Selling a home care agency in Illinois

Three license types and the change of ownership rule

IDPH licenses three kinds of home care business under Part 245: home health agencies, which provide skilled services; home nursing agencies, which provide nursing in the home; and home services agencies, which provide non-medical help with daily activities. Each holds its own license, and a business that does more than one thing may hold more than one.

Under Part 245, a sale, assignment, lease, or other transfer requires the new owner to have a new license before it maintains, operates, or conducts the agency. IDPH's guidance asks sellers to notify it of the impending sale at least 30 days in advance, to keep the existing license from expiring during the process, and asks buyers to submit the change of ownership application, fee, and supporting documents before the sale completes, followed by a copy of the bill of sale.

Attorney General notice for health care transactions

Since January 1, 2024, Public Act 103-0526 has required health care facilities and provider organizations to give the Illinois Attorney General 30 days' notice of covered transactions, including mergers, acquisitions, and contracting affiliations between entities not previously under common ownership. The Attorney General can request more information, and the deal cannot close until 30 days after the parties substantially comply. Penalties for not filing can reach $500 per day.

Whether your agency is covered depends on how the law's definitions apply to your business, so ask counsel early. If notice is required, it sets a floor on how fast you can close.

Payer mix: Community Care Program and private pay

The Illinois Department on Aging's Community Care Program helps adults 60 and older who would otherwise need nursing home care stay at home, with in-home services such as cleaning, meal preparation, laundry, and errands delivered through contracted providers. Many Illinois home services agencies rely on it alongside private pay and long-term care insurance.

Buyers look at the balance between program revenue and private pay, at how stable authorized hours are, and at how concentrated referrals are. A mix that is not dependent on a single program or referral source carries the least risk.

What moves value for an Illinois agency

The items buyers price most heavily in Illinois:

Licenses held

Which Part 245 licenses you hold, and whether services match them.

Caregiver supply

Fill rate, turnover, and complete training and background check files.

Payer mix

Community Care Program, Medicare, Medicaid managed care, and private pay.

Timeline

IDPH change of ownership and, if it applies, the Attorney General notice period.