What is the best place to sell an assisted living facility?

There is no single best channel. For larger facilities (60+ beds, EBITDA in the millions), specialty senior-housing M&A firms (JLL, CBRE, Marcus & Millichap, Berkadia) and direct outreach to public REITs and large operators are the highest-clearing channels. For smaller community-based RCFEs and ALFs (6 to 50 beds), direct buyer-to-seller transactions, regional specialty brokers, and FSBO listings on generic marketplaces (BizBuySell, LoopNet) are more common. The right channel depends on facility size, license type, real-estate structure, payer mix, and the seller's willingness to manage the regulatory process directly.

Do assisted living licenses transfer with the business?

No. Assisted living licenses are state-issued to the operator and do not automatically transfer with the business. California requires a new license application under Health and Safety Code § 1569.191 with 30-day resident notice, buyer's application within five days of accepted offer, and a 60-day department decision after a complete application. Texas (HHSC, Health and Safety Code Chapter 247) requires the buyer to apply for a new license and pass inspections. Florida (AHCA, Chapter 429 Part I, Rule 59A-36) requires the buyer to apply through the AHCA licensing process. New York (DOH, Public Health Law Article 46-B) requires Department of Health character-and-competence review of the buyer.

What's the difference between an RCFE, ALF, and ACF?

These are state-specific names for residential assisted living. California licenses Residential Care Facilities for the Elderly (RCFE) under Title 22, Division 6, Chapter 8 of the California Code of Regulations. Texas licenses Assisted Living Facilities (ALF) as Type A or Type B based on resident evacuation capability under Health and Safety Code Chapter 247 and 26 TAC Chapter 553. Florida licenses Assisted Living Facilities (ALF) with four sub-types (Standard, Extended Congregate Care, Limited Nursing Services, Limited Mental Health) under Chapter 429 Part I and Rule 59A-36. New York licenses Adult Care Facilities (ACF) and certifies Assisted Living Residences (ALR), Enhanced ALR (EALR), and Special Needs ALR (SNALR) under Public Health Law Article 46-B.

How is an assisted living facility valued?

Assisted living facilities are typically valued using a combination of a real-estate component (per-key or per-unit valuation, capitalization rate applied to net operating income from rent) and an operating-company component (EBITDA multiple applied to the care and services business). The valuation split depends on whether the deal is a stock sale of the operator, an asset sale of the operator, a sale of the real estate to a REIT with a separate operator/management agreement, or a fully combined sale. Specific multiples and capitalization rates vary by occupancy, payer mix, regulatory standing, market, and acquirer type. Benchmark current ranges with a senior-housing M&A advisor or a CPA experienced with assisted living.

Should I sell the real estate and operations together?

It depends on the acquirer. Public REITs (Welltower, Ventas, Healthpeak, National Health Investors, LTC Properties) typically buy the real estate and lease it to a third-party operator under a triple-net lease or operate it through a RIDEA structure with an affiliated operator. Operator-buyers (Brookdale, Atria, Sunrise, Discovery Senior Living, Holiday by Atria, Watermark, regional operators) typically want both the real estate and the operations or partner with a REIT to acquire the real estate. Private equity sponsors structure deals either way. Single-facility independent owners often sell the combined real estate and operations to a regional buyer or a strategic operator-buyer.

Can I sell my assisted living facility without a broker?

Yes. Small to mid-sized assisted living facilities, especially single-location RCFEs in California, single-location Type A/B ALFs in Texas, and single-location ALFs in Florida, frequently change hands directly between known operators in a region. The seller engages flat-fee healthcare-services counsel for the regulatory work (state licensing CHOW, resident notice, employment compliance), engages a CPA experienced with assisted living for the financial diligence package, and identifies qualified buyers directly through state senior-living associations, regional operator networks, and targeted outreach to strategic acquirers.

What are the major risks specific to assisted living acquisitions?

Key acquisition risks include: state licensing CHOW timing and conditions (the buyer must obtain a new license before operating); existing enforcement actions, civil monetary penalties, and pending complaints that survive a CHOW; resident contracts and refund liabilities; pre-need or entrance-fee liabilities (for life-plan or CCRC-affiliated facilities); life-safety code compliance and pending construction deficiencies; payer-mix risk (Medicaid HCBS waiver participation can vary by state); workforce shortages and caregiver classification; and federal protections (ADA, Fair Housing Act, Section 504) that govern admissions, accommodations, and discharge.

