Volume 12, Issue 19, September 23, 2025
By: Anna Elliott, CM&AA
Selling a healthcare company is one of the most important steps an owner will ever take. It's not just a financial decision. It's about the future of their people, their patients, and the business they've built. Some sales move forward smoothly and create lasting value. Others stall or collapse, often for avoidable reasons.
A recent deal I advised on — the sale of a Pennsylvania-based home health care provider to a large, publicly traded company — was one of the smooth ones. In this column, I'll share what made it work, along with a few examples of sales that went off track, so you can see both sides of the process and learn how to better prepare for your own transaction journey.
In early 2025, the CEO of a respected Pennsylvania home health provider reached out to VERTESS. His company had three locations, more than 500 employees, and a strong reputation for personal care, home health, and hospice services. The organization cared for roughly 600 patients each day and had become a trusted resource in its communities. The CEO had built something strong, but he also knew that finding the right partner could help the company grow further and reach even more patients.
Before choosing VERTESS as his M&A advisor, he spoke with seven different investment banks. His thorough approach told me something important: He was very serious about finding the right partner. He wasn't just looking for someone to run a process. He wanted an advisor who understood healthcare — and home health in particular — who could help protect his legacy and bring discipline to what is often an emotional process. That mindset, combined with his willingness to stay engaged and actively prepare his company for sale, set the stage for success.
We started with a sell-side quality of earnings (QofE) report before going to market. That transparency built credibility with buyers and prevented unnecessary back-and-forth later. Thanks to thorough financial analysis by David Coit, VERTESS' director of finance and valuation, combined with a diverse service line and a compelling confidential information memorandum (CIM), our marketing campaign drew more than 150 inquiries in the first month alone. Within weeks, we had multiple strong offers on the table. From that pool, we selected a buyer whose values aligned closely with the provider's mission, which made negotiations noticeably easier.
The result: A deal that closed in seven months — faster than the industry norm — with both sides satisfied. The provider's legacy was preserved, the employees had security, and the organization's patients would benefit from a larger platform of support.
Every deal has its own story, but this one highlighted three factors that are critical to success in nearly every sale.
1. Preparation and transparency. Having a QofE report ready gave buyers confidence and eliminated surprises. The financial picture was clear from day one, which kept the process moving and removed the risk of "repricing" (buyers lowering their offer late in the process).
2. Legal and tax expertise. The seller engaged attorneys and tax professionals with deep healthcare M&A experience. Their knowledge of state-specific regulations, compliance issues, and employee contracts kept the process moving. On the buyer side, equally skilled advisors helped resolve small issues in a single call instead of prolonged discussions.
3. Clear communication. Selling a business is as emotional as it is strategic. The CEO and I stayed aligned through regular check-ins, which helped manage expectations and prevent roadblocks. That trust kept momentum strong even in the toughest stages. Along the way, VERTESS' expertise in home care and hospice helped identify opportunities to increase the deal's value.
Taken together, these factors allowed us to move through diligence in less than six weeks — much faster than the two- to three-month industry average. They also kept the process collaborative, even when negotiating important details like earnouts and valuation.
Not every sale goes this smoothly. I've seen strong companies struggle to close deals for reasons that could have been avoided. Here are three examples.
1. Focusing on short-term cash over long-term value. A behavioral health provider was preparing for a sale but ignored advice to diversify payors and improve operations. Instead, the owners prioritized immediate cash flow, hoping buyers would pay a premium based on revenue alone. The result was a weak valuation and little buyer interest. After months of effort, the deal stalled.
Lesson: Engage a healthcare M&A advisory firm at least 12–18 months before a sale to strengthen your financial picture and maximize value. Small operational changes can have a big impact on EBITDA and buyer interest.
2. Hiring the wrong attorney. One seller chose a generalist lawyer rather than a healthcare M&A specialist. At first, it seemed like a cost-saving move, but the decision backfired. Key compliance requirements tied to state licensure were missed, which led to buyer mistrust and extended negotiations. Eventually, the deal collapsed after four months of frustration.
Lesson: Choose counsel with direct healthcare M&A experience. They understand the nuances of licensing, compliance, and regulatory approval that can make or break a deal.
3. Letting the process drag. A home care provider found a perfect-fit buyer — one that shared their mission and community focus. Unfortunately, the seller hesitated on decisions and allowed deadlines to slip. As weeks stretched into months, tensions rose, and trust eroded. The buyer began questioning the seller's commitment, and eventually the deal fell apart.
Lesson: Stick to a disciplined timeline. Momentum matters. Delays often cause buyers to lose confidence or shift their attention elsewhere, even if the match is a strong one.
Unfortunately, these aren't rare situations. They happen more often than most owners realize. But they're also preventable.
The sale of your company can absolutely be a success story, but it doesn't happen by accident or luck. Preparation, knowledgeable advisors, and disciplined execution are the difference between a smooth close and a stalled process. Just as important is recognizing that selling your company is a deeply personal experience. Having a trusted healthcare M&A advisor like those at VERTESS by your side can help you stay focused and make confident and sound decisions along the way.
I've seen the good and the bad — the successful closings that protect a company's legacy, and the painful collapses that could have been avoided. My goal, and the goal of everyone at VERTESS, is to ensure owners end up on the first side of that equation.
If you're considering selling your healthcare company, I would gladly share even more of what I've learned and help you map the best path forward.
Anna Elliott, CM&AA
With over 15 years of experience in healthcare technology, post-acute care, hospice, and urgent care, I am a highly experienced healthcare executive. I have successfully supported numerous private equity roll-ups and exits in the home healthcare sector. My extensive knowledge of the healthcare industry and my leadership in the M&A community, as a certified M&A Advisor (CM&AA) and member of the Executive Committee of the Chapter of the Association for Mergers & Acquisitions Advisors (AM&AA), distinguish me from others in the field.
Throughout my career, I have specialized in healthcare and have excelled in attracting healthcare technology firms and industries that are growing through Mergers + Acquisitions. I have a strong ability to target specific needs and opportunities in the business supply and demand process, resulting in over $150 million in value delivered to organizations.
As a co-founder of M&A Finders, a boutique Merger and Acquisition advisory firm in Pittsburgh, I have been able to pursue my passion for advocating on behalf of buyers and sellers in achieving their M&A goals. I am excited to bring my skills and network to VERTESS, where I have access to the necessary resources to further expand my impact in the healthcare industry.
We can help you with more information on this and related topics. Contact us today!
Email Anna Elliott or Call: (724) 900-1377.