Selling a healthcare agency in North Carolina
Riverbluff Advisors is a healthcare business broker that sells independent, owner-operated home care, home health, and hospice agencies in North Carolina. We work with owners across the state, from Charlotte, Raleigh–Durham, and the Triad to eastern and western North Carolina.
North Carolina agency types we sell
- Home care: non-medical in-home aide services, often paid through NC Medicaid Personal Care Services (PCS) or the CAP programs. Buyers look at weekly hours, caregiver retention, and which payer contracts move with the sale.
- Home health: Medicare-certified agencies. North Carolina requires a certificate of need to open a new home health agency, so existing certified agencies are scarce and in demand.
- Hospice: also subject to certificate of need for new providers. Buyers price census, cap position, and survey history.
How a North Carolina agency sale works
The buyer gets a new license. North Carolina's Division of Health Service Regulation (DHSR) issues a new license to the buyer after approving the change of ownership. The seller notifies DHSR in writing at least 30 days before the sale date, and the buyer files a licensure application with the purchase documents, policies and procedures, and staffing and agency director qualifications.
The agency must be in good standing. DHSR requires the agency to be in compliance with all applicable rules, with no outstanding complaints, before the change of ownership. We check this before your agency goes to market.
Buying an existing agency avoids a new certificate of need. Under North Carolina law, acquiring an existing health service facility is exempt from certificate of need review when the buyer gives the state prior written notice. That's a big part of why existing home health and hospice agencies sell at a premium in North Carolina.
Medicare-certified agencies have a second clock. For home health and hospice, the federal change of ownership rules apply on top of the state process, including the CMS 36-month rule.
Medicaid contracts set the timeline for home care. Agencies paid through NC Medicaid PCS, the CAP programs, or Standard and Tailored Plans usually need the buyer enrolled or credentialed with each payer. We review every contract up front so the closing date holds.
Why now is a good time to sell a North Carolina home care agency
In August 2026, NC Medicaid raised Personal Care Services and CAP rates by 18%, including PCS paid through Standard and Tailored Plans. Higher rates mean higher earnings, and buyers price agencies on earnings.
What North Carolina agencies sell for
Price depends on agency type, hours or census, payer mix, and the agency's record. See current ranges on our What agencies sell for page, or request a free Agency Value Report for a number specific to your agency.
North Carolina agencies for sale
No North Carolina agencies are on the market right now. Join the buyer list to hear about new ones.
North Carolina seller questions
How long does a North Carolina agency sale take?
Most take three to eight months. The state requires 30 days' notice before a change of ownership, and Medicare and Medicaid approvals usually set the final timeline.
Does the buyer need a certificate of need?
Not to buy an existing agency. Acquiring an existing agency is generally exempt from certificate of need review with prior written notice to the state.
Can I sell a home care agency with Medicaid PCS clients?
Yes. Agencies with steady PCS and CAP hours are in demand, especially after the 2026 rate increase. The buyer usually has to enroll or credential with each payer, so we confirm what each one requires before going to market.
Do I need a North Carolina attorney?
Yes. We coordinate with your attorney on the purchase agreement and filings, but we do not give legal advice.
What does it cost?
Nothing until closing. Our fee is a success fee paid when the sale closes.