A buyer will want to see sustainable earnings, census stability, length of stay, payer mix, referral sources, staffing, surveys, and claims history. The state moratorium may make an established license more relevant, but it does not guarantee a higher price. The confidential calculator can help frame the discussion. A reliable answer requires review of the financials, compliance record, enrollment history, and proposed transaction structure.

A sale may still be possible, but the answer depends on structure. California’s state moratorium restricts new hospice licenses, while CMS’s separate nationwide moratorium applies to initial Medicare enrollment applications and includes non-exempt changes in majority ownership. A transaction that is treated as a barred enrollment action cannot be described as an ordinary CHOW. CDPH licensing, Medicare enrollment history, and the proposed ownership change must be reviewed before marketing. Buyers will also scrutinize survey history and enforcement exposure, so complete compliance files and early healthcare-counsel review are essential.

The 36-month rule applies to Medicare-certified home health agencies nationwide, including California. If a majority ownership change occurs within 36 months of initial Medicare enrollment or a prior majority change, the provider agreement generally does not transfer. The buyer must enroll as a new provider, which can interrupt billing. That history can affect whether an asset sale, equity sale, management arrangement, or later closing date is workable. Review it with an advisor and healthcare counsel before going to market.

California sale timelines vary with the agency and the proposed deal. Buyer diligence, CDPH review, Medicare enrollment, financing, and third-party consents can all affect the schedule. The current federal moratorium may make some ownership changes unavailable, not just slower. Current licenses, organized survey and complaint files, clean cost reports, normalized financials, and a documented ownership history give the team a better chance to identify a workable path before buyers are contacted.

We begin with a blind profile and require qualified buyers to sign an NDA before receiving identifying information. Staff, patients, and referral sources are not brought into the conversation unless the transaction reaches the point where a communication plan is needed. You approve that plan. Keeping the circle small helps protect census, staffing, and referral relationships while the sale is being evaluated.

IHSS is California’s public in-home supportive services program. Estimated 2025-26 spending is roughly $29.9 billion for about 771,650 recipients. Buyers will look at how revenue is divided among IHSS, Medi-Cal waiver work, and private pay. Private-pay concentration can support stronger margins, while public-program revenue may offer greater volume and continuity at lower rates. Each profile appeals to a different buyer group.