This is Dr. Tehrani’s story.
How to sell a home health agency at the right time, to the right buyer, for the right price is the question Dr. Soraya Tehrani, RN, BSN, MSN had been carrying for almost a year before she finally picked up the phone. When the right time came, she called CGK Business Sales. Soraya ran an $11M revenue, $1.8M EBITDA Joint Commission-accredited home health agency out of a Cherry Creek office on East Belleview Avenue near the Denver Tech Center medical-services corridor in Denver, Colorado. Twenty-eight W-2 admin and clinical-leadership staff worked from the office every week (Soraya as RN-credentialed administrator plus 2 RN clinical directors, 4 RN field-supervisors, 12 schedulers and coordinators, 6 billing and intake staff, 3 quality-and-compliance specialists, and 1 HR lead), supported by a field bench of more than 200 caregivers across W-2 and 1099 arrangements (RNs, LPNs, CNAs, Home Health Aides, and companion-care staff). The business ran 60 percent on Medicare-certified skilled nursing home health (post-acute home rehab, IV infusion, wound care, chronic disease management, the regulated and audited core), 25 percent on private duty home care (non-medical companion care, ADL assistance, meal prep, transportation under Medicaid and private pay), and the remaining 15 percent on hospice handoff and palliative coordination through three Denver hospice referral relationships. Approximately 1,400 active patients across the Front Range were on the active caseload (Denver metro plus Boulder, Lakewood, Aurora, Arvada, Westminster, Centennial, Highlands Ranch, and Lone Tree), with 22 percent of revenue concentrated in a single hospital system referral relationship with UCHealth, 14 percent from a HealthONE referral relationship, and 11 percent from a regional private-pay assisted-living network for hospice handoff. Soraya was 53. She had founded the agency in 2012 after leaving a clinical-leadership role at HealthONE Denver, and over fourteen years she had built it into a 28-person admin and clinical-leadership team with a 200-plus caregiver bench, Joint Commission accreditation (the higher bar over CHAP, held by only about 30 percent of Medicare-certified home health agencies), a Medicare 5-star quality rating across all reportable metrics for the prior 4 quarters (rare, only about 15 percent of US home health agencies achieve this), and an 89 percent caregiver-retention rate against an industry average of 65 to 75 percent. Her father Cyrus, a former Tehran University medical school professor who had emigrated to the US in 1982, had been diagnosed with stage III pancreatic cancer in late 2025 and was in treatment at the University of Colorado Anschutz Medical Campus. Her husband Reza, a vascular surgeon at Anschutz, supported the timing. She came to us because she did not know who else to talk to about how to sell a home health agency at this size, with Joint Commission accreditation, a 5-star CMS rating, the UCHealth and HealthONE referral relationships, and the existing clinical leadership team that she wanted to keep running the operation post-close. This page is what happened next, and what could happen for you. Soraya is a composite, not a single real CGK seller, but the patterns and details are pulled from real home health agency engagements.
The night before Soraya decided to sell a home health agency.
Most owners who decide to sell a home health agency have been carrying the question quietly for months before they reach for the phone. Soraya was no different. She was 53. For fourteen years she had been the RN-credentialed administrator on every plan-of-care signature at the Cherry Creek office, the founder who had personally signed the original lease in 2012 on a 4,200 square foot suite on East Belleview Avenue, the lead clinical voice on every Joint Commission survey the agency had ever sat through, the relationship lead on the UCHealth and HealthONE post-acute referral programs, and the late-night phone line for the on-call clinical directors when a complex IV infusion or wound care patient destabilized at home. The agency did $11 million in annual revenue, $1.8 million in EBITDA at the upper end of home health norms (driven by the Medicare-certified skilled nursing share, the Joint Commission accreditation premium on rates, and the 5-star CMS quality rating), and a 28-person admin and clinical-leadership team plus a 200-plus caregiver bench. Soraya led the office personally as the RN-credentialed administrator. Two RN clinical directors (Maria Gutierrez, age 47, who ran the Medicare-certified skilled nursing service line, and Ngozi Okonkwo, age 44, who ran the private duty and hospice handoff service lines) sat under her. Four RN field-supervisors, twelve schedulers and coordinators, six billing and intake staff, three quality-and-compliance specialists, and one HR lead rounded out the office. The 200-plus caregiver bench ran across RN, LPN, CNA, Home Health Aide, and companion-care levels, with about 60 percent W-2 and 40 percent 1099 by headcount. The agency served roughly 1,400 active patients across the Front Range and ran on the Axxess home health management software platform Soraya had migrated to in 2017, with billing-revenue cycle integration into Medicare, Colorado Medicaid, and roughly twenty commercial payer contracts.
