Two Texas Medicaid PAS Agencies, El Paso Home Care, Est. 2008

$8.7M

Revenue

$517K

SDE

4.8x

Multiple

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Full Editorial Writeup

This deal bundles two commonly owned, separately licensed Texas Medicaid Personal Assistance Services (PAS) agencies operating out of a single El Paso facility. The agencies deliver non-technical, medically related personal care in clients' homes, helping eligible Medicaid members with activities of daily living under a practitioner's statement of medical need. One entity was incorporated in 2008 and the other has been an enrolled provider since 2013. Both are sold together as a single stock transaction so the payer contracts carry over intact. Combined trailing twelve month revenue was $8,740,423 with adjusted EBITDA of $517,447.

The revenue base rests on four Medicaid payer relationships: a direct Texas HHSC contract through TMHP (33.3 percent), and managed care contracts with El Paso Health (33.5 percent), Molina Healthcare (32.6 percent), and a sliver from Superior HealthPlan. The larger agency holds the direct state contract covering Primary Home Care, Community Attendant Services, and Family Care, plus three MCO contracts. As of mid-September 2026 the platform carried 328 active members and 8,134 authorized weekly service hours, with utilization of authorized hours averaging 87 percent over the trailing year.

The moat here is regulatory. HCSSA licensure, an HHSC provider agreement, and individual managed care contracts each take meaningful time to obtain, and a buyer acquires two licenses and four payer relationships in one shot. The business runs on 17 office staff with attendants delivering care in the field. Notably, census declined over the measured period while revenue held, meaning rate movements and volume movements have been pulling in opposite directions. That dynamic, along with the payroll tax position at both entities, is the heart of what diligence needs to unpack.

Why we like it

Revenue is Medicaid-funded personal care for disabled and elderly clients, which is about as non-discretionary as earnings get. People do not stop needing help with bathing, dressing, and daily living during a recession, and the state pays regardless of the economic cycle. The 87 percent utilization of authorized hours shows real, consumed demand rather than paper authorizations.
The regulatory moat is genuine and transferable. HCSSA licensure in the PAS category, an HHSC provider agreement, and individual managed care contracts each take time to secure, and this deal hands the buyer two licenses plus four payer relationships via a stock purchase that keeps contracts in place. Rebuilding this from scratch would cost years, not dollars.
Payer concentration is unusually balanced for a business this size. The three principal payers each sit between 32.6 and 33.5 percent, so no single contract exceeds 34 percent of revenue. Losing any one would hurt, but none is an existential single point of failure the way a 70 percent payer would be.
This is a recurring, authorization-driven revenue model. Members carry ongoing weekly service hour authorizations that renew by default under managed care and HHSC, not one-off sales you re-win each month. At 8,134 authorized weekly hours across 328 members, the revenue is a repeating stream tied to standing care plans.
The price is reasonable on headline math at 4.84x SDE for an essential-service business with real barriers to entry. If the earnings hold up under scrutiny, a buyer with home care operating experience is buying durable, contracted cash flow at a defensible multiple with seller financing on the table.

How to improve it

Attack the census decline immediately. Revenue held while member count fell, which means rate increases or hour-per-member growth masked volume erosion, and that cannot continue forever. Build a referral engine with hospital discharge planners, MCO care coordinators, and community organizations to refill the top of the funnel in the first 90 days.
Push utilization above 87 percent toward the authorized ceiling. Every authorized hour not delivered is revenue left on the table, and the gap between 8,134 authorized weekly hours and actual delivered hours is pure upside. Tighten attendant scheduling, reduce call-offs, and improve shift coverage to capture it.
Consolidate the two agencies' back offices to the extent the licenses allow. They already share a facility and ownership, so there is likely duplicated administrative and supervisory cost that a single management layer can absorb. The listing itself flags a replacement cost analysis showing management can be covered by one hire, so execute that.
Fix attendant recruitment and retention, which is the binding constraint in PAS. Client relationships are driven by attendant continuity, so turnover directly destroys billable hours and member satisfaction. Introduce referral bonuses, faster onboarding, and schedule stability to grow deliverable capacity.
Renegotiate or market-rate the related-party lease. The facility is leased from an ownership-affiliated party at $102,848 of rent, and a buyer should confirm that rate is at or below market and lock a long-term lease at arm's length terms. Overpaying affiliated rent is a quiet way SDE gets inflated.
Pursue additional MCO contracts and expand program participation. The smaller agency only holds managed care contracts, and adding the direct HHSC programs or new plans broadens the payer base and creates capacity to absorb more members. More contracts means more authorization pipelines feeding the same operating platform.
Clean up the financial reporting infrastructure before or right after close. The figures are company-prepared, unaudited, and not reconciled to tax returns, so installing proper monthly financials and payroll tax compliance protects both the buyer and any future exit. Buyers pay premiums for clean numbers.

Diligence notes

The earnings are company-prepared, unaudited, and explicitly not reconciled to filed tax returns, which is a major red flag at this scale. Demand the tax returns, bank statements, and a quality of earnings review, and reconcile the $517,447 adjusted EBITDA line by line against the add-back schedule before trusting any multiple.
The listing openly references the payroll tax position at both entities being set out in the CIM, which signals there may be an outstanding or sensitive payroll tax issue. Payroll tax liabilities can carry personal liability and attach to the business, so insist on IRS and state tax clearance and a full accounting of any back taxes owed.
Scrutinize the diverging census and revenue trend carefully. Member count fell while revenue held, and the smaller agency's census dropped sharply in mid-2026 before a reported rebound, so you need the monthly census and hour data per agency to confirm the business is stable rather than quietly declining with rate increases papering over it.
Validate contract transferability under a stock purchase, including change-of-ownership notification and consent requirements with Texas HHSC and each MCO. Even on a stock deal, payers often require notice, credentialing updates, or approval, and a gap in contract continuity would gut the revenue the moat is built on.
Confirm the sustainability of the three balanced payer rates and any pending Medicaid reimbursement rate changes. Texas HHSC and MCO rate schedules drive this entire P&L, so understand upcoming rate adjustments, electronic visit verification compliance, and any audit exposure or clawback risk from prior billing.
Verify the attendant workforce is properly classified and compliant. PAS agencies live and die on W-2 attendant compliance, background checks, and EVV documentation, so audit worker classification, overtime exposure, and the completeness of client authorizations and medical necessity documentation that supports every billed hour.

Source

Originally listed on BizBuySell. View original listing →