Interim HealthCare franchise unit economics
Interim HealthCare franchisees run a healthcare agency across four lines (personal care at home, medical staffing, medicare-certified home health and hospice) inside a territory of 175,000 to 200,000 people with roughly 25,000 residents aged 65 and over. 168 reporting territories averaged $3,837,660 of healthcare and staffing sales during 2025 against a median of $1,797,780, and 22 hospice territories averaged $5,082,473. Royalty runs 3.5%, 4.5% or 5.5% depending on who pays the invoice.
- Primary source
- Interim HealthCare Inc., 2026 Franchise Disclosure Document
- Items read
- Items 5 and 6 for fees; Item 7 for cost to open; Item 19 for sales and any profit figure; Item 20 for the location count
- Population
- 168 of 201 locations
- Our calculations
- Marked on the page with an asterisk. Method
- Last reviewed
- 26 September 2026
Disclosure-based. Not a forecast, not an offer to sell a franchise, and not advice.
Your royalty rate here is decided by who pays the invoice. Palliative care bills at 3.5%, Medicare, Medicare Advantage and Medicaid at 4.5%, and everything else (private pay, commercial insurance, staffing contracts) at 5.5%. The average territory sells $3,837,660. Every million dollars charged at 4.5% instead of 5.5% saves $10,000 a year. A full shift takes $38,377 off the fee line.
- Royalty is 3.5%, 4.5% or 5.5% depending on the payer. Each $1,000,000 shifted from private pay and staffing into Medicare or Medicaid saves $10,000 a year.
- Territories past ten years average $5,181,259; territories at three to five years average $707,442. A factor of 7.3, and the climb continues the whole way.
- Staffing sales average $494,431 at three to five years against $584,961 of healthcare sales. Past ten years the staffing line is $729,858 against $4,926,572.
- Owners holding one territory post a median of $2,158,167 against $1,797,780 across the network. Their median climbed 21.03% in 2025 while the network median climbed 8.43%.
- Franchised territories fell from 235 to 201 in two years. 2025 brought 12 terminations and 23 cessations against 8 openings.
How much does a Interim HealthCare franchise make?
The average Interim HealthCare unit reported $3,837,660 of revenue in the 2026 FDD, and the median reported $1,797,780. The brand’s disclosure document discloses revenue and not profit, so what an owner keeps depends on the cost structure set out below. Revenue is not income. Rent, wages, cost of goods and the franchise fees all come out before an owner is paid. The figures for the highest-selling and lowest-selling businesses are below.
Who pays the bill
Who pays sets the rate.
| Sales | Rate | Royalty per $1,000,000 |
|---|---|---|
| Palliative care | 3.5% | $35,000 |
| Medicare, Medicare Advantage, Medicaid | 4.5% | $45,000 |
| All other sales | 5.5% | $55,000 |
| Hospice | 5.5% | $55,000 |
Rates as the brand reported it.
Two points separate your cheapest dollar from your dearest. Palliative care pays 3.5% royalty. Staffing pays 5.5%. What an agency sells decides the fee as much as the care does. At the average territory a full swing between those two groups is worth $76,753 a year. About half of what an hour of care sells for is left after paying the caregiver.
Medicare-certified work bills a point cheaper than private pay. Medicare, Medicare Advantage and Medicaid all sit at 4.5% while commercial insurance, private pay and supplemental staffing sit at 5.5%. Adding the certified home health line costs $60,000 up front. Everything it sells is then charged at the lower royalty rate. One point of that volume repays the fee at $6,000,000 of cumulative billings.
What the fees come to.
| Territory | Revenue | Royalty at 5.5% | Marketing | Fixed fees | Total | Share |
|---|---|---|---|---|---|---|
| 3 to 5 years, average | $707,442 | $38,909 | $14,149 | $6,820 | $59,878 | 8.46% |
| Median territory | $1,797,780 | $98,878 | $35,956 | $6,820 | $141,654 | 7.88% |
| Average territory | $3,837,660 | $211,071 | $76,753 | $6,820 | $294,644 | 7.68% |
| Past ten years, average | $5,181,259 | $284,969 | $103,625 | $6,820 | $395,414 | 7.63% |
| Top 50, average | $9,660,850 | $531,347 | $193,217 | $6,820 | $731,384 | 7.57% |
We worked this out at the 5.5% royalty rate.
