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Home-based care executives say acquisition decisions increasingly weigh sustainable organic growth, clinical quality and leadership alongside financial performance. Buyers may also keep sellers involved after closing, including through leadership roles, operating partnerships or equity stakes.
Home-based care acquisitions are increasingly being treated as the start of an ongoing partnership, rather than a clean break at closing, executives said at Home Health Care News’ FUTURE conference. They described buyers giving greater weight to sustainable organic growth, clinical quality and leadership—and, in some cases, retaining sellers as executives, operating partners or equity owners.
The executives said earnings alone do not capture a company’s readiness or long-term value. Dustin Distefano, chief operating officer of franchise operations at A Place At Home, said sellers should be able to show sustained growth, infrastructure and a team capable of supporting the business. A strong EBITDA figure, he argued, can obscure a company that has stopped growing.
“If you’re showing organic growth and infrastructure, and that you’re building your team, your value’s going with it,” Distefano said. He said he has used an organic-growth framework to tell operators that a business showing “staleness” is losing value in his view. That is his assessment of valuation, not a reported industry-wide pricing formula.
Aveanna Healthcare Holdings CEO Jeff Shaner said he would favor a slower-growing company with stronger clinical quality over one pursuing faster growth without the same commitment. He said financial outcomes correlate with clinical results. Aveanna closed its $175.5 million acquisition of Family First Homecare in June, adding 27 locations across seven states, according to the source report.
Bill Mixon, an executive partner at private equity firm Waud Capital, said cohesive management and a clear company culture can affect whether buyers see a business as prepared for its next stage. A fragmented leadership team can shift a buyer’s attention from growth plans to questions about who will run the company after the sale.
Growth and Quality Shape Deal Readiness
The shift described by the panel matters to owners considering a sale because it broadens the evidence buyers may expect beyond reported earnings. Sellers may need to show that growth is repeatable, that operational infrastructure can support it, and that care quality and leadership are not dependent on one person or a short-term push.
For buyers, keeping former owners involved can preserve operating knowledge and provide continuity for staff and clients. It can also tie sellers’ future returns to the acquired company’s performance. These arrangements are not presented as universal practice: the executives described approaches at their own organizations, and specific terms will vary by transaction.
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Recent Deals Show Seller Continuity
The conference discussion reflects a change from a traditional sale in which an owner received proceeds and left the company. Shaner said buyers are now increasingly keeping acquired-company executives involved. At Aveanna, he said, sellers can become equity owners and leaders in the acquired operations, aligning their interests with the company’s future results.
One example is A Place At Home, a non-medical home care and care coordination provider operating across 22 states. The company was acquired by European home care company Dovida in February. Its co-founder Distefano became chief operating officer after the deal closed. A Place At Home’s joint venture approach can also allow franchise owners to retain minority stakes and continue as general managers, according to the report.
““If you’re showing organic growth and infrastructure, and that you’re building your team, your value’s going with it.””
— Dustin Distefano, chief operating officer of franchise operations at A Place At Home
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Deal Terms Remain Company-Specific
The conference comments describe executives’ preferences and company strategies, not a measured market-wide rule. The report does not provide data on how often sellers remain after closing, how much those arrangements affect purchase prices, or whether they are becoming more common across the sector.
It also does not detail the equity, employment or governance terms involved in the examples. Those terms can vary, and the panel discussion does not establish how a particular buyer will value a company or structure a future transaction.
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Owners Face Closer Buyer Scrutiny
For prospective sellers, the next step is to prepare evidence of sustained growth, operational capacity, clinical performance and leadership continuity, while clarifying whether they want to remain involved after a sale. Buyers will need to assess those factors against their own investment plans and the specific business.
The source report does not identify a new regulation, transaction deadline or scheduled industry milestone. The approaches described will be tested in future deals, where final valuations and post-close roles will depend on negotiations between each buyer and seller.
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Key Questions
What are buyers said to value beyond EBITDA?
Executives at the conference pointed to sustainable organic growth, operational infrastructure, clinical quality and cohesive leadership. The comments reflect their views and do not establish a universal valuation formula.
Do sellers have to stay with a company after a sale?
No. The report describes buyers retaining some sellers as executives, operating partners or equity owners, but it does not say this is required or standard in every transaction.
Which companies and deals were cited?
Aveanna Healthcare said it closed a $175.5 million acquisition of Family First Homecare in June, adding 27 locations in seven states. A Place At Home was acquired by Dovida in February, and co-founder Dustin Distefano took a leadership role after closing.
What remains unknown about this shift?
The report gives no market-wide figures showing how frequently sellers stay involved, how these arrangements affect deal prices, or the specific equity and employment terms used in the cited transactions.
Source: rss
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