Guide
How to choose a home health agency
Short answer
You choose your home health agency. Start with Medicare-certified agencies that serve your address, compare their CMS quality star ratings and measures, confirm they offer the services in your care plan, and call two or three of them with your questions. CMS says the star rating is a first step, not the only factor (CMS star rating fact sheet).
1. Get the list of agencies that serve you
Your doctor or provider should give you a list of agencies that serve your area and must tell you if their organization has a financial interest in any agency listed (Medicare.gov). Agencies serve areas, not just the city where their office is, so always ask whether they serve your address.
2. Understand the CMS star rating
- The Quality of Patient Care star rating runs from 1 to 5 stars in half-star steps and summarizes how an agency performs on quality measures compared with other agencies (CMS).
- Most agencies are "in the middle" at 3 stars, which CMS describes as good quality. Above 3 means better than average on the measured practices and outcomes; below 3 means below average, which "doesn't necessarily mean care is poor" (CMS fact sheet).
- CMS updates the ratings quarterly, in January, April, July and October (CMS fact sheet).
- Some agencies have no rating, often because they had too few patients for CMS to report a measure or were certified recently. No rating is not a bad rating.
- Medicare Care Compare also shows a separate patient survey star rating. Our pages don't show it yet.
3. Match services to your care plan
Check that the agency offers what your doctor ordered: skilled nursing, physical therapy, occupational therapy, speech-language pathology, medical social services and home health aide services. Each of our city pages shows the services CMS lists for each agency, and you can filter by service.
4. Questions you can ask an agency
These are our suggestions, not a CMS list:
- Do you serve my address, and can you start care when I need it?
- Are you accepting new patients for the services my doctor ordered?
- Do you accept my Medicare Advantage plan (if I have one)?
- Who will visit, how often, and how do I reach someone after hours?
- How will you coordinate with my doctor and update the care plan?
- Will anything I need not be covered, and what would it cost? (Agencies must give an ABN before non-covered services.)
- What happens if a scheduled visit is missed?
- Do you speak my family's language?
5. You can switch
Choosing an agency is your decision. If an agency doesn't call back or isn't a good fit, contact another one and tell your doctor. Compare options any time on Medicare Care Compare.
Frequently asked questions
What is a good CMS star rating for a home health agency?
CMS says most agencies are in the middle at 3 stars, which means good quality; above 3 means better than average on the measured practices and outcomes, and below 3 means below average, which doesn't necessarily mean care is poor. Source: CMS Quality of Patient Care Star Rating fact sheet.
Should I choose a home health agency by star rating alone?
No. CMS describes the rating as a first step. Also consider the patient's needs and preferences, other quality measures, references and past experience. Source: CMS fact sheet.
How often are home health star ratings updated?
Quarterly, in January, April, July and October. Source: CMS fact sheet.