Why owners decide to sell a home health agency
The Friday Soraya finally submitted the form, her father Cyrus had finished his third chemo cycle that morning at the University of Colorado Anschutz Medical Campus. Cyrus was 78. He had been a medical school professor at Tehran University before he emigrated to the United States in 1982 with his wife Farah and a five-year-old Soraya, and he had spent the rest of his career on the faculty at a teaching hospital in Maryland before he retired. Soraya was his primary advocate and family coordinator now. Her husband Reza, a vascular surgeon at Anschutz who had grown up in Tehran and Los Angeles, had told her gently the night before that the chemo regimen was going to be harder than the oncology team had told them at the consultation, and that she needed to be there for her father in a way she could not be there if she was running a 200-plus caregiver agency at full speed. Her older daughter Yasmin, a third-year medical student at CU Anschutz, was already shaping her residency choices around staying in Denver. Her son Darius, a sophomore at the University of Denver, was studying public health policy. Soraya was on the board of the Iranian-American Society of Colorado and had been the practical organizer of a community medication-counseling clinic for first-generation Persian families across the Front Range who could not navigate the Medicare Advantage plan finder on their own. She wanted to be at her father’s bedside, in her temple-like community work, and at home with Reza and the kids. The two RN clinical directors were 44 to 47 years old and had each been with the agency for at least eight years. Maria Gutierrez had been there ten years and ran the Medicare-certified skilled nursing service line. Ngozi Okonkwo had been there nine years and ran the private duty and hospice handoff service lines. Both were committed to staying on post-close if the buyer ran the agency under its existing brand rather than absorbing it into a national identity. Soraya had been approached fourteen times in the prior eighteen months: seven times by PE-backed home health consolidators headquartered out of Atlanta, Boston, Dallas, and a handful of national platforms, four times by regional home health operators based in Denver and Colorado Springs that were expanding their Mountain West footprint, twice by a national home health platform’s M&A program, and once by an individual RN buyer with a private-equity capital partner trying to put together a Front Range platform play. Soraya did not know what her agency was actually worth at $11 million revenue and $1.8 million EBITDA, with the Joint Commission accreditation, the 5-star CMS rating, the UCHealth and HealthONE referral relationships, the 89 percent caregiver-retention rate, and the Iranian-American Denver community network that had driven her early word-of-mouth growth. She did not know whether the firms calling her were the right buyers for her two RN clinical directors, her four RN field-supervisors, her 28-person admin and clinical-leadership team, or her 200-plus caregiver bench. She did not know whether the UCHealth and HealthONE concentration was a value driver or a buyer-friction point. She did not have a single peer in her life who had ever sold a home health agency at this size, accreditation depth, and quality rating.
That is the night she found CGK and submitted the form. We called her back at 7:42 the next morning, while Soraya was on her way from the family house in Greenwood Village to the Cherry Creek office between her father’s morning labs check-in at Anschutz and the 8:30 a.m. clinical leadership huddle.
The first call about how to sell a home health agency.
The first call was 52 minutes. We did most of the listening.
Owners who think about how to sell a home health agency in their early fifties, like Soraya, usually carry the same handful of pressures into the first call. Soraya talked about her two RN clinical directors and the way each one carried a different operating book. Maria Gutierrez ran the Medicare-certified skilled nursing service line and had been the practical lead on the UCHealth and HealthONE post-acute referral relationships, the IV infusion protocols, the wound care escalation pathways, and the chronic disease management plans. Ngozi Okonkwo ran the private duty and hospice handoff service lines and had been the relationship lead on the three Denver hospice partner agencies for end-of-life transition coordination. She talked about her four RN field-supervisors, three of whom had been with the agency for more than seven years and had been the practical operators of the daily caregiver schedule across the Front Range. She talked about the 12 schedulers and coordinators who held together the daily operational rhythm of a 1,400-patient caseload across nine Front Range cities. She talked about the 6 billing and intake staff who had built the Axxess revenue-cycle integration with Medicare, Colorado Medicaid, and the commercial payer roster. She talked about the 3 quality-and-compliance specialists who had walked the agency through three consecutive Joint Commission triennial surveys without a single conditional finding. She talked about the 200-plus caregiver bench that had carried the 89 percent retention rate against an industry average of 65 to 75 percent, and the way that retention number was the operational backbone of the 5-star CMS quality rating across all reportable metrics. She talked about the UCHealth and HealthONE post-acute referral programs and the way each of those hospital-system credentialing relationships needed individual transfer attention at close. She talked about the Axxess platform she had migrated to in 2017 and the way the platform had become the operational nerve center of the agency. She talked about the Iranian-American Society of Colorado community network that had driven her first 200 patients in 2012 to 2015 and the way the community work was something she wanted to continue once the operating-day pressure was off her. She talked about Cyrus and the chemo schedule and the way Reza had been the steady voice telling her to step back. We asked about the agency the way you would ask if you were trying to understand it, not the way you would ask if you were trying to win the engagement. What we were listening for was not just the financials. We were listening for whether Soraya was actually ready to sell, what she was working toward, and whether her expectations on price were grounded in what the home health agency M&A market would actually support.
