Care Considered Research · 2026 edition · CMS data vintage Jul2026
Care Considered Home Health Quality Report
Every figure on this page is computed directly from CMS Care Compare public data files covering 12,460 Medicare-certified home health agencies. Methodology below. Cite freely with attribution and a link.
Free to quote and reuse with attribution and a link.
Care Considered. (2026). Care Considered Home Health Quality Report. Own the Answer. https://careconsidered.com/research/home-health-quality/ (CMS Care Compare data, Jul2026). Charts and figures on this page may be reproduced with attribution and a link to this page. For a custom data cut (a specific state, chain, or measure), or the underlying dataset, contact us — we're glad to help reporters and researchers.
Free to reuse, republish, and analyze — with attribution and a link to careconsidered.com. Refreshed with each CMS data update.
Key findings
- For-profit and non-profit agencies score virtually identically on CMS quality (3.27 vs 3.36 stars) — a contrast with the ownership gaps documented in nursing home research. 72.3% of US agencies are for-profit.
- The national average quality rating is 3.25 stars; only 35.3% of rated agencies earn 4 stars or better.
- South Carolina leads the nation (3.93★ average); Montana ranks last (2.71★).
- 35.4% of agencies have no published quality rating at all — families are choosing blind across a third of the market.
- New Jersey is America's biggest home health desert: 0.24 agencies per 10,000 residents 65+.
National distribution of CMS quality stars
8,050 rated agencies out of 12,460 total. The shape shows how concentrated the market is around 3–4 stars — genuinely 5-star agencies are rare.
State rankings — average CMS quality star
Top 10 and bottom 5 states, by average rating (states with fewer than 10 rated agencies excluded — see methodology).
| # | State | Agencies | Avg star | % 4★+ | Avg survey star |
|---|---|---|---|---|---|
| 1 | South Carolina | 68 | 3.93 | 60.9 | 4.41 |
| 2 | Alabama | 116 | 3.82 | 62.3 | 4.71 |
| 3 | Maryland | 51 | 3.8 | 46.8 | 3.75 |
| 4 | New Jersey | 38 | 3.76 | 60.5 | 3.82 |
| 5 | Tennessee | 128 | 3.76 | 55 | 4.5 |
| 6 | South Dakota | 23 | 3.71 | 57.1 | 4.53 |
| 7 | Louisiana | 176 | 3.68 | 55 | 4.54 |
| 8 | Utah | 82 | 3.68 | 53.8 | 3.73 |
| 9 | Mississippi | 42 | 3.65 | 50 | 4.71 |
| 10 | North Carolina | 166 | 3.65 | 46.4 | 4.4 |
| 11 | Washington | 74 | 3.63 | 47.6 | 3.57 |
| 12 | West Virginia | 43 | 3.6 | 50 | 4.63 |
| 13 | New York | 100 | 3.58 | 40.4 | 3.74 |
| 14 | Kentucky | 88 | 3.55 | 46.4 | 4.56 |
| 15 | Georgia | 105 | 3.53 | 45.9 | 3.97 |
| 16 | Puerto Rico | 39 | 3.5 | 40 | 3.21 |
| 17 | Florida | 1146 | 3.48 | 42.8 | 3.65 |
| 18 | Wisconsin | 87 | 3.44 | 43.5 | 4.02 |
| 19 | Delaware | 22 | 3.42 | 46.2 | 4.45 |
| 20 | District of Columbia | 35 | 3.41 | 36.4 | 2.17 |
| 21 | Arizona | 177 | 3.39 | 40.6 | 3.63 |
