Nurse Next Door franchise unit economics
Nurse Next Door franchisees run in-home care businesses that bill care by the hour, with intake and scheduling run by a central Care Services Center.
Nurse Next Door franchise at a glance
Nurse Next Door's Item 19 reports sales for territories in their first, second and third years of operation, with an average and a median for each year group.
Nurse Next Door territories in months 25 to 36 of operation averaged $922,781 of sales, with a median of $620,532, according to Item 19 of Nurse Next Door’s 2026 FDD, issued 5 December 2025. The 15 in that group are 21%* of Nurse Next Door’s 71 territories. Fees paid to Nurse Next Door come to about 13%* of sales.
- A Nurse Next Door franchise costs $119,286 to $217,210 to open, including a $72,000 initial franchise fee, according to the brand's 2026 FDD.
- Nurse Next Door charges a royalty of 5% of sales, a 1% brand fund contribution and a $600 monthly technology fee.
- Nurse Next Door territories in months 25 to 36 averaged $922,781 of sales, with a median of $620,532.
- 6 of 15 Nurse Next Door territories in months 25 to 36, 40%, reached their group’s average.
- Work out Nurse Next Door's fees at your own sales with the minimum fee calculator.
These figures come from Nurse Next Door's 2026 Franchise Disclosure Document, as the brand reported them, and were read by Averan Advisors.
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Talk to Averan → Move your books and accounting to Averan →- Fees take 26.8% of sales at the first-year median and 15.8% at the third-year average. That is $37,301 on $139,239, against $145,617 on $922,781.
- Hitting $40,000 a month for six straight months cuts the Care Services Center fee from 7% to 5%. The average territory bills $34,117 in month twelve, $5,883 short of starting the clock.
- The average territory has about ten clients at the end of year one. That is $34,117 of month-twelve sales at $3,348 per client per month.
- 31 territories closed in five years and 14 of them shut inside twelve months. The network peaked at 74 and stands at 71.
- Sales run $221,375, $525,653 and $922,781 across years one, two and three. The medians are $139,239, $373,360 and $620,532.
How much does a Nurse Next Door franchise make?
The average Nurse Next Door unit reported $922,781 of revenue in the 2026 FDD, and the median reported $620,532. The brand’s disclosure document discloses revenue and not profit, so what an owner keeps depends on the cost structure set out below. Fees come off the top first, at about 13% of sales across royalty, brand fund and the rest of the stack. 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.
Franchise fees
What the fees come to at each stage
| Stage | Gross sales | Royalty | Care Services Center | Brand fund | Local marketing | Technology | Total | Share |
|---|---|---|---|---|---|---|---|---|
| Year 1, median | $139,239 | $6,962 | $9,747 | $1,392 | $12,000 | $7,200 | $37,301 | 26.8% |
| Year 1, average | $221,375 | $11,069 | $15,496 | $2,214 | $12,000 | $7,200 | $47,979 | 21.7% |
| Year 2, median | $373,360 | $18,668 | $26,135 | $3,734 | $12,000 | $7,200 | $67,737 | 18.1% |
| Year 2, average | $525,653 | $26,283 | $36,796 | $5,257 | $12,000 | $7,200 | $87,535 | 16.7% |
| Year 3, median | $620,532 | $31,027 | $43,437 | $6,205 | $12,411 | $7,200 | $100,280 | 16.2% |
| Year 3, average | $922,781 | $46,139 | $64,595 | $9,228 | $18,456 | $7,200 | $145,617 | 15.8% |
We applied the 5% royalty against its annual minimum, the Care Services Center fee at the greater of 7% of gross sales or $300 a month, the 1% brand fund, and the local marketing requirement of the greater of $1,000 a month or 2% of gross sales, capped at $2,000 a month. We also applied the $600 monthly technology maintenance fee.
The fixed minimum is $19,200 a year, payable from day one. It is $12,000 of local marketing and $7,200 of technology maintenance, regardless of what you bill. At the first-year median that alone is 13.8% of gross sales, before a single percentage point of royalty or Care Services Center fee.
The Care Services Center fee is larger than the royalty. The Care Services Center fee is 7% against 5%, and at the third-year average it is $64,595 a year. What you get for it is round-the-clock intake, scheduling, virtual consults, attendance monitoring and overnight coverage run out of Vancouver. So this is an outsourced back office charged as a percentage.
The load falls 11 points between the first-year median and the third-year average. It falls from 26.8% to 15.8%, on a fee schedule that stays exactly the same. The fixed $19,200 simply becomes a smaller share. That is the arithmetic case for pushing hard on the build-up.