At the end of that call, we set up a working session: an in-person conversation where one of our Managing Directors would walk Soraya through our valuation model and tell her honestly what her agency was likely to command. We did not promise her a written report. Written valuations involve substantially more work, and we charge for those when a seller actually needs one for partnership buyout, estate planning, a divorce, or another documentary purpose. The walkthrough was free because Soraya was clearly thinking seriously about how to sell a home health agency, the way someone thinks about it before they actually do it. Whether that ends up being in a year, five years, or longer, we make the same call.
The valuation session was the following Tuesday at 6:45 a.m. at the Cherry Creek office, before the 7:30 a.m. clinical leadership huddle and after Soraya had finished her morning chart review on three medically complex post-acute patients with Maria Gutierrez.
Soraya was not ready to sell a home health agency yet. She went home and waited four months.
The valuation session showed Soraya that her agency was worth meaningfully more than she had been hoping in some areas and meaningfully less in others, which is how these conversations usually go. The Joint Commission accreditation (held by only about 30 percent of Medicare-certified home health agencies, the higher bar over CHAP), the Medicare 5-star quality rating across all reportable metrics for the prior four quarters (rare, only about 15 percent of US agencies achieve this), the UCHealth and HealthONE post-acute referral programs (a recurring-volume book a sophisticated buyer treats almost like a contract roster), the 89 percent caregiver-retention rate against an industry average of 65 to 75 percent, the 14-year operating history under a single administrator-owner, and the Iranian-American Denver community word-of-mouth flywheel were all premium-multiple drivers a sophisticated home health consolidator would pay up for. Three issues, though, were dragging the number down. The first was the hospital referral concentration story. UCHealth was 22 percent of revenue and HealthONE was 14 percent, and a buyer’s diligence team was going to underwrite both as concentration-risk factors unless Soraya could document the breadth of the referring physicians, the discharge-planner relationships across multiple hospital units, and the historical replacement velocity when a single referring relationship went quiet. The second was the W-2 versus 1099 caregiver mix. Approximately 40 percent of the field bench was 1099, which a sophisticated buyer’s diligence team and the buyer’s home-health-specific employment counsel were going to pressure-test against the federal Department of Labor and IRS classification standards as well as Colorado Department of Labor and Employment guidance on home care worker classification. The third was the hospice handoff revenue concentration. The three Denver hospice referral relationships were on handshake-extended evergreen terms with informal renewal language rather than formally signed multi-year referral agreements, which a sophisticated buyer’s diligence team was going to underwrite as a transition-risk factor on a recurring-revenue book worth roughly 15 percent of the agency’s gross.
We told Soraya honestly: she could go to market now and accept the discount, or she could spend three to four months building a hospital referral concentration narrative that documented the breadth of the UCHealth and HealthONE relationships across multiple referring physicians and discharge planners, walking the field bench through a structured W-2 conversion plan that moved most of the 1099 caregivers onto W-2 status with no reduction in net pay (the agency could absorb the payroll tax cost inside the existing margin given the EBITDA cushion), and formalizing multi-year or one-year-with-change-of-control hospice referral agreements with all three Denver hospice partners. We said the second path would likely command a meaningfully better number from a wider range of buyers, especially a PE-backed home health consolidator with an underwriter that cared about caregiver classification compliance and hospital referral diversification. The realistic buyer pool for an $11 million revenue, $1.8 million EBITDA, Joint Commission-accredited, 5-star CMS-rated home health agency with hospital referral relationships and a balanced sub-segment mix is wider than people think, but each band of buyer prices the same agency differently, and the cleaner the diligence file is the more buyers can compete. CGK is an active member of the International Business Brokers Association and the M&A Source, both of which give us deep visibility into the active home health agency buyer landscape, and we are in regular dialogue with the National Association for Home Care & Hospice on home health M&A trends.
This is the part most brokers skip. Most brokers would have signed Soraya that day, taken her to market, and made the commission whether or not the deal was the best one for her. We told her to wait, even though it meant we did not get paid for four months and might never get paid at all if she changed her mind.
