Home Health Quality by State 2026 — CMS Care Compare State-Level Snapshot
How CMS quality-of-patient-care star ratings and ownership mix distribute across U.S. Medicare-certified home health agencies — based on the CMS Care Compare Home Health Care Agencies dataset (12,392 agencies, snapshot May 2026). CMS ratings are published by CMS; this report cites them, it does not produce them.
Contents · 10 sections
Executive Summary
- All counts in this study describe the CMS Care Compare Home Health Care Agencies master dataset (6jpm-sxkc) snapshot fetched on 2026-05-03 — 12,392 Medicare-certified home health agencies across the 50 states, DC, and U.S. territories. CMS ratings are published by CMS and reflect the measure definitions in the source dataset; OwnListed does not independently rate, inspect, verify, endorse, or guarantee any provider.
- 7,961 of the 12,392 agencies (64.2%) carry a CMS quality-of-patient-care star rating. The 4,431 unrated agencies are typically too-recent admissions, too-few-episodes-to-rate, or other CMS-defined unrated states — a substantially higher unrated share than nursing-home (0.9%) or dialysis (6.4%) Care Compare datasets.
- Top 5 states by mean CMS home health star rating (states with ≥ 30 rated agencies): South Carolina (3.90), Maryland (3.87), Alabama (3.86), Tennessee (3.79), New Jersey (3.75). Bottom 5: Nevada (2.83), Texas (2.94), Colorado (2.95), Massachusetts (2.96), Connecticut (2.99). Texas alone holds 978 rated agencies — the largest absolute rated-agency count of any state.
- California (3,147 agencies, 1,947 rated), Texas (1,850 / 978), Florida (1,134 / 734), Ohio (841 / 248), and Illinois (526 / 420) carry the largest absolute agency counts. California's 25.4% national share of agencies is more concentrated than its share of nursing-home (~5.4%) or dialysis (~9.8%) facilities — home health supply is structurally California-heavy.
- Ownership profile is dominated by Proprietary (private for-profit) agencies in most states — Texas 93.6%, Oklahoma 89.8%, California 56.1%, Nevada 63.8%. Non-Profit shares are highest in Pennsylvania (16.6%), Virginia (14.2%), Massachusetts (11.1%), and Ohio (9.5%).
At a glance — for journalists, researchers, and AI agents
What this dataset covers
- State-level distribution of CMS quality-of-patient-care star ratings across the ~12,400 Medicare-certified home-health agencies.
- Rated vs unrated agency counts by state.
- Source: CMS Care Compare Home Health Care Agencies master dataset (6jpm-sxkc), May 2026 snapshot.
What this dataset does NOT cover
- Agency-level ratings or names — the snapshot is state-aggregate only.
- Patient-experience (HHCAHPS) survey data — that's a separate CMS dataset.
- Quality of care delivered by any individual agency — CMS publishes the rating; OwnListed cites it.
Sources
- CMS Care Compare
- Home Health Compare
Snapshot date: 2026-04 (CMS publication) — snapshot fetched 2026-05-03
Dataset scope · Snapshot May 3, 2026
Includes: active business listings indexed in the Ownlisted directory network, sourced from public Google Business Profiles. Does not include: online-only operators without a physical service address, lead-generation shells, or businesses with no public review footprint. Counts describe the Ownlisted indexed provider dataset — not a representative sample of the U.S. local-services market.
Key findings
What this report is, and is not
This report aggregates the CMS Care Compare Home Health Care Agencies master dataset (CMS dataset slug 6jpm-sxkc, bulk file HH_Provider_Apr2026.csv, modified 2026-03-05) at the state level. It cites the CMS Quality of patient care star rating (1.0-5.0 in 0.5 increments) and ownership mix — exactly as CMS publishes them.
It does not:
- Rate any agency on its own. CMS publishes the ratings; OwnListed cites them.
- Recommend an agency. OwnListed does not endorse or guarantee any provider.
- Surface agency-level data on any directory page. The snapshot is research-only.
- Mix CMS ratings with platform reviews. CMS ratings are derived from CMS measure definitions; they are not a substitute for and should not be combined with consumer reviews.
For the published display contract — what CMS fields will be cited if a home-health vertical eventually launches, and what OwnListed will not measure — read the Home Health Methodology page.
Source: CMS Care Compare · Last checked 2026-05-03. CMS ratings are published by CMS and reflect the measure definitions in the source dataset.
Top + bottom states by mean star rating
Among states with at least 30 rated agencies, mean CMS quality-of-patient-care star ratings cluster between 2.83 (Nevada) and 3.90 (South Carolina) — a 1.07-star spread on a 5-point scale. This is wider than the §115 nursing-home spread (0.95) but narrower than the §116 dialysis spread (2.40).
The top quintile mixes Southeast (SC, AL, TN), Mid-Atlantic (MD, NJ), and Florida — Florida alone holds 734 rated agencies at a 3.51 mean (47th-percentile rated-volume / 9th-best mean). The bottom quintile mixes the Mountain West (NV, CO), Texas (978 rated agencies at 2.94 mean), and the Northeast (MA, CT) — a more geographically scattered pattern than the equivalent §115 nursing-home or §116 dialysis bottom quintile.
