Selling a home care agency in Tennessee

The 60-day change of ownership process

For a home health change of ownership, the Health Facilities Commission asks for a notarized application and fee together with a letter of intent 60 days before the anticipated change. The letter names the agency and the seller, includes the seller's acknowledgment authorizing the sale, and gives the projected date. After closing, the buyer sends the bill of sale or closing documents to the Commission.

The Commission then asks the regional office for a recommendation. The regional office checks when the last annual survey was done with no outstanding deficiencies and reviews the agency's survey performance, including complaint surveys. A clean survey history is therefore not just a valuation point; it is part of how the change gets approved.

Certificate of need

Tennessee's 2021 certificate of need reform, Public Chapter 557, kept home care organizations providing home health under CON, with exemptions for agencies limited to the federal EEOICPA program or to patients under 18. A 2024 law phases further CON changes in through 2029, so confirm the current status for your services with counsel.

Where CON applies, an existing licensed agency is the practical way for a buyer to enter a county, which supports value.

What moves value for a Tennessee agency

The items buyers price most heavily in Tennessee:

Survey history

No outstanding deficiencies and a clean complaint record.

CON-protected footprint

Counties where a new agency would need a CON.

Caregiver supply

Fill rate, turnover, and complete personnel files.

Payer mix

Medicare, TennCare managed care, and private pay.