Is Florida a good state to sell a home care agency in?

Yes. Florida is one of the most active home care M&A markets in the US, driven by strong senior demographics, an active PE buyer pool, and significant strategic acquirer presence. Multiples for quality Florida agencies are at or above national benchmarks across home care, home health, and hospice.

What licenses do Florida home care agencies need, and how do they transfer in a sale?

Florida home care agencies are licensed by the Agency for Health Care Administration (AHCA). Common licenses include Home Health Agency, Nurse Registry, Homemaker and Companion Services, and Home Medical Equipment. Licenses do not automatically transfer in a sale; the buyer typically applies for change of ownership (CHOW) approval through AHCA, with timelines and process varying by license type.

Does Florida have Certificate of Need (CON) for home health or hospice?

Florida eliminated CON for most healthcare services, including hospice, in recent years. Hospice CON was repealed effective 2025, opening the Florida hospice market to new entry. This has affected hospice valuations and M&A dynamics significantly.

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

A typical sale process from engagement through close runs 6 to 9 months for non-medical home care, 7 to 10 months for Medicare-certified home health (due to CHOW timelines), and 7 to 10 months for hospice. Florida-specific licensing and CHOW timelines should be planned for early.

Selling a Home Care Agency in Florida 2026

Florida is one of the most active home-based care M&A markets in the United States. Strong senior demographics, a deep PE buyer pool, significant strategic acquirer presence, and recent regulatory shifts have combined to make Florida a structurally attractive state for sellers across home care, home health, and hospice.

This guide covers what Florida agency owners should understand about selling in the current market — buyer landscape, valuation context, licensing mechanics, and the specific issues that come up in Florida transactions.

Why Florida Is a Strong Selling Market

Several factors converge:

Demographics. Florida has the highest proportion of residents 65+ of any large state, and net in-migration of retirees continues. The 75+ population — the most relevant cohort for home care, home health, and hospice utilization — is growing meaningfully faster than the national average.

Buyer concentration. Most major PE-backed home care, home health, and hospice platforms have Florida as a priority acquisition geography. Several platforms were built around or are headquartered in Florida (Aveanna in Atlanta with deep Florida operations, multiple hospice platforms with Florida footprint).

Payer mix. Florida agencies typically have a heavier private pay and Medicare Advantage mix than national averages, which is attractive to buyers concerned about Medicaid rate adequacy and 80/20 rule exposure.

Recent regulatory shifts. The 2025 repeal of hospice CON in Florida fundamentally changed hospice M&A dynamics — increasing both new entry and acquisition activity.

Florida-Specific Licensing and Regulatory Context

Agency for Health Care Administration (AHCA)

Florida home-based care licensure is administered by AHCA. Common license types in M&A transactions include:

Home Health Agency (HHA) — Medicare-certified or non-certified
Nurse Registry — staffing model for private duty nursing
Homemaker and Companion Services — non-medical
Home Medical Equipment Provider
Hospice

License-specific requirements, surveys, and inspection histories all become diligence items in a sale.

Change of Ownership (CHOW)

Florida licenses do not automatically transfer with the sale of a business. Buyers must apply for CHOW approval through AHCA, with timelines varying by license type. CHOW is one of the most operationally important variables in a Florida transaction:

Non-medical (homemaker/companion): typically faster CHOW process, often weeks to a few months
Nurse Registry: moderate timeline
Home Health Agency (Medicare-certified): longer process; coordination with CMS for the Medicare provider number transfer is the longer-pole
Hospice: moderate to long, depending on AHCA workload

CHOW timelines drive the closing structure — many transactions use a management services arrangement during the gap between deal signing and CHOW approval, with the buyer operating under the seller’s license through closing.

Certificate of Need (CON) — Recently Repealed for Hospice

Florida eliminated CON for most healthcare services, and hospice CON was repealed effective 2025. This is one of the most consequential recent regulatory shifts in the state:

Pre-repeal, hospice CON limited new entry and supported scarcity-driven valuations for incumbent hospice providers in their service areas
Post-repeal, new hospice entry is permitted across the state, increasing competition over time
The immediate effect on M&A has been increased activity from out-of-state and PE-backed hospice platforms entering Florida via acquisition rather than waiting for de novo build-out

Florida hospice owners should understand that the post-CON market has more buyers but also more competitive pressure on the underlying business.

