Selling a home care agency in Ohio

A young license regime

Ohio's 2021 budget bill, HB 110, created licensure for home health agencies under Revised Code Chapter 3740, with the Ohio Department of Health issuing licenses from 2023. Before that, most Ohio home care businesses operated under Medicare certification, Medicaid provider agreements, or accreditation, without a state license of general application.

For buyers, that history matters in two ways. Diligence starts with confirming that the agency obtained its Chapter 3740 license on time and in the right name, and that the services it delivers match what the license covers. And because license applications must list the names and addresses of everyone with an ownership or controlling interest, any change in owners needs to be reflected with the Department. Confirm the exact change of ownership filing with counsel, since the rules are still new.

Payer mix: PASSPORT, MyCare Ohio, and private pay

Ohio Medicaid funds home care through waiver programs. PASSPORT helps Medicaid-eligible older Ohioans receive long-term services and supports at home rather than in a nursing home. MyCare Ohio coordinates care for people who are eligible for both Medicare and Medicaid, who may receive home services through the Ohio Home Care, PASSPORT, or assisted living waivers.

Buyers look at how revenue splits between waiver programs, MyCare Ohio plans, Medicare, and private pay, and at how concentrated it is. Agencies with several payer relationships and a meaningful private pay book usually draw more interest than those tied to one program.

Certificate of need: not for home health

Ohio's certificate of need program restricts developing, relocating, or adding beds at long-term care facilities. It does not apply to opening a home health agency. That keeps the market open to new entrants, so buyers pay for what is slow to build: caregiver recruiting, referral relationships, and payer contracts in your service area.

What moves value for an Ohio agency

The items buyers price most heavily in Ohio:

Licensing record

A clean Chapter 3740 license history and services that match what is licensed.

Caregiver supply

Fill rate on authorized hours, turnover, and overtime load.

Payer mix

Waiver, MyCare Ohio, Medicare, and private pay revenue, and concentration in any one.

Management depth

An administrator who runs daily operations without the owner.