4.7.6.2Vertical

Hospital-Based Skilled Nursing

SNF units located within or operated by hospital systems.

Market snapshot

These figures describe Skilled Nursing Facilities (SNF) (4.7.6), the segment that Hospital-Based Skilled Nursing sits within. They are not figures for Hospital-Based Skilled Nursing on its own.

Market size
~$135B
Growth
~2.6%CAGR (2017–22, nominal)
Companies
~10,501 firms
Firms by employee count

28% of firms have fewer than 20 employees: 2,942 micro-businesses, below most mandates.

The investable universe7,559 firms with 20+ employees
20–99
4,08554%
100–499
2,88338%
500+
5918%

growth muted by pandemic occupancy losses.

NAICS 623110. U.S. Census Bureau, 2022 Statistics of U.S. Businesses; U.S. Census Bureau, 2022 Economic Census.

Business model & economics

Revenue model

Medicaid, Medicare, and private-pay per-diem; leased real estate

Key economics

Revenue per firm
$12,893,657
Revenue per employee
$97,210
Employees per firm
131.8
Recurring revenue
High

long-term and post-acute occupancy

EBITDA margin
Thin

Medicaid- and labor-constrained

Capex intensity
High

Characteristics

  • Balanced cost base: payroll is 43% of revenue, leaving room to scale margin without cutting staff
  • Deep strategic-buyer pool: 591 firms exceed 500 employees, so a scaled asset has trade buyers
  • Most clinically intensive and most distressed senior-care segment.
  • Heavily Medicaid-dependent and labor-squeezed.
  • Federal minimum-staffing mandates a key risk; REIT-owned real estate.

NAICS 623110. U.S. Census Bureau, 2022 Statistics of U.S. Businesses; U.S. Census Bureau, 2022 Economic Census.

M&A deal context

Deal activityModerate

Who’s acquiring

  • Skilled-nursing operators
  • Healthcare REITs
  • Distressed-asset acquirers

What’s driving deals

  • Distress-driven consolidation and restructuring.
  • Staffing-mandate and Medicaid-rate dynamics.
  • Operations/real-estate separation and REIT activity.

Find Hospital-Based Skilled Nursing acquisition targets

Search Acquisera’s index for companies classified under Hospital-Based Skilled Nursing (4.7.6.2) and build a targeted deal pipeline.

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