Sell your home care agency

What buyers are actually buying

Home care acquirers underwrite recurring authorized hours, not goodwill. A private duty nursing agency with stable Medicaid waiver authorizations and a caregiver retention rate above the market is worth more than a larger agency whose census swings with one referral source.

Before a number is on the table, expect buyers to look closely at a small set of items.

Payer mix

Medicaid waiver, managed care, VA, long term care insurance, and private pay each carry different rate stability and collection profiles.

Referral concentration

If one hospital, case manager, or MCO drives more than a quarter of volume, buyers discount for it or push the risk into an earnout.

Caregiver supply

Fill rate, overtime load, and turnover tell a buyer whether they can grow the census they just paid for.

Clean compliance history

Survey results, plan of correction history, wage and hour exposure, exclusion screening, and documentation quality.

What your agency is likely worth

Value is normally expressed as a multiple of adjusted EBITDA, meaning profit after a market rate salary for you and after removing personal or one time expenses. Agencies under roughly one million dollars of adjusted EBITDA trade in a lower band than regional platforms, because a buyer inherits more owner dependence and less infrastructure.

Two agencies with identical revenue routinely receive offers that differ by several turns of EBITDA. The difference is usually payer mix, clinical documentation quality, and whether the business runs without the owner in it every day.

How confidentiality is protected

Nothing is listed publicly, and your agency name never appears in a marketplace or an email blast. Buyers receive an anonymized profile first: segment, state, payer mix, revenue band, and adjusted EBITDA band. Your identity is shared only with the buyers you approve.

Staff, referral partners, and competitors have no reason to learn anything until you decide to tell them, which for most owners is after a signed purchase agreement.

The sequence, start to close

Most home care transactions follow the same path. Two weeks to buyer conversations, then roughly 90 to 150 days to close, with licensure and change of ownership approvals often setting the outer limit.

1. Details

You send revenue, adjusted EBITDA, payer mix, state, and what you want out of a transaction.

2. Buyer list

We come back with the acquirers in our network that fit, and why each one fits.

3. Conversations

You speak with the buyers directly. No auction, no bid deadline, no pressure to continue.

4. Offer and diligence

A letter of intent, then quality of earnings, compliance review, and licensure planning.

5. Close

Purchase agreement, working capital settlement, and the transition you negotiated for yourself and your staff.

Preparing for a Personal Care Exit

Selling a home care agency requires a meticulous review of caregiver retention and payer mix. Private pay revenue is often valued differently than Medicaid waivers due to margin stability. Buyers prioritize agencies with a scalable recruitment engine because labor is the primary constraint on growth. You must ensure all caregiver files are audit-ready, as missing documentation can lead to significant holdbacks or price reductions during the due diligence phase.

Consolidation in the personal care sector remains active as larger providers seek to expand their geographic footprint. In a notable June 2024 transaction, Addus HomeCare announced the acquisition of Gentiva personal care operations for approximately $350 million. This deal closed in December 2024 and involved over 16,000 daily patients across seven states. The price reflected approximately 1.25x the disclosed annualized revenue of $280 million.

Valuation Drivers in Personal Care

The value of your agency is not a fixed multiple. It is influenced by your EBITDA margin, the concentration of your largest payer, and the depth of your local management team. Buyers will look for agencies that can operate independently of the owner. If you are the primary point of contact for all referral sources, the buyer may perceive higher risk and demand a larger portion of the price be tied to an earnout.

It is important to note that public company metrics are not comparable to small private agencies. Public entities like Addus have access to cheaper capital and different risk profiles. For a private seller, the focus should be on normalizing earnings by adding back one-time expenses or owner-specific costs that will not persist under new ownership. Consult with financial professionals as this is not tax or legal advice.

The Closing Process and Licensing

The transition of ownership in home care involves state-specific regulatory requirements. A Change of Ownership (CHOW) filing or notice may be required, and its timing depends on the state, license, payer, and transaction structure. Buyers will often structure the deal as an asset purchase to mitigate successor liability, although this has different tax implications than a stock sale. You should involve specialized counsel early to navigate these requirements.

A major risk factor in recent years is the federal inquiry into private equity and corporate ownership in healthcare, launched in March 2024 by the DOJ, FTC, and HHS. This scrutiny underscores the importance of maintaining impeccable compliance records. Buyers will conduct deep dives into your billing practices to ensure every hour billed is supported by a documented visit that meets state regulations.