The fixed $6,820 lands hardest on the small territories. At the bottom 50's average of $587,124 it is 1.16% of revenue by itself; at the top 50's $9,660,850 it is 0.07%. The technology fee starts 90 days after signing, which is ahead of most first invoices.
One of the two marketing points stays in your own market. The 1% local advertising requirement is spend you direct, sized off last year's sales. At the average territory that is $38,377 a year to place against referral sources you choose.
Top performers
What separates the top Interim HealthCare performers
Interim HealthCare splits its locations into groups instead of publishing one average. The best group averaged $9,660,850 a year. The worst averaged $587,124. Both run the same brand, on the same agreement, paying the same fees. The middle location sold $1,797,780. The average was $3,837,660. More than half the system is below the number the brand quotes.
Decided before you open
- Trade area and site.A 16.5× gap between bands is not an operating gap. Catchment, daytime population and what sits next door set the ceiling before the first customer arrives.
- Territory, and how much of it is real.This model sells from a territory rather than a building, quoted at 200,000 people. Two owners with the same brand and different ground are running different businesses, and density decides how much driving sits between jobs.
- What you spend to open.Opening costs $156,000 to $628,000, a 4.0× range inside one brand. The high end usually buys more capacity, so the cheapest build is not always the cheapest route to the top band.
Live operating levers
- Accounts, the operating driver.This model bills on accounts. An account signed this year still bills next year, so keeping accounts matters more than winning them. It is worth watching every week, because by the time it turns up in a monthly close the quarter is half gone.
- The first year.This filing shows how a new location builds up, so the ramp can be underwritten from the document rather than assumed. Read two things out of it: the month sales cross the point where costs are covered, and how much cash you fund before that month arrives. Everything before break-even is paid for by you.
Context you underwrite around
- The reporting screen.168 of 201 locations are behind these figures. Locations open less than the full year, brand-owned, or not meeting the reporting criteria are excluded, so the numbers describe locations that cleared that screen, not the system as a whole.
- What the disclosure leaves out.Item 19 publishes no profit or cost data for franchised locations. Anything below the sales line has to come from the franchisor or from owners you call.
Sales
Revenue by time in the system.
| Time in system | Territories | Average healthcare sales | Average staffing sales | Average total | Median total |
|---|---|---|---|---|---|
| Under 3 years | 2 | $50,617 | n/a | $50,617 | $50,617 |
| 3 to 5 years | 51 | $584,961 | $494,431 | $707,442 | $466,778 |
| 5 to 10 years | 38 | $1,595,484 | $321,697 | $1,671,109 | $1,224,956 |
| Over 10 years | 106 | $4,926,572 | $729,858 | $5,181,259 | $2,856,544 |
As the brand reported it.
Year eleven is the step that matters. $1,671,109 at five to ten years against $5,181,259 past ten, a three-fold move at the point most owners have long since found their ceiling. In residents that is $66.84 a year from each over-65 person rising to $207.25. Is the highest yield per resident in senior care franchising and the reason the certified lines exist.
New territories sell mostly staffing. Older ones sell less of it. At three to five years the average staffing line is $494,431 against $584,961 of healthcare sales, 85% as large. Past ten years it is $729,858 against $4,926,572, or 15%. Staffing fills schedules early because a contract lands faster than a Medicare census builds. The ones who keep it running have a second engine at maturity.
The mature median is $2,856,544 against a $5,181,259 average. Half the territories past ten years sell less than $2.86 million. A few lift the average, one of them selling $57,621,347. Plan a mature territory against the median and treat the average as the shape of the tail.
