The Home Health Guide
Understanding Home Health Star Ratings
What Medicare's Quality of Patient Care and Patient Survey star ratings measure, what a missing rating means and how to use them.
Medicare gives home health agencies two star ratings, each from 1 to 5 stars in half-star steps: a Quality of Patient Care rating based on how patients improve and how quickly care starts, and a Patient Survey rating based on what patients say about their care. Ratings are updated every quarter. The “Medicare star rating” on our agency profiles is the Quality of Patient Care rating.
Quality of Patient Care rating
This rating combines seven measures that CMS calculates from patient assessments and Medicare claims:
- Starting care on time
- Improvement in taking medicines by mouth correctly
- Improvement in walking or moving around
- Improvement in getting in and out of bed
- Improvement in bathing
- Improvement in shortness of breath
- Avoiding hospital stays that could have been prevented
A 3-star rating is the middle of the range, and most agencies score around there. An agency needs enough patients to report at least five of the seven measures to receive a rating.
Patient Survey rating
This rating comes from the Home Health Care Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) survey, which an independent company sends to patients after their care. It covers four areas:
- How well the team cared for patients
- How well the team communicated
- How the team handled specific issues such as medicines, pain and home safety
- Patients’ overall rating of the agency
An agency needs at least 40 completed surveys over a year to get this rating.
What a missing rating means
Many agencies have no star rating. Usually that means the agency is small or new and does not yet have enough patients or surveys for a reliable score. It is not a sign of poor care. For an agency without a rating, ask how long it has served your area and how quickly it can start care.
How to use star ratings
- Treat ratings as one factor, alongside services, coverage area, insurance and how quickly the agency can start.
- Look at the individual measures on Medicare’s Care Compare, especially timely start of care if you are leaving the hospital.
- Compare agencies within the same area, since patient needs differ from place to place.
- Ask the agency what it is doing about any low score.
Find rated agencies near you in our home health directory, or read how to choose an agency.
Common questions
How often do star ratings change?
CMS updates home health star ratings every quarter, using data that is several months old by the time it is published.
Can an agency pay for a better rating?
No. Medicare calculates the ratings from patient data and surveys. On this site, paid plans never change an agency’s rating or its Verified status.
Sources
This guide is general information, not medical advice. See our medical disclaimer.