FAQ

A professional M&A advisor maximizes your outcome and simplifies the process. Advisors conduct a rigorous valuation, prepare your company for sale, and confidentially market it to qualified buyers. This means you can continue running your business while we handle complex tasks like buyer outreach, negotiations and due diligence. Working with an advisor brings expertise: for example, Covenant’s healthcare team brings decades of industry experience and strategic insight to drive growth and maximize value for your company.

We provide full-service M&A advisory services tailored to healthcare businesses. This includes sell-side and buy-side representation, business valuation, strategic planning, and operational consulting. In practice, that means we handle everything from analyzing and optimizing your operations to creating marketing materials, identifying and vetting buyers, negotiating deal terms, and closing the transaction. We also guide improvements (finance, compliance, marketing, etc.) so your business is “market ready,” and we provide ongoing strategic advice throughout the process.

We follow a structured, phased process to sell your business:

• Consultation & Goal Setting: We begin with a one-on-one meeting to learn your objectives (e.g. exit vs. partnership) and assess your business’s readiness. This helps us tailor the strategy to your goals.

• Preparation & Documentation: We gather and organize key documents (financial statements, contracts, licenses, etc.) and recommend any operational improvements to maximize value.

• Marketing: We create a confidential teaser and a detailed Confidential Information Memorandum (CIM) that highlights your business in the best light. We then reach out to a targeted list of vetted buyers under non-disclosure.

• Buyer Engagement: Interested buyers execute NDAs, review the CIM and data room, and meet with you for Q&A. We collect and compare Letters of Intent (LOIs) and help you select the best offer.

• Negotiation & Due Diligence: We negotiate deal terms on your behalf and coordinate the due diligence process to address buyer questions.

• Closing: We help finalize the definitive agreements and oversee closing logistics.

At each step, Covenant’s advisors manage communications and timelines, so you stay on track and protected.

While each transaction is unique, most sell-side engagements at Covenant follow a structured 6 to 9 month timeline, broken into 5 key phases:

Phase 1: Pre-Market Preparation (4–6 Weeks)

Goal: Package your business to maximize valuation and attract the right buyers

Activities Include:

• Initial consultation and engagement agreement
• Financial and operational review
• Normalized EBITDA and valuation modeling
• Seller Q&A and strategic positioning
• Buildout of marketing materials:
o Teaser Sheet
o Confidential Information Memorandum (CIM)
o Buyer target list
• Finalize go-to-market strategy

Phase 2: Go-to-Market & IOI Round (4–6 Weeks) (IOI Round as needed)

Goal: Generate interest and secure initial Indications of Interest (IOIs)

Activities Include:

• Launch of outreach to curated buyer list under NDA
• Teaser + CIM distribution
• Buyer Q&A (with Covenant leading)
• Initial management calls (VP-level)
• Deadline for IOI submissions
• IOI review and evaluation with seller Goal: Package your business to maximize valuation and attract the right buyers
Activities Include:
• Initial consultation and engagement agreement
• Financial and operational review
• Normalized EBITDA and valuation modeling
• Seller Q&A and strategic positioning
• Buildout of marketing materials:
o Teaser Sheet
o Confidential Information Memorandum (CIM)
o Buyer target list
• Finalize go-to-market strategy

Phase 3: LOI Round & Buyer Selection (3–4 Weeks)

Goal: Narrow field to top buyers and receive strong, well-structured LOIs

Activities Include:

• Selection of priority buyers from IOI round
• More in-depth management calls (often including clinical owners/medical directors)
• Buyers receive deeper access to data room
• Submission of Letters of Intent (LOIs)
• Final LOI negotiations and selection of winning party

Phase 4: Due Diligence & Purchase Agreement (6–8 Weeks)

Goal: Satisfy all buyer diligence requests and finalize definitive agreements

Activities Include:

• Coordination of legal, financial, clinical, and operational diligence
• Responding to buyer requests (Covenant manages flow)
• Purchase Agreement (PA) drafting and negotiation
• QofE (Quality of Earnings) review (if applicable)
• Real estate/lease structuring (if separate from OpCo)

Phase 5: Closing & Funding (2–4 Weeks)

Goal: Finalize documentation, wire funds, and transfer ownership

Activities Include:

• Signing of Purchase Agreement and ancillary docs
• Escrow setup (if applicable)
• Final walkthrough of transition steps
• Wire transfer of funds
• Deal announcement (if agreed upon)

Typical Timeline Summary

Protecting your privacy is paramount. We begin with a blind teaser (a high-level summary without identifying details) and require prospective buyers to sign strict non-disclosure agreements (NDAs) before receiving any sensitive information. All buyer communication is managed by our team, keeping you at arm’s length from unsolicited inquiries. An experienced advisor manages the flow of information to shield your identity until it’s absolutely necessary. In short, Covenant enforces robust confidentiality protocols at every phase.

We operate on a success-fee basis, meaning our fee is a percentage of the transaction value and is paid only when your deal closes. This aligns our interests with yours – we only get paid if we achieve results. The exact fee percentage (and any retainer) depends on deal size and is agreed upon in our engagement letter. In general, mid-market transactions often involve single-digit percentage success fees, as is standard in the industry. (We’re happy to explain any fee detail upfront so you know exactly how it works.)