Soraya went home and waited. She spent the next four months working with her two RN clinical directors and her HR lead to convert most of the 1099 caregiver bench to W-2 status (about 80 percent of the 1099 bench moved to W-2 with no take-home pay reduction, the remaining 20 percent stayed 1099 in roles where the classification was clearly defensible under the IRS and Colorado DOLE tests), pulling together a hospital referral concentration narrative that documented forty-three referring physicians and twenty-eight discharge planners across UCHealth and HealthONE units, walking each of the three Denver hospice partner agencies through a formal multi-year or one-year-with-change-of-control referral agreement conversation (all three signed multi-year terms), formalizing a Joint Commission triennial survey audit binder for buyer diligence, and tightening the Axxess platform data hygiene across the trailing thirty-six months of episodic billing data. She read background material on home health M&A through the National Association for Home Care & Hospice and stayed close to the Joint Commission resource library on home health accreditation. She called us back in early 2026 and said she was ready to sell a home health agency that was finally in the shape it needed to be in.
What we did when Soraya came back.
What it takes to sell a home health agency properly
When an owner is ready to sell a home health agency with CGK, the speed of the on-ramp surprises them. We took Soraya’s agency to market in just over six weeks once she got us her updated financials, the W-2 conversion documentation, the hospital referral concentration narrative across UCHealth and HealthONE, the formalized hospice referral agreements with the three Denver hospice partners, the Joint Commission triennial survey audit binder, the CMS Star Rating Program documentation across all reportable metrics for the prior four quarters, the 89 percent caregiver-retention historical analytics, the sub-segment-by-sub-segment revenue and margin breakouts (Medicare-certified skilled nursing, private duty, hospice handoff and palliative coordination), the patient-by-patient revenue concentration map for the top one hundred active accounts, the Axxess platform episodic billing data pulled for the trailing thirty-six months, the Medicare provider transmittal history, the Colorado Medicaid contract documentation, the commercial payer roster, the lease terms on the East Belleview Avenue suite, and the full P&L breakouts across all three sub-segments. The blind teaser went out to twenty-eight buyers we had pre-qualified, a tighter funnel than other industries because the home health agency M&A buyer pool at this revenue band is structurally concentrated (fewer than twenty active home health platforms operate at this acquisition band). Buyers fell across four buckets we routinely use to think about how to sell a home health agency: PE-backed home health consolidators (active across Atlanta, Boston, Dallas, and a few national platforms, typically running multi-state roll-up theses with central admin, billing, and clinical-quality support, usually pricing on a 6.5x to 8x EBITDA band on diligence-clean agencies with Joint Commission accreditation, 5-star CMS ratings, and strong hospital referral books), regional home health operators (privately held, often family or RN-owned, expanding their state or multi-state footprint through targeted acquisitions and typically operating acquired agencies under their original brand names with central revenue cycle and clinical-quality support, usually pricing on a 6x to 7.5x EBITDA band with stronger employee continuity than PE buyers), national home health platforms (the largest band by deal volume, typically rebranding within twelve to eighteen months and absorbing acquired agencies into a single national identity), and individual RN buyers running SBA-financed or seller-note-financed acquisitions (the rarest buyer pool at this band because the EBITDA size pushes the deal value above SBA capacity, typically focused on agencies under $500K EBITDA). Each bucket prices the same agency differently.
Twenty-one of the twenty-eight buyers signed NDAs and received the full Confidential Information Memorandum. Thirteen submitted Indications of Interest after data-room review. Seven advanced to Letters of Intent. We narrowed to five for management presentations. Three re-submitted refined LOIs after the management meetings. Two went into a final-final negotiation cycle.
Soraya decided between two of the top LOIs. They were materially different. One was a slightly higher headline price from a national home health platform with roughly $4.1 billion in revenue across more than 380 agencies, where the Cherry Creek agency would absorb into the platform’s central admin and billing stack within ninety days, the local brand name would close at acquisition (the platform operated all acquired agencies under a single national identity), Soraya would transition to a one-year strategic-advisor role with no continuing patient-facing involvement, the two RN clinical directors would absorb under the platform’s standardized clinical-leadership comp model (which sat below the comp model Soraya had built), and the 28-person admin and clinical-leadership team would absorb under a different scheduling and billing platform that would meaningfully reduce the regional autonomy each of the schedulers and coordinators currently operated with. The other was a slightly lower headline price from a PE-backed home health consolidator with approximately $2.4 billion in revenue across 280-plus agencies, expanding their Mountain West footprint with Soraya’s Denver agency as the Front Range flagship, with a long-hold thesis (10-plus years, positioning for a 2030+ second-bite or strategic exit) and a satellite-brand preservation thesis. Under that LOI, Soraya’s agency would keep its existing brand name on the East Belleview Avenue suite (the consolidator operates each acquired agency under its original brand with central admin, billing, and clinical-quality support consolidated up to the parent), the 28-person office bench would stay in the Cherry Creek location, the two RN clinical directors would absorb at or above their existing comp under the consolidator’s clinical-leadership compensation framework with Maria Gutierrez formally named as the post-close clinical-services director and Ngozi Okonkwo formally named as the post-close private duty and hospice coordination director, the four RN field-supervisors, twelve schedulers and coordinators, six billing and intake staff, three quality-and-compliance specialists, and one HR lead would retain their roles and