What is a CHOW in assisted living?

CHOW stands for Change of Ownership. Each state's licensing agency treats a change in ownership of an assisted living facility as a license transfer that requires a new application by the prospective licensee. California processes CHOWs under Health and Safety Code § 1569.191. Texas, Florida, and New York follow their own state procedures. Most state CHOW processes require character-and-competence review, fingerprinting, criminal-history checks, financial-capacity review, life-safety inspection, and resident notification.

Research • Industries • May 2026

Where to Buy or Sell an Assisted Living Facility (2026 Guide)

What Is an Assisted Living Sale?

An assisted living sale is the transfer of a residential care business (called RCFE in California, ALF in Texas and Florida, ACF/ALR in New York) from one licensed operator to another. The license does not freely transfer. The buyer must obtain a new license through the state's change-of-ownership (CHOW) process, and the deal typically separates the real estate from the operating company.^[1]^[2]

The right channel depends on facility size, license type, real-estate structure, payer mix, and the seller's willingness to manage state licensing in parallel with the transaction.

Key Takeaways

State licenses do not transfer; the buyer must apply for a new license through the state CHOW process.^[1]
The deal usually splits real estate from the operating company. Public REITs (Welltower, Ventas) buy real estate; operator-buyers (Brookdale, Discovery, LCS) operate or co-own.^[3]
California processes RCFE CHOWs under Health and Safety Code § 1569.191, with statutory resident-notice and application timing.^[1]
Texas regulates ALFs under Health and Safety Code Chapter 247 and 26 TAC Chapter 553 (Type A and Type B based on evacuation capability).^[4]^[5]
Florida regulates ALFs under Chapter 429 Part I and Rule 59A-36, with Standard, ECC, LNS, and LMH license types.^[6]^[7]
New York regulates ACFs and certifies ALR/EALR/SNALR under Public Health Law Article 46-B.^[8]
Top 5 ASHA 50 owners hold 44% of total ASHA 50 units; the broader market remains fragmented (estimated 86% owned by private investors, owner-operators, and non-profits).^[3]

What Actually Transfers in an Assisted Living Sale

Acquirers diligence each component separately. License treatment is the single biggest constraint on how the deal closes.

Component	Transfer Mechanism	Typical Risk
State assisted living license	Buyer files new application under state CHOW process	Conditions to closing, timing
Administrator certification	Individual to the buyer's administrator (CA RCFE Admin Cert, FL Administrator)	Need certified administrator on day one
Real estate	Deed transfer (sale) or lease assignment	Title, zoning, life-safety
Resident contracts	Assignment with resident consent and statutory notice	Refund obligations, deposits
Medicaid HCBS waiver provider agreement	State Medicaid CHOW + new provider enrollment	Audit exposure, billing transition
VA Aid & Attendance / private LTC insurance	Resident-level contracts; new licensee notifies payers	Payment disruption
Caregiver workforce	Hire-over with new background checks and training	Turnover, wage compliance
Pre-need / entrance-fee liabilities	Assumed at close with trust accounting review	Underfunding, refund triggers
Pending enforcement actions	Survive the CHOW; addressed in indemnification	License conditions, fines
Brand, phone, web, referral sources	Asset transfer	Inquiry continuity

