Sell My Home Health Agency: A Confidential, Advisor-Run Process
A confidential, advisor-run process built to create competitive tension among vetted buyers — not a listing on a broker board. Understand what your agency is worth, who is buying in 2026, and how a sell-side process protects your value through Medicare change-of-ownership.
Inquiries are strictly confidential — no public listing of your firm.
A listing is not a process
Search "home health agency for sale" and you will find listing marketplaces and business-broker boards. Posting your agency to a board is not the same as running a sell-side process — and the difference shows up in your final number, especially when a Medicare change-of-ownership and census retention are on the line.
4.5x – 8x adjusted EBITDA
for Medicare-certified skilled home health; scaled, multi-state certified platforms with diversified payor mix and strong CMS star ratings reach 9x–12x+, while private-duty and non-medical home care typically clears lower, in the 3x–6x range
Who is buying home health agencies in 2026
The buyer universe for home health has widened and deepened. Deal volume in home-based care hit 110 transactions in 2025, surpassing 2024, and Q1 2026 was the strongest quarter for the sub-sector in over a year. Private equity is actively building home-health platforms, national payers are vertically integrating care into the home, and succession buyers remain active for owner-run agencies.
Medicare change-of-ownership, licensure, and accreditation
Selling a Medicare-certified home health agency triggers a change-of-ownership (CHOW) with CMS, filed on Form CMS-855A. In an asset-style CHOW the buyer often accepts assignment of your existing Medicare provider agreement — inheriting its effective date but also its successor liability for prior overpayments and audit exposure — which is why escrow and indemnity terms matter. CMS also applies a 36-month rule: agencies that changed majority ownership within 36 months of initial Medicare enrollment (or their last CHOW) generally cannot assign the provider number and must re-enroll, which can pause billing. Separately, most states require a home health license transfer, and a handful still operate Certificate of Need (CON) regimes that gate who may own or expand an agency. Buyers also expect accreditation (ACHC, CHAP, or The Joint Commission) to transfer cleanly. None of this is legal or tax advice — build the CHOW, licensure, and accreditation timeline into your deal plan with qualified counsel early.
PE-backed home-health platforms & consolidators
Private-equity-sponsored platforms acquiring for census density, referral access, and operating leverage — Kinderhook Industries (which took Enhabit private in a ~$1.1B deal at roughly 10.2x EBITDA), Waud Capital (Altocare and, with Nautic Partners, VitalCaring), Ares Management with DaVita (Elara Caring), Choice Health at Home, and Aveanna Healthcare. PE activity in home-based care expanded materially in 2025, with add-on acquisitions driving most volume. Usually partnership structures with rollover equity and earnouts, not clean exits.
Strategic health systems & payers
Insurers and payer-owned care delivery arms integrating care into the home — UnitedHealth Group / Optum (which closed its $3.3B acquisition of Amedisys in 2025) and Humana / CenterWell (which owns CenterWell Home Health). These strategics value diversified Medicare and Medicare Advantage relationships, geographic coverage, and the ability to manage total cost of care at home.
Individual-buyer succession
A single buyer, operating partner, or regional agency acquiring the business for succession. Best fit for smaller, owner-dependent agencies with a clear transition runway and a clean survey history.
UnitedHealth Group / Optum closed its $3.3 billion acquisition of Amedisys — a home health and hospice provider with 500+ locations across 37 states — after resolving a DOJ antitrust challenge that required divesting at least 164 facilities.
A blockbuster example of a national payer vertically integrating home health at scale. It signals durable strategic and PE appetite for agencies with diversified payer mix and geographic density — not just top-line growth.
How a sell-side process works, end to end
A structured process is what turns "I got an offer" into "I ran a market and chose the best one." Each stage is designed to protect your confidentiality, your census, and your leverage — and to keep the Medicare change-of-ownership on track.
- 013–5 weeks
Preparation & positioning
Normalize financials, build the confidential information memorandum, and frame the payer-mix, census, and caregiver-retention story that moves your multiple.
- 021–2 weeks
Valuation & strategy
Establish a defensible value range and target the right buyer archetype — PE platform, strategic payer, or succession.