pay structure, the 200-plus caregiver bench would absorb under the consolidator’s caregiver employment platform with the existing W-2 status preserved, the Joint Commission accreditation would transfer cleanly through a structured change-of-ownership survey, the UCHealth and HealthONE post-acute referral programs would continue under the consolidator’s hospital partnership umbrella, the three Denver hospice referral agreements would transfer cleanly under the consolidator’s hospice partnership framework, the Axxess platform would be retained for the Cherry Creek agency through a 24-month integration window, and Soraya would step back to a part-time strategic role at one day per week with full freedom to spend the rest of her time on her father’s care and her Iranian-American Society community work. The consolidator committed to keeping the existing 5-star CMS rating posture intact through the transition. We walked Soraya through what each LOI would actually deliver under realistic and pessimistic scenarios, including what the cultural continuity would look like for her two RN clinical directors, her four RN field-supervisors, her 28-person admin team, and her 200-plus caregiver bench under each acquisition structure. The PE-backed consolidator deal was the better one for Soraya. The part-time strategic role gave her the structural off-ramp she needed to be at her father’s bedside and to fully step into her community work. The bench preservation kept her two RN clinical directors and the broader 28-person team in the roles they had earned. The local brand preservation kept the Cherry Creek office the office the patient households and the UCHealth and HealthONE discharge planners recognized.
Through the whole process, the same CGK Managing Director who had taken Soraya’s first call four months earlier was the person walking her through every conversation.
The deal Soraya took to sell a home health agency.
How the deal looks when you sell a home health agency with CGK
This is the part of how to sell a home health agency that gets the least attention in the trade press and the most attention from owners who have actually closed a transaction: the structure of the consideration package matters more than the headline number, and the structure for a Joint Commission-accredited, 5-star-CMS-rated home health agency with hospital referral relationships and a balanced sub-segment mix is meaningfully different from the structure typical of every other industry CGK works in. Soraya’s deal closed roughly seven months after we restarted the engagement, the longer end of the typical CGK healthcare-services window because home health M&A involves Medicare provider number transfer mechanics, Colorado Department of Public Health and Environment licensure transfer, separate change-of-ownership credentialing on each commercial payer contract, Joint Commission change-of-ownership survey, CMS 855A enrollment update, UCHealth and HealthONE hospital partnership re-credentialing, three Denver hospice referral agreement change-of-control consents, Axxess data migration, and a more involved pre-close due diligence cycle on the Medicare claims history and the caregiver classification documentation than typical industry M&A. The buyer was the PE-backed home health consolidator with approximately $2.4 billion in revenue across 280-plus agencies, expanding its Mountain West footprint with Soraya’s Denver agency as the Front Range flagship, operating on a 10-plus year long-hold thesis with a 2030+ second-bite or strategic exit horizon. The acquisition structure was an asset purchase rather than a stock purchase: the agency folded into the consolidator at close while keeping its existing brand name, the 28-person office bench stayed at the East Belleview Avenue suite, the two RN clinical directors absorbed at or above their existing comp with Maria Gutierrez formally named as the post-close clinical-services director and Ngozi Okonkwo formally named as the post-close private duty and hospice coordination director, the four RN field-supervisors, twelve schedulers and coordinators, six billing and intake staff, three quality-and-compliance specialists, and one HR lead retained their roles and pay structure, the 200-plus caregiver bench absorbed under the consolidator’s caregiver employment platform with the existing W-2 status preserved, the Joint Commission accreditation transferred through a structured change-of-ownership survey, and Soraya transitioned to a part-time strategic role at one day per week.
The total deal economic value was approximately $13.5 million, roughly 7.5 times trailing EBITDA, a premium home health multiple driven by the Joint Commission accreditation, the Medicare 5-star quality rating across all reportable metrics for the prior four quarters, the UCHealth and HealthONE post-acute referral relationships, the 89 percent caregiver-retention rate, the 14-year operating history under a single administrator-owner, the diversified sub-segment mix (Medicare-certified skilled nursing, private duty, hospice handoff and palliative coordination), the W-2 caregiver classification posture Soraya had built during the wait period, and the formalized clinical-leadership succession story. About 75 percent of it came as cash at closing, slightly lower than industries like distribution because home health buyers price an extended escrow against the Medicare audit window. About 8 percent was held back in escrow for 15 months, an extended pharmacy-style escrow window because the Medicare audit cycle runs longer on home health claims than on retail-pharmacy script-volume reconciliation, because the change-of-ownership Joint Commission survey can land within twelve to fifteen months, and because the UCHealth and HealthONE referral concentration is verified within that same window. The remaining 17 percent was a rollover-as-equity stake into the consolidator’s holding company, with Soraya’s existing equity converting into the consolidator’s holding-company partnership interests on a vesting schedule tied to her continued part-time strategic involvement. The rollover percentage runs higher in home health deals than in many other industries (15 to 20 percent is the central tendency) because the consolidators tie part of the sale value to the administrator-owner’s continued clinical-leadership presence through the Joint Commission change-of-ownership survey window. The numbers add up to one hundred. Wire hit on a Friday morning at 10:18 a.m. while Soraya was at the Cherry Creek office between her morning chart review with Maria Gutierrez and her drive to Anschutz to be at her father’s side for the end of his fourth chemo cycle.