The Six Channels

FSBO direct (seller-to-buyer). Common for single-location RCFEs, small Type A/B ALFs, single-location FL ALFs, and small NY adult homes. Seller pays flat-fee healthcare counsel and a CPA experienced with assisted living. Best when the buyer pool is regional operators and known industry contacts. No commission.
Specialty senior-housing M&A advisors. Firms like JLL Capital Markets Seniors Housing, CBRE Senior Housing, Marcus & Millichap Seniors Housing Group, Berkadia Seniors Housing & Healthcare, Senior Living Investment Brokerage, and Blueprint Healthcare Real Estate Advisors. Best for facilities at scale (typically 60+ beds, multi-facility portfolios). Marketed to public REITs, large operators, and PE.
Public senior-housing REITs. Welltower, Ventas, Healthpeak Properties, National Health Investors (NHI), LTC Properties, CareTrust REIT, Diversified Healthcare Trust. Buy the real estate and pair with an affiliated or third-party operator under a triple-net lease or RIDEA structure.^[3] Direct outreach for larger facilities or portfolios; commonly contracted through M&A advisors.
Large operator-buyers. Brookdale Senior Living (~53,510 units, the largest operator), Discovery Senior Living, LCS, Erickson Senior Living, Greystar, Atria Senior Living, Sunrise Senior Living, Watermark, Holiday by Atria, Five Star Senior Living, and many regional operators. Acquire single facilities or portfolios; may co-invest with a REIT.^[3]
Private equity / family-office sponsors. PE platforms target single-asset acquisitions and bolt-ons into existing senior-living portfolios. Often partner with a regional operator.
Generic marketplaces. BizBuySell, LoopNet, BizQuest. Lead-generation channel for single-location facilities. The seller filters incoming inquiries for licensing capacity and capital.

Channel Comparison Table

Channel	Best For	Cost Structure	Typical Buyer
FSBO direct	Small RCFE/ALF, known regional buyer	Flat-fee counsel + CPA	Regional operator, family office
Specialty M&A advisor	60+ beds, portfolios	Percentage of value + retainer	REIT, large operator, PE
REIT outreach	Real-estate-led deals, portfolios	Counsel + advisor fees	Welltower, Ventas, Healthpeak, NHI, LTC
Large operator outreach	Operations-led deals	Counsel + advisor fees	Brookdale, Discovery, Atria, Sunrise
PE platforms	Mid-market deals, roll-ups	Advisor + transaction fees	Healthcare-focused PE sponsors
Generic marketplace	Single-location small ALFs	Listing fees	First-time licensee, regional operator

Specific commission percentages, retainers, and listing fees vary by firm. Request fee schedules from each provider before signing. Cost ranges shown reflect the structure of fees, not specific amounts.

State Mini-Sections

California (RCFE)

California licenses Residential Care Facilities for the Elderly (RCFE) under Title 22, California Code of Regulations, Division 6, Chapter 8.^[2] The licensing agency is the California Department of Social Services (CDSS) Community Care Licensing Division. Change of ownership is governed by Health and Safety Code § 1569.191.^[1] Key statutory requirements: 30-day written notice to the department and each resident of intent to sell; the buyer's license application must be submitted within five days of accepting the offer; no sale completes until 30 days have elapsed from notice; the department prioritizes the application and must decide within 60 days of a complete application. The Centralized Applications Bureau (CAB) targets 90 to 120 days for processing the full application package.^[9]

Texas (ALF Type A and Type B)

Texas licenses Assisted Living Facilities under Health and Safety Code Chapter 247.^[4] Operating rules are in 26 TAC Chapter 553. Facilities are licensed as Type A (residents physically and mentally capable of evacuation without staff assistance) or Type B (residents may need staff assistance to evacuate).^[5] Licensing is administered by the Texas Health and Human Services Commission (HHSC). Application requirements include pre-survey training, the application form, ownership documentation, life-safety and health inspections, and the application fee set by the executive commissioner.^[10] The department has up to 30 days to review applications and incomplete applications must be corrected within 30 days.

Florida (ALF)

Florida licenses Assisted Living Facilities under Chapter 429 Part I, Florida Statutes, and Rule 59A-36, Florida Administrative Code.^[6] The licensing agency is the Agency for Health Care Administration (AHCA). Florida offers four license sub-types: Standard (personal services), Extended Congregate Care (ECC, requires 2+ years licensed and additional services), Limited Nursing Services (LNS), and Limited Mental Health (LMH, for facilities serving mental health residents).^[7] Applications are filed pursuant to Chapter 408 Part II, Chapter 429 Part I, and Rule 59A-35.

New York (ACF/ALR/EALR/SNALR)

New York regulates Adult Care Facilities (ACF) and certifies Assisted Living Residences (ALR) under Public Health Law Article 46-B.^[8] Licensing is administered by the New York State Department of Health (DOH). An operator must first be licensed as an adult home or enriched housing program before applying for ALR certification. Certifications include Enhanced Assisted Living Residence (EALR), with beds that may "float" up to a designated number, and Special Needs Assisted Living Residence (SNALR), with beds located in a fixed area of the building.^[11] Application is through 10 NYCRR § 1001.5, with statutory public-comment authority under Public Health Law § 4656.