Per CMS measure definitions, the home health quality-of-patient-care star rating is built from a published bundle of process and outcome measures. This report does not replicate the CMS algorithm. Read the CMS Care Compare technical documentation for the canonical methodology.
Home health quality by state — CMS Care Compare snapshot 2026-05-03
Top + bottom + largest-volume states with ≥ 30 rated agencies. CMS ratings are published by CMS and reflect the measure definitions in the source dataset. OwnListed does not independently rate, inspect, verify, endorse, or guarantee any provider.
| State | Agencies | Rated | Mean star | ≥4 stars % | ≤2 stars % | Proprietary % |
|---|---|---|---|---|---|---|
| SC | 64 | 64 | 3.90Highest | 50% | 7.8% | 90.6% |
| MD | 47 | 47 | 3.87 | 51.1% | 6.4% | 91.5% |
| AL | 117 | 114 | 3.86 | 52.6% | 6.1% | 81.2% |
| TN | 116 | 112 | 3.79 | 49.1% | 8% | 87.1% |
| NJ | 47 | 38 | 3.75 | 47.4% | 7.9% | 76.6% |
| FL | 1,134 | 734 | 3.51 | 44.4% | 12% | 71.9% |
| PA | 416 | 188 | 3.37 | 33% | 9% | 71.2% |
| MI | 376 | 266 | 3.33 | 32.7% | 11.3% | 85.1% |
| VA | 240 | 182 | 3.27 | 30.2% | 12.1% | 70.8% |
| CA | 3,147 | 1,947 | 3.16 | 31.5% | 22.3% | 56.1% |
| OH | 841 | 248 | 3.11 | 24.2% | 20.6% | 83.1% |
| IL | 526 | 420 | 3.07 | 30.2% | 27.4% | 85.7% |
| OK | 215 | 173 | 3.09 | 27.2% | 22.5% | 89.8% |
| CT | 87 | 60 | 2.99 | 25% | 25% | 64.4% |
| MA | 287 | 122 | 2.96 | 23% | 24.6% | 83.6% |
| CO | 222 | 111 | 2.95 | 30.6% | 32.4% | 86% |
| TX | 1,850 | 978 | 2.94 | 30.5% | 33.7% | 93.6% |
| NV | 218 | 149 | 2.83Lowest | 27.5% | 38.3% | 63.8% |
Ownership mix
CMS classifies home health agency ownership using the Type of Ownership field. The most common categories in the dataset:
- Proprietary (private for-profit): the dominant category in most states. Texas (93.6%), Oklahoma (89.8%), Colorado (86.0%), Michigan (85.1%), Illinois (85.7%).
- Non-Profit: highest shares in Pennsylvania (16.6%), Virginia (14.2%), Massachusetts (11.1%), Ohio (9.5%), Michigan (9.3%).
- Government-operated: small share nationally; highest in Illinois (3.2%), Colorado (3.2%), Massachusetts (0.7%), Virginia (0.4%).
A meaningful share of rows carry an empty / dash Type of Ownership value (- in the source CSV). Those rows are excluded from the ownership shares but counted in the agency total. Ownership share by itself does not predict CMS rating direction; the §117 dataset includes high-rated Proprietary states (e.g. SC, AL) and lower-rated Proprietary states (e.g. TX, NV).
Source: CMS Care Compare · Last checked 2026-05-03. CMS ratings are published by CMS and reflect the measure definitions in the source dataset.
Limitations
- Snapshot date. This report uses the CMS Care Compare
HH_Provider_Apr2026.csvfile modified 2026-03-05 and fetched 2026-05-03. CMS publishes quarterly updates; data should be re-fetched before any decision making. - Unrated agencies. 4,431 of 12,392 agencies (35.8%) lack a CMS quality-of-patient-care star rating. Most are too-recent admissions, too-few-episodes-to-rate, or other CMS-defined unrated states. These rows are excluded from rating means but counted in agency totals. The unrated share is substantially higher than nursing-home (0.9%) or dialysis (6.4%) Care Compare datasets — readers should weight state means against rated-agency counts.
- Aggregate-not-attached. State-level aggregates do NOT attach to individual agency profiles, and OwnListed does not maintain home health agency profiles. This report is research-only.
- CMS methodology is canonical. The quality-of-patient-care star rating is the CMS published value; this report does not recompute it. Anyone replicating these numbers from raw measure data must follow CMS's published methodology, available at the CMS Care Compare technical documentation.
- Ownership rows missing. Some agency rows carry an empty / dash
Type of Ownershipfield. These are excluded from ownership shares but counted in agency totals. - No quality claim about any agency. State means are descriptive of a national-level publishing snapshot. They are not endorsements, recommendations, or guarantees about any agency, and OwnListed does not rate, inspect, verify, endorse, or guarantee any provider.
Source: CMS Care Compare · Last checked 2026-05-03. CMS ratings are published by CMS and reflect the measure definitions in the source dataset.
