Question 1

How do I sell my home care agency?

Accepted Answer

Start by getting a realistic value, then prepare before you go to market. That means clean financials with defensible add-backs, organized licenses and payer contracts, and a team that can run the agency without you. Next, a sell-side advisor builds a confidential summary and takes it to several qualified buyers so you can compare offers. After you accept a letter of intent, the buyer runs diligence and the lawyers draft the purchase agreement. Rules for transferring licenses and Medicare or Medicaid enrollment vary by state and payer, so plan for them early.

Question 2

What is a sell-side home care business broker?

Accepted Answer

A sell-side broker or M&A advisor represents only the owner who is selling. Their job is to get the seller the best overall outcome: price, terms, timing and a good fit for staff and clients. That is different from a firm that also represents buyers or earns fees from them. Acquire Care is a sell-side-only healthcare M&A and business brokerage firm founded by Jake Knopfler, who spent 12 years on the operating side of home care. We never represent the buyer in a deal.

Question 3

Do I need a broker to sell my home care agency?

Accepted Answer

No law requires one, and some owners sell directly to a buyer who calls them. The risk is that one interested buyer sets the price and the terms, and you have nothing to compare it to. A sell-side advisor prepares the company, keeps the process confidential, finds multiple qualified buyers and helps you negotiate structure, escrow and transition terms. At Acquire Care we say one buyer is no buyer. Whether an advisor is worth the fee depends on the size of your agency and how much competition they can create.

Question 4

How is a home care specialist different from a general business broker?

Accepted Answer

A general broker may sell restaurants, car washes and agencies in the same month. Home care buyers ask about things those brokers rarely see: payer mix, Medicaid waiver authorizations, Medicare certification, caregiver turnover, change-of-ownership rules and survey history. A specialist knows how those items move value and how to present them before a buyer finds them. Jake Knopfler works only on home care and healthcare sales, drawing on 12 years operating in home care, and Acquire Care represents sellers only.

Question 5

How long does it take to sell a home care agency?

Accepted Answer

It depends on how prepared you are, the size of the agency, the buyer type and the regulatory steps in your state. Preparation can take a few months, marketing and offers several more, and diligence and closing after that. Deals that need state license approval, Medicare change-of-ownership processing or Medicaid re-enrollment can take longer. Owners who plan two to three years ahead usually have more options, because they have time to fix issues that would lower value.

Question 6

When is the right time to sell?

Accepted Answer

The best time is usually when the business is healthy and you are not forced to sell. Buyers pay for steady or growing earnings, stable staff and a clear payer picture. Outside factors matter too, such as Medicaid rate changes, labor markets and how active buyers are. You can't control those, but you can control how prepared you are. If you are thinking about selling in the next one to three years, the time to start getting ready is now.

Question 7

What is my home care agency worth?

Accepted Answer

Most home care agencies are valued as a multiple of earnings, usually seller's discretionary earnings (SDE) for smaller agencies or adjusted EBITDA for larger ones. The multiple depends on size, growth, payer mix, service line, staff stability, how much the business relies on the owner, and the state. There is no single correct multiple, and anyone quoting one without seeing your numbers is guessing. Acquire Care offers a free 15-minute call to give owners a starting point.

Question 8

What are add-backs, and why do they matter?

Accepted Answer

Add-backs are expenses that run through your business but would not continue for a new owner, such as your personal car, a family member on payroll who doesn't work there, or a one-time legal bill. Adding them back raises the earnings a buyer uses to price your agency. Buyers will test every add-back in diligence, so each one needs records behind it. Weak or aggressive add-backs can hurt trust and lower the final price.

Question 9

How does payer mix affect value?

Accepted Answer

Buyers look at where your revenue comes from: private pay, Medicaid (often through managed care plans or waivers), Medicare, VA or long-term care insurance. Each carries different rates, collection timing and policy risk. Heavy reliance on one payer or one managed care contract can worry buyers, while a balanced mix can widen the buyer pool. How a buyer reads your mix also depends on the buyer: some prefer private pay, others specialize in Medicaid. The details vary by state.

Question 10

Is nonmedical home care valued differently from home health, hospice or private duty nursing?

Accepted Answer

Yes. Nonmedical personal care, Medicare-certified home health, private duty nursing, hospice and home infusion each have different payers, licenses, labor models and buyer groups. Medicare-certified agencies bring certification and survey history into the picture, while nonmedical agencies are judged heavily on caregiver supply and private pay or Medicaid hours. A buyer for one may have no interest in another. Treating them as the same business is one of the most common pricing mistakes.

Question 11

Why won't buyers pay the price I think my agency is worth?

Accepted Answer

Usually because what the agency pays you is not the same as what it is worth to someone else. If you run recruiting, scheduling and referrals yourself, a buyer has to replace that work, and they price that cost and risk in. Thin records, one large referral source or one payer, and high caregiver turnover also pull value down. The fix is often preparation: building a team that runs without you and records that support your numbers.

Question 12

Does my staff affect what buyers will pay?

Accepted Answer

A great deal. In home care, caregivers and nurses are the product. Buyers ask about turnover, recruiting pipelines, open shifts, overtime and whether key managers will stay. An agency that can staff the hours it is authorized for is easier to grow and easier to finance. Strong retention, documented recruiting and a capable office team can make your agency more attractive than a competitor with similar revenue.

