HOME CARE

How to sell a home care agency, step by step

To sell a home care agency, clean up 2 to 3 years of financials, calculate adjusted EBITDA, document payer mix and caregiver metrics, choose how you will reach buyers, compare letters of intent, survive diligence, and complete licensing and change of ownership filings before closing. Most of the value is won or lost in preparation, before any buyer sees a number.

110

Home health and hospice deals announced in 2025

70%

Average cash at close, 2025 lower middle market survey

33%

Share of surveyed 2025 deals using an earnout

Step 1: Decide what you want from a sale

Write down your goals before talking to anyone. Do you want all cash, or are you open to rollover equity? Do you want to stay on for a year, or leave at closing? Do you care whether your caregivers and office staff keep their jobs? Buyers structure offers around these answers, and knowing them lets you compare offers on more than price.

Step 2: Get your financials buyer ready

Buyers want at least two full years of financial statements plus year to date results, ideally on an accrual basis and reconciled to tax returns. Separate personal expenses, one time costs, and owner compensation so a buyer can see what the agency earns on its own.

Monthly P&L
24 to 36 months, with revenue split by payer and service line.
Addback schedule
Each adjustment to EBITDA listed with the evidence behind it.
Payroll data
Caregiver wages, overtime, and turnover by month.

Step 3: Document the metrics buyers underwrite

Home care buyers look past revenue to billable hours per week, average bill rate and pay rate by payer, caregiver fill rate, client retention, and referral source concentration. Having these ready shortens diligence and signals a well run agency.

Step 4: Choose how you will reach buyers

Owners typically sell to an inbound buyer who approached them, hire a broker who markets the agency, or use a buy-side introduction to several screened acquirers. Each route trades off price discovery, confidentiality, and cost. Talking to more than one qualified buyer is the most reliable way to test price and terms.

Step 5: Compare letters of intent

A letter of intent sets the headline price, the cash at close, any rollover or earnout, the working capital target, exclusivity period, and your post closing role. Compare offers on cash you actually receive at closing, not on headline value.

Step 6: Diligence, licensing, and closing

During exclusivity the buyer reviews financials, payer contracts, caregiver files, compliance history, and litigation. In parallel your attorney handles state licensing, Medicaid provider enrollment, and change of ownership notices, which can set the timeline. The purchase agreement, escrow, and transition plan are then signed at closing.

Illustrative example: comparing two offers

Headline price rarely tells you which offer is better. Compare the cash you receive at closing and the risk attached to the rest.

Hypothetical termOffer AOffer B
Headline price$6.0M$6.5M
Cash at close$5.4M$4.5M
Rollover equity$0.6M$1.0M
EarnoutNone$1.0M, tied to 2 year EBITDA targets

Hypothetical takeaway

Offer B is $500,000 higher on paper, but $900,000 less certain at closing. Whether it is better depends on how confident you are in hitting the earnout and in the buyer's platform. These figures are illustrative, not market data.

Pre-sale preparation checklist

Work through these items before speaking with buyers.

Owner checklist

  • Accrual financials reconciled to tax returns
  • Addback schedule with supporting documents
  • Revenue by payer and referral source
  • Caregiver roster, fill rate, and turnover
  • Licenses, surveys, and plans of correction
  • Copies of payer and MCO contracts
  • List of key staff and their agreements
  • Written goals for price, structure, and your role

How Lartico fits in

Lartico introduces home care owners to screened acquirers already looking for agencies like theirs. You send your details, we return a list of qualified buyers, and you choose who to speak with. The buyer pays our fee.

Sources and methodology

Public transactions provide market context, not a valuation quote for a private practice. Illustrative examples use hypothetical assumptions and are not predictions. This guide is educational and is not legal, tax, accounting, or investment advice.

  1. 1. Lower Middle Market M&A Deal Structure: What the Latest Survey Data Reveals (Lippes Mathias, citing AM&AA). Cash, rollover, and earnout usage in surveyed 2025 deals of $25M to $50M.

Reviewed September 2026

Questions owners ask

Straight answers, before you commit to anything.

How long does it take to sell a home care agency?+

Preparation can take a few months. Once you sign a letter of intent, diligence and closing commonly take several more months, with state licensing and payer enrollment often driving the timeline.

What documents do I need to sell a home care agency?+

Financial statements and tax returns for 2 to 3 years, payer contracts, a client census, caregiver roster and payroll data, licenses, policies, and any survey or audit results.

Can I sell a home care agency that relies on Medicaid?+

Yes. Many buyers focus on Medicaid waiver agencies. They will look closely at state rate trends, authorization stability, and your documentation quality.

Do I have to stay after the sale?+

It is negotiable. Many buyers ask for a transition period so referral sources and staff stay stable. The length and pay should be written into the agreement.

Should I tell my staff I am selling?+

Usually not until late in the process. Keep the circle small and let the buyer and your attorney help plan the announcement.

Confidential inquiry

Tell us about your practice.

Everything you send stays between us. We never list or shop a practice, and nothing goes to a buyer without your explicit approval. There is no cost to you at any stage.