Home-Based Care Deals No Longer End At The Closing Table
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TL;DR

Executives at Home Health Care News’ FUTURE conference said home-based care buyers are looking beyond EBITDA to sustainable growth, clinical quality and leadership. Some buyers are also keeping former owners involved after acquisitions through ongoing operating roles or equity stakes.

Home-based care buyers are looking beyond earnings and, in some cases, keeping sellers involved after acquisitions, executives said at Home Health Care News’ FUTURE conference. Their comments point to a dealmaking approach that puts more weight on sustainable organic growth, clinical quality and leadership than on EBITDA alone, while treating some sales as continuing partnerships rather than complete exits.

Dustin Distefano, chief operating officer of franchise operations at A Place At Home, said sellers can support their valuation by showing that growth is ongoing and backed by the right infrastructure and team. EBITDA can look strong without revealing whether a company is growing organically, he said. Distefano said he encourages operators not to settle into a plateau: in his view, signs of stagnation can weaken a company’s value to a buyer.

A Place At Home provides non-medical in-home care, care coordination and other services across 22 states. The company was acquired by Dovida in February, and co-founder Distefano became its COO after the deal closed. The example illustrates how a founder may remain in a leadership role rather than leave immediately after a sale.

Aveanna Healthcare Holdings CEO Jeff Shaner said he would favor a slower-growing company with stronger clinical quality over a faster-growing business that did not show the same commitment to care. He said financial outcomes correlate with clinical results. Aveanna, which provides home health care, hospice, private duty nursing and other services in 39 states, completed its $175.5 million acquisition of Family First Homecare in June, adding 27 locations across seven states.

At a glance
reportWhen: Reported October 2026; comments made at…
The developmentHome-based care executives described a shift toward evaluating businesses on sustainable growth and quality, while building post-acquisition partnerships with sellers.

Buyers Weigh Growth Beyond Earnings

The approach described by the executives affects what sellers may need to show when pursuing a deal. Strong earnings remain relevant, but buyers may also examine whether growth can continue after the transaction, whether operations have the infrastructure to support it, and whether clinical quality and leadership are strong enough to sustain performance.

Post-sale arrangements can also change what an acquisition means for owners and employees. Aveanna aims to give some sellers equity and leadership roles in acquired operations, Shaner said. At A Place At Home, the company’s joint-venture strategy can allow franchise owners to keep minority ownership stakes and serve as general managers. Those arrangements may align sellers’ interests with the acquired business’s future results, though the specific terms differ by deal.

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Recent Deals Show Ongoing Roles

The conference discussion comes as buyers and sellers consider not only purchase price, but also how a company will operate and grow once ownership changes. The executives described a shift away from treating the closing as the end of the relationship in every case. Instead, some buyers are retaining former owners or executives as partners in the business.

Bill Mixon, an executive partner at private equity firm Waud Capital, said buyer selectivity and fit with an investor’s strategy make management and workplace culture relevant during evaluation. A management team that lacks cohesion can prompt questions about whether leadership changes will be needed, he said. Waud Capital has completed more than 480 investments since its founding in 1993.

The examples are not evidence that every buyer is adopting the same model. Shaner described Aveanna’s approach, while Distefano discussed A Place At Home’s acquisition and joint ventures. The conference remarks offer executives’ views on dealmaking, rather than a survey measuring how common these practices are across the sector.

“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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How Broad the Shift Remains

The conference comments do not establish how frequently buyers across home-based care are retaining sellers or giving them equity. The report provides examples and executive perspectives, but no industry-wide figures on deal terms, valuation methods or post-acquisition retention.

It is also unclear how much weight buyers assign to organic growth, clinical quality and leadership relative to earnings in any particular transaction. Those priorities can differ by company and buyer. The reported examples do not include detailed terms for the acquisitions or joint ventures, including the size of any retained stakes or how performance is measured.

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Seller Readiness and Deal Terms

For prospective sellers, the executives’ comments suggest buyers may ask for evidence that growth is durable, teams can support expansion and care quality is maintained. Sellers may also need to discuss whether they would remain with the business and how responsibilities or ownership could continue after closing.

Further detail will depend on future transactions and how buyers structure them. The conference report does not identify a specific next deal or policy change. As acquisitions proceed, public announcements and company disclosures may clarify whether the partnerships described by the executives are reflected in additional transactions.

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Key Questions

What are home-based care buyers looking at besides EBITDA?

Executives at the conference cited organic growth, operational infrastructure, clinical quality, leadership and team cohesion as factors buyers may consider alongside earnings. The remarks do not set a universal formula for valuations.

Do sellers always leave after a home-care acquisition?

No. The executives described examples in which former owners or executives remain in leadership or operating roles. Some arrangements may also include equity, but the terms vary by transaction.

What happened after A Place At Home was acquired?

A Place At Home was acquired by Dovida in February. Co-founder Dustin Distefano became chief operating officer of franchise operations after the deal closed.

What did Aveanna acquire in June?

Aveanna completed its $175.5 million acquisition of Family First Homecare in June. The deal added 27 locations across seven states, according to the report.

Is this approach now standard across the industry?

The report does not establish that it is. It presents comments from executives at a conference and examples involving specific companies, but provides no industry-wide data on how common these practices are.

Source: rss

This article is for informational purposes only and is not medical advice. Always consult a qualified healthcare professional about your specific situation.
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