Unbundling conditions
| Condition | Requirement | Where the network stands |
|---|---|---|
| Time in operation | 12 months | n/a |
| Operational excellence audit | 80% or better | n/a |
| Monthly gross sales | $40,000 for six consecutive months | Month 12 average: $34,117 |
| Reward | Care Services Center fee falls from 7% to 5% | Worth $18,456 at the third-year average |
Conditions as the brand reported it.
The average territory ends year one $5,883 a month below the $40,000 threshold. That is $34,117 against $40,000. The median territory, at $23,815, is $16,185 short. Only the top quartile, billing $81,642 in month twelve, clears the bar with room to spare.
Two points is $18,456 a year at the third-year average. Set that against the scheduling work you take back in-house. That is a coordinator's salary somewhere between $45,000 and $60,000 in most markets. So unbundling pays only once your volume makes that coordinator busy. At the third-year median of $620,532 the saving is $12,411, which is well short of a full-time hire.
The minimum royalty rises from $6,250 in year one to $51,154 from year twelve. That is $6,250 in year one, $26,250 by year five, $42,276 by year ten and $51,154 from year twelve. 5% equals the year-five minimum at $525,000 of sales and the year-ten minimum at $845,520. Half of third-year territories sell less than $620,532. A territory that stops there starts paying a minimum.
Top performers
What separates the top Nurse Next Door performers
Nurse Next Door reports sales for three groups of territories by age. In months 25 to 36, 15 territories averaged $922,781 with a median of $620,532, and sales ran from $0 to $2,312,857. In months 1 to 12, 35 territories averaged $221,375.
Decided before you open
- Territory.This model sells from a territory quoted at 10,000 residents, with no storefront. Population density sets how much driving sits between jobs.
- Opening cost range.Opening costs $119,286 to $217,210, a 1.8× range inside one brand.
- Fees and the minimum.Fees run about 13.0% of sales. A minimum fee also applies, so lower-selling locations pay a higher effective rate. Work out the sales level where the percentage overtakes the minimum.
- Cash needed in the first year.Nurse Next Door’s filing shows how sales build in the first 36 months. It gives no costs, so the month sales cover costs is not in the filing.
Live operating levers
- Billed hours.You pay for every hour worked and bill only the hours a client accepts. Track hours worked against hours billed, and the rate charged against the rate paid.
Context you underwrite around
- Locations included.Nurse Next Door’s figures cover 35, 32 and 15 of 71 territories, by age group. The filing leaves out 10 territories that began before 1 October 2020, 10 run by different franchisees in their first 3 years, and territories not open long enough for each group.
- What the filing does not include.Item 19 publishes no profit or cost data for franchised locations. Ask the franchisor or current owners for cost and profit figures.
- Sales spread in the category.Across 25 Senior Care brands in this library, the top group sells 15.0× the bottom at the typical brand, and a median 34% of locations reach their own average *. Nurse Next Door’s own spread is in the tables on this page.
The first year, month by month
Gross sales over the first three years
| Period | Territories | Average | Median | Top 25% average | Highest | At or above average |
|---|---|---|---|---|---|---|
| Months 1 to 12 | 35 | $221,375 | $139,239 | $526,527 | $771,306 | 10 (29%) |
| Months 13 to 24 | 32 | $525,653 | $373,360 | $1,319,927 | $2,134,807 | 10 (31%) |
| Months 25 to 36 | 15 | $922,781 | $620,532 | $1,789,703 | $2,312,857 | 6 (40%) |
As the brand reported it, measured to 30 September 2025.
Year two is a 2.4-fold step and year three adds 76% more. That is $221,375 to $525,653 to $922,781, with medians moving $139,239 to $373,360 to $620,532. In residents that is $22.14 a year from each senior in the territory rising to $92.28. At the month-36 average a Nurse Next Door territory serves about 26 clients, about a quarter of one percent of the 10,000 seniors it covers *.
The top quartile bills 2.4, 2.5 and 1.9 times the average in years one, two and three. That is $526,527 against $221,375 in year one, $1,319,927 against $525,653 in year two and $1,789,703 against $922,781 in year three, ratios of 2.4, 2.5 and 1.9. The gap opens in the first twelve months and then travels with you.
29%, 31% and 40% of territories reach their own group's average in years one, two and three. The average is pulled by a top-quarter tail, so the median is the number to plan against. The year-one median of $139,239 is a business making about $11,600 a month.
