Agencies trade at 5.5x to 10.0x+ EBITDA because home-based clinical care is the lowest-cost, highest-satisfaction care setting for an aging demographic, securing strong bipartisan reimbursement support.

Average Daily Census measures the average number of active patients receiving care per day; ADC stability and average length of stay dictate the enterprise value of a hospice agency.

The Medicare aggregate cap limits total annual Medicare reimbursement per patient; buyers audit historical reimbursement to ensure the agency has zero Medicare overpayment refund liabilities.

Transfers require filing CMS-855A change-of-ownership forms and state Department of Health notifications; we guide buyers and sellers through regulatory approvals smoothly.

Sellers typically provide 6 to 12 months of structured transition support to maintain key hospital discharge planner relationships and mentor clinical administrators.