Q3 2026 Home-Based Care M&A Report
Updated: 8 minutes ago
By Cory Mertz, M&AMI, Managing Partner, Mertz Taggart
Home-based care M&A volume stepped down in Q3 2026, with 11 transactions closed during the quarter, down from 23 in Q2 2026 and 22 a year ago. Home health and hospice tied for the lead at six closed transactions each, followed by home care at four. Private equity remained the most active source of capital: eight of the 11 closings were either new sponsor platform investments or add-ons by sponsor-backed strategics. The softer count tracked the broader healthcare market, where LevinPro's preliminary data showed announced deal volume down 16% from Q2. Several significant deals were announced but not closed by quarter-end, led by Addus HomeCare's agreement to acquire AccentCare's personal care division for approximately $275 million; those are covered below and excluded from the count.
“Q3 was a light quarter, but it is one quarter—not a trend. Deals are taking longer to close, and we fully expect a strong Q4,” said Cory Mertz, managing partner at Mertz Taggart.
Home-Based Care M&A
Of the 11 closings, six were add-ons by sponsor-backed strategics, two were new sponsor platform investments, one was by a strategic buyer, and two were by other buyers, including independent operators.
The quarter played out against an active regulatory calendar. In May, CMS announced a six-month nationwide moratorium on new home health and hospice enrollments. In July, CMS issued its proposed CY 2027 home health rule, which it estimates would increase aggregate Medicare home health payments by 2.4% while expanding program-integrity and enforcement provisions. For hospice, the FY 2027 final rule set a 2.3% payment update, effective October 1, 2026.
“Buyers have gotten more careful, and that's not bad news for owners who run a clean shop. Compliance history, documentation, and leadership depth are getting a harder look in diligence than they did a few years ago. With positive rate updates on the table for both home health and hospice next year, buyers have a clearer reimbursement picture to underwrite. Agencies that can show they're well run are still getting deals done,” Mertz said.
Home Health M&A
Home health recorded six closed transactions in Q3 2026: one platform investment, four sponsor-backed add-ons, and one transaction by an independent buyer.
The quarter's headline closing was Ares Management's investment in Elara Caring. Ares' Private Equity Group, alongside DaVita as a minority investor, completed its strategic investment in Elara effective July 20, 2026. Elara is a national provider of skilled home health, hospice, behavioral health, and personal care services. Terms were not disclosed, although DaVita reported a cash payment of approximately $200 million at closing for its noncontrolling interest. DaVita and Elara plan to co-develop a kidney-specific home-based care model.
Backed by The Vistria Group, VitalCaring acquired Carter Healthcare, adding home health and hospice operations in Ohio and West Virginia and strengthening its presence in Oklahoma, Texas, Kansas, and Missouri. Following the deal, VitalCaring operates 89 home health locations and 40 hospice and palliative care locations.
“The Elara closing tells you serious capital still sees home health as a place to build, especially for higher-acuity patients who need to be managed at home. Buyers will pay for scale and clinical capability, and they're willing to wait for the right asset,” Mertz said.
Other home health closings included LiveWell Partners' acquisition of Michigan Community VNA Home Health and Hospice, its third acquisition in Michigan; the Detroit-area agency will keep its name and leadership. Webster Equity Partners-backed Care Options for Kids added Health Force, a pediatric home care provider in Chicago. Havencrest Capital Management-backed Avid Health at Home acquired Tech Medical Home Care Services, a home health and personal care provider, entering Kentucky and Ohio with its eighth acquisition. RN Enterprises acquired Helping Hands Home Healthcare in Florida.
Hospice M&A
Hospice also recorded six closed transactions, matching the prior-year quarter: two platform investments, two sponsor-backed add-ons, one strategic acquisition, and one transaction by an independent operator.
“Demand for hospice businesses remains very strong, and there are plenty of deals working toward closing,” Mertz said.
Chapters Health System, the largest nonprofit hospice provider in the country, finalized its affiliation with Housecall Providers of Portland, Oregon, in August. The deal expands Chapters' Oregon footprint and adds Housecall's in-home primary care, palliative care, and hospice services to support its value-based care strategy.
A healthcare focused private equity group closed on a hospice platform in the western U.S. Family Hospice acquired North Georgia Community Hospice in Dalton, Georgia. The Elara, Carter Healthcare, and Michigan Community VNA transactions also included hospice operations.
Home Care M&A
Home care recorded four closed transactions: one platform investment and three sponsor-backed add-ons.
Flexpoint Ford-backed MGA Homecare acquired the private duty nursing division of Care IV Home Health in Arkansas, expanding its care for medically complex patients. Webster Equity Partners-backed Honor Health Network added Atlanta-based Agility Home Care. The Elara and Tech Medical transactions also included personal care operations.
“The Addus announcement is a reminder that buyers are still willing to commit substantial capital to home care. I wouldn’t read one quarter’s closing volume as a lack of demand,” Mertz said.
Announced (Pipeline)
The following transactions were announced but had not closed as of September 30, 2026. They are not included in the quarter's transaction count, the sub-sector counts, or the charts above.
Addus HomeCare (Nasdaq: ADUS) agreed to acquire the personal care division of AccentCare, outside of New York, for approximately $275 million in cash. The business serves an average daily census of about 13,700 clients across 10 states, led by Texas, Illinois, California, and Arizona, and is expected to add approximately $280 million in annualized revenue, roughly 19% of Addus' revenue base. AccentCare's home health and hospice operations are excluded. Dirk Allison, chairman and CEO of Addus, said, "This acquisition continues our growth strategy to leverage our strong personal care experience to build scale in existing markets as well as enter select new markets."
Circle of Life agreed to acquire Washington Regional Hospice in Northwest Arkansas, including the Willard Walker Hospice Home, with closing targeted for the end of September. In addition, Center for Hope Hospice and Palliative Care and VNA Hospice NWI announced a strategic affiliation in Indiana.
After quarter-end, Deaconess Associations (DAI) closed its acquisition of 31 home health and hospice agencies from HCA Healthcare (NYSE: HCA), comprising 24 home health and seven hospice locations across eight states. The deal, announced in June, places the agencies under DAI's Central Pyramid subsidiary. DAI CEO Trey Crabb said, "I think we were in a unique place to be able to execute the transaction after HCA made the decision to strategically exit the (home health and hospice) business in most of its markets."
If you are interested, you can also download the .PDF version of the Q3 2026 Home-Based Care M&A Report via the following link:
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