Agency owners
Selling your home health or hospice business
PE-backed platforms and post-acute strategics buy agencies with clean compliance, stable census and broad referrals.
By Axia Growth
What is my home health or hospice agency worth?
If you own a home health or hospice agency with under $2M of earnings, buyers price it on SDE (seller's discretionary earnings: profit plus the owner's pay and perks). In Axia Growth's analysis of closed small-business sales, Healthcare businesses with under $500K of SDE sold for a median 3.4x SDE (middle half 2.7x to 4.2x, 182 sales). Home health and hospice agencies are grouped in the Healthcare sector of that data; there is no figure for home health and hospice agencies alone.
| Earnings size | Median | Middle half | Sales |
|---|---|---|---|
| Under $500K SDE | 3.4x SDE | 2.7x to 4.2x | 182 |
| $500K-$1M SDE | 3.4x SDE | 2.5x to 4.4x | 42 |
| $1M-$2M SDE | 3.3x SDE | 2.7x to 7.5x | 22 |
| $2M-$3M EBITDA | 5.1x EBITDA | 3.1x to 10.9x | 13 |
| $5M-$10M EBITDA | 8.8x EBITDA | 3.4x to 10.7x | 14 |
| $10M+ EBITDA | 12.9x EBITDA | 9.4x to 18.5x | 17 |
Larger businesses, with $2M or more of EBITDA, are usually priced on an EBITDA multiple instead. For the Healthcare sector the median was 5.1x at $2M to $3M of EBITDA (13 sales), 8.8x at $5M to $10M of EBITDA (14 sales) and 12.9x at $10M+ of EBITDA (17 sales). No figure is published for $3M to $5M of EBITDA: fewer than 10 sales.
Example
Take a home health or hospice agency with $400,000 of SDE. $400,000 x 3.4x (the median for under $500K of SDE) = about $1,360,000. At the middle half of sales (2.7x to 4.2x), the same business lands between about $1,080,000 and $1,680,000. This is arithmetic on a published median, not a valuation of your business.
What moves the price of a home health or hospice agency:
- An enrollment history outside the change-of-ownership look-back window, with no open ownership-change issues.
- Stable or rising census fed by several referral sources, not a single hospital or physician group.
- Clean state surveys and accreditation, with no open program-integrity reviews.
- Management and clinical leadership that can run the agency without the founder.
Source: Axia Growth analysis of 4,554 closed small-business sales over $500K, aggregated and de-identified. Sector-level medians; a size band is published only when it has at least 10 sales. Data as of October 28, 2026. How the data is built.
Get an instant range with the business value calculator · Read the Home Health & Hospice industry guide
Not an auction.
One acquirer, one direct conversation. Our buyers typically keep the team and have the capital to close.
How long it takes to sell a home health or hospice agency
Axia Growth does not publish an average time to sell, because the honest answer depends on you more than on the market: a sale moves as fast as you can answer a buyer's questions. Every sale goes through the same five stages.
- Prepare. Separate personal and business expenses, pull two to three years of financials, and list what transfers with the business. The cleaner this is, the faster everything after it goes.
- First conversations. A buyer learns the business and your goals, and you learn what they plan to do with the home health or hospice agency and your team.
- Letter of intent. The buyer puts price, structure (cash at close, seller note, earnout) and your role after the sale in writing. It is usually non-binding, with a period of exclusivity.
- Diligence. The buyer checks financials, customers, staff and contracts, and will check enrollment and ownership-change history first, review census, referral-source concentration and payer mix, look at survey and accreditation history, and, for hospice, model aggregate cap liability by year. Most delays happen here, and most trace back to missing records.
- Close and transition. Final agreements are signed, money moves, and you help hand over customers and staff for an agreed period.
Who buys home health and hospice agencies
- PE-backed home health and hospice platforms. They want new platform investments and add-ons, with hospice a steady focus.
- Public post-acute companies. They want agencies and locations that take them into new markets and adjacent home-based services.
- Health-system and regional buyers. They want established agencies, sometimes several at once when a health system sells.
- Independent sponsors. They want agencies with clean records and leaders who can run them without the founder.
What buyers pay for
- A clean compliance and survey history.
- Stable or rising census from several referral sources.
- Strong financials and a favorable payer mix.
- Leaders who can run the agency without the founder.
What hurts value
- A recent enrollment or ownership change that buyers flag in diligence. They review that history before they price anything.
- Census that depends on a single hospital or physician group.
- Open program-integrity reviews or a weak survey and accreditation record.
- For hospice, long average stays that create aggregate cap repayment exposure.
- An agency that depends on the founder, without management and clinical leaders who can run it.
How to prepare
- Get 2 to 3 years of books clean and separate.
- Gather enrollment, ownership-change and survey records.
- Track census, referral sources and, for hospice, cap history.
For deal activity, buyer types and every published size band, see home health or hospice valuation multiples→ Or see every Healthcare Servicesguide →
Common questions
What is my home health or hospice agency worth?
If you own a home health or hospice agency with under $2M of earnings, buyers price it on SDE (seller's discretionary earnings: profit plus the owner's pay and perks). In Axia Growth's analysis of closed small-business sales, Healthcare businesses with under $500K of SDE sold for a median 3.4x SDE (middle half 2.7x to 4.2x, 182 sales). Home health and hospice agencies are grouped in the Healthcare sector of that data; there is no figure for home health and hospice agencies alone. Larger businesses, with $2M or more of EBITDA, are usually priced on an EBITDA multiple instead. For the Healthcare sector the median was 5.1x at $2M to $3M of EBITDA (13 sales), 8.8x at $5M to $10M of EBITDA (14 sales) and 12.9x at $10M+ of EBITDA (17 sales). No figure is published for $3M to $5M of EBITDA: fewer than 10 sales. Example: Take a home health or hospice agency with $400,000 of SDE. $400,000 x 3.4x (the median for under $500K of SDE) = about $1,360,000. At the middle half of sales (2.7x to 4.2x), the same business lands between about $1,080,000 and $1,680,000. This is arithmetic on a published median, not a valuation of your business. Source: Axia Growth analysis of 4,554 closed small-business sales over $500K, aggregated and de-identified. Sector-level medians; a size band is published only when it has at least 10 sales. Data as of October 28, 2026.
How long does it take to sell a home health or hospice agency?
Axia Growth does not publish an average time to sell, because the honest answer depends on you more than on the market: a sale moves as fast as you can answer a buyer's questions. Every sale goes through the same five stages. Prepare, first conversations, letter of intent, diligence, then close and transition. For home health and hospice agencies, the longest stage is usually diligence, where buyers check enrollment and ownership-change history first, review census, referral-source concentration and payer mix, look at survey and accreditation history, and, for hospice, model aggregate cap liability by year.
Does my enrollment history affect a sale?
It can. Buyers check when the agency was enrolled, acquired or last changed ownership, and they look at this before they price anything. Have those dates and records ready before the first conversation.
What do buyers look at in a hospice?
Beyond census and referrals, hospice buyers review aggregate cap history by year. Long average lengths of stay can lead to repayments, so a record of staying under the cap with no recent repayment demands helps.
Does it matter which state I operate in?
It can. Buyers expect longer diligence and more structuring questions in states with heightened screening or advance-notice rules for investor-backed deals. A licensed footprint in a certificate-of-need state can add value because it limits new competitors.
How do I get a number for my own business?
Enter your industry and annual earnings (SDE or EBITDA) in Axia Growth's free business value calculator for an instant range from the same closed-sales data. For a detailed valuation, continue from the calculator; it is free and confidential. The Home Health & Hospice industry guide shows every published size band for the sector.
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