Residential Assisted Living / Adult Family Home Acquisition & SBA Model
Originally published: 26/07/2026 19:43
Publication number: ELQ-34499-1
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Residential Assisted Living / Adult Family Home Acquisition & SBA Model

Underwrite a residential assisted living / adult family home acquisition: a Medicaid bed is not a private-pay bed. Payer-mix revenue, staffing ratio, SBA/DSCR.

Description
The broker prices this care home as if every bed paid private. One in five beds is Medicaid. That gap is $162,000 of purchase price. A lender-ready acquisition-underwriting model for buying a single residential assisted living / adult family home (6-16 beds) with an SBA 7(a) loan. Revenue is built bottom-up from beds x occupancy at each payer rate, the caregiver labor is sized from a 24/7 staffing ratio, and you charge for the licensed administrator you must hire to replace the live-in owner.

What it does: a census x payer-mix revenue engine (10 beds at 90% occupancy, split 80% private / 20% Medicaid, at $5,500 private and $3,000 Medicaid-net = a $5,000 blended rate and $540,000 revenue); two prices side by side - the all-private pro-forma price ($610,800) next to the real blended-rate price ($448,800), overpay avoided $162,000 (26.5%), and the DSCR at each (1.12x vs 1.51x); a caregiver staffing-ratio engine (about 40% of revenue, roughly fixed at 24/7 coverage); the DSCR true 1.51x vs naive 2.55x (after a $55,000 administrator); an occupancy plus caregiver-shortage down-case at 0.78x; and the honest fact that owning the real estate compresses the combined DSCR to 1.06x. 11 Excel tabs (Google-Sheets safe) plus a PDF guide. Benchmarks from CDC/NCHS, Genworth, NIC, AHCA/NCAL, PHI, BizBuySell and BLS. Educational planning tool - not financial, lending, legal or medical advice.

This Best Practice includes
Excel model (11 tabs, 5-year, every assumption editable and highlighted, Google-Sheets compatible), a PDF guide with sources, and a README. Census and payer-mix revenue engine, the two-price bridge, the caregiver staffing-ratio cost engine, the owner-administrator replacement, the SBA capital stack, the DSCR gate, an occupancy/caregiver-shortage down-case, the fee-simple info block, three payer-mix profiles, and the returns.

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Further information

Underwrite a small residential assisted living / adult family home acquisition the way an SBA lender will: price the census on the blended net rate it actually collects (not the private sticker), size the fixed 24/7 caregiver labor, replace the owner-administrator, and clear the DSCR gate.

You are buying a 6-16 bed residential assisted living or adult family home with an SBA 7(a) loan and need a lender-ready model, or you are stress-testing a broker pro-forma that prices every bed at the private rate.

You need a 100+ unit institutional senior-living model, a startup forecast, or investment/medical advice. This is an educational planning tool, not financial, legal or medical advice.


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