Q1 2026 Home-Based Care M&A Report
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Home-based care M&A activity held steady in Q1 2026, with 22 transactions closed during the quarter — continuing the momentum from last year's rebound. Seven additional deals were announced but not yet closed as of quarter-end, signaling a healthy pipeline heading into the second quarter. Hospice led all sub-sectors with 10 closed transactions, followed by home care at 9 and home health at 6.
Cory Mertz, managing partner at Mertz Taggart, noted: "Q1 2026 was an encouraging start to the year. We're seeing more sponsors reach the point where they need to transact — some of these platforms have been held for five, six, seven years, and the pressure to return capital to LPs is real. The clock is ticking on a lot of these funds, and buyers are active. We expect deal volume to continue building through Q2 and into the back half of the year."
Home-Based Care M&A
The 22 closed transactions in Q1 2026 were driven by sponsor-backed activity across all three sub-sectors. Home care and hospice each contributed double-digit deal counts on a combined basis, while home health showed modest improvement from the multi-quarter lows seen through much of 2024 and early 2025.
Cory Mertz added: "The announced deals this quarter tell the real story. Elara Caring, Enhabit, TEAM Services, Aveanna/Family First — these are meaningful transactions that reflect growing conviction from both buyers and sellers."
Home Health M&A
Home health activity improved in Q1 2026, with 6 total transactions — including 1 new platform and 5 sponsor-backed add-ons — up from 3 in Q4 2025 and the best quarter for the sub-sector in over a year.
The quarter's headline deal was the announced acquisition of Enhabit Home Health & Hospice by Kinderhook Industries for $1.1 billion, representing a 10.2x EBITDA multiple on $108 million of EBITDA and $1.06 billion in revenue. Enhabit had been publicly traded since spinning out of Encompass Health in 2022 and had spent much of its time as a standalone company navigating reimbursement headwinds and investor skepticism about Medicare home health. The Kinderhook deal delivers a 24% premium to Enhabit's share price at announcement and nearly 34% to the 60-day average — the kind of outcome that speaks for itself.
Cory Mertz offered this perspective: "The Enhabit deal is a good reminder of why we don't lead with multiples. Shareholders received a 24% premium to market and nearly 34% to the 60-day average — real value by any measure. But if you just read '10.2x EBITDA' in a headline, it sounds unremarkable. The multiple is an output, not the goal. For Enhabit's board, the goal was maximizing value for shareholders and getting the company out from under the quarterly earnings spotlight — both of which this transaction accomplished."
Also announced — but not yet closed — was Ares Management's (alongside DaVita) strategic investment in Elara Caring, the large national home health, hospice and personal care platform formed in 2018 from the three-way merger of Great Lakes Caring, National Home Health Care and Jordan Health Services. Blue Wolf Capital had held the asset for nearly eight years — an unusually long hold period by private equity standards — navigating a difficult regulatory environment, a $4.2 million DOJ settlement in 2024, and a home health reimbursement landscape that kept many large-platform exits on hold. DaVita disclosed an approximately $200 million minority investment alongside a majority investment from Ares, with Elara continuing to operate as an independent company. The strategic rationale centers on co-developing a kidney-specific in-home care model, leveraging DaVita's clinical expertise to reduce preventable hospitalizations and lower total cost of care for patients with kidney disease.
Among closed deals, Choice Health at Home added Cyfair Healthcare in Texas and Alliant Home Health in back-to-back transactions, extending its multi-state footprint. Residential Healthcare Group acquired Covenant Home Health to deepen its presence in eastern Pennsylvania, and Superior Health Holdings closed on Pulse Home Health & Hospice. Also announced was Aveanna Healthcare's agreement to acquire Family First Homecare for $175.5 million. Family First is a pediatric home care provider focused on skilled private duty nursing, operating 27 locations across seven states including Florida and Texas. The deal expands Aveanna's specialized pediatric footprint and reinforces its strategy of building scale in medically complex, high-cost patient populations.
Hospice M&A
Hospice maintained its position as the most active sub-sector in Q1 2026, with 10 closed transactions — including 5 sponsor-backed strategic add-ons. This is consistent with the record activity seen in Q4 2025 and confirms hospice as the preferred target for both strategic and financial buyers in the current environment.
Notable transactions include Uplift Hospice's purchase of Autumn View Hospice in Georgia, continuing the platform's active acquisition streak. On the not-for-profit side, Chapters Health System announced another transaction in its acquisition of HouseCall Providers, a Portland, Oregon-based organization offering home health, hospice and palliative care services across the Pacific Northwest. Hospice of Southern Maine announced the pending acquisition of Andwell Health Partners, and VNA of Texas completed the acquisition of Faith Presbyterian Hospice. Heart to Heart Hospice continued its add-on pace with the acquisition of a former Cura-HPC location in Oklahoma City. Kara Health launched a joint venture with Loma Linda University Health to form Loma Linda University Hospice, expanding Kara's health system partnership model into the Inland Empire region of California.
Cory Mertz noted: "Hospice M&A has been on a run, and we don't think it's over. The activity we saw in Q4 2025 and Q1 2026 is being driven by real demand from buyers and growing willingness from owners to engage. A few precedent platform transactions were received well in 2025, and that fuels more PE interest in the space — which drives demand for all hospice agencies, large and small. For hospice operators who are thinking about a sale in the next one to three years, the current environment rewards preparation — particularly around billing compliance and documentation."
Home Care M&A
Non-medical home care contributed 9 closed transactions in Q1 2026, including 5 sponsor-backed strategic add-ons and 1 new platform. While slightly below the elevated levels seen in Q1 and Q2 2025, activity remained healthy and the announced deal pipeline points to continued momentum.
The quarter's most notable announced transaction was General Atlantic's acquisition of TEAM Services Group, one of the largest Medicaid-focused home and community-based services providers in the country, from Alpine Investors, which had built the platform through more than a decade of aggressive add-on activity since forming the company in 2015. The deal, backed by $1.38 billion in financing, closed in early Q2 — but its announcement during the quarter is a meaningful signal of continued large-platform appetite in the home care space.
Among closed deals, Care Advantage acquired the Delaware locations of Neighborly Home Care, HouseWorks HomeCare added A Caring Experience Nursing Services in the Northeast, and PurposeCare added Freedom Home Care to its expanding portfolio. Choice Health at Home continued its aggressive add-on pace, closing on Florida-based Senior Nannies Home Care Services in addition to its home health transactions this quarter. Q1 also saw two home care franchise networks change hands: Main Post Partners established a new platform with the acquisition of HomeWell Franchising, and Dovida, a global home care provider operating across six international markets, made its U.S. market entry with the acquisition of A Place At Home, a franchise network with approximately 55 locations across 27 states.
Cory Mertz noted: "Home care is still very much in play. We have a number of sponsor-backed platforms that have been building for several years and are getting close to exit-ready, and buyers — including some we haven't seen active in a while — are showing renewed interest."
If you are interested, you can also download the .PDF version of the Q1 2026 Home-Based Care M&A Report via the following link:
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