How long does a change of ownership take?

It depends on the state and the payer programs involved. It is usually the longest item on the closing schedule, so we start it first.

Will my caregivers be retained?

That is the intent; the workforce is the business. Retention terms can be documented.

Do you buy agencies with private pay only?

Yes. Private pay avoids much of the enrollment complexity, though it has its own referral concentration questions.

Selling a home healthcare or DSP agency

Home care and direct support provider agencies are valued on authorized service hours, payer mix and compliance history. The transaction is governed as much by the licensing and change-of-ownership process as by the purchase agreement, and that process sets the timeline more than the financing does.

Written and reviewed by Antoine Campbell. Last reviewed 2026-08-12.

Payer mix and authorized hours

Utilization against authorization is the operational tell. Agencies that cannot staff their authorized hours are leaving revenue on the table, which is an opportunity for a buyer and a discount for a seller who has not fixed it.

Medicaid waiver programs, managed care organizations, private pay and VA sources
Authorized hours per client and actual utilization against authorization
Rate structure by service line and any pending state rate changes
Client census stability and referral sources

Change of ownership is the timeline

Licensure, provider agreements and payer enrollments generally do not transfer automatically. Requirements vary by state and by program, and the change-of-ownership process for Medicare and Medicaid enrollment has its own defined steps and timelines administered by CMS and the state agency.

This is the single largest scheduling factor. Start it early, and structure the closing around it rather than pretending it will keep pace with the financing.

Caregiver workforce

Caregiver count, turnover rate and average tenure
Wage rates relative to the local market and to reimbursement
Scheduler and coordinator capacity, which is the real operating constraint
Background check, training and credentialing compliance
Overtime patterns and any wage and hour exposure

Compliance diligence

Billing compliance is where value is destroyed after closing. A buyer who does not test documentation against claims is buying a recoupment risk, so expect that testing to happen.

Survey and inspection history with any deficiencies and corrective plans
Documentation quality: visit verification, notes, timesheets tied to billing
Any audits, recoupments or payment suspensions
HIPAA policies and any breach history
Electronic visit verification compliance

What Maurant needs to evaluate this

Three years of tax returns and current financials
Revenue by payer and by service line
Client census with authorized versus delivered hours
Licenses, provider agreements and enrollment documentation
Survey history and corrective action plans
Caregiver roster with turnover data

When Maurant is not the right buyer

Agencies under payment suspension or active fraud investigation
Providers with systemic documentation failures behind the billing
Operations dependent on the owner personally holding a clinical credential with no successor

Questions owners ask

How long does a change of ownership take?: It depends on the state and the payer programs involved. It is usually the longest item on the closing schedule, so we start it first.
Will my caregivers be retained?: That is the intent; the workforce is the business. Retention terms can be documented.
Do you buy agencies with private pay only?: Yes. Private pay avoids much of the enrollment complexity, though it has its own referral concentration questions.

Sources

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