Miami Home Health Care Agency, 17-Year Medicare & Medicaid Provider

$2.5M

Revenue

$510K

SDE

4.9x

Multiple

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Full Editorial Writeup

This is a 17-year-old home health care agency serving Miami-Dade County, offering a full menu of services including Medicare home health, Medicaid long-term care, personal aide services, private-duty nursing, and in-home physical therapy. The payer mix runs roughly 31% Medicare and 69% Medicaid, and the agency currently serves about 86 active clients per month, split between roughly 30 Medicare cases and 56 Medicaid Waiver long-term care cases. Referrals flow in from doctors, hospitals, and word-of-mouth from families and staff, which is the low-cost acquisition engine that makes this category attractive.

The business runs lean on paper: nine W2 employees anchoring the office and clinical management, plus over 100 field staff paid as per-service contractors. That structure keeps labor variable and margins protected, though it also raises the classic home-health question of worker classification. Trailing twelve month revenue is $2.514M with adjusted EBITDA of $510,000, a roughly 20% margin that is healthy for the space.

What stands out is the trajectory: gross revenue was $1.9M in 2023, dipped to $1.8M in 2024, then jumped about 20% to $2.179M in 2025 and now sits at $2.514M trailing. The seller is retiring and describes themselves as primarily hands-off with the team staying in place, which is exactly the profile a buyer wants: a durable, essential-service book of business with an operational spine that survives the transition.

Why we like it

Earnings quality is genuinely recurring here. Home health is care delivered week after week to the same patient panel under Medicare and Medicaid reimbursement, not one-off transactions, so the $510K EBITDA is built on a returning book rather than perpetually re-won sales. The 20% jump to $2.179M in 2025 and $2.514M trailing shows the revenue base is expanding, not eroding.
The moat is regulatory and relationship-based. A 17-year-old licensed agency with active Medicare certification and Medicaid Waiver contracts carries barriers to entry that a new operator cannot replicate overnight, and the referral pipeline from doctors and hospitals is sticky. That combination protects pricing and volume in a way pure discretionary services cannot.
The demographic tailwind is real and durable. South Florida has one of the densest aging populations in the country, and the listing flags huge growing demand for in-home care. Aging-in-place is a multi-decade secular trend, and home health is one of the few categories that gets cheaper and more attractive to payers as hospital costs rise.
This is recession-resistant essential care with an operator-run team already in place. Nine W2 staff plus 100-plus field contractors keep running post-sale, and the seller being hands-off means the org chart does not depend on the owner. A buyer is acquiring a functioning machine, not a job disguised as a business.

How to improve it

Rebalance the payer mix toward higher-margin Medicare and private-pay. The book is 69% Medicaid, which is lower-reimbursement and slower-paying, so a deliberate push on Medicare home health referrals and cash private-duty nursing would lift blended revenue per case within the first two quarters. Track margin by payer to know exactly where the dollars are strongest.
Systematize and expand the referral engine. Referrals currently come organically from doctors, hospitals, and word of mouth, which means there is likely no formal business development function. Hiring or assigning a dedicated community liaison to work discharge planners and physician offices could meaningfully increase active case count above the current 86 per month.
Audit and harden contractor classification immediately. With over 100 field staff paid as per-service contractors, worker classification is the single biggest structural risk and also an opportunity to formalize. Getting the classification defensible protects margin and removes a discount buyers will otherwise apply.
Increase active clients per month with existing capacity. The agency serves only about 86 active clients despite 17 years in a market with surging demand, suggesting intake and scheduling capacity is underutilized. Investing in intake speed and staffing depth could grow caseload without proportionally growing overhead.
Tighten billing and collections cycle time. Medicaid and Medicare reimbursement timing directly drives working capital, so a review of days-to-collect and denial rates can free cash and improve realized EBITDA. Small improvements in first-pass claim acceptance compound quickly at this revenue scale.
Build a light management layer to reduce owner dependence further. The seller is already hands-off, but formalizing a clinical director and operations manager with documented SOPs makes the business more valuable and more scalable. This also positions the agency as a platform for tuck-in acquisitions of smaller local agencies.

Diligence notes

Reconcile the revenue history and the trailing figure carefully. The listing shows $1.9M in 2023, $1.8M in 2024, then $2.179M in 2025 and $2.514M trailing (June 25 to May 26), which mixes calendar and trailing periods and includes a forward-dated window. Verify the actual collected revenue and adjusted EBITDA against bank deposits, tax returns, and billing reports before trusting the 20% growth narrative.
Scrutinize contractor classification and its liability exposure. Paying 100-plus field staff as per-service contractors in home health is a common audit and reclassification target, and a reclassification would raise labor cost and payroll tax substantially. Confirm the structure is defensible and quantify the downside if a buyer needs to convert staff to W2.
Confirm the licenses, Medicare certification, and Medicaid Waiver contracts transfer cleanly. Home health value lives in its regulatory standing, so verify there are no survey deficiencies, no pending recoupments, no probationary status, and that ownership change of information will not trigger re-enrollment delays or gaps in billing. A lapse here can freeze cash flow.
Assess referral source concentration and payer dependence. With 69% Medicaid and referrals from doctors and hospitals, understand whether a few discharge planners or facilities drive most intake and how sensitive the book is to reimbursement rate changes. Ask for a case-by-case payer and referral source breakdown for the trailing year.
Validate the owner's hands-off claim and post-sale continuity. The seller says the office and field teams remain, but confirm which specific individuals are essential, whether the clinical leadership stays, and what the owner personally does day to day. Structure a transition agreement and retention terms for key staff before closing.

Source

Originally listed on BizBuySell. View original listing →