Selling a home care agency in Florida

Three ways to run home care in Florida

Florida recognizes several home care business models, and each one is regulated differently. Home health agencies are licensed by AHCA under Part III of Chapter 400 and can employ nurses, therapists, and aides. Nurse registries, licensed under section 400.506, refer independent contractor nurses and caregivers to clients. Homemaker and companion services, registered under section 400.509, provide non-medical help without personal care.

Buyers price these models differently. An agency that employs its caregivers has more control over quality and scheduling but carries payroll and wage and hour exposure. A nurse registry has a lighter cost structure, but buyers will look carefully at how worker classification is documented. Knowing which model you operate, and whether you hold more than one, is the starting point for any valuation conversation.

What AHCA counts as a change of ownership

Florida's home health rule defines a change of ownership as a purchase of the agency by a new corporation or partnership from the entity that holds the license, or a sale by individual owners to new owners. A purchase of 100 percent of the stock of the corporation or partnership that owns the agency, or a change in its principals, is not a change of ownership as long as that entity continues to own the agency.

That distinction shapes deal structure. In an asset purchase, the buyer's entity applies to AHCA on the prescribed form, and Medicare and Medicaid enrollment follow their own rules. In a stock purchase, the licensed entity stays in place, which can make the licensing side simpler, but the buyer inherits the entity's history and will negotiate indemnities and escrow to match.

Payer mix: SMMC long-term care and private pay

Florida Medicaid delivers home and community based long-term care through the Statewide Medicaid Managed Care Long-Term Care program, for eligible people 18 and older who need long-term services and supports. Covered services include adult companion care, homemaker services, attendant nursing care, and adult day health care, among others, and they are paid through contracted managed care plans.

Florida also has one of the largest private pay senior populations in the country, so many agencies carry a meaningful private pay and long-term care insurance book. Buyers usually like a blend: managed care contracts provide steady volume, and private pay supports margin. Heavy dependence on one plan or one referral source is what gets discounted.

What moves value for a Florida agency

Without a certificate of need protecting home health, a buyer pays for what would take years to build.

Model and licenses

Which AHCA licenses and registrations you hold, in which counties, and whether they cover the services you actually bill.

Caregiver supply and classification

Fill rate, turnover, and, for nurse registries, clean independent contractor documentation.

Payer and referral diversity

SMMC LTC plan contracts, private pay share, and the spread of hospital, physician, and community referrals.

Survey history

AHCA survey results and how deficiencies were corrected. Buyers use this to size holdbacks.