Practice area
Home health and hospice agencies
Texas publishes a directory of every licensed home and community support services agency, and it is the most complete operating picture any state file offers: the administrator, the services licensed, the Medicare certification, and the agency's own reported client census.
What a buyer is paying for
Not revenue. In this trade specifically, price is driven by the share of work that recurs without being sold again.
Census and payer mix
The census is the book of business, and what stands behind it determines the multiple: Medicare-certified episodic care, hospice days and private-pay personal assistance are three different businesses that share a license type.
Certification and survey history
Medicare certification is a barrier a buyer cannot quickly replicate, and a clean survey history is what allows them to rely on the census. Both are documentary; neither can be assembled in the month before a sale.
The administrator and the change of ownership
The license names an administrator and does not transfer on sale; a change of ownership runs through the state. Transactions in this trade are won by whoever has the regulatory path mapped before the letter of intent.
The market, measured
The most active acquirers in this market are Texas companies buying in Texas, several of them serial acquirers with dedicated acquisition financing. Demand is local, current and documented in their own announcements.
The state directory self-reports each agency's client census, the only trade we cover in which a size figure comes from the operator rather than being inferred. 1,406 agencies report a census of one hundred or more.
Measured August 2026
Figures drift as the market changes. We re-measure quarterly rather than quoting a figure once and repeating it.
Who this practice serves
- An owner-operated agency, licensed-only or Medicare-certified, with a stable census and a clean survey history.
- Hospice license holders, where buyer demand is currently strongest.
- Founders who built the agency and want the change of ownership handled properly, because an HCSSA license does not transfer with an informal agreement.
If you have already received an approach, bring the offer to us before signing anything. A letter of intent usually carries an exclusivity clause, and once it is executed the seller’s leverage is largely gone.