Soraya stayed on as a strategic part-time advisor for the consolidator’s Mountain West region for twenty-four months after closing, dropping to one day per week so she could personally introduce each of the three Denver hospice partner agencies to Ngozi Okonkwo as the new private duty and hospice coordination director, walk the UCHealth and HealthONE discharge-planner team through the consolidator’s central hospital partnership umbrella with Maria Gutierrez as the new clinical-services director, and shape the consolidator’s Mountain West expansion strategy across two adjacent agencies the consolidator was actively in conversation with in Boulder and Colorado Springs. After twenty-four months, Soraya stepped back to a quarterly clinical-advisor relationship that gave her room to spend the bulk of her weeks at her father’s bedside and on the Iranian-American Society of Colorado community medication-counseling clinic she had been building for two years.
What happened to Soraya’s people and her patients.
The people-side of how to sell a home health agency usually weighs heavier on the founding administrator than the financial-side, even when the financial-side is what triggers the call to a broker in the first place. Soraya cared most about her two RN clinical directors (Maria Gutierrez and Ngozi Okonkwo), her four RN field-supervisors, her twelve schedulers and coordinators (four of whom had been with her for more than eight years), her six billing and intake staff, her three quality-and-compliance specialists who had walked the agency through three consecutive Joint Commission triennial surveys without a single conditional finding, her one HR lead, and the 200-plus caregiver bench that ran the daily home visits across the Front Range. She also cared about the active patient roster: roughly 1,400 active patients across nine Front Range cities, the medically complex post-acute discharge patients flowing through the UCHealth and HealthONE hospital relationships, the IV infusion and wound care caseloads, the chronic disease management plans, the private duty companion-care patients across the Medicaid and private-pay rosters, and the hospice handoff patients moving through the three Denver hospice partner agencies for end-of-life transition coordination. The PE-backed consolidator buyer was a long-hold operator that intended to actually preserve the Cherry Creek agency as a standing local-brand storefront under its original name rather than absorb it into a national identity on a tight ninety-day timeline. That made the people part substantially cleaner than it would have been under the higher-headline-price national platform deal that wanted to absorb the agency into a single national brand within ninety days.
The buyer kept all 28 admin and clinical-leadership employees, honored the existing pay structure across clinical directors, field-supervisors, schedulers, billing and intake staff, quality-and-compliance specialists, and HR, and committed to keeping Maria Gutierrez running the Medicare-certified skilled nursing service line as the new Mountain West clinical-services hub, Ngozi Okonkwo running the private duty and hospice handoff service lines as the new Mountain West private duty director, and the four RN field-supervisors continuing to operate the daily caregiver scheduling and clinical oversight across the Front Range. The clinical-leadership succession work Soraya had done during the wait period (formalizing Maria Gutierrez and Ngozi Okonkwo into named post-close clinical-services and private duty director roles and pre-negotiating three-to-five-year stay arrangements with each) was preserved with formal employment agreements at or above the existing comp model. The 200-plus caregiver bench absorbed under the consolidator’s caregiver employment platform with the existing W-2 status preserved for the 80 percent of the bench Soraya had converted during the wait period, and the remaining 20 percent stayed on a defensible 1099 status. The Joint Commission accreditation transferred cleanly through a structured change-of-ownership survey conducted six months post-close, and the agency retained the 5-star CMS quality rating posture across all reportable metrics through the transition. The Axxess home health management software platform was retained for the Cherry Creek agency through a 24-month integration window before any consolidation onto the consolidator’s enterprise stack. The three Denver hospice referral agreements transferred under the consolidator’s hospice partnership framework with all three signing multi-year change-of-control language. The UCHealth and HealthONE post-acute referral programs continued under the consolidator’s hospital partnership umbrella with formal re-credentialing through the consolidator’s central credentialing team. The Medicare provider number transferred through a structured CMS 855A enrollment update. The Colorado Department of Public Health and Environment home health licensure transferred cleanly. The Iranian-American Denver community network and the agency’s Joint Commission accreditation badge stayed firmly attached to the brand because the brand and the office and the people stayed in place.
