sector, and keeps most of it. What hospices earn, why an asset-light per-diem model is so attractive, and the payer and cap dynamics that govern it.
The largest hospice operator runs about 1.5% of the market, and more than 330 deals have closed since 2019 at a median 10x EBITDA. Who is consolidating hospice, what they are paying, and why.
Average daily census is the patients a hospice serves on an average day. In a per-diem business, ADC is most of the revenue line, which is why it is the first number a hospice buyer asks for.
Three posts on the thinnest margins in post-acute, the operators consolidating them, and the per-visit figure that decides them.
The two largest home health operators are owned by health insurers. The biggest agencies by footprint, the payer and PE ownership behind them, and what buyers are actually paying for.
Revenue per visit is the number a home health operator watches most, even though Medicare no longer pays by the visit.
The median home health agency generates a 7% margin, while margins at the 25th percentile are negative. What agencies earn, why the profitability variance is so wide, and who is consolidating the sector anyway.
A cross-sector benchmark pulling SNF, hospice, and home health onto one page, with deal volume and multiples over time.