Aveanna Healthcare’s $1.2B Acquisition of Maxim Collapses Under Weight of FTC Investigation

Atlanta-based Aveanna Healthcare’s agreement to acquire the home health care division of Maxim Healthcare Services — for a reported $1.25 billion — is officially off the table.

The deal’s demise comes in the conclusion of a Federal Trade Commission (FTC) investigation. The FTC is the regulatory body tasked with ensuring competition throughout U.S. markets and nixing any would-be monopoly-like entities that emerge.

Aveanna Healthcare is a giant within the pediatric home care space — with Epic Health Services and PSA Healthcare under its umbrella. The company and its affiliates operate across 23 states with over 200 branch offices.


Meanwhile, Columbia, Maryland-based Maxim is a provider of home health, behavioral health care, health care staffing and personal caregiving.

Aveanna Healthcare and Maxim Healthcare Services originally announced their deal last February.

Since then, FTC regulators raised concerns over the deal’s potential impact on markets for nursing services and for private-duty nursing care. Regulators launched an investigation that lasted several months.


“As a result of that investigation, staff had concerns about the transaction’s potential anti-competitive effects,” FTC Chairman Joseph Simons said in a statement. “Now that the deal has been abandoned, patients and private-duty nurses will continue to benefit from competition between Aveanna and Maxim.”

Prior to Maxim, Bain Capital and J.H. Whitney-back Aveanna Healthcare acquired Pasadena, California-based Premier Healthcare Services, a provider of pediatric services, in July 2018.

The FTC officially closed its investigation into the Maxim transaction on Thursday.

In general, FTC regulators will make moves to prevent business deals that violate anticompetitive practices. Typically, deals that may lead to reduced competition, higher prices or reduced quality of services fall under this mission.

Aside from the news of Aveanna Healthcare’s deal with Maxim Healthcare Services collapsing, the company was recently in hot water for a number of safety violations, according to reports from Bloomberg in October.

Aveanna Healthcare and Maxim Healthcare Services did not respond to Home Health Care News’ requests for comments.

In terms of the overall home health market, pediatric care represents only a fraction of all services delivered. Pediatric home health is a difficult business due to low and complex reimbursement structures that typically vary from state to state.

“There’s really a national shortage of home health care workers who have the skills to care for the level of needs [medically complex] children have,” Dr. Carolyn Foster, an assistant professor of pediatrics at Northwestern University’s Feinberg School of Medicine, previously told HHCN.

Among the usual home health giants, Moorestown, New Jersey-based Bayada Home Health Care is one of the more active in-home pediatric care providers. Previously, executives from Bayada told HHCN that the company gets roughly one-third of its revenue from pediatric home health services.

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