Soraya was at the Cherry Creek office on a Friday morning when the wire confirmation came through. Home health agency closings often happen at the end of the week to coincide with weekend coverage cycles. She drove east on Belleview Avenue to the University of Colorado Anschutz Medical Campus, where her father was finishing his fourth chemo cycle. She walked into his treatment room, took his hand, and said in Farsi: “Tamam shod, Pedar.” It is done, Father. Cyrus opened his eyes and said in English, in his still-lecture-room voice: “You did good work, my dear.” Soraya did not say anything for a long time. She held his hand. The chemo nurse, who had been adjusting the line, stepped back without speaking. Reza arrived from his vascular surgery list at the Anschutz hospital twenty minutes later. The three of them stayed in the treatment room together until the cycle was complete. Then Soraya drove Cyrus home to Greenwood Village, helped him to the recliner where he liked to read, made him weak black tea the way Farah had taught her, and sat with him while he fell asleep with a Persian poetry collection open on his chest.
What Soraya told us afterward.
Why owners who sell a home health agency with CGK keep coming back
Most owners who sell a home health agency do not call the broker again in the first year. The ones who do call usually want to talk about the parts of the engagement that, in retrospect, mattered more than they realized at the time. About seven months after closing, Soraya called the Managing Director who had run her engagement. She said two things that the Managing Director still tells new sellers about.
The first was about the four-month wait. She said: “Four of the buyers who had been calling me were ready to sign LOIs in thirty days, and two different home health M&A consultants I talked to before you told me they could take me to market right then with the 1099 caregivers still classified as 1099 and the hospice referral relationships still on handshake-evergreen terms. The reason I sold with you is that you told me the truth about how my Joint Commission accreditation and my 5-star CMS rating and my UCHealth and HealthONE referral concentration were actually being valued by a sophisticated PE-backed home health consolidator underwriter, the truth about what the W-2 conversion would buy me in LOI conversations five months later, and the truth about what the formalized hospice referral agreements would buy me in management-presentation conversations. You told me what would happen to the price if I went out without fixing those things. I would have left more than two million dollars on the table, and Maria and Ngozi would have folded into a worse comp tier under a different operator, and my caregivers would have absorbed under a buyer with a 1099-heavy classification posture I had been working to clean up for two years.”
The second was about who she sold to. She said: “I almost signed with the higher-headline-price national platform because the number on the top line was bigger and they told me they could close in sixty days. The fact that you walked me through what each buyer would actually do with my two RN clinical directors, my 28-person admin and clinical-leadership team, the office I had run for fourteen years, and the UCHealth and HealthONE hospital relationships I had built over a decade, what each buyer’s brand-and-bench integration thesis would mean for the patient households three and five years out, and how a PE-backed consolidator with a satellite-brand preservation thesis was structurally different from a national platform with a single-brand absorption thesis, is a conversation I never even thought to have until you raised it. I sold to a buyer who is actually going to keep the Cherry Creek agency the agency my patients and my discharge planners walk into and recognize. And the fact that I could be at my father’s bedside through the chemo cycles instead of running an office, that came from the part-time strategic role you negotiated for me. That was not on the original LOI. You pushed for it.”
This is what we mean when we say we sit with you in the decision, not just the transaction. Soraya is one composite story, but the pattern is real. The owners we work with who decide to sell a home health agency usually find their way to us through versions of Soraya’s situation, and the relationships start with a long listening session and a free walkthrough, not a pitch.
Ready to sell a home health agency? Where are you in Soraya’s story?
If you are starting to think about how to sell a home health agency, we should talk. There is no commitment and no pressure. The first conversation is free. The valuation walkthrough that follows is free when you are seriously thinking about selling, whether that is in a year, five years, or longer. We only charge for formal written valuations, and only when you actually need one for a partnership buyout, estate planning, or another documentary purpose. Submit the form and a senior CGK Managing Director will reach out within one business day.
If you are Soraya at month 1: just exploring
You are not sure if you want to sell yet. The home health agency M&A landscape keeps shifting, your hospital referral concentration is meaningful but undocumented, your 1099 versus W-2 caregiver mix is unresolved, your hospice referral relationships are running on handshake-evergreen terms, your Joint Commission triennial survey audit binder is incomplete, your CMS Star Rating Program documentation is scattered, more than a decade of running the office is starting to tell you something, your kids are not coming back to the agency, you are curious about how a buyer would value your Medicare-certified skilled nursing exposure versus your private duty mix or your hospice handoff book, or maybe a PE-backed home health consolidator or a national home health platform has been calling you. Most of our best engagements start here. Submit the form and we will schedule a working session. You walk away with a real number and a clear sense of what to do next, with no obligation to do anything.
