Sell your pediatric home care agency

What buyers see in a pediatric agency

Most pediatric home care is paid by Medicaid, either fee for service or through Medicaid managed care plans, with some commercial insurance. Medicaid's EPSDT benefit requires states to cover medically necessary services for enrolled children under 21, including services the state does not cover for adults. That gives a well-run pediatric agency a durable base of demand.

Buyers do not value the agency as one block. They look at each service line separately, because each carries its own margin, staffing constraint, and regulatory risk. An agency that is mostly private duty nursing is underwritten differently from one built on parent-as-caregiver CNA hours or pediatric therapy visits.

Pediatric skilled nursing

RN and LPN hours, often in long shifts. Revenue depends on staffing authorized hours, so nurse recruiting and retention set the ceiling.

Aide and CNA hours

Personal care and home health aide services, including programs where a parent or relative is trained and employed by the agency as the child's paid caregiver.

Therapy at home

Physical, occupational, and speech therapy visits. Smaller hours, but a referral source for the other lines and a sign of clinical depth.

What drives value

The same few questions come up in every pediatric diligence. Answer them with data before a buyer asks.

Fill rate by line

Staffed hours as a share of authorized hours, by month, county, and payer. Unstaffed hours are upside for the buyer, not value you are paid for.

Payer and state mix

Revenue by state, Medicaid fee for service, each managed care plan, and commercial. Concentration in one plan or one state's rate schedule is discounted.

Family caregiver exposure

The share of hours and margin from parent or relative caregivers. States have started to cap these hours, so buyers model what happens if your state does too.

Rate direction

Recent and pending rate changes, managed care contract renewals, and any wage pass-through rules that tie part of the rate to caregiver pay.

Licensure and change of ownership

Which state licenses, Medicaid enrollments, and plan contracts transfer, which need approval, and how long a change of ownership takes in each state.

Who buys pediatric home care agencies

The most active buyers are national pediatric platforms, private equity backed pediatric operators building density in specific states, and diversified home care companies adding a pediatric line. Recent deals include Aveanna's acquisitions of Thrive Skilled Pediatric Care in 2025 and Family First Homecare in 2026, and Nautic Partners' purchase of Angels of Care from Varsity Healthcare Partners in 2024.

Smaller agencies are usually bought as add-ons by these platforms, which often value a strong local nurse pool, payer contracts, and licenses in a state they want to enter. Talking to several of them at once is the most reliable way to learn which one values your agency most.

What recent deals and rules tell you

Buyers are paying for scale in pediatric home care. Aveanna completed its purchase of Thrive Skilled Pediatric Care in June 2025 (23 locations in seven states, mostly private duty nursing plus pediatric therapy, licensed health aide, and CNA services) and paid $175.5 million in cash for Family First Homecare in June 2026 (27 locations in seven states). Earlier, in 2024, Nautic Partners bought a controlling interest in Angels of Care, whose services include private duty nursing, therapy, and family caregiving. A public platform's price is not a benchmark for a smaller agency, but these deals show that buyers want pediatric density in specific states.

The rules are moving at the same time. In August 2026 CMS approved a Colorado state plan amendment, effective July 1, 2026, that limits any one caregiver to 16 hours a day and 56 hours a week of reimbursed care per member for Long Term Home Health, with exceptions by request. Agencies whose CNA hours come largely from one caregiver per child, often a parent, feel that kind of limit first.

At the federal level, CMS's September 2024 EPSDT guidance reminded states that services covered under section 1905(a), personal care among them, must be available to children when medically necessary even if adults do not get them, and that states stay responsible when managed care plans run the benefit. Separately, the 2024 Medicaid access rule requires that at least 80 percent of Medicaid payments for homemaker, home health aide, and personal care services under HCBS waiver and similar authorities go to direct care worker compensation, starting July 9, 2030. It does not reach every pediatric service, and its future has been debated, so check how it applies to your programs before relying on it either way.

Preparing a pediatric home care agency for sale

Buyers rebuild your revenue line by line from authorizations, staffed hours, and rates. Agencies that hand over reconciled data early keep control of the story.

How Lartico fits in

Lartico introduces pediatric home care agency owners to approved platforms and operators that are actively acquiring in this segment. There is no listing and no exclusivity, you choose which buyers to speak with, and the buyer pays our fee at closing.