Medical Staffing Agency
Hospitals always need nurses — and they'll pay to get them
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.
Avg Revenue
$3.5M
Profit Margin
10%
Acquisition Multiple
2x - 5x
Startup Cost
$30K - $120K
Difficulty
4/5
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
Real Acquisitions in This Category
SBA 7(a) change-of-ownership loans · NAICS 561320 · Temporary Help Services
Deal Size Distribution
Deal Flow Over Time
Financing Profile
Recent Comparable Deals
| Closed | State | Loan | Implied deal | Jobs | Franchise |
|---|---|---|---|---|---|
| Dec 2025 | MA | $5.0M | $5.9M | — | — |
| Sep 2025 | AZ | $843K | $992K | 5 | — |
| Jun 2025 | MD | $2.1M | $2.5M | 11 | — |
| Apr 2025 | TX | $1.4M | $1.6M | 1 | — |
| Mar 2025 | GA | $950K | $1.1M | 7 | Express Employment Professiona |
| Mar 2025 | MN | $1.0M | $1.2M | 45 | — |
| Oct 2024 | UT | $3.5M | $4.1M | 32 | Spherion General Staffing |
| Aug 2024 | IL | $2.0M | $2.3M | — | — |
| Jul 2024 | OH | $500K | $588K | 6 | Express Employment Professiona |
| Jul 2024 | OH | $50K | $59K | 6 | Express Employment Professiona |
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
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
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
Acquisition Score
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
Buyer's Toolkit
Essential tools to get started
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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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