If you are Soraya at month 4: ready to go
You have done the work to clean up the agency. The financials are tight. Your caregiver classification posture is W-2-heavy and defensible. Your hospital referral concentration is documented across forty-plus referring physicians and discharge planners. Your hospice referral agreements are formalized with multi-year terms or one-year-with-change-of-control language. Your Joint Commission triennial survey audit binder is buyer-grade. Your CMS Star Rating Program documentation across all reportable metrics is current and clean. Your clinical-leadership succession plan names specific RN clinical directors and includes formal three-to-five-year stay arrangements. Your Axxess platform episodic billing data is pulled into a buyer-grade report for the trailing thirty-six months. Your Medicare provider transmittal history is documented. Your Colorado Medicaid contract documentation and commercial payer roster are current. Maybe a buyer is already in the conversation. You want to run a real process. Submit the form and we will be in touch within a business day to talk about timing, scope, and what your first 30 days as a CGK seller would look like.
If you are not sure where you are
Most owners are not sure. Submit the form and start with the conversation. We will figure out together where you are. We are equally happy to tell you to wait twelve months as we are to take you to market in six weeks.
Or call us directly at (888) 858-7191.
Start your own story
A senior CGK Managing Director will respond within one business day. Strictly confidential. For owners of home health agencies doing $1.5M+ in annual revenue, including Medicare-certified skilled nursing home health agencies, private duty home care operators, hospice and palliative coordination agencies, and combined home health and hospice operators. The first conversation and the valuation walkthrough that follows are free for any seller seriously thinking about selling, on any horizon.
Confidential. No obligation. Direct routing to a named CGK business broker, not a junior screener.
One of these eight people would lead your engagement.
When you decide to sell a home health agency with CGK, one named senior Managing Director stays with you from the first call through the wire transfer, just like Soraya’s Managing Director stayed with her for four months and then for the engagement that followed. Our Managing Directors come from Wall Street investment banks, hedge funds, Fortune 500 corporate finance, and operating-business leadership. Cornell MBA. U Chicago Booth MBA. CFA. CMT. Naval Academy. Goldman Sachs. Merrill Lynch. Deutsche Bank. AIG. T. Rowe Price.
What sellers say after they sell a home health agency (and other businesses) with CGK
I could not be happier with the experience I had selling my business with CGK. Greg did a detailed analysis of my business and helped me price and position it right for the market. After receiving multiple offers at full asking price, the rest of the process went very smoothly, and we closed in less than two months.
Hanna M.Selling my business was a once-in-a-lifetime experience, and I’m incredibly grateful to have had Wes by my side throughout the process. He brought perspective, pushed when necessary, and always had my best interests in mind. His experience and strategic approach allowed me to maximize the sale price while minimizing long-term risk and obligations. If I had to do it all over again, I wouldn’t hesitate to choose him as my broker.
Adam NevilleDerik located multiple interested strategic buyers that produced more than one serious offer. The negotiations were tough but Greg and Derik’s experience helped us overcome. We got a great result for our employees and for the owners. We would recommend them without reservation.
Bob TaylorWe sold a business that was 47 years old and being run by second generation within a year of working with Wes. CGK has a system that attracts serious prospects to review opportunities. Wes was able to make the overwhelming feeling of selling easy and to a certain extent enjoyable. I never felt alone or in the dark throughout the entire process.
Jennifer WilliamsWe decided to sell our company in 2025. Talked to another M&A company in the Houston area. We felt very comfortable with Greg and Matthew at CGK. Could not have made a better choice. From day 1 till final closing and even after 30+ days, they have been here helping us with documents and support during the transition. Thanks can not be said enough.
Rickey ThomasInside the Blueprint, on Bloomberg TV and Fox Business News.
Soraya’s husband Reza, the vascular surgeon at Anschutz, was the one who first sent her a clip of CGK on Bloomberg. He had been watching the segment in their kitchen on a Sunday morning and recognized the firm name from a home health trade article about how to sell a home health agency he had read a few months earlier. He texted her the link with a note that read “Look at this. This is the firm for the conversation we keep having about your father.” CGK Business Sales is featured on Inside the Blueprint, the syndicated business television series. Our episode aired on Bloomberg TV and Fox Business News. Watch the segment, then start a confidential conversation.
The CGK office Soraya called was the CGK Denver office. Yours might be one of these.
When you sell a home health agency with CGK, whichever office you reach, you get the entire firm. Soraya worked with a CGK Managing Director based out of the firm’s Denver office, but her deal benefited from a buyer pool we sourced firm-wide, including the PE-backed home health consolidator that ultimately won the engagement and is now using the Cherry Creek agency as its Mountain West Front Range flagship. Click any city to learn about our local presence and the named Managing Director leading that market.
Other Questions Soraya and Other Home Health Agency Sellers Ask Us
Practical answers to what comes up before, during, and after the kind of engagement Soraya went through, when you sell a home health agency with CGK.