Business valuation considers many factors: your financial performance, profit margins, growth prospects, market trends, and comparable transactions in the sector. In healthcare services, valuations are often framed as a multiple of EBITDA (earnings before interest, taxes, depreciation and amortization) adjusted for industry specifics. Covenant will conduct a thorough analysis of your financials, market position and future potential to arrive at a defensible value range. This helps set realistic expectations and target pricing when marketing your company.

At Covenant Health Advisors, we don’t just close deals—we build trusted partnerships with healthcare business owners. Here’s what sets us apart:

Healthcare Is All We Do
Unlike generalist M&A firms, we specialize exclusively in healthcare services. From home care and hospice to behavioral health, assisted living, and staffing—we know the regulatory environment, payer models, growth metrics, and buyer landscape inside and out. That means better positioning, better buyer matches, and better outcomes.

Built for Founder-Led Companies
Most of our clients are private, owner-operated healthcare businesses. We understand the emotional and strategic complexity of selling a business you built—and we tailor every step to reflect your goals, protect your legacy, and maximize value.

Values-Driven, Boutique Approach
We chose the name “Covenant” because it represents commitment, trust, and integrity. You won’t be passed around a big firm’s pipeline. You’ll work directly with experienced professionals who take the time to understand your business and walk with you through every step—from preparation to closing and beyond.

Deep Buyer Network, Real Results
We maintain strong relationships with private equity groups, family offices, strategic buyers, and healthcare operators across the country. Our targeted outreach and industry knowledge allow us to create competitive buyer processes that drive valuation and favorable deal terms.

We Handle the Heavy Lifting
From preparing a professional CIM and running a discreet marketing process to coordinating buyer calls, managing diligence, and negotiating final terms—we lead the full M&A lifecycle so you can stay focused on running your business.

Valuation + Strategy
Even if you’re not ready to sell today, we help you understand what your business is worth, how to increase its value, and what steps to take to align with what top buyers are looking for—whether that’s now or 12–24 months from now.

Preparation is key to a smooth sale and higher valuation. We recommend getting your financials and operations in order beforehand. That means clean, up-to-date financial statements and tax returns (typically 3–5 years), a strong management team (so the business can run without you), and documented processes across the company. Gather all legal paperwork (contracts, licenses, leases), and make sure your records (patient/payer reports, insurance, compliance documents) are organized. You can also focus on growing revenue and streamlining costs now, which will pay off in the sale. Covenant can guide you through a “preparation phase” to address any gaps and ensure your business is presented in its best light.

1. M&A Advisory (Sell-Side & Buy-Side)

We guide healthcare business owners through strategic exits and acquisitions on a national scale. Our team handles everything from:

• Business positioning and valuation
• Confidential marketing to our healthcare investor network
• Buyer qualification, outreach, and negotiation
• Deal structuring, due diligence oversight, and transaction closing

2. Business Valuation & Market Analysis

We conduct rigorous financial analyses and market research to determine fair market value—providing insight into operational strengths and opportunities for enhancing business value.

3. M&A Readiness & Strategic Consulting

Our team works with owners to optimize operations and fix performance gaps prior to sale, covering functions like finance, compliance, staffing, payer mix, marketing, and digital presence.

4. Targeted Buy-Side Advisory

For investors, PE firms, and healthcare operators seeking acquisitions, we provide full-service buy-side support, including target identification, due diligence, deal structure, and post-close integration.

Yes, we do! How?

1. Acquisition Strategy Development

We begin by understanding your investment thesis, growth objectives, and geographic or vertical focus. Then we help refine your:

• Target profile (e.g., home care in Southeast with $3M+ EBITDA)
• Preferred deal structures (100% buyout, minority stake, roll-up, etc.)
• Criteria for platform vs. add-on acquisitions

2. Proprietary Deal Sourcing

We leverage our national healthcare network to present you with off-market and selectively marketed opportunities—many from founders who’ve engaged Covenant on the sell-side.

• Access to exclusive deals across home health, hospice, behavioral health, assisted living, and more
• Outreach on your behalf to strategic targets who meet your investment profile
• Pre-screening to ensure clinical and financial viability

3. Diligence Support & Valuation Analysis

Once a target is identified, we provide hands-on support to:

• Review financials (normalized EBITDA, add-backs, revenue mix, etc.)
• Evaluate payer mix, regulatory risks, licensing, staffing, and compliance
• Benchmark against market comps and M&A multiples
• Coordinate data room setup and management

4. Negotiation & Deal Structuring

We act as an intermediary to facilitate:

• LOI terms (valuation, earnouts, rollover equity, working capital targets)
• Creative structuring to bridge valuation gaps or regulatory hurdles
• Coordination with legal, financial, and clinical consultants
• Communication between buyer, seller, and counsel to keep the deal on track

