Home-based care providers are zeroing in on culture and talent alignment as they pursue acquisitions.

As consolidation continues across the home-based care sector, operators say a deal’s success can hinge on cultural fit and impressive talent. Organizations that bring strong leadership and cultural alignment to the table can command greater attention, according to experts at Home Health Care News’ Capital+Strategy conference.

But getting culture and talent right is not always straightforward.

“We’ve sometimes hired people that maybe weren’t the right cultural fit,” Chris Dobbin, the founding president, CEO and director of Nova Leap Health (OTCMKTS: NVLPF), said. “That has been sort of a value destroyer. When you get people who are really good for the culture, those are value enhancers for us.”

Halifax, Nova Scotia-based Nova Leap manages a portfolio of private pay home care agencies across 10 U.S. states and Nova Scotia, Canada.

Risks of ignoring cultural fit

While cultural fit is critical regardless of operating model, ensuring acquisitions are aligned culturally, with the right talent, is not straightforward. Cultural alignment and desirable talent often becomes the defining factor in whether a deal succeeds or fails.

“We did five acquisitions last year,” Dean Alverson, the CEO of LifeCare Home Health Family, said. “The biggest challenge has been cultural alignment.”

Irving, Texas-based LifeCare Home Health offers Medicare-certified home health, private duty and hospice services through several local brands operating in Texas, Florida, Nevada and Georgia.

When that alignment is missing, the consequences can be significant. For Nova Leap, missteps in culture have directly impacted performance. The company has shifted its acquisition approach over time and now spends significantly more time considering talent and cultural fit in an acquisition than a decade ago, Dobbin said.

Talent within a potential acquisition target has become a deciding factor in whether to pursue a transaction, according to Ari Medoff, the CEO of Arosa.

Arosa’s best acquisition was the largest deal, he noted, attributing its success to the fact that it brought in three leaders who remain central to the organization today. Deals that lack sufficient talent, however, are increasingly viewed as not worth the risk.

“I have come to look more carefully at the talent within the target company, and if it ain’t there, being willing to walk away is a discipline that’s taken years to develop,” Madoff said.

Los Angeles-based Arosa provides integrated care management and caregiving services from 32 offices in 10 states. Private equity firm HCAP Partners announced its exit from the company in 2025.

Communication, nuts and bolts

While cultural and talent alignment are now central to acquisition strategy, executives said the operational realities of integration are just as important. Specifically, communication and infrastructure readiness can influence a deal’s success.

Acquirers must align expectations regarding differences between the legacy company and the newly acquired organization, Alverson said. This includes “overstating” the benefits of the combination and ensuring clear communication.

Timing is also key to consider. When possible, offering sufficient time for such communication and other integration-related tasks can improve the integration process. At Arosa, Madoff said internal teams consistently push for earlier and more detailed integration planning.

“Our internal, existing Arosa team feels like on every single acquisition we’ve done, they never have enough heads up ahead of time,” Medoff said. “We’ve done some that have been 48 hours of heads up. We’ve done some of that have been two weeks. Now we try to do two months, and they’re like, ‘Can we please have three or four months?’”

Beyond communication, providers also pointed to infrastructure as a limiting factor in how quickly and effectively they can scale through acquisitions. Alverson noted that private equity-backed operators in particular must balance cost discipline with the need to invest ahead of growth.

“[It’s important to] make sure you’ve got the right scale of infrastructure to support the amount of business that you’re bringing on,” he said. “It’s our nature, I think, in private equity, to focus on cost containment, but [make] investments early on the infrastructure so that you can take on these larger books of business and make them seamless.”

Having additional resources can sustain referral patterns and other markers of acquisition success, Alverson continued.

Taken together, executives said successful acquisitions in home-based care are defined by a combination of cultural and talent alignment, disciplined communication during integration and the infrastructure needed to support scale – and that missteps in any one area can undermine deal value.

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