Final-month sales and clients
| Month 12 | Month 24 | Month 36 | |
|---|---|---|---|
| Average | $34,117 | $52,124 | $85,504 |
| Median | $23,815 | $29,000 | $80,900 |
| Top 25% average | $81,642 | $137,630 | $165,619 |
| Highest | $143,446 | $217,242 | $197,100 |
| Annualized average | $409,404 | $625,488 | $1,026,048 |
| Clients at the average | 10.2 | n/a | n/a |
Month 12, 24 and 36 figures as the brand reported it.
The average territory has about ten clients after one year. That is $34,117 a month at $3,348 a client. The median territory has about eight and a half. Against a territory of 10,000 seniors, the first year is about finding the first dozen households.
A client is worth $40,176 a year at the average rate. That is $3,348 a month, and the top disclosed client runs $18,150 a month, $217,800 a year from one household. Monthly sales for each client run from $586 to $18,150. Hours vary more between clients than the hourly rate does. So a single high-hours case moves a young territory's whole year.
Month twelve annualizes to $409,404 against a first-year total of $221,375. The exit rate is 1.85 times the year's average, which is what a ramp looks like from inside. The same comparison at month 36 gives $1,026,048 against $922,781, a ratio of 1.11. So by year three the curve has flattened and growth has to come from somewhere other than the build-up.
What it costs to open, and the network
What it costs to open
| Line | Low | High |
|---|---|---|
| Initial franchise fee | $72,000 | $72,000 |
| Technology start-up fee | $8,000 | $8,000 |
| Pre-opening branding and promotion | $7,000 | $7,000 |
| Insurance, workers compensation, crime cover and bonds | $4,900 | $21,500 |
| Consultant or director of nursing | $0 | $15,000 |
| Everything else to open | $7,386 | $43,710 |
| Additional funds, three to six months | $20,000 | $50,000 |
| Total | $119,286 | $217,210 |
As the brand reported it, except the two grouped lines. Those are marked *. The insurance line adds general insurance, workers compensation, first and third party crime cover and state bonds. The remainder adds training travel, office equipment, legal and accounting, leased premises, utility deposits, the opening local marketing payment, a vehicle, computers, licenses and permits, accreditation and the first three months of the workplace software.
Discounts available
- Nurse Next Door takes $5,000 off the fee for each additional territory bought at the same time as the first.
- Nurse Next Door takes 10% off the fee for military service members.
- Nurse Next Door takes $10,000 off the fee for frontline healthcare workers such as nurses, physicians, paramedics and EMTs (Frontline to Franchisee program).
- Nurse Next Door takes $10,000 off an initial territory in a metro area with no operating Nurse Next Door franchise (New Market Incentive).
From Item 5 of the Nurse Next Door 2026 FDD. The costs on this page use the full initial franchise fee for one unit, before any discount.
Working capital (cash to run the business day to day) of $20,000 to $50,000 covers three to six months. Half of first-year territories sell less than $139,239, and the fixed minimum is $19,200. The low end of the opening range leaves little spare cash. The month-twelve median of $23,815 says the business is still building through the whole period that money has to cover.
A director of nursing can add $15,000 before you open. Whether you need one depends on your state's licensure, and the licenses and permits line runs $200 to $5,000 with accreditation up to $8,500 on top. Three separate costs follow the same state rules. Those state-driven lines explain part of the gap between the $119,286 low and the $217,210 high.
The network of locations
| Year | Start | End | Net change |
|---|---|---|---|
| 2023 | 50 | 74 | +24 |
| 2024 | 74 | 73 | −1 |
| 2025 | 73 | 71 | −2 |
As the brand reported it.
14 of the 31 closures happened inside twelve months. That puts 45% of Nurse Next Door closures inside the first year *, in a network that has ranged between 50 and 74 territories across the period. It matches the shape of the fee table, where the load sits above 20% of sales for the whole of a typical first year.
The network added 24 territories in 2023 and lost three across the two years since. That is 50 to 74 to 73 to 71. A system that stops growing while the brand reports global expansion is consolidating around the territories that work. So the comparison set you are measured against keeps rising.
Your territory is protected. A territory holds at least 10,000 residents aged 65 and over. The brand keeps other owners' territories out of it, even as that population grows. Clients from outside the territory require the out-of-territory services policy.
Questions we get asked
How much does a Nurse Next Door franchise make?
Nurse Next Door territories in months 25 to 36 of operation averaged $922,781 of sales, with a median of $620,532, according to Item 19 of Nurse Next Door’s 2026 FDD, issued 5 December 2025. The 15 in that group are 21%* of Nurse Next Door’s 71 territories. Fees paid to Nurse Next Door come to about 13%* of sales.
What should my Nurse Next Door territory be billing?
