Established New York Home Care Agency, Medicaid-Funded, $19M Revenue

$19.0M

Revenue

$2.4M

SDE

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Full Editorial Writeup

This is an established New York home care agency delivering personal care and supportive services to seniors and individuals with disabilities across the New York metropolitan area. Built over more than a decade, the business runs on an established caregiver network, experienced administrative staff, and long-standing community relationships. It is a scaled operation doing $19M in revenue with $2.35M in EBITDA, funded primarily through Medicaid and managed care programs.

The revenue model is the attraction here. Medicaid and managed care payers generate recurring service hours and repeat client demand, which creates a durable base of billing that does not evaporate in a downturn. The company maintains multiple referral sources and payer relationships, and its broad service offering lets it serve a diverse client census across its operating territory. Intake, scheduling, caregiver management, compliance, and administrative systems are already in place to support the current scale.

The seller is retiring after a long ownership run and is offering a transition period to preserve continuity. The listing frames the buyer profile as a strategic home care operator, a healthcare platform, or a financial buyer seeking a New York-based operation with meaningful scale and a clear runway for census growth, additional referral relationships, and expansion into other New York and Tri-State markets.

Why we like it

Earnings quality is anchored in Medicaid and managed care billing, which produces recurring service hours and repeat client demand rather than one-off sales. At $19M revenue and $2.35M EBITDA the margin sits around 12 percent, typical for personal care agencies where labor is the dominant cost, but the reimbursement base is sticky and predictable.
Durability comes from more than a decade of operating history, an established caregiver network, and long-standing referral relationships. Home care licensure and payer enrollment in New York are meaningful barriers to entry, so the existing platform and compliance infrastructure are hard to replicate quickly.
Market tailwinds are strong and structural. An aging population, a policy preference for in-home care over institutional settings, and New York's large Medicaid home care spend all support continued demand for these service hours.
The operator advantage is scale plus fragmentation. This is already a scaled census with intake, scheduling, and compliance systems built out, and the industry is full of small subscale agencies that make it a natural roll-up or add-on for a strategic buyer seeking additional New York coverage.

How to improve it

Attack caregiver recruiting capacity in the first 90 days, since in this business the binding constraint on revenue is fillable hours, not client demand. Every additional recruited and retained aide converts directly into billable service hours against existing authorizations.
Expand managed care contracting by pursuing additional MLTC and MCO relationships. Broadening the payer panel reduces concentration risk and opens new authorized-hour volume without needing to build new geography.
Deepen penetration within the existing service area by strengthening referral relationships with hospitals, discharge planners, and community organizations. Growing census inside the current footprint is cheaper and faster than opening new markets.
Tighten scheduling and utilization to reduce unfilled shifts and overtime leakage. Small improvements in fill rate and shift efficiency flow straight to EBITDA given the thin margin structure.
Build out specialized Medicaid service offerings such as CDPAP or higher-acuity programs where reimbursement and demand support it. Diversifying the service mix can lift blended rates and stabilize the census.
Pursue tuck-in acquisitions of smaller subscale agencies in the Tri-State area to add census and caregiver headcount. Integrating them onto the existing compliance and scheduling platform captures overhead synergies.
Institutionalize the back office and management layer so the business is not dependent on the retiring owner. Documenting intake, billing, and compliance workflows protects continuity and supports a cleaner future exit.

Diligence notes

Scrutinize payer concentration and reimbursement rates across Medicaid and managed care. Understand how CDPAP reforms, wage parity, and any pending New York rate changes could compress the roughly 12 percent margin.
Verify all licensure, certification, and Medicaid provider enrollment, plus compliance history with audits, clawbacks, and any outstanding recoupment liabilities. In this space a single failed audit or lapsed license can impair the entire revenue base.
Test caregiver turnover, wage costs, and overtime exposure, and confirm whether staff are W-2 or contracted. Labor availability is the operational choke point, so churn and recruiting economics are core to sustaining the census.
Confirm the quality of the $2.35M EBITDA by reviewing add-backs, owner compensation, and working capital tied up in slow Medicaid receivables. Home care collections cycles can lock up meaningful cash, so map DSO and any billing backlog.
Assess owner dependence given the retirement-driven sale. Identify who runs intake, compliance, and payer relationships day to day, and lock the retiring owner into a transition and non-compete before close.

Source

Originally listed on BizBuySell. View original listing →