Three years across the whole network. (Item 20)
| 2025 | 2024 | 2023 | |
|---|---|---|---|
| Reporting territories | 168 | 165 | 150 |
| Top 50, average | $9,660,850 | $9,233,556 | $9,949,042 |
| All territories, average | $3,837,660 | $3,645,974 | $4,190,109 |
| All territories, median | $1,797,780 | $1,658,044 | $1,951,852 |
| Bottom 50, average | $587,124 | $459,339 | $684,732 |
| Highest single territory | $57,621,347 | $56,254,101 | $52,665,377 |
| Lowest single territory | $67,187 | $93,201 | $78,467 |
As the brand reported it.
2025 recovered part of what 2024 gave up. The average sits at $3,837,660 against $4,190,109 two years earlier and the median at $1,797,780 against $1,951,852. Both halves of the distribution are still below where they stood in 2023. So a territory that has held flat for three years has held its position in the network.
The top 50 average sixteen times the bottom 50. $9,660,850 against $587,124. 27% of territories reach the network average, which runs 2.13 times the median. This is a business where a few certified, multi-line operations set the mean.
Owners with a single territory.
| 2025 | 2024 | 2023 | |
|---|---|---|---|
| Owners holding one territory | 70 | 65 | 64 |
| Average | $3,808,529 | $3,458,683 | $4,181,380 |
| Median | $2,158,167 | $1,783,112 | $1,985,573 |
As the brand reported it.
How we calculated this
98 franchise owners held the 168 reporting territories in 2025, 70 of them a single territory.
The single-territory median is 20% above the network median. $2,158,167 against $1,797,780, and it rose 21.03% in 2025 while the network median rose 8.43%. Depth in one market is doing more here than breadth across several, the same pattern that shows up across senior care, and stronger in this brand than most.
Hospice & network
Hospice is the larger line.
| 2025 | 2024 | 2023 | |
|---|---|---|---|
| Reporting territories | 22 | 20 | 18 |
| Franchise owners | 13 | 21 | 19 |
| Average | $5,082,473 | $6,834,431 | $4,186,865 |
| Median | $4,167,757 | $4,512,383 | $2,749,551 |
| Highest | $15,316,282 | $25,786,021 | $19,408,099 |
| Lowest | $633,563 | $90,068 | $207,984 |
As the brand reported it.
How we calculated this
28 hospice territories were operating at 26 December 2025 and 22 of them reported for the full year.
A hospice territory bills $1,244,813 more than a healthcare one. $5,082,473 against $3,837,660, and the hospice median of $4,167,757 is more than double the healthcare median. The line costs $60,000 to add, plus $8,000 to $12,000 of accreditation alongside the certified home health line.
The hospice average fell 26% in 2025 after rising 63%. $6,834,431 to $5,082,473, with the top territory dropping from $25,786,021 to $15,316,282. The median moved far less, from $4,512,383 to $4,167,757, so the swing sits at the top.
What it costs to open.
| Configuration | Low | High |
|---|---|---|
| Primary services only | $156,000 | $239,000 |
| With certified home health and hospice | $422,150 | $628,000 |
As the brand reported it.
The certified lines add $266,150 at the low end and $389,000 at the high end. $120,000 of that is franchise fees; the rest is working capital. That jumps from $51,850 to $185,000 at the low end. Medicare pays on a 30-day episode after the work is done, so the cash gap is the real cost of entering certified care.
Expanding an existing area costs $5,000 for each additional 10,000 people. A territory holds 175,000 to 200,000 people. Adding a quarter again costs about $22,500. A mature territory averages $5,181,259, so expanding the area you already know is the cheapest growth on this page.
The network of locations.
| Year | Start | Opened | Terminated | Ceased | Reacquired | End | Transfers |
|---|---|---|---|---|---|---|---|
| 2023 | 222 | 29 | 3 | 15 | 0 | 235 | 13 |
| 2024 | 235 | 20 | 4 | 19 | 0 | 231 | 5 |
| 2025 | 231 | 8 | 12 | 23 | 8 | 201 | 3 |
Starts, openings, departures and transfers as the brand reported it in the outlet status table. The year-end column here comes from the system-wide summary. Puts franchised territories at 235, 231 and 201. Which Item 19 corroborates for 2025.
