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BIZBITE

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.

35
Acquisition score
Fair

Avg Revenue

$3.5M

Profit Margin

10%

Acquisition Multiple

2x - 5x

Startup Cost

$30K - $120K

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.

Revenue Range

Low End
$800K
Typical
$3.5M
High End
$15.0M

BizBite underwriting snapshot

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.

22
Avoid / 100
Data confidence
medium
52/100
Financing fit
medium

Category-level fit before lender-specific diligence.

Confidence cap
78

Weak source data caps the final score.

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
  • !No category model yet
  • !Thin margin profile

Real Acquisitions in This Category

SBA 7(a) change-of-ownership loans · NAICS 561320 · Temporary Help Services

Deals tracked
20
11 in last 24 mo
Median loan
$993K
$470K–$2.0M p25/p75
Implied deal size
$1.2M
median · ~85% LTV
Charge-off rate
not enough resolved loans

Deal Size Distribution

<$150K
1
$150K–500K
4
$500K–1M
5
$1M–2M
4
>$2M
6

Deal Flow Over Time

12-month momentum
-62.5%
deal volume vs prior 12 mo
Median loan Δ
+71.4%
3 recent · 8 prior

Financing Profile

Median rate
10.00%
18% fixed · last 24 mo
Median term
120 mo
standard 10-yr
Collateralized
0%
of loans secured
Median jobs
6
supported per deal
Top lenders in this space
The Huntington National Bank3
First Internet Bank of Indiana3
U.S. Bank, National Association2
Old National Bank1
Bank of America, National Association1
Where deals happen
OH4
CA3
GA2
TX2
MI1
MD1
AZ1
MA1
MN1
WI1
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

ClosedStateLoanImplied deal
Dec 2025MA$5.0M$5.9M
Sep 2025AZ$843K$992K
Jun 2025MD$2.1M$2.5M
Apr 2025TX$1.4M$1.6M
Mar 2025GA$950K$1.1M
Mar 2025MN$1.0M$1.2M
Oct 2024UT$3.5M$4.1M
Aug 2024IL$2.0M$2.3M
Jul 2024OH$500K$588K
Jul 2024OH$50K$59K
Volume rank #261/544Deal-size rank #153/544Momentum rank #344p90 loan: $3.2MData as of Mar 2026

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.

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.

SBA Financing Estimator

Adjust the deal — see if it cash flows after debt service

$-29806/mo
after debt service
Deal price — $5.3M
Range: $5.3M (2×) to $21.0M (5×+)
Down payment — 15% ($788K)
SBA minimum equity injection is 10% for change-of-ownership
Interest rate — 10.00%
SBA median for this category: 10.0%
Loan term — 10 years (120 mo)
SBA median for this category: 120 months
Down payment
$788K
15% equity injection
Loan amount
$4.5M
85% SBA-financed
Monthly payment
$59K/mo
$2.6M total interest
Monthly profit
$29K/mo
at 10% margin
Monthly cash flow after debt service
$-29806/mo
Margin does not cover debt service at these terms. Lower the deal price, increase the down payment, or extend the loan term.

Estimates only. Excludes owner compensation, capex, working capital draws, and taxes. Margin assumes average occupancy and volume. Actual SBA terms vary by lender and borrower profile.

Where to Buy

BizBuySell - Healthcare Staffing

Active listings for healthcare and medical staffing agencies for sale

Staffing Industry Analysts

Industry research, valuation benchmarks, and M&A data for the staffing sector

Raincatcher - Staffing Valuation

Detailed breakdown of staffing company valuation multiples and deal terms

35/100Fair

Acquisition Score

Profit margin
7/30
Entry multiple
19/25
Market depth
1/20
Risk (charge-off)
8/15
Deal momentum
0/10

Scores margin (30), entry multiple (25), SBA market depth (20), category risk (15), and deal momentum (10). Higher = better acquisition candidate.

Quick Facts

Category
service
Difficulty
4/5
Buy price
$7.0M$17.5M

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