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How to buy a home health agency
Buying a certified home health agency is mostly a Medicare enrollment problem wearing a transaction costume. The purchase agreement is the easy part.
The 36-month rule
Medicare restricts changes of ownership for home health agencies within 36 months of initial certification or a prior change of ownership. If the rule applies, the buyer cannot simply take assignment — the agency must undergo a new survey and certification, which resets the clock and interrupts billing. Check the certification date before anything else.
Assignment or fresh enrollment
As with any CHOW, the buyer either assumes the existing provider agreement — and its compliance history, overpayment exposure and any sanctions — or lets it terminate. For home health the continuity argument is usually decisive, because re-certification can take many months.
Diligence you can do from public data before you sign an NDA
Certification date, current owners of record, whether the agency has changed hands before and when, and whether the sellers appear as owners of other agencies. All of that is in the CMS enrollment and ownership files, free, before you ever speak to a broker.
Common questions
What is the 36-month rule for home health agencies?
A Medicare restriction on changes of ownership within 36 months of initial certification or a previous ownership change, which can force a new survey and certification.
Can I look up who owns a home health agency before making an offer?
Yes. CMS publishes owner filings for every Medicare-certified home health agency.