Selling a home care agency in Washington

In-home services agency change of ownership

In Washington, a change of ownership occurs when the legal owner or operator of a licensed in-home services agency changes because of a sale. At least 30 days before the change, the current licensee submits a change of ownership form and the prospective owner submits a change of ownership application to the Department of Health, with a fee of $350 for each licensed service category. A new license is issued for the rest of the current license period.

Agencies licensed in more than one category, such as home health and home care, pay per category and should expect the department to review each one.

Certificate of need for home health and hospice

Washington uses certificate of need for home health and hospice. When a Medicare-certified home health or hospice agency changes hands, the parties must inform the department's certificate of need program and receive its approval before the state change of ownership can be approved. That step sits ahead of licensing in the timeline, so file early.

Attorney General notice

Washington requires written notice to the Attorney General 60 days before closing certain health care transactions, including those involving provider organizations representing seven or more health care providers in contracting with insurers. The definition of provider includes home care aides, so larger home care agencies can be covered. The Attorney General can request more information within 30 days of notice.

If notice applies, it sets the minimum time to close. Ask counsel early whether your deal is covered.

What moves value for a Washington agency

The items buyers price most heavily in Washington:

Regulatory timeline

CON approval, DOH change of ownership, and any AG notice.

CON-protected home health

Medicare-certified home health in counties where new entry needs a CN.

Caregiver supply

Fill rate, turnover, and wages in high-cost labor markets.

Payer mix

Medicare, Medicaid in-home care, and private pay.