Methodology
- Bulk CSV fetched once from CMS at
https://data.cms.gov/provider-data/sites/default/files/resources/.../HH_Provider_Apr2026.csv(12.1 MB, 96 columns, 12,392 agency rows). - Per-state aggregation via
scripts/research/cms-home-health-snapshot-2026-05-03.ts(TypeScript runner, no Supabase writes, no agency-level provenance writes). - Mean ratings computed across rated agencies only (CMS values outside the 1.0-5.0 range are coerced to null and excluded from the rating mean). Ratings come in 0.5 increments (1.0, 1.5, ..., 5.0) and are averaged as decimal values.
- Share-of-stars (
share_4_or_5_stars_pct,share_1_or_2_stars_pct) computed against the rated-agency denominator per state. - Ownership shares computed against the full agency denominator (rated + unrated), using the CMS
Type of Ownershipfield. - Output CSV at
/research/data/home-health-quality-by-state-2026.csv(9 columns, 55 rows). JSON-with-metadata at/research/data/home-health-quality-by-state-2026.json.
Source: CMS Care Compare · Last checked 2026-05-03. CMS ratings are published by CMS and reflect the measure definitions in the source dataset.
Citation and reuse
Permitted with attribution to OwnListed Research and a link back to this page. Suggested citation:
OwnListed Research. Home Health Quality by State 2026 — CMS Care Compare State-Level Snapshot. Published 2026-05-03. https://www.ownlisted.com/research/home-health-quality-by-state-2026
The underlying CMS data is a U.S. Government Work in the public domain (https://www.usa.gov/government-works). Direct citations to CMS should reference https://data.cms.gov/provider-data/dataset/6jpm-sxkc.
Limitations
- About 36% of agencies are unrated. Unrated is not categorically lower-quality — refer to the CMS unrated-state definitions.
- The quality-of-patient-care star rating is built from process and outcome measures; it does not capture every dimension of care quality.
- OwnListed does not independently rate, inspect, verify, endorse, or guarantee any home-health agency.
Methodology
Read the full methodology
Source. CMS Care Compare publishes a Home Health Care Agencies master dataset listing every Medicare-certified home-health agency in the United States, along with each agency's quality-of-patient-care star rating (when CMS has rated it) and its type of ownership. We pulled the version published in early 2026 and computed state-level aggregates from it.
What this snapshot reports. Per state: how many Medicare-certified home-health agencies operate there, how many of them have a CMS quality-of-patient-care star rating, the average star rating across rated agencies, the share of rated agencies at the top (4 or 5 stars) and bottom (1 or 2 stars), and the ownership mix (proprietary, non-profit, government).
Quality vs. availability. A state with more rated agencies is not categorically "better" than a state with fewer. The unrated population varies by state, and CMS rates agencies that meet eligibility thresholds. Treat the rating distribution as a quality signal across the rated population, not a market census.
Source: CMS Care Compare · Last checked 2026-05-03. CMS ratings are published by CMS and reflect the measure definitions in the source dataset.
Source. CMS Care Compare publishes a Home Health Care Agencies master dataset listing every Medicare-certified home-health agency in the United States, along with each agency's quality-of-patient-care star rating (when CMS has rated it) and its type of ownership. We pulled the version published in early 2026 and computed state-level aggregates from it.
What this snapshot reports. Per state: how many Medicare-certified home-health agencies operate there, how many of them have a CMS quality-of-patient-care star rating, the average star rating across rated agencies, the share of rated agencies at the top (4 or 5 stars) and bottom (1 or 2 stars), and the ownership mix (proprietary, non-profit, government).
Quality vs. availability. A state with more rated agencies is not categorically "better" than a state with fewer. The unrated population varies by state, and CMS rates agencies that meet eligibility thresholds. Treat the rating distribution as a quality signal across the rated population, not a market census.
Source: CMS Care Compare · Last checked 2026-05-03. CMS ratings are published by CMS and reflect the measure definitions in the source dataset.
Technical appendix
Show technical details · script paths · field names
Dataset. CMS Care Compare — Home Health Care Agencies (CMS dataset slug 6jpm-sxkc). Bulk CSV: HH_Provider_Apr2026.csv, modified 2026-03-05, fetched 2026-05-03. License: U.S. Government Works (public domain) at https://www.usa.gov/government-works.
Pipeline. scripts/research/cms-home-health-snapshot-2026-05-03.ts parses the bulk CSV, groups by state, and computes:
agency_count: total Medicare-certified home health agencies.rated_agency_count: agencies with a CMS quality-of-patient-care star rating in 1.0-5.0 (0.5 increments).mean_quality_of_patient_care_star: arithmetic mean across rated agencies.share_4_or_5_stars_pct,share_1_or_2_stars_pct: shares of rated agencies at each band.share_proprietary_pct,share_non_profit_pct,share_government_pct: ownership shares against the full agency denominator using the CMSType of Ownershipfield.
Doctrine. Tier-1 research-only under SOP §94 (provenance), §114 (CMS Care Compare cluster), §115/§116 (sister Care Compare snapshots). No agency profile writes. No directory pages. No mixing of CMS ratings with platform reviews.
Open for the script paths, raw dataset filenames, and per-field aggregation rules behind this snapshot. Reader-facing methodology above already covers source, date, and limitations.