NEW YORK · HOME CARE

Selling a home care agency in New York

In New York, a buyer of a licensed home care services agency (LHCSA) must be approved by the Public Health and Health Planning Council. For an LHCSA actively serving at least 25 patients, that change of ownership review looks at the buyer's financial feasibility and character and competence, not public need, which is why established agencies are worth more than new licenses. Many transactions also require 30 days' notice to the Department of Health under Article 45-A, and the 2025 move of CDPAP to a single fiscal intermediary has changed which agencies buyers want.

By Akim Guennani, Founder · Updated October 2026

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New York home care at a glance

Licensing agency	New York State Department of Health
Licenses	Licensed home care services agency (LHCSA); certified home health agency (CHHA)
Approval of new owners	Public Health and Health Planning Council (PHHPC)
Public need review	Yes for new LHCSAs; not for a change of ownership of an LHCSA serving 25+ patients
Transaction notice	Article 45-A: notice to DOH 30 days before closing material transactions
Consumer directed care	CDPAP moved to a single statewide fiscal intermediary (PPL) in 2025

LHCSA and CHHA licensing

New York has two main home care licenses. Licensed home care services agencies provide nursing, home health aide, and personal care services, and are the license most private duty and Medicaid personal care businesses hold. Certified home health agencies are Medicare and Medicaid certified and provide skilled intermittent care. Both are licensed by the Department of Health, and both require Public Health and Health Planning Council approval of the operator.

New York stopped approving new LHCSA licenses under a moratorium that began April 1, 2018, and replaced it with a public need methodology from April 2020. New entrants now have to show need in the planning area. That makes an existing, active LHCSA a scarce asset, and it is the main reason buyers acquire rather than start agencies in New York.

How a change of ownership is reviewed

Under the LHCSA regulations, a change of ownership application for an agency actively serving at least 25 patients is evaluated only on financial feasibility and the character and competence of the proposed operator. Public need is not part of that review. An agency below that threshold may face the full need analysis, which can change both the timeline and whether the deal works at all.

PHHPC approval adds months, not weeks, to a closing. Buyers often sign a purchase agreement, file with the Department, and close once approval is granted, sometimes with an interim arrangement in between. Your census at the time of filing matters, so keep the agency's active patient count stable through the process.

Article 45-A: 30 days of public notice

Since August 1, 2023, Article 45-A of the Public Health Law has required health care entities to notify the Department of Health at least 30 days before closing a material transaction, such as a merger or acquisition above the law's revenue threshold. The Department shares the notice with the Attorney General and posts a summary on its website for public comment. Failing to file can bring civil penalties of up to $2,000 per day.

For a seller, this means confidentiality has an end date. Once the notice is filed, the deal becomes public before it closes. Plan staff and referral source communications around that date.

Payer mix after the CDPAP transition

The State's 2024-25 budget required the Department of Health to contract with a single statewide fiscal intermediary for the Consumer Directed Personal Assistance Program. Public Partnerships LLC was selected in September 2024, and the transition from hundreds of fiscal intermediaries ran through April 2025. Agencies that earned most of their revenue as CDPAP fiscal intermediaries lost that business.

Buyers now focus on agency-delivered personal care and nursing under managed long-term care plans, private pay, and skilled home health. If your agency used to rely on CDPAP, expect buyers to look at trailing revenue without it and at how quickly you replaced those hours.

Sources

Rules change. This page summarizes public sources as of the review date and is educational, not legal, tax, or regulatory advice. Confirm licensing and change of ownership steps with counsel and the relevant state agency before signing.

1. LHCSA adopted regulation (10 NYCRR Part 765) (New York State Department of Health)
2. Required reporting of material transactions (Article 45-A) (New York State Department of Health)
3. New York imposes new review process for material transactions involving health care entities (Polsinelli)
4. CDPAP transition update, March 31, 2025 (New York State Department of Health)
5. MLTC Policy 24.04, CDPAP statewide fiscal intermediary (New York State Department of Health)

Reviewed October 2026

Questions New York owners ask

Straight answers, before you commit to anything.

Does a buyer of my New York LHCSA need state approval?+

Yes. The new operator must be approved by the Public Health and Health Planning Council. For an LHCSA serving at least 25 patients, the change of ownership review covers financial feasibility and the operator's character and competence, not public need.

Will the sale of my New York agency become public?+

If it is a material transaction under Article 45-A, the Department of Health posts a summary for public comment during the 30 days before closing. Plan internal and referral source communications around that date.

How did the CDPAP change affect agency values?+

Agencies that acted as CDPAP fiscal intermediaries lost that role when the program moved to a single statewide intermediary in 2025. Buyers now value agencies on agency-delivered care, managed long-term care contracts, and private pay.

How long does a New York home care sale take?+

Longer than in most states. PHHPC approval and Article 45-A notice usually push closing beyond the 90 to 150 days typical elsewhere, so start regulatory filings as soon as terms are agreed.

Confidential inquiry

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Everything you send stays between us. We never list or shop a practice, and nothing goes to a buyer without your explicit approval. There is no cost to you at any stage.