- 034–6 weeks
Confidential buyer outreach
Approach a curated set of vetted buyers under NDA. No public listing, no exposure to caregivers, referral sources, or patients.
- 042–4 weeks
Offers & LOI
Drive competitive tension to a deadline, compare structures side by side, and negotiate the letter of intent.
- 056–10 weeks
Diligence
Manage the buyer's quality-of-earnings, payer, clinical, and compliance/survey review while keeping the deal on track.
- 063–6 weeks
CHOW, close & transition
Coordinate the Medicare change-of-ownership (CMS-855A), state licensure, and accreditation transfer, then fund and execute the retention/transition plan that keeps caregivers and referral sources in place.
Deal structures owners should understand
Most home-health deals are not all-cash at close. Knowing the levers in advance — including how a Medicare CHOW affects timing and liability — is how you avoid leaving value or protection on the table.
Asset vs. equity sale
Whether the buyer purchases the agency's assets or the entity itself changes tax treatment, and it shapes successor liability under the Medicare provider agreement — a decision worth modeling before you go to market.
Earnouts
A portion of price tied to post-close census, admissions, or payer retention. Common in platform deals; the terms decide whether it is fair or a discount in disguise.
Escrow & holdbacks
Buyers often hold back part of the price against pre-close billing, RAC/UPIC audit exposure, and survey findings. Size and release timing are negotiable and material to your net proceeds.
Rollover equity & transition
Reinvesting part of your proceeds into the acquiring platform — a "second bite" if the platform grows and sells again — plus a negotiated retention and transition period during the CHOW. Standard in PE partnership structures.
What to fix before you go to market
The same levers buyers price are the ones you can move beforehand. In a 2026 market that rewards sustainable margins and compliance readiness over pure growth, addressing them early is the highest-ROI work an owner can do before a sale.
Diversify and document payer mix
Buyers pay up for a balanced Medicare, Medicare Advantage, Medicaid, and private-pay mix. Concentration in a single payer or referral source is discounted — make the mix explicit and durable.
Stabilize census and admissions
A steady, growing census with a diversified referral base is the core value driver. Document admissions trends, recertification rates, and episode volume so a buyer can underwrite them.
Shore up caregiver recruiting and retention
Turnover among nurses, aides, and therapists directly threatens census and margin. Demonstrable retention, staffing depth, and low agency-labor reliance protect the multiple.
Clean up survey and compliance history
A clean state survey and accreditation record, a functioning compliance program, and low audit exposure de-risk the deal. Unresolved deficiencies, ADRs, or repayment demands read as risk a buyer will price against you.
Frequently asked questions
Through a confidential sell-side process: prepare and value the agency, approach vetted buyers under NDA, drive competitive offers, negotiate the LOI, and manage diligence and the Medicare change-of-ownership to close. The goal is to run a market rather than accept a single inbound offer.
Medicare-certified skilled home health agencies commonly sell for roughly 4.5x–8x adjusted EBITDA, with scaled, multi-state platforms reaching 9x–12x+, while private-duty and non-medical home care typically clears 3x–6x. Payer mix, census stability, caregiver retention, and survey history drive where you land. See what your business is worth for a current estimate.
PE-backed home-health platforms and consolidators, strategic health systems and payers such as UnitedHealth / Optum and Humana / CenterWell, and individual succession buyers. In 2026, private equity and national payers are actively acquiring agencies with diversified payer mix and geographic density.
A home health sale triggers a CHOW filed with CMS on Form CMS-855A, plus state licensure transfer and accreditation. In an asset CHOW the buyer may assume your existing provider agreement — and its prior liabilities — and CMS's 36-month rule can block provider-number assignment if ownership changed too recently. Structure, escrow, and timeline all flow from these rules, so they should be planned early with counsel.
A well-run sell-side process typically runs five to eight months from preparation to close, with the Medicare change-of-ownership, licensure, and accreditation transfer often driving the back end of the timeline.
Start a confidential valuation conversation
No public listing, no upfront fees. Understand what your home health agency is worth and what a real sell-side process could deliver. 100% success fee · $0 upfront · $1B+ closed.