| 22 | Maine | 19 | 3.39 | 31.6 | 4.72 |
| 23 | Missouri | 120 | 3.39 | 40.7 | 4.18 |
| 24 | Arkansas | 92 | 3.38 | 34.9 | 4.51 |
| 25 | Michigan | 371 | 3.34 | 34.1 | 3.89 |
| 26 | New Hampshire | 27 | 3.34 | 27.3 | 4.37 |
| 27 | Nebraska | 62 | 3.33 | 33.3 | 4.3 |
| 28 | Pennsylvania | 415 | 3.32 | 29.6 | 4.31 |
| 29 | Idaho | 48 | 3.31 | 26.7 | 4 |
| 30 | Kansas | 108 | 3.31 | 33.3 | 4.32 |
| 31 | Virginia | 237 | 3.28 | 30.2 | 3.89 |
| 32 | New Mexico | 70 | 3.25 | 37.1 | 3.85 |
| 33 | Rhode Island | 22 | 3.22 | 33.3 | 4.39 |
| 34 | Oregon | 51 | 3.21 | 33.3 | 3.74 |
| 35 | Oklahoma | 212 | 3.2 | 34.9 | 4.37 |
| 36 | North Dakota | 20 | 3.19 | 15.4 | 4.58 |
| 37 | California | 3213 | 3.17 | 33 | 3.43 |
| 38 | Indiana | 173 | 3.12 | 31.1 | 4.13 |
| 39 | Connecticut | 72 | 3.1 | 25.9 | 3.62 |
| 40 | Ohio | 835 | 3.09 | 23.6 | 3.97 |
| 41 | Illinois | 530 | 3.08 | 30.4 | 3.87 |
| 42 | Iowa | 125 | 3.07 | 20.9 | 4.33 |
| 43 | Minnesota | 138 | 3.05 | 25.6 | 4.03 |
| 44 | Wyoming | 32 | 3 | 18.2 | 4.07 |
| 45 | Colorado | 222 | 2.93 | 29.1 | 3.95 |
| 46 | Texas | 1854 | 2.93 | 30.5 | 3.99 |
| 47 | Massachusetts | 287 | 2.91 | 22.1 | 3.85 |
| 48 | Hawaii | 18 | 2.81 | 15.4 | 4.18 |
| 49 | Nevada | 228 | 2.79 | 25.3 | 3.5 |
| 50 | Alaska | 14 | 2.77 | 0 | 3 |
| 51 | Montana | 21 | 2.71 | 21.1 | 4.33 |
Quality by ownership type
For-profit agencies make up 72.3% of the market. Their average CMS quality rating is nearly identical to non-profit agencies — a genuine finding, not a rounding artifact.
Home health deserts — agencies per 10,000 residents 65+
| # | State | Agencies / 10k seniors | Agencies | Residents 65+ |
|---|---|---|---|---|
| 1 | New Jersey | 0.24 | 38 | 1,559,816 |
| 2 | New York | 0.29 | 100 | 3,461,186 |
| 3 | Maryland | 0.51 | 51 | 1,003,219 |
| 4 | Puerto Rico | 0.53 | 39 | 740,397 |
| 5 | Washington | 0.59 | 74 | 1,259,313 |
| 6 | Hawaii | 0.63 | 18 | 287,642 |
| 7 | Maine | 0.63 | 19 | 301,161 |
| 8 | Oregon | 0.65 | 51 | 789,610 |
| 9 | Georgia | 0.66 | 105 | 1,581,263 |
| 10 | Vermont | 0.67 | 9 | 134,141 |
Population: US Census Bureau, ACS 2023 5-year estimates. Caveat: several low-count states (e.g. New York, New Jersey) regulate home health entry via Certificate of Need licensing, producing fewer but larger agencies — this metric measures market structure and consumer choice, not necessarily unmet need.
Methodology
All figures computed from CMS Care Compare public data files, Jul2026 refresh. Star means include only agencies with a published quality star rating (CMS withholds ratings below episode thresholds). State rankings exclude states with fewer than 10 rated agencies. Ownership per CMS 'Type of Ownership'.
© Care Considered (careconsidered.com). Source data: CMS Provider Data Catalog — Home Health Care Agencies + HHCAHPS (data.cms.gov), quarterly refresh. Reuse of these findings is permitted — and encouraged — with attribution and a link to this page.