Question 13

Who buys home care agencies?

Accepted Answer

Common buyers include larger strategic operators, private equity-backed platforms adding locations, independent sponsors and search funds, and individual buyers, often first-time owners. Each values and structures deals differently. A strategic buyer may pay for fit with its existing markets, while an individual buyer may rely on SBA financing and need you to stay on for a transition. Knowing who is across the table helps you judge offers.

Question 14

How do I know if a buyer is serious?

Accepted Answer

Watch the questions they ask and how they ask them. Serious buyers ask about staffing, payer contracts, compliance and how the agency runs day to day, and they can show how they will pay. Warning signs include pushing for exclusivity early, vague answers about financing, or asking for sensitive data before signing a confidentiality agreement. A competitive process makes this easier to see, because you can compare buyers side by side.

Question 15

What are escrow and indemnification, and why do buyers ask for them?

Accepted Answer

Indemnification is your promise to cover certain losses if something you said about the business turns out to be wrong, or if a problem from before closing shows up later, such as a payer recoupment. Escrow or a holdback sets part of the price aside for a period to back that promise. Buyers ask for them because they are taking on a business they don't fully know yet. The amounts, time limits and caps are negotiable and should be reviewed with your attorney.

Question 16

Will I have to stay on after the sale?

Accepted Answer

Often, for some period. Buyers want referral sources, staff and key accounts to stay through the handoff, and many ask the seller to help with a transition. That could be a few weeks or longer, paid or unpaid, and sometimes it is tied to an earn-out or a seller note. The length and terms are negotiable. The less the agency depends on you before the sale, the shorter and lighter that commitment tends to be.

Question 17

What is an earn-out or seller note?

Accepted Answer

An earn-out pays part of the price later if the business hits agreed targets after closing. A seller note means you finance part of the price and the buyer pays you over time. Both can help close a gap between what you want and what a buyer will pay up front, but both put some of your money at risk after you give up control. Clear targets, security and legal review matter.

Question 18

Should I sell to the first buyer who calls me?

Accepted Answer

Not without comparing. An unsolicited offer can be real, but with only one buyer you have no way to know if the price and terms are fair, and the buyer knows it. Many owners who sign early exclusivity find the terms change during diligence. Hearing from several qualified buyers protects price, terms and your ability to walk away. At Acquire Care, our rule is simple: one buyer is no buyer.

Question 19

Do my licenses and Medicaid or Medicare contracts transfer to a buyer?

Accepted Answer

It depends on the deal structure, the state and the payer. In a stock sale, the legal entity holding the license and provider numbers usually stays the same, though change-of-ownership notices or approvals are often still required. In an asset sale, the buyer may need new licenses or enrollments, which can take time. Medicare, state Medicaid programs and managed care plans each have their own rules. Check them early with a healthcare attorney.

Question 20

Does a license or certificate of need add value?

Accepted Answer

In some states, yes. Where new home care or home health licenses are limited, slow to get, or require a certificate of need, an existing license can be worth something on its own, because a buyer saves time and uncertainty. Where licenses are easy to get, they add less. Rules differ by state and service type, and they change, so the value of a license has to be checked state by state.

Question 21

How do audits, payment suspensions or compliance issues affect a sale?

Accepted Answer

Buyers will ask about past audits, recoupments, survey results and any open investigations. An issue doesn't always kill a deal, but surprises found late can lower the price, add escrow or end talks. Regulators in many states have increased scrutiny of home care billing. The best approach is to know your own history, fix what you can, and disclose it early with a plan. Your attorney should guide how it is handled.

Question 22

Does my state change how my agency is valued?

Accepted Answer

Yes. States differ in Medicaid rates, waiver programs, managed care setup, licensing barriers and labor costs, and buyers price those differences in. Concentration in one region or one program can also matter. Acquire Care's 50 States of Care series looks at specific markets, including Georgia, Texas, Ohio, Connecticut, Massachusetts, New Mexico and North Carolina.

Question 23

When should I tell my employees I'm selling?

Accepted Answer

Most sellers keep a sale confidential until late in the process, often near or after signing, because early news can cause staff to leave, clients to worry and competitors to recruit. Key managers may need to know sooner if they are part of diligence or the transition. A good process uses confidentiality agreements and shares sensitive information in stages. When you tell your team, have a clear plan for what changes and what doesn't.

Question 24

What should I do now if I might sell in two or three years?

Accepted Answer

Get a baseline value so you know where you stand. Clean up your financials and separate personal expenses. Reduce how much the agency depends on you by building a manager and documenting how things run. Strengthen recruiting and retention, review licenses and payer contracts, and fix any compliance gaps. Owners who prepare early usually have more buyers to choose from and more control over terms.

Question 25

What happens on a first call with Acquire Care, and what does it cost?

Accepted Answer

The first call is a free, confidential 15-minute conversation with Jake. You talk through your current pain points, your long-term plans and where value could be added before a sale. There is no obligation to sell or to hire anyone. If it makes sense to keep going, Jake explains how Acquire Care would represent you and what the engagement terms look like.

Selling your agency: the basics