I'm looking to buy a home health business in California that provides skilled care and is also medicare approved by the state of California. Almost all of the revenue is through medicare patients for such businesses. Transferring current approvals and licenses seems to be a complex process. Getting new medicare certification currently takes###-###-#### years in California. How do I approach such acquisitions?

1. Should we target stock purchases instead of asset purchases? How do we handle liability issues if we go with stock purchase?
2. Should we look into 338(h)(10) type transaction even for smaller businesses below $500K in EBITDA/SDE?
3. I have heard of consultants who are available for effective CHOW (change of ownership) work for such transactions. Does anyone in the community know of a reliable such consultant?
4. Has anyone here done such an acquisition (in California) and can offer any pointers?
5. Any pointers for helpful resources (besides just googling for California+CHOW+home health+medicare keywords?
6. Any typical major concerns that we should keep in mind other than standard items like working capital, medicare reimbursement rates, reliable DPCS in the business etc?

Getting medicare license transfers by themselves seem complicated but adding California state approvals on top of it for a business change of ownership seems more so. Any advice/suggestions from the community here can be very helpful.