Home health star ratings, and what they leave out

Two ratings, two sources

• Quality of patient care — computed from clinical measures the agency reports through patient assessments and from Medicare claims: whether care started promptly, whether patients improved at walking, bathing, breathing and taking medicines, and rates of hospitalisation and readmission.
• Patient survey rating — from the HHCAHPS survey, completed by patients themselves: professionalism of the team, communication, whether medicines and safety were discussed, and overall rating.

An agency can score well clinically and poorly on experience, or the reverse. Read both; every agency page on this site shows them side by side.

Why so many agencies have no stars

Rating either scale requires a minimum volume — enough completed episodes for the clinical measures, enough survey responses for the experience rating. Small and newly certified agencies frequently fall below both thresholds.

Of the 12,460 certified agencies in the country, a substantial minority carry no quality star and a larger share carry no survey star. No rating is not a poor rating. For those agencies, read the individual measures on the page and ask the agency directly for its own numbers.

What the stars do not capture

1. Whether the agency serves your area at all. Certification is national; service areas are local, and a listed address tells you where the office is, not where the nurses drive.
2. Staffing stability. Home health outcomes depend heavily on whether the same clinician returns. No published measure captures turnover.
3. Ownership. The largest group operates 449 agencies across 40 states. Its record across all of them is more predictive than any single branch's stars — and it appears nowhere in the star rating. Ownership group records →
4. What Medicare will actually authorise. A five-star agency cannot deliver care that does not meet the coverage rules — see the two rules that decide coverage.

A practical sequence

1. Confirm the patient meets the homebound and skilled-need rules before shortlisting anything.
2. List certified agencies serving the address: browse by state and city.
3. Compare both star ratings, then read the underlying measures — especially timely start of care and hospitalisation rates.
4. Open the ownership group page for each finalist.
5. Call and ask: which clinicians will come, how often, and what happens if a visit is missed.

Common questions

Which home health star rating matters more?

They answer different questions. The quality of patient care rating reflects clinical outcomes; the survey rating reflects what patients experienced. A serious comparison reads both, plus the individual measures behind them.

Why does an agency have no star rating?

Usually too few completed episodes or too few survey responses to compute one reliably. It is common among small and new agencies and says nothing about quality on its own.

Are home health ratings updated?

CMS refreshes the underlying provider files periodically. Every page on this site prints the release date of the data it shows.

Does a higher rating mean Medicare will cover more?

No. Coverage depends on the homebound and skilled-need rules and the physician's plan of care, not on the agency's rating.

Check a specific provider

Records for 14,690 nursing homes, 5,597 assisted living facilities and 28,152 hospice, home health, dialysis and rehabilitation providers: search by name or city · nursing homes · hospice · home health · dialysis · inpatient rehab · nursing home groups · other ownership groups.