The Resurgence of Private Duty Home Care M&A
Updated: 1 day ago
By Cory Mertz, Managing Partner, Mertz Taggart
At a Glance Private duty home care M&A is picking up after a quiet two years. Buyer interest is returning, platforms are receiving new capital, and the regulatory environment around government-funded care is pushing some acquirers toward private-pay alternatives. For owners of non-medical home care agencies funded by private pay or LTC insurance, the market is more receptive than it has been in some time. The fundamentals still drive outcomes, but a broader buyer pool gives sellers more options on price, structure, and what comes next. |
Private duty home care M&A is beginning a resurgence.
Over the past three months, we have heard from more buyers asking about private duty home care opportunities—or making sure we still have them on our radar—than we did in the previous two years. Some are new to us. Others are established buyers renewing their interest. That is a meaningful change in the conversations we are having.
The interest is backed by investment in established platforms and continued acquisitions of local agencies. For owners who have been waiting for a more receptive market, the change is worth paying attention to.
Government-funded home-based care transactions have become harder to underwrite and close. Buyers still need to grow, and private duty home care offers a path without direct dependence on government reimbursement.
What We Mean by Private Duty Home Care
Private duty home care is non-medical care funded by private pay or LTC insurance. It includes companionship, meal preparation, transportation, medication reminders, and assistance with activities of daily living.
It does not include Medicaid-funded personal care or VA-funded services. It is also different from private duty nursing, which involves skilled nursing care delivered in the home.
A private duty agency has plenty of operating challenges: caregiver recruiting and retention, wage pressure, scheduling, client turnover, and local management. But it does not face the same government rate-setting, enrollment, billing-review, or repayment exposure that buyers must evaluate in Medicare- and Medicaid-funded businesses.
That difference is becoming more valuable.
Recent Investments Show Where Buyers Are Looking
The past 12 months have brought a series of investments in home care platforms—from healthcare-focused sponsors and franchise investors to international operators.
Frontline Healthcare Partners acquired Integracare, a Canada-based private-pay home care provider, in October 2025. NexPhase Capital invested in Always Best Care the following month.
In January 2026, Main Post Partners acquired HomeWell Care Services. A month later, Dovida entered the U.S. through its acquisition of A Place at Home.
General Atlantic’s reported $3 billion acquisition of TEAM Services Group, a diversified home care and household employment platform with private-pay operations. Warburg Pincus also invested in Cornerstone Caregiving, a national non-medical home care provider serving both private duty and VA-funded clients..
The acquisitions are happening at the local level, too. Avenues Home Care acquired Alabama-based As Close As Family in October 2025, an example of the expansion these platforms are pursuing.
Some of these platforms operate across multiple payer or service lines. The common thread is investment in home care businesses with private duty exposure, not an exclusive focus on private-pay providers.
For an agency owner, the significance goes beyond the announcements. A platform investment puts capital, management resources, and acquisition capacity behind a business. Your agency may provide the geographic coverage, caregivers, referral relationships, or leadership team that buyer needs next.
Government Scrutiny Is Changing the Calculation
The private duty investment case predates the current fraud crackdown. But the environment around government-funded healthcare has made the comparison more compelling.
In May 2026, CMS imposed nationwide Medicare enrollment moratoria on new home health agencies and hospices, including certain changes in majority ownership. The agency also announced expanded investigations, enrollment screening, site visits, and claims reviews.
Medicaid enforcement has intensified as well.
CMS reported that the first 88 days of its Medicaid Fraud War Room produced federal or state enforcement activity involving 50 high-risk providers and more than $203 million of Medicaid payments.
In a transaction, that environment means more attention to billing practices, eligibility documentation, payer contracts, enrollment history, and potential repayment exposure. Medicaid adds state-specific requirements that can affect transaction structure and closing.
We are seeing how difficult it can be to get government-funded deals across the finish line, even when the underlying business is attractive.
Buyers with both government-funded and private duty operations have a choice about where to deploy acquisition capital. Private duty allows them to add clients, caregivers, referral relationships, and cash flow without taking on the same reimbursement uncertainty.
What Buyers See in Your Agency
For owners of private duty platforms, the expanding buyer universe is particularly significant. Buyers looking to enter the sector or establish a regional presence will pay a premium for a business that already has the management team, operating infrastructure, and scale to support further growth. They are acquiring both current earnings and the ability to build on them.
Established local agencies can also benefit. A buyer may value your agency for its market position, caregiver base, referral relationships, or the density it adds to an existing footprint. The value depends on what you have built—and what it allows the buyer to do next.
That is why the buyer’s strategy matters as much as the headline multiple. A competitive process helps identify who sees the greatest value in your business and gives them a reason to pay for it.
Nova Leap Provides a Public-Market Perspective
Nova Leap Health is a Canadian company headquartered in Halifax, trading on the TSX Venture Exchange under NLH and on the U.S. OTCQX market under NVLPF. It has built much of its U.S. home care business through acquisitions, with U.S. operations accounting for approximately three-quarters of revenue in the first half of 2026.
In our view, Nova Leap is the closest public-market comparable for private duty home care. Its focus on acquiring and operating local home care agencies makes it particularly relevant to owners considering a sale.
The company’s share price increased approximately 82% between year-end 2025 and September 30, 2026. It also reported record Q2 results, with revenue increasing 17.1% and Adjusted EBITDA increasing 65.2% from the prior-year quarter.
As of September 30, Nova Leap had an enterprise value of approximately US$34.3 million, representing roughly 13.2x its US$2.6 million of trailing-12-month Adjusted EBITDA through June 30, 2026.
What This Means if You Are Considering a Sale
A broader buyer market can give you more choices—not just on price, but on your role after closing, the future of your team, and how the business continues to grow.
The fundamentals still determine the outcome. Buyers want reliable financials, defensible margins, stable client relationships, and a business that can operate after the owner steps away. Those qualities become more valuable when several credible buyers are competing for them.
If you have thought about selling but assumed the market was too quiet, this is a good time to revisit that assumption.
The freeze is beginning to thaw. We are hearing directly from buyers, investors are committing capital, and platforms are expanding.
If you own a private duty home care agency, and are curious about how it would be viewed in the current private duty M&A marketplace, we’ll be happy to have a discussion.
Key Takeaways
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