Post-Acute & Senior Care

• Home Health (Skilled and Non-Skilled)
• Hospice
• Pediatric Home Health
• Private Duty Nursing
• Non-Medical Home Care
• Adult Day Services
• Non-Emergency Medical Transportation (NEMT)
• Assisted Living & Memory Care Communities
• Skilled Nursing Facilities (SNFs)

Behavioral Health & Intellectual/Developmental Disabilities (IDD)

• Substance Use Disorder (SUD) Treatment
o Residential, Outpatient, Detox, MAT
• Intellectual & Developmental Disabilities (IDD/HCBS)
• ABA Therapy & Autism Services
• Counseling & Community-Based Mental Health
• Psychiatric Services
• Medication Management
• TMS & Ketamine Clinics

Ambulatory & Specialty Care

• Urgent Care Centers
• Ambulatory Surgery Centers (ASCs)
• Physical Therapy & Rehabilitation
• Pharmacies (Retail & Compounding)
• Hormone Replacement Therapy (HRT) Clinics
• MedSpas & Aesthetics Practices
• IV Therapy & Wellness Clinics

Staffing & Ancillary Services

• Healthcare Staffing & Nursing Pool Agencies
• Durable Medical Equipment (DME) / Home Medical Equipment (HME)
• Franchised Healthcare Services

Geographic Focus

Covenant works with clients nationwide, with particular activity in:

• Southeast (FL, GA, NC, SC)
• Southwest (AZ, TX, NM)
• Midwest (OH, MN, IL, MI)
• Northeast & Mid-Atlantic (NY, NJ, PA, VA, MD)
• West Coast (CA, OR, WA)

We Specialize Exclusively in Healthcare Services

At Covenant, healthcare isn’t just a vertical—it’s our entire focus. We work exclusively with healthcare service providers across home care, behavioral health, senior care, staffing, urgent care, pharmacies, therapy clinics, and more. We understand the regulations, payer models, referral networks, staffing dynamics, and valuation drivers that make your business unique.

We’re Built for Founder-Led Businesses

Most of our clients are owner-operators who have built their businesses from the ground up. We understand the emotional, financial, and operational weight that comes with selling—and we tailor the process to protect your legacy, ensure alignment with the right buyer, and maximize your outcome.

We Know How to Maximize Valuation

We don’t just list your business—we position it. That means helping you clean up your financials, prepare for due diligence, and craft a narrative that highlights the full value of your company to buyers. We bring a deep bench of healthcare-specific comps, multiples, and growth strategies to the table.

We Handle the Entire Process, So You Can Focus on Operations

From confidential outreach and teaser creation to managing NDAs, buyer calls, LOIs, and closing—our team does the heavy lifting so you can stay focused on running your business. Our hands-on, boutique approach means you're never just a number in a deal pipeline.

We Have Deep Buyer Relationships

We maintain direct relationships with private equity firms, strategic operators, and financial sponsors across the U.S. who are actively investing in healthcare. Whether you’re selling a single site or a multi-state platform, we know which buyers are a fit—and how to create competition for your business.

We Operate with Integrity—It’s in Our Name

At Covenant Health Advisors, we believe in the power of trust, transparency, and commitment—principles that define the word “covenant.” We’re not just closing deals; we’re forging partnerships that honor your vision and values.

Yes - having a valuation is one of the most important first steps when considering a sale. Here’s why:

1. Know What Your Business Is Worth

A valuation gives you a realistic, data-driven picture of what buyers are likely to pay based on:

• Your financial performance (revenue, EBITDA, margins)
• Payer mix (Medicare, Medicaid, Private Pay, Commercial)
• Growth potential, staffing, and geographic footprint
• Comparable transactions in your vertical (e.g. home care, SUD, assisted living, etc.)

Without a valuation, you risk underpricing your business—or setting expectations that are too high and turning buyers away.

2. Prepare for Buyer Scrutiny

Buyers will do their own financial analysis. A valuation:

• Prepares you for the questions they’ll ask
• Helps you defend your numbers (with add-backs and adjustments)
• Gives you leverage in LOI negotiations

3. Identify Gaps and Opportunities

Our valuations don’t just tell you the number—we explain:

• What’s driving your value
• What areas might lower it (e.g. staffing issues, lack of clinical oversight)
• What changes could increase it if you wait 6–12 months to sell

4. Plan the Right Exit Strategy

Whether you want to sell 100%, retain equity, or explore a partnership, a valuation helps shape:

• Deal structure options
• Target buyers
• Timing of your exit

At Covenant Health Advisors, we specialize in representing founder-led and privately held healthcare services businesses across the U.S.—primarily in the lower middle market.

Typical Financial Profile:

• Revenue: $2 million to $50 million+
• EBITDA (Profit): $500K to $10 million+
• Transaction Values: $3 million to $100 million+

Whether you own a single-location behavioral health clinic or a multi-site home care platform, we tailor the M&A process to your specific size, goals, and growth story.

Who We Serve:

• Single-site operators preparing for retirement or transition
• Regional operators seeking growth capital or partial equity sale
• Multi-state groups exploring strategic exits to private equity or strategic buyers
• Healthcare franchises looking to sell or recapitalize
• Owner-operators in Medicaid waiver, Medicare-certified, or private-pay models