TL;DR
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Home-based care executives at Home Health Care News’ FUTURE conference described a shift in dealmaking: buyers are looking beyond EBITDA to sustainable growth, clinical quality and leadership. Some are also keeping sellers involved as executives, operating partners or equity owners after a sale.
Home-based care acquisitions are increasingly being judged on sustainable growth, care quality and leadership, not earnings alone, executives said at Home Health Care News’ FUTURE conference. They also described a shift toward keeping some sellers involved after a deal closes, as buyers seek continuity and shared responsibility for the acquired business’s performance.
Dustin Distefano, chief operating officer of franchise operations at A Place At Home, said EBITDA can present an incomplete picture of a company’s prospects. Buyers also want evidence that growth is organic and supported by infrastructure and a developing team. He said operators who show those qualities can strengthen their value, while businesses that plateau may lose appeal.
Clinical quality and leadership are also part of the evaluation, according to the panelists. Aveanna Healthcare CEO Jeff Shaner said he would favor a slower-growing company with stronger care quality over a faster-growing business without the same commitment. Bill Mixon, an executive partner at private equity firm Waud Capital, said a cohesive management team and clear company culture help investors assess whether a business can sustain its next stage of growth.
The panelists also described more continued seller involvement after closing. Shaner said Aveanna seeks to make sellers equity owners and leaders in acquired operations. Distefano, an A Place At Home co-founder, remained with the company as COO after its acquisition by Dovida in February. The company’s joint venture approach can also allow franchise owners to retain minority stakes and stay on as general managers.
How Buyers Judge Care Businesses
The approach described by the executives could affect both how sellers prepare for a transaction and what happens to a company afterward. Financial results remain relevant, but buyers may also scrutinize whether growth can continue, whether care quality is a priority and whether the leadership team can execute a plan.
For sellers, staying on after a sale can preserve operational knowledge and link their financial interests to future performance. It also means that a transaction may not amount to an immediate exit. The specific terms—such as equity, management roles and decision-making authority—depend on individual deals and were not detailed for every example discussed.
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Recent Deals and Continuing Roles
The conference discussion comes as home-based care companies and investors weigh acquisitions across a sector that includes home health, hospice, private duty nursing and non-medical in-home care. The panelists spoke from different positions: Aveanna Healthcare operates care services in 39 states, while A Place At Home provides non-medical in-home care and related services across 22 states.
Aveanna closed its $175.5 million acquisition of Family First Homecare in June, adding 27 locations across seven states, according to the source report. Separately, Dovida acquired A Place At Home in February, after which co-founder Distefano became its chief operating officer. These examples illustrate continuing leadership roles, but they do not establish that every buyer or seller is adopting the same arrangement.
“If you’re showing organic growth and infrastructure, and that you’re building your team, your value’s going with it.”
— Dustin Distefano, chief operating officer of franchise operations at A Place At Home
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Deal Terms Vary by Buyer
The conference comments describe the panelists’ practices and views, not a sector-wide measure of how often sellers remain involved after acquisitions. The source report does not provide data comparing current deal structures with past ones or quantify how much growth, quality or leadership affect valuations.
Details such as the size and duration of sellers’ equity stakes, their authority after closing and the performance conditions attached to those roles were not specified. It is also unclear whether the arrangements discussed apply broadly beyond the companies and strategies cited by the executives.
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What Sellers May Need to Show
Prospective sellers can expect buyers to ask about organic growth, operational infrastructure, clinical outcomes and management cohesion, based on the panelists’ comments. Sellers considering a continuing role will also need to assess the proposed responsibilities and financial terms as part of negotiations.
No specific future deal, industry forecast or new policy was announced at the conference. The next indication of how widely these practices are being adopted will come from individual transactions and further reporting on their terms and post-close results.
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Key Questions
What is changing in home-based care acquisitions?
Executives at the conference said buyers are looking beyond EBITDA to sustainable growth, care quality, infrastructure and leadership. Some buyers also keep sellers involved after closing.
Does EBITDA still matter to buyers?
Yes. The panelists did not say earnings are irrelevant. Distefano said EBITDA can look strong without showing whether a company has sustained organic growth or the team and infrastructure to support it.
Do sellers always leave after a home care deal?
No. The examples discussed included sellers staying as executives, operating leaders or equity owners. The source does not establish how common those arrangements are across the industry.
What recent acquisitions were cited?
Aveanna completed its $175.5 million purchase of Family First Homecare in June, adding 27 locations in seven states. A Place At Home was acquired by Dovida in February, and co-founder Dustin Distefano became COO.
Source: rss
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