Across the disclosed group, gross sales averaged $221,375 in months 1 to 12, $525,653 in months 13 to 24 and $922,781 in months 25 to 36, with medians of $139,239, $373,360 and $620,532. The top quartile averaged $526,527, $1,319,927 and $1,789,703. Month by month, the average territory billed $34,117 in month twelve, $52,124 in month twenty-four and $85,504 in month thirty-six.
What do Nurse Next Door's fees add up to?
Nurse Next Door charges 13% of gross sales (a 5% royalty against an escalating annual minimum, 7% for the Care Services Center and 1% to the brand fund) plus $12,000 a year of required local marketing and $7,200 a year of technology maintenance. In practice that works out to 26.8% of sales at the first-year median, 18.1% at the second-year median and 15.8% at the third-year average. Technology user fees of $4.65 a caregiver and $21.00 a franchisee account apply beyond the included licenses.
How do I cut the Care Services Center fee at Nurse Next Door?
Nurse Next Door lets an owner cut the Care Services Center fee by unbundling. Once you have operated twelve months, scored 80% or better on an operational excellence audit and reached $40,000 in monthly gross sales for six consecutive months, you may give up the scheduling service in exchange for a two-point reduction, taking the fee from 7% to 5%. You also need good standing with no outstanding defaults and a signed Unbundled Declaration Form. The average territory bills $34,117 in month twelve, so most owners are a quarter or two of growth away from starting the six-month clock.
How many clients do I need at Nurse Next Door?
The disclosed average gross sales per client per month in the twelfth month is $3,348. The median is $2,812, the high $18,150 and the low $586. At the average that puts the average territory at about ten clients after a year and the median at about eight and a half. Reaching the $40,000 a month unbundling gate is roughly twelve clients at the average rate; reaching the third-year average of $85,504 a month is about twenty-six.
Who does bookkeeping for a Nurse Next Door franchise?
The Nurse Next Door fee stack has three moving parts on one base: the royalty against an annual minimum, the Care Services Center fee at a rate that can step down, and a local marketing minimum that applies for most of the first two years. So what franchise fees cost as a share of sales changes as the business grows. Monthly gross sales are the compliance number as well as the management number, since the unbundling gate turns on six consecutive months above $40,000. Gross sales per client is the one benchmarked operating ratio, so report it beside client count each month and read your own position against $3,348. Averan provides bookkeeping, controller, and fractional CFO support for franchise owners and has Certified QuickBooks ProAdvisors on the team.
- The filing gives no profit figure. The filing reports sales and not earnings, so what an owner keeps is not disclosed.
- The filing breaks out 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 Nurse Next Door
These are questions the Nurse Next Door filing leaves open. An owner or a buyer can put them to Nurse Next Door directly.
- What do locations at the median spend on wages and rent as a share of sales? The filing reports sales only.
- What did the highest and lowest locations sell last year, and what explains the gap?
- How long does a new location take to reach the average you publish, and what does the build-up look like month by month?
- At what level of sales do the minimum charges stop applying and the percentage take over?
- How many Nurse Next Door locations closed, were sold, or changed hands last year, and why?
Run your own numbers.
The Franchise Numbers Check 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.
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Talk to AveranWhere these figures come from.
Every figure here comes from Nurse Next Door Home Healthcare Services (USA) Inc.’s 2026 FDD and is unaudited by us. We are unaffiliated with the brand. Calculations of our own are labeled where they appear, the figures describe past performance at other businesses and are not a projection of yours. This page is an educational summary. It is not an offer to sell a franchise, and it is not financial, legal or tax advice. Nurse Next Door® is a registered trademark of its owner. How Averan reads a Franchise Disclosure Document.
These figures come from the brand's disclosure. They are not a forecast, an offer to sell a franchise or advice. Source: Nurse Next Door Home Healthcare Services (USA) Inc., 2026 Franchise Disclosure Document, issued 5 December 2025.
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Nurse Next Door reads against the rest of the non-medical home care group: Assisting Hands Home Care · CareBuilders At Home · Caring Senior Service · ComForCare · Comfort Keepers · Executive Home Care. The non-medical home care guide compares all of them on the same figures.
Questions owners ask next
The figures above raise these, and each one is answered on its own page.
- At what level of sales does a minimum fee stop costing me more than the percentage?It works out the sales level where a minimum fee stops applying.
- How much cash do I fund before a new location covers its own costs?It builds a 13-week forecast for the months before break-even.
- My payroll percentage keeps climbing. Is that a payroll problem?It shows how to tell whether payroll is rising or revenue is falling.
- How much of Item 19 can I rely on?It explains what an Item 19 financial performance representation tells you and what it leaves out.
- What should I be looking at every week?It lists the handful of numbers that move before the P&L does.