The best home care franchises ranked by Item 19 median revenue divided by Item 7 midpoint, using 2026 FDD data from 14 non-medical brands.
Quick answer SYNERGY HomeCare generates $14.40 of disclosed median revenue per dollar of Item 7 midpoint investment, the highest ratio among non-medical home care brands with a sample of 20+ units. Home Instead leads on absolute revenue at a $2,261,503 median but ranks third on the ratio at 10.2x.
Home Instead’s 2026 FDD reports a median of $2,261,503 in annual revenue across 611 franchised units. That is the largest verified Item 19 median in non-medical home care, about $500,000 clear of the next brand, and it is the number every ranking of this category leads with.
It is also not the best return on the capital you put in.
Home Instead’s Item 7 runs $92,640 to $350,550, a midpoint of $221,595. SYNERGY HomeCare’s Item 7 runs $80,245 to $164,091, a midpoint of $122,168. SYNERGY’s disclosed median is lower, at $1,763,025 across 523 units. Divide each median by its Item 7 midpoint and the order flips: SYNERGY produces $14.40 of median revenue per dollar of disclosed startup cost, Home Instead produces $10.21. Our senior care overview ranks this sector by system size, which is a different and equally legitimate question. This post asks a narrower one.
Item 19 median revenue divided by the Item 7 midpoint is a capital-efficiency screen, not a return calculation. Revenue is not profit, and the margin section below is where that distinction gets expensive. Item 7 midpoints are franchisor estimates, and the real number depends on your market’s rent, your insurance quotes, and how many territories you buy on day one.
What the ratio does catch is the thing raw AUV rankings hide: two brands can post similar revenue while asking wildly different amounts of money to get there. Fourteen non-medical home care systems in our database disclose an Item 19 median against a sample of at least 20 units. Here are the eight with the largest samples.
| Brand | Item 7 range | Midpoint | Item 19 median | Sample | Revenue per $1 |
|---|---|---|---|---|---|
| SYNERGY HomeCare | $80,245 to $164,091 | $122,168 | $1,763,025 | 523 | 14.4x |
| Griswold Home Care | $99,600 to $180,600 | $140,100 | $1,492,691 | 59 | 10.7x |
| Home Instead | $92,640 to $350,550 | $221,595 | $2,261,503 | 611 | 10.2x |
| Right at Home | $94,330 to $176,239 | $135,285 | $1,334,579 | 390 | 9.9x |
| Homewatch CareGivers | $142,890 to $194,080 | $168,485 | $1,360,485 | 214 | 8.1x |
| Home Helpers Home Care | $120,750 to $175,250 | $148,000 | $1,122,828 | 173 | 7.6x |
| Senior Helpers | $176,500 to $231,500 | $204,000 | $1,452,858 | 346 | 7.1x |
| Amada Senior Care | $121,577 to $438,440 | $280,009 | $1,242,391 | 162 | 4.4x |
All figures come from 2026 FDDs. A 3.3-fold spread inside a single category, between brands selling substantially the same service to the same client, is larger than most buyers expect going in.
The spread does not come from fees. Franchise fees across these eight run $49,500 to $59,000, and royalties sit at 5% or 6% of gross sales with almost no variation. What differs is everything else in Item 7: territory pricing, required office buildout, mandated software, working-capital assumptions, and how many months of losses the franchisor tells you to budget for. Amada Senior Care’s $438,440 ceiling and SYNERGY’s $164,091 ceiling describe the same business model with very different assumptions baked in about how you should open it.
SYNERGY HomeCare closed 2025 at 626 territories and is the second-largest system in non-medical home care by that count. Its Item 19 sample of 523 covers single-unit and multi-unit businesses operating a year or more, combined into one median. That combination is worth flagging: multi-territory owners pull a combined median upward, so a single-territory buyer should expect to land below $1,763,025 in the early years. Even discounting for that, a $122,168 midpoint against a seven-figure median is the cheapest path to that revenue level in the category.
Right at Home’s 9.9x comes off a 390-unit sample of offices open one year or more, on a $135,285 midpoint. Griswold Home Care posts the second-best ratio at 10.7x, but on 59 reporting units out of 114 in the system. Half the network is missing from that median, and a 59-unit sample moves a lot with a handful of strong offices. Treat it as directional.
If you want the brand-level comparison rather than the category view, we ran three of these systems side by side in Home Instead vs Right at Home vs Visiting Angels. You can also filter the full senior care category by investment range and Item 19 disclosure.
Third place on the ratio is not a knock. Home Instead’s median is the highest absolute revenue figure any non-medical home care brand discloses, and absolute revenue is what determines your exit price. A business doing $2.26M sells for meaningfully more than one doing $1.76M at the same multiple of earnings, and the $99,427 gap in Item 7 midpoint is a one-time cost against a permanent revenue difference.
Home Instead also has the cleanest disclosure in the set. Its Item 19 segment is “all franchised units,” 611 of 626, with no filter for tenure, size, or performance. Nothing is screened out. We took that disclosure apart line by line in our Home Instead Item 19 deep dive.