Bottom Line

Assisted living transactions split the real estate from the operating company. Smaller facilities clear through FSBO direct and regional brokers; larger facilities and portfolios clear through specialty M&A advisors and direct outreach to public REITs and large operators. The state CHOW timeline (notice, application, decision) sets the floor on the deal calendar.

Related Guides

Buyer Guide

How to Get an Assisted Living License (2026 Guide)

State-by-state licensing application, administrator certification, life-safety inspection.

Seller Guide

How to Sell an Assisted Living Facility Without a Broker (2026 FSBO Guide)

Pricing real estate vs. operations, CHOW management, indemnification, two-stage close.

Hub

All Regulated Industry Guides

Aviation, end-of-life services, retail alcohol, towing, bail bonds, NEMT, assisted living, and more.

References

^1. California Legislature. “California Health and Safety Code § 1569.191 (RCFE change of ownership: 30-day notice, buyer 5-day application, 60-day department decision).” https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=HSC&sectionNum=1569.191.

^2. California Code of Regulations. “Title 22, Division 6, Chapter 8 - Residential Care Facilities for the Elderly (RCFE).” https://regulations.justia.com/states/california/title-22/division-6/chapter-8/

^3. American Seniors Housing Association (ASHA). “ASHA 50 (2025) - largest senior-housing owners and operators.” https://seniorshousingbusiness.com/welltower-brookdale-remain-kings-of-the-hill-in-2025-asha-50-owner-operator-rankings

^4. Texas Legislature. “Texas Health and Safety Code Chapter 247 - Assisted Living Facilities.” https://statutes.capitol.texas.gov/Docs/HS/htm/HS.247.htm

^5. Texas Administrative Code. “26 TAC § 553.5 - Types of Assisted Living Facilities (Type A and Type B).” https://www.law.cornell.edu/regulations/texas/26-Tex-Admin-Code-SS-553-5

^6. Florida Legislature. “Florida Statutes Chapter 429 Part I - Assisted Living Facilities.” https://www.flsenate.gov/Laws/Statutes/2024/Chapter429/Part_I

^7. Florida Administrative Code. “Rule 59A-36 - Assisted Living Facility.” https://flrules.elaws.us/fac/59a-36

^8. New York Legislature. “New York Public Health Law Article 46-B - Assisted Living.” https://newyork.public.law/laws/n.y._public_health_law_article_46-b

^9. California Department of Social Services. “Adult and Senior Care Program Centralized Application Bureau (CAB) - 90-120 day processing target.” https://www.cdss.ca.gov/inforesources/community-care/ascp-centralized-application-units

^10. Texas Health and Human Services. “How to Become an ALF Provider - HHSC application process.” https://hhs.texas.gov/providers/long-term-care-providers/assisted-living-facilities-alf/how-become-alf-provider

^11. New York Codes, Rules and Regulations. “10 NYCRR § 1001.5 - Applications for ALR Licensure and Certification for EALR and SNALR.” https://regs.health.ny.gov/content/section-10015-applications-licensure-assisted-living-residence-certification-enhanced

Suggested Citation

Jeschke, Hans Peter. 2026. Where to Buy or Sell an Assisted Living Facility (2026 Guide). BusinessForSaleByOwner.us. https://businessforsalebyowner.us/research/where-to-buy-or-sell-an-assisted-living-facility

Last updated: May 2026

About the Author

Hans Peter Jeschke is the founder of Idillo Inc. (dba BizForSaleByOwner.us) and the creator of BusinessForSaleByOwner.us. He holds a Dipl.-Ing. in Mechanical Engineering (equivalent to a Master of Science) from RWTH Aachen University. He previously served as Editor-in-Chief of HR Watches, a bimonthly print magazine that ceased publication in 2008, with distribution exceeding 100,000 copies sold at retailers including Barnes & Noble and 3,000+ paid subscribers. He operates the Business For Sale by Owner Facebook community, the largest of its kind in the United States. It currently has 284,600+ members and grows by roughly 10,000 each month. He publishes original research on small business acquisitions and seller behavior, drawn from community polling.