Medical Staffing Agency
Hospitals always need nurses — and they'll pay to get them
Bottom line
Worth studying, but do not buy without strong local proof.
Medical staffing agencies place temporary and contract healthcare workers — nurses, medical assistants, therapists, lab technicians — at hospitals, clinics, and long-term care facilities. The model is simple: agency pays the worker $35–$60/hr and bills the facility $60–$110/hr, keeping the spread. Revenue scales with headcount: a 20-nurse agency running full-time earns $3–5M/year. The U.S. nursing shortage is structurally persistent — the American Nurses Association projects a deficit of 1.1 million nurses by 2030. EBITDA margins run 8–12% on revenue, but acquisition multiples have been 3.25x+ for agencies over $2.5M in sales, with large strategic buyers (AMN Healthcare, Cross Country) paying premium prices for regional books of business.
How It Works
Agency recruits licensed nurses and healthcare workers onto a W-2 or 1099 basis. Sales team sells shifts and contracts to hospital systems, clinics, and long-term care facilities. Workers fill open shifts on demand. Revenue = bill rate × hours worked. Profit = bill rate minus pay rate, minus benefits, minus overhead. The key skill is the sales cycle (securing facility contracts) and the recruitment engine (building a reliable bench of workers). Digital platforms like Clipboard Health are disrupting the agency model but also creating a staffing marketplace that favors connected operators.
BizBite verdict
Pass for now
Medical Staffing Agency has enough high-level data for a first look, but BizBite has not assigned a category-specific operating model yet. Treat the score as preliminary.
Why it may work
- +SBA dataset shows 11 recent comparable loans
Be careful
- !Source link status has not been verified yet
- !No last-checked date yet
- !No category operating model yet
- !Thin margin profile
SBA 7(a) data
Real acquisitions in this category
Change-of-ownership loans · NAICS 561320 · Temporary Help Services
Deal size distribution
Deal flow over time
Financing profile
Franchise vs independent
Franchised acquisitions finance at $500K median vs $1.4M for independents — a −64% franchise discount. Franchises make up 35% of deals tracked.
Recent comparable deals
| Closed | State | Loan | Implied deal |
|---|---|---|---|
| Dec 2025 | MA | $5M | $5.9M |
| Sep 2025 | AZ | $843K | $992K |
| Jun 2025 | MD | $2.1M | $2.5M |
| Apr 2025 | TX | $1.4M | $1.6M |
| Mar 2025 | GA | $950K | $1.1M |
| Mar 2025 | MN | $1.0M | $1.2M |
| Oct 2024 | UT | $3.5M | $4.1M |
| Aug 2024 | IL | $2.0M | $2.3M |
| Jul 2024 | OH | $500K | $588K |
| Jul 2024 | OH | $50K | $59K |
Source: SBA 7(a) FOIA dataset, filtered to acquisitions (loans where business age is "Change of Ownership"). Implied deal size assumes an 85% loan-to-purchase ratio, a common SBA change-of-ownership structure. Charge-off rate shown only when 10+ loans have resolved (paid in full or charged off). Interest rates reflect last 24 months only. Actual deal values vary with equity injections, seller financing, and working capital terms.
Deal Calculator
Priced off $350K SDE — can this deal service its own debt?
SDE = revenue × margin estimate for this niche; it includes owner compensation, so budget your salary out of cash flow. Excludes working-capital injection, capex reserves, and taxes. Actual SBA terms vary by lender and borrower.
Pros
- +Structural tailwind: 1.1M nurse shortage projected by 2030
- +Revenue scales linearly with headcount — no physical constraints
- +Acquisition multiples of 3.25x+ for agencies over $2.5M revenue
- +Strategic buyers (AMN Healthcare, Cross Country) actively acquiring regional agencies
- +Recession-resistant — healthcare demand does not shrink in downturns
Cons
- -Payroll float is significant — pay workers weekly before facilities pay 30–60 days later
- -Compliance is complex: Joint Commission accreditation, state licensing, credentialing
- -Slim EBITDA margins (8–12%) — revenue looks bigger than it is
- -Worker loyalty is low — good nurses are constantly poached by competing agencies
- -Liability exposure if a placed worker makes a clinical error
Best For
Former healthcare administrators, HR professionals, or operators with access to startup capital ($50K+) and existing relationships with hospitals or nurse networks
Operating Costs
Pay rates for RNs run $35–$60/hr; bill rates $65–$110/hr. Gross margin on each worker is roughly 35–45%. After agency overhead (recruiter salaries, ATS software, insurance, compliance, payroll processing), EBITDA margins land at 8–12%. A $3.5M revenue agency nets $280–$420K EBITDA before owner compensation. Factoring/invoice financing is commonly used to bridge the payroll-to-payment gap.
Where to Buy
Active listings for healthcare and medical staffing agencies for sale
Industry research, valuation benchmarks, and M&A data for the staffing sector
Detailed breakdown of staffing company valuation multiples and deal terms
Buyer's Toolkit
Essential tools to get started
Some links may be affiliate links. We only recommend tools we'd use ourselves.
Ready to Buy? Start Here →
Largest business-for-sale marketplace in the US
SBA loans and business acquisition financing — get funded fast
ROBS financing — use retirement funds to buy a business tax-free
Bookkeeping for small business owners — hands-off financials
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