Buy an Assisted Living Facility in San Antonio, TX

Why San Antonio Makes Sense for This Acquisition

San Antonio is the second-largest city in Texas and one of the fastest-growing in the country. Its population skews older than the Texas average, and the 65-plus demographic is expanding faster than in most comparable metros.

That matters for assisted living because occupancy drives everything. A market with a growing senior population and rising Medicaid per-diem rates is the foundation a buyer needs before worrying about anything else.

Bexar County's median household income sits at roughly $62,917, which positions most residents in the sweet spot for small-to-midsize residential care homes: not wealthy enough for luxury memory care, but not exclusively Medicaid-dependent either. Many facilities in this market run a blended private-pay and Medicaid census, which provides revenue diversification.

The Deal Economics Here Are Unusually Attractive

The median asking price in the Texas market is $595,000, with median annual cash flow of $293,582. That implies an average acquisition multiple of approximately 1.6x annual earnings.

To put that in context: most SBA lenders prefer to see deals priced between 3x and 5x EBITDA. A 1.6x multiple is well below that range, which means either the cash flow is overstated, the business has a specific risk that the seller is pricing in, or this is a legitimate value acquisition.

A $595,000 acquisition financed through SBA 7(a) looks roughly like this:

• Asking price: $595,000
• Annual cash flow: ~$293,582
• Implied multiple: ~2.0x (using cash flow, not SDE)
• SBA loan (80%): ~$476,000
• Seller note on full standby (15%): ~$89,250
• Buyer cash (5%): ~$29,750
• Annual debt service (10-year term, ~10.5% rate): ~$78,000
• DSCR: approximately 3.7x

That DSCR is well above the 2x target, which means there is real margin for error here. Even if actual cash flow comes in 30% lower than reported, you are still above the 1.5x floor.

These are rough estimates based on market data. Actual terms depend on individual qualification and lender.

Note on SDE: the $293,582 figure above is reported cash flow from listings. If this is stated as SDE, apply a 15% to 30% discount to approximate the buyer's true take-home after replacing owner labor.

Financing an Assisted Living Acquisition with SBA 7(a)

SBA 7(a) is the standard vehicle for acquisitions in this price range. The 10% equity injection is structured as 5% buyer cash plus a 5% seller note on full standby, acting as equity. On a $595,000 deal, that is roughly $29,750 in cash out of pocket.

Full standby means the seller receives no payments on their note during the entire 10-year SBA loan term. Regalis Capital achieves this structure on over 90% of our deals.

One thing specific to assisted living: SBA lenders will look hard at license transferability. The facility license, Medicaid certification, and any state certifications tied to the current owner need to have a clean path to transfer before a lender will commit. Get this confirmed early.

What to Look for in a San Antonio Assisted Living Deal

Census stability. What is the average occupancy over the trailing 12 months? A facility at 70% or below with no clear explanation for the vacancy is a red flag.

Payor mix. Private-pay residents generate higher per-diem rates than Medicaid. A facility that is 80% Medicaid-dependent has a ceiling on its revenue growth and is more exposed to rate changes from the state.

Staffing ratios and turnover. Texas DADS (Department of Aging and Disability Services) sets minimum staffing ratios for licensed facilities. Ask for the last two inspection reports and look for any citation patterns around staffing.

License type. Texas licenses assisted living facilities as either Type A (residents do not require evacuation assistance) or Type B (residents may need assistance). Type B facilities carry higher regulatory requirements. Know which type you are buying before you get deep into diligence.

Owner involvement. Many small residential care homes in this market have an owner-operator who is also the administrator of record. If the seller is leaving, the administrator license needs to transfer or a new licensed administrator needs to be in place before closing.

Frequently Asked Questions

How much does it cost to buy an assisted living facility in San Antonio?

The median asking price for assisted living facilities in the Texas market is $595,000, with a price range from roughly $158,900 to $25,000,000. Smaller residential care homes (6 to 16 beds) typically fall in the $300,000 to $800,000 range in the San Antonio metro. Larger licensed facilities with 20 or more beds trade at higher multiples and larger dollar amounts.

What is the typical cash flow for an assisted living facility in this market?

The median reported cash flow for Texas assisted living listings is $293,582 annually. If this figure is stated as SDE rather than net income, buyers should apply a 15% to 30% discount to account for the cost of replacing the owner's labor before building a debt service model.

Can I use SBA 7(a) to buy an assisted living facility in Texas?

Yes. Assisted living facilities are eligible for SBA 7(a) financing in Texas, provided the license and Medicaid certification have a clear path to transfer. Equity injection is 10%, structured as 5% cash plus a 5% seller note on full standby. Lenders will require proof of management continuity and a licensed administrator in place at or before closing.

What state licensing requirements affect the acquisition process in Texas?

Texas licenses assisted living facilities through the Health and Human Services Commission. Type A and Type B licenses are non-transferable in the traditional sense: the buyer applies for a new license, and the timing of that approval affects closing. Most purchase agreements in Texas include a license contingency, and buyers should budget 60 to 90 days for regulatory review after the application is filed.

How long does it take to close on an assisted living facility acquisition?

A standard SBA-financed acquisition takes 60 to 90 days from signed LOI to close. Assisted living acquisitions in Texas often run longer, closer to 90 to 120 days, due to the state licensing process. Building this into your letter of intent timeline and your lender conversations upfront avoids last-minute extension requests.

Talk to Our Team About Assisted Living Acquisitions in San Antonio

If you are seriously looking at assisted living facilities in San Antonio, the deal economics here are worth paying attention to. A 1.6x average multiple with cash flows near $300K annually is not something you see in most acquisition categories.

The regulatory complexity is real, but it is also what keeps casual buyers out of this market. That is a structural advantage for buyers who do the work.

Regalis Capital reviews 120 to 150 deals per week across all industries. If you want our team to assess a specific deal or help you identify what is available in the San Antonio market, start with a deal assessment here.