The trade-off is capital. Home Instead’s Item 7 ceiling of $350,550 is more than double SYNERGY’s $164,091 ceiling, and the gap is not in the franchise fee, which is $54,000 against SYNERGY’s $55,000. If your available capital caps out near $150,000, the ratio question is academic: the higher-revenue brand is not on your list.
Every number above assumes you can staff the hours. In home care that assumption does most of the work.
This is a labor brokerage before it is anything else. You recruit, background-check, train, schedule, and retain hourly caregivers in a market where hospitals, assisted living facilities, and two competing agencies are chasing the same people. Item 7 gives you a line for initial advertising and a line for training. It gives you nothing for the recurring cost of replacing caregivers who leave, and industry turnover in this workforce has run near or above 60% annually for years.
A franchisee sitting on unfilled shifts has revenue on the whiteboard and none in the bank. During validation, ask every owner you call what their current fill rate is and how many open shifts they turned back to referral sources last month. The answers separate brands more reliably than any FDD table. We wrote up the general version of this diligence in can you actually staff it.
Gross margin in non-medical home care runs 30% to 40%. Read that the direction that matters to your bank account: 60 to 70 cents of every revenue dollar is gone to caregiver wages, payroll taxes, and workers’ comp before you have paid for an office, a scheduler, a care coordinator, liability insurance, or the royalty.
Run SYNERGY’s median at a 35% gross margin and $1,763,025 becomes about $617,000 of gross profit. The 5% royalty takes $88,151 of it. Home Instead’s $2,261,503 at the same margin yields roughly $791,500 gross, with a $113,075 royalty. What remains covers office rent, two to four administrative salaries, recruiting spend, insurance, software, and the ad fund contribution, and only then becomes owner earnings.
This is why a seven-figure revenue headline in home care should not be read the way a seven-figure headline in food service or fitness reads. The revenue is real. The share of it you keep is structurally thinner than in most franchise categories, and it moves with your bill rate and your caregiver wage, both of which local labor markets set rather than the franchisor. Our performance benchmarks by industry show how the category compares on disclosed revenue across the rest of the franchise universe.
Item 19 medians are only comparable when they describe comparable units, and in this category they frequently do not.
Senior Helpers reports a median of $1,452,858 across 346 units, and the segment is “franchised businesses operating 60+ months.” That is a five-year survivorship filter. Every office that opened recently or closed early is out of the sample. The number is honest about what it measures, and it is not measuring the same population as Home Instead’s all-units figure, so the 7.1x and 10.2x ratios are not a like-for-like comparison.
The sharpest example sits outside the table. Acti-Kare discloses an Item 7 of $32,530 to $57,550 against a median of $879,976, which computes to 19.5x, the highest ratio in the entire category. Its segment: franchised businesses operating 35 or more hours per week for at least 24 months under the same owner. Three filters stacked on top of each other, screening for tenure, volume, and ownership continuity. Fifty-four units qualified out of 150 in the system. That is a disclosure about the brand’s best third, and publishing it in a ranking would be misleading.
The general rule holds across the sector: the more filters a franchisor puts on its Item 19 population, the less the number tells you about what your first three years look like. Brands reporting all franchised units are making a harder claim, and they know it.
Our AUV leaderboard carries the disclosed medians, sample sizes, and segment definitions for every system in the database, home care included, so you can run this arithmetic on any category you are considering. The ratio takes two numbers. Most buyers never compute it.
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best home care franchisessenior home care franchise costnon-medical home care franchiseItem 19senior careSYNERGY HomeCareHome Instead
About this analysis The franchise data in this article is drawn from VetMyFranchise's structured analysis of 2,300+ Franchise Disclosure Documents filed with U.S. state regulators. See our data & methodology.
Item 7 ranges in non-medical home care cluster between $80,000 and $440,000 depending on brand and territory count. SYNERGY HomeCare discloses $80,245 to $164,091 and Home Instead discloses $92,640 to $350,550. Franchise fees are tightly grouped: $49,500 to $59,000 covers most of the category, and royalties sit at 5% to 6% of gross sales.
No FDD in this category discloses franchisee profit, only revenue, so nobody can answer that from public paper. On revenue per dollar invested, SYNERGY HomeCare leads at 14.4x, followed by Griswold Home Care at 10.7x and Home Instead at 10.2x. Profit depends on your bill rate, your caregiver wage, and your billable hours, none of which the franchisor controls.
Not for non-medical home care, which is the model every brand in this ranking operates. You are running a recruiting, scheduling, and referral-relationship business. Home health, hospice, and skilled nursing franchises are a separate category with clinical licensure requirements and a Director of Nursing on payroll.
Non-medical home care covers companionship, bathing, dressing, meal prep, and transportation, is usually paid privately or by long-term care insurance, and needs no clinical license in most states. Home health delivers skilled nursing and therapy under a physician's plan of care, bills Medicare and Medicaid, and carries certification and survey requirements. The FDDs look nothing alike.
No brand in this ranking discloses a payback period, because Item 19 in non-medical home care reports revenue and never profit. Cash-flow breakeven is a function of billable hours: an office generally needs 300 to 500 billable hours a week, or roughly 15 to 25 steady clients, to carry a full overhead load. How fast you get there depends on your referral relationships and your caregiver pipeline, so ask franchisees directly during validation.
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