34 territories left the system in two years. 2025 alone brought 12 terminations and 23 cessations against 8 openings. Brand-owned territories went from 4 to 8 by the end of the financial year, and to 13 by 31 December after the South Carolina and Georgia purchase.
Transfers fell from 13 to 3 while terminations tripled. More owners are handing the territory back than selling it on. For an operator with capital, a contracting network of large territories is a buying market. The twelve territories terminated in 2025 are markets with a referral base already built and an open seat behind it.
Questions we get asked
What should my territory be billing?
Across 168 reporting territories the 2025 average was $3,837,660 and the median $1,797,780 for healthcare and staffing sales. By age: $707,442 at three to five years, $1,671,109 at five to ten, $5,181,259 past ten, with medians of $466,778, $1,224,956 and $2,856,544. Hospice territories sit separately at an average of $5,082,473. Owners holding a single territory post a median of $2,158,167.
How is my royalty rate set?
By who pays the bill. Palliative care pays 3.5%. Medicare, Medicare Advantage and Medicaid pay 4.5%. Everything else pays 5.5%, including families paying directly, commercial insurance and supplemental staffing, has 5.5%. Hospice runs at 5.5% monthly. Primary services and home health are charged weekly on the previous week's sales with a $100 weekly minimum. Each $1,000,000 that moves from the 5.5% group to the 4.5% group saves $10,000 a year.
What does the brand cost in total?
Royalty runs 3.5% to 5.5% depending on who pays. On top there is a 1% national marketing fee, 1% of local advertising the owner spends, a $485 monthly technology fee and a $1,000 annual regulatory subscription. At the 5.5% rate that is 8.46% of sales at a three-to-five-year territory, 7.88% at the middle territory, 7.68% at the average and 7.57% at the top 50. The fixed $6,820 is what makes the small end more expensive.
Is adding certified home health or hospice worth it?
Each line costs $60,000 in fees. Taking both raises the opening cost from $156,000–$239,000 to $422,150–$628,000, mostly through working capital that rises from $51,850–$103,500 to $185,000–$350,000. Against that, hospice territories averaged $5,082,473 in 2025 with a median of $4,167,757, and Medicare and Medicaid sales royalty at 4.5% instead of 5.5%. The cash cycle is the thing to plan for, since Medicare settles a 30-day episode after the care is given.
Who does bookkeeping for an Interim HealthCare franchise?
Royalty is charged at three rates depending on who pays, and taken weekly. Record who pays at the time of billing. A territory that codes Medicare and Medicaid loosely pays 5.5% on work that qualifies for 4.5%. The four service lines are paid at different speeds. Medicare settles a 30-day period afterwards. Staffing contracts pay on their own terms. So a single cash forecast that mixes them will mislead you. The 1% local advertising requirement is sized off the preceding calendar year and belongs on a tracked schedule. Averan provides bookkeeping, controller, and fractional CFO support for franchise owners and has Certified QuickBooks ProAdvisors on the team.
- No profit figure. The filing reports sales and not earnings, so what an owner keeps is not disclosed.
- No cost lines. Wages, rent and cost of goods are not broken out, so margin cannot be rebuilt from the document.
Questions worth putting to Interim HealthCare
The filing answers what it answers. These are the gaps an owner or a buyer should close directly.
- What do locations at the median spend on wages and rent as a share of sales? The filing reports sales only.
- What separates the highest-selling locations from the lowest: trade area, years open, size, or the owner?
- How long does a new location take to reach the average you publish, and what does the build-up look like month by month?
- What do the fees add up to as a share of sales at the average location, once minimums and technology charges are counted?
- How many Interim HealthCare locations closed, were sold, or changed hands last year, and why?
Run your own numbers.
The Franchise Finance Diagnostic runs the same checks on your own numbers. It scores where you stand and compares you with Item 19 of your brand’s FDD. It works out what one location earns and spends, and builds a 13-week cash forecast. Checks whether you are ready to open another one. It is free and it runs in your browser.
Launch the diagnostic →Run these numbers against your own agency.
A structured review of your unit economics, cash forecast, and reporting, so you know where you stand against the disclosed figures.
Request the review