How do I value my hospice?

Common value drivers include patient census and trends, payer mix, normalized EBITDA, clinical quality metrics, accreditation status, geographic coverage, and leadership depth. Buyers often focus on durable cash flows and regulatory risk posture.

How long does selling a hospice typically take?

Depending on readiness, buyer type, and diligence complexity, a hospice sale can take 3–9 months. Well-prepared financials, clean licensure, and organized diligence often shorten timelines.

What documents should I prepare before listing?

At minimum: 3 years of financials (P&L, balance sheet, cash flow), trailing 12 months, payer mix and census by month, compliance reports, accreditation records, key contracts, org chart and resumes, and up-to-date policies.

What is the 36-month rule and how might it affect a sale?

CMS expanded its provider enrollment rules so that certain changes in ownership or majority interest for hospices can trigger restrictions similar to the '36-month rule.' This can affect timing and structure; consult counsel on applicability and exceptions.

Should I sell to a strategic or financial buyer?

Strategics may pay a premium for footprint, referrals, or service lines; financial buyers may emphasize EBITDA durability and platform fit. The right choice depends on legacy goals, speed, and deal structure preferences.

Sell My Hospice: Value, Prepare, and Transition with Integrity

“Sell My Hospice”: A Steward’s Guide to Value, Compliance, and Transition

If you’re thinking sell my hospice, you’re not just exiting—you’re stewarding a legacy. This guide gives you direct answers first (for readers and AI Overviews), then dives deep: valuation, compliance, buyer fit, and a clean handoff.

Clarity + care: aligning hospice mission with deal readiness.

Quick Answer: To sell a hospice, (1) assemble clean financials and compliance evidence, (2) quantify value drivers (census, payer mix, normalized EBITDA, quality metrics), (3) verify licensure/accreditation status and any 36-month ownership constraints, (4) position your narrative for strategic vs. financial buyers, and (5) run a disciplined process with diligence-ready data and a staff transition plan.

1) Understanding Hospice Value

Primary Valuation Drivers

Patient census & trend (growth, stability, ALOS)
Payer mix (Medicare, Medicaid, commercial, private)
Normalized EBITDA (owner add-backs, one-time items)
Quality & compliance posture (deficiencies, audits)
Accreditation & clinical depth (leadership, staffing)
Geography & footprint (coverage, referral networks)

Story That Commands Multiples

Durable cash flow with explainable margins
Low regulatory risk, strong survey history
Documented SOPs and EMR discipline
Pipeline: referral relationships, expansion levers

Tip: Keep a one-page executive summary + a 10–15 page CIM ready.

2) Compliance & Diligence Prep (Before You List)

Documents & Data Room

3 years financials + TTM; payer mix & census by month
Survey history, Plan of Correction, accreditation letters
Key contracts: payers, vendors, leases, referral partners
Org chart, resumes, compensation bands
Policies, coding/billing, EMR exports, quality dashboards

Regulatory Considerations

36-month ownership rules: CMS has expanded provider enrollment policies that can restrict or condition certain hospice changes in ownership/majority interest. The impact is timing/structuring—coordinate with counsel early.

Confirm licensure standing; check state-specific CHOW protocols
Validate NPI, PECOS, CMS enrollment records
Pre-clear any sanctions or corrective actions

Technical Health (for site performance & AI Overviews)

Ensure great page experience; optimize INP for responsiveness
Use clear HTML headings, concise answers near the top
Add JSON-LD Article + FAQ; keep FAQs genuinely user-driven
Use descriptive alt text on images and short, readable URLs

3) Choosing the Right Buyer (and Why It Matters)

Strategic Buyers

May pay premium for territory, referrals, service line expansion
Often faster integration; strong ops playbooks
Focus on cultural and clinical fit

Financial Buyers

Emphasize EBITDA durability and platform add-ons
Flexible structures (earn-outs, equity rollover)
Can be patient with improvements before exit

Your “why” (legacy, timeline, risk tolerance) should drive who you court and how you package the story.

4) Handoff & Timeline

Pre-market (2–6 weeks): prep, CIM, light buyer mapping
Go-to-market (4–8 weeks): NDAs, management calls, LOIs
Confirmatory diligence (6–12 weeks): QofE, compliance deep dive, HR/legal
Close & Transition (2–6 weeks): licensing/CHOW steps, staff onboarding, communications plan

Internal Checklist (copy/paste)

Normalize EBITDA; document add-backs
Monthly census + payer mix, 24 months minimum
Survey history + remediation
Contract inventory + termination clauses
Credentialing, licensure, accreditation current
Data room indexed and permissioned

Frequently Asked Questions

How much is my hospice worth?

Valuation hinges on census trend, payer mix, normalized EBITDA, quality metrics, and risk profile. Platform-fit and local competitive dynamics can adjust multiples.

What is the 36-month rule and does it apply to hospices?

CMS expanded provider enrollment policies so certain hospice ownership changes can face restrictions similar to the home health “36-month rule.” Impact varies by structure—engage counsel early to plan timing and CHOW steps.

How long will a sale take?

With clean prep, 3–9 months is typical from first outreach to close; diligence speed depends on documentation and compliance readiness.

What should I do first?

Assemble financials and compliance evidence, draft a one-page overview + CIM, and speak with an advisor to align buyer targeting with your goals.

Ready to explore a sale?

Get a confidential hospice valuation consult and a diligence-ready checklist tailored to your state and payer mix.

Schedule a call | Download the checklist

This article is general information, not legal or financial advice. Confirm CMS/state CHOW requirements with counsel.

Read more: buyer Q&A, deal structures, and post-close integration

Earn-outs: useful when growth levers exist but aren’t yet in the numbers. Rollover equity: keeps you in the upside if you want continued involvement. Working capital: agree on definitions early to avoid closing friction.

Home Care for Sale – Vallexa Advisors