Data Source

All agency data is sourced exclusively from the CMS Home Health Compare dataset, published through the CMS Provider Data Catalog at data.cms.gov. This is the same data Medicare uses to evaluate and monitor home health agencies nationwide.

We download and process the following datasets each quarter:

Home Health Care — Provider Data — Core table containing agency name, address, phone, ownership type, CMS certification number, and the Quality of Patient Care star rating
Home Health Care — Patient Survey (CAHPS) — Patient experience survey results including summary star rating and individual measure scores
Home Health Care — Quality Measures — Clinical outcome measures including hospitalization rates, ER use, and functional improvement metrics
Home Health Care — State and National Averages — Benchmark data for comparing individual agencies against state and national performance

Quality of Patient Care Star Rating

CMS assigns each home health agency a Quality of Patient Care star rating from 1 to 5. This rating is calculated from a set of process and outcome quality measures derived from OASIS patient assessments and Medicare claims data.

The measures used in the star calculation include timely initiation of care, drug education, functional improvement (ambulation, bed transferring, bathing), acute care hospitalization rates, and emergency department use. CMS applies a clustering algorithm to the composite quality score to assign each agency a star level.

We display this rating as-is from CMS. We do not modify, weight, or adjust it.

CAHPS Patient Survey

The Consumer Assessment of Healthcare Providers and Systems (CAHPS) Home Health Care Survey measures patient experience across several domains:

Care of Patients — How well the agency's staff provided care, including medication and pain management
Communication — Whether staff communicated well with patients and family members
Specific Care Issues — Whether staff discussed medicines, pain, and home safety
Overall Rating — Patient's overall rating of care on a 0-10 scale
Willingness to Recommend — Whether the patient would recommend the agency to friends and family

The CAHPS survey is administered by approved vendors to a random sample of patients who received care from each agency. CMS publishes results as percentages (e.g., the percentage of patients who gave a rating of 9 or 10) and as a summary star rating.

Hospitalization and ER Rates

Two of the most telling metrics for any home health agency are how often patients end up back in the hospital and how often they visit the emergency room during a home health episode.

CMS publishes the rate of acute care hospitalization and the rate of emergency department visits (without hospitalization) for each agency. Lower rates generally indicate better care management — the agency is catching problems before they escalate.

We display these rates alongside state and national averages so families can see exactly how an agency compares to its peers.

Functional Improvement Measures

These measures track whether patients actually got better during their home health episode. CMS publishes improvement rates for specific functional domains:

Improvement in ambulation / locomotion
Improvement in bed transferring
Improvement in bathing
Improvement in management of oral medications
Improvement in dyspnea (shortness of breath)

These are outcome measures, not process measures. They reflect what actually happened to the patient, not just whether the agency followed a checklist.

Quality Issue Flag

CMS flags agencies that have data quality issues, insufficient data for rating, or that have been identified through monitoring as having potential performance concerns. When CMS sets the quality issue flag, we display it prominently on the agency's profile page.

We do not hide or minimize this flag. If CMS has flagged an agency, families should know about it.

Update Frequency

CMS updates Home Health Compare data on a quarterly cycle. We import the new data after each release. Agency pages show the date of the most recent CMS data refresh.

The Quality Gap Finding

Throughout this site, we reference our finding that most Medicare home health patients in a given service area receive care from an agency that is not the highest-rated option available to them. Here is how that figure is derived:

Using CMS Home Health Compare data, we identify every active Medicare-certified agency operating in each US county and metro area. For each county, we find the highest Quality of Patient Care star rating available. We then look at the distribution of ratings among all agencies in that area. In most service areas, the majority of agencies carry ratings below the area's top rating — meaning that for any given patient who receives care from a non-top-rated agency, a higher-rated option existed in the same area.

This is a structural observation about the distribution of quality ratings in local markets, not a claim about individual patients' specific choices. It reflects the gap between what CMS data shows is available and what the referral system typically delivers. Raw data used in this analysis is available at data.cms.gov.

What We Do Not Do

We do not rank agencies by anything other than their CMS quality rating
We do not accept payment to alter an agency's ranking or appearance
We do not suppress negative information for any reason
We do not generate or infer ratings — we display only what CMS publishes
We do not claim to make specific recommendations for individual patients

Our Methodology