Home health star ratings explained
What the CMS Quality of Patient Care star rating measures, how to read the percentages on each profile, and the limits of the numbers.
Every agency profile on Home Health Stars shows the numbers Medicare publishes about it. Here's how to read them.
The Quality of Patient Care star rating
CMS gives each home health agency a Quality of Patient Care star rating from 1 to 5 in half-star steps. It combines several of the agency's quality measures — such as how often care started on time and how often patients got better at walking, getting in and out of bed, bathing, and breathing — and compares them with agencies nationwide. Around 3 stars means roughly typical performance.
CMS also publishes a separate patient survey star rating based on the Home Health Care CAHPS survey, where patients rate communication, care and the agency overall. The two can differ: one reflects clinical outcomes, the other patients' experience.
Reading the percentages
- Started care on time — how often the first visit happened promptly after the referral or discharge. Higher is better.
- Got better at walking / bathing / breathing — among the agency's patients who could improve, how often they did. Higher is better.
Compare agencies in the same city rather than against a perfect 100%. Small differences of a point or two are usually noise; large gaps are meaningful.
When there's no rating
CMS doesn't rate agencies that served too few patients in the measurement period, or new ones. "Not enough data" isn't a bad sign — just a reason to ask more questions on the phone.
Limits of the numbers
- Data lags: measures cover past periods, so recent staffing changes won't show yet.
- Case mix: agencies treating sicker patients can post lower improvement rates.
- Ratings describe the whole agency, not the specific nurse or therapist you'll get.
Use the stars to narrow a list of agencies to two or three, then call. Source: Medicare Care Compare, data file 6jpm-sxkc.