EVV and Medicaid

Florida participates in EVV requirements for Medicaid HCBS personal care. Compliance gaps create both regulatory and billing risk that buyers will diligence carefully.

Valuation Context for Florida Agencies

Multiples for Florida home-based care agencies generally meet or exceed national benchmarks, particularly for:

Hospice — Florida hospice agencies have historically commanded premium multiples; post-CON repeal, premium multiples remain for established agencies with strong census, referral diversification, and Medicare cap headroom
Private pay home care — strong demographic tailwinds support multiples at the high end of national ranges
Pediatric PDN — Florida has an active pediatric PDN buyer market with several platforms acquiring
Medicare-certified home health — solid market, with the usual emphasis on star ratings, LUPA rates, and survey history

Discount drivers in Florida specifically:

High caregiver wage pressure in South Florida and major metros
Hurricane and weather-related operational risk (continuity planning matters in diligence)
Medicaid managed care concentration (Florida’s Medicaid managed care structure means MCO contract concentration is a real diligence item)

The Buyer Landscape in Florida

Active buyers for Florida home-based care assets include:

Hospice platforms — Compassus, Bristol Hospice, Agape Care, Three Oaks, Traditions, multiple PE-backed regional platforms
Home care platforms — Help at Home, regional PE-backed platforms, franchise systems with Florida growth strategies
Pediatric platforms — Aveanna, Care Options for Kids, regional pediatric platforms
Strategic health systems — Florida health systems acquiring home health and hospice in their service areas

The buyer pool is deep. A well-run Florida sale process typically generates strong competitive interest.

Practical Considerations for Florida Sellers

Plan for CHOW Timing Early

Build CHOW into your sale timeline from the start. A buyer’s diligence will include reviewing your AHCA inspection history, deficiency reports, plan of correction history, and current standing. Anything that complicates CHOW approval becomes a negotiation point.

Get a Florida-Aware Valuation

Generic national valuation benchmarks miss Florida-specific variables: post-CON hospice dynamics, Medicaid managed care contract economics, hurricane operational risk, geographic micro-markets (Miami-Dade, Broward, Tampa Bay, Orlando, Jacksonville, North Florida each have distinct buyer dynamics).

Document Hurricane and Continuity Planning

Florida buyers diligence operational continuity planning carefully. Documented business continuity plans, emergency staffing protocols, generator and backup arrangements, and insurance coverage become favorable diligence items.

Understand Your Medicaid Managed Care Concentration

If you have meaningful Medicaid HCBS or PDN revenue, your concentration across Florida MCO contracts (Sunshine, Humana, Molina, Simply, etc.) is a key diligence item. MCO contract renewal risk gets discounted; diversified contract relationships get rewarded.

Consider Multi-Service Line Positioning

Florida buyers often value agencies that offer combined service lines (home health + hospice, home care + PDN, etc.) at premium multiples versus single-line operators of similar EBITDA.

Common Mistakes Florida Sellers Make

Engaging a single inbound buyer without competitive process. Florida sees heavy inbound BD activity. Direct response to one buyer typically produces 15–25% lower outcomes than running a structured process with three to seven serious buyers.
Ignoring CHOW timeline implications. Failing to plan around CHOW creates last-minute structuring problems.
Underestimating post-CON competitive pressure in hospice. The market has changed; pricing assumptions from the pre-2025 regime no longer apply.
Inadequate documentation of compliance history. AHCA inspection history is public; buyers find weaknesses fast and discount accordingly.
Not having a Florida-experienced advisor. State-specific licensing, MCO dynamics, and buyer relationships matter materially in execution.

Strategic Implications

Florida is a strong selling market in 2026 for quality home-based care agencies. The combination of demographic tailwinds, active buyer pool, and post-CON hospice dynamics creates favorable conditions, but execution discipline matters: CHOW planning, competitive process design, and Florida-specific buyer targeting are the difference between a good outcome and a great one.

If you operate a home care, home health, hospice, or pediatric agency in Florida and would like to understand current market conditions for your specific business, contact us for a confidential conversation.

Selling a Home Care Agency in Florida: 2026 Market Guide