After Hitting Lowest Level Since Pandemic, Home-Based Care M&A Poised For Rebound

Home-based care deals significantly slowed in 2024, but conditions are improving, according to a new report from Mertz Taggart.

M&A activity declined from 183 deals in 2021 to 110 in 2023, and then further decreased to 72 in 2024, according to the report. Ultimately, only 14 transactions took place in the last quarter, marking the lowest level of home-based care M&A activity since the pandemic. Those deals were inclusive of home care, home health and hospice, with some transactions involving more than one type of care.

“Transactions are beginning to progress,” said Cory Mertz, managing partner at Mertz Taggart. “While we don’t want to get ahead of ourselves, we’re observing a strong start to Q1 2025 in terms of closed deals.”

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Home Health, Home Care & Hospice transactions by quarter Mertz Taggart

Mertz Taggart, based in Fort Myers, Florida, has successfully completed more than 140 health care transactions since 2006.

In discussing the trends in M&A within the home-based care sector, Mertz highlighted that the election was the most significant event in the fourth quarter. The Trump administration is expected to positively impact the health care M&A landscape by promoting private sector growth and minimizing regulatory obstacles.

“By prioritizing deregulation, the administration is fostering an environment where private-equity (PE) investors feel more confident in efficiently securing deals, thereby unlocking opportunities in the health care sector,” Mertz said.

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Home health care M&A

Throughout the last 16 quarters, the two lowest for home health M&A were in 2024, with just two deals completed in the fourth quarter of last year, the report said. However, those deals were significant.

The first announcement came on Oct. 13 when home health care agency Prime Home Health Services, based in Brooklyn, New York, acquired the assets of the Visiting Nurse Association of Staten Island, which ceased operations on Sept. 27.

The second deal occurred less than a month later, when Choice Health at Home acquired Accentra Home Health and Hospice, based in Oklahoma City. This acquisition provides Choice with coverage of 90% of Oklahoma’s urban and rural areas.

Home care M&A

The fourth quarter was a busier time for home care, with eight deals completed. Help at Home closed four transactions in the quarter, including acquisitions of Helpmates Home Nurses in Pennsylvania and Florida-based Caregiver Services.

Other noteworthy transactions included Canada-based Nova Leap Health’s expansion into Florida with the $4.6 million acquisition of a private-duty home care agency. The selling company’s name has been withheld; however, the definitive agreement was announced on Oct. 11.

Dallas-based Avenues Home Care acquired Clear Path Home Care, while Havencrest Capital Management, a Dallas-based PE firm, acquired Sandhills Home Care in Rockingham, North Carolina, through its Chicago-based home care platform, Avid Health at Home.

“We expect activity to pick up in 2025 relative to 2024,” Mertz said. “There is too much demand from private equity, driven by aging dry powder. These are committed funds from their investors that they have not yet been able to invest. Leaving committed funds uninvested can make raising their next fund more of a challenge, so there is an impetus to invest now. We also expect more activity by sponsor-backed portfolio companies seeking an exit.”

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