Selling a home care agency in Michigan

No state license, so diligence moves elsewhere

Michigan does not license home health agencies or non-medical home care agencies at the state level. Skilled home health agencies that bill Medicare are certified under the federal conditions of participation, with LARA's Bureau of Survey and Certification conducting surveys for CMS. Personal care, companion, and homemaker agencies operate without a state license.

That changes what a buyer checks. Instead of a state license, diligence focuses on Medicare certification and survey history for skilled agencies, Medicaid provider enrollment and managed care or waiver contracts, accreditation, and the employment and training records of caregivers. A buyer also pays close attention to Medicare change of ownership rules, because those, not state licensing, set the timeline for a skilled agency.

Certificate of need does not apply

Michigan's certificate of need program covers hospitals, psychiatric hospitals, nursing homes and hospital long-term care units, freestanding surgical outpatient facilities, and certain services and equipment. Home health agencies are not on that list. New competitors can enter a Michigan market without state approval, which puts the weight of valuation on what is slow to build: caregiver recruiting, referral relationships, and payer contracts.

What Michigan buyers look for instead

Because the state does not set a licensing baseline for non-medical home care, buyers set their own. Expect them to ask for evidence of background checks, training, supervision, and insurance that would satisfy a licensed state, since that is how they reduce risk when they integrate your agency into a multi-state platform.

Certification and surveys

Medicare certification and recent survey results for skilled agencies.

Payer contracts

Medicaid enrollment, managed care and waiver contracts, and private pay share.

Caregiver files

Background checks, training, and supervision records for every caregiver.

Caregiver supply

Fill rate, turnover, and overtime load.