Home-health research · National data report

Who Runs America's Home Health Agencies

Medicare-certified home health is overwhelmingly a for-profit sector. This report measures the ownership composition CMS reports — and finds the ownership types differ far more in whether CMS can rate them at all than in how they score once rated.

By SeniorCareRating.com Editorial Team · Published 2026-08-18 · CMS data released 2026-08-21

What the ownership data shows

Of the 12,392 Medicare-certified home health agencies in this snapshot, CMS records 72.9% as for-profit and 8.6% as non-profit. Once CMS rates an agency, the average quality-of-patient-care star barely moves across ownership types — a spread of just 0.51 stars. What does move, sharply, is whether a star exists at all: rating coverage varies by 19.6 percentage points between ownership types. For a family comparing agencies, that is the practical finding — the largest group is also the group most likely to have no rating to compare. A missing star is not a poor rating. This is analysis of public CMS data, not a ranking; SeniorCareRating.com does not rate providers.

Agencies analyzed: 12,392; Medicare-certified
For-profit share: 72.9%; 9,037 agencies
Star spread by ownership: 0.51★; highest minus lowest average
Rating-coverage spread: 19.6 pts; highest minus lowest

Who owns Medicare-certified home health

Ownership composition as CMS reports it.

Agencies by ownership type

How the Medicare-certified home health sector is distributed across for-profit, non-profit, and government operators.

For-profit (proprietary)

72.9%

Not reported to CMS

16.4%

Non-profit

8.6%

Government-operated

12,392 Medicare-certified agencies.

CMS-reported data · updated 2026-08-21 · site-calculated context, not a CMS rating

Methodology

Counts every Medicare-certified home health agency in the current CMS snapshot, grouped by the ownership type CMS reports. Agencies with no ownership type in the CMS record are shown separately rather than dropped, because excluding them would overstate the precision of the remaining shares.

The gap is coverage, not score

Average star barely differs by ownership. Whether a star exists differs a great deal.

Rating coverage by ownership type

The share of each ownership group's agencies that carry a CMS quality-of-patient-care star.

For-profit (proprietary)

67.1%

Non-profit

86.7%

Government-operated

81.6%

Nationally, CMS rates 64.2% of all 12,392 agencies.

CMS-reported data · updated 2026-08-21 · site-calculated context, not a CMS rating

Methodology

Coverage = agencies with a CMS quality-of-patient-care star ÷ all agencies in that ownership group. Average star is computed over rated agencies only; unrated agencies are excluded from the average rather than counted as zero, which would misrepresent a missing measurement as a poor one.

Agency count, share of sector, rating coverage, and average CMS star by ownership type
Ownership type	Agencies	Share	With a CMS star	Avg star (rated)
For-profit (proprietary)	9,037	72.9%	67.1%	3.27★
Not reported to CMS	2,037	16.4%	37.5%	3.02★
Non-profit	1,068	8.6%	86.7%	3.37★
Government-operated	250	2%	81.6%	2.86★

Read the last two columns together. The average star moves very little across ownership types, so ownership is a weak predictor of how CMS scores an agency that it does score. The coverage column moves a great deal — which means ownership is a much stronger predictor of whether a family will find any CMS rating to look at.

What this does and does not tell you

A missing star is not a low star. CMS withholds the quality-of-patient-care rating when an agency has too few episodes to measure reliably. Newer and smaller agencies are therefore more likely to be unrated regardless of the care they provide.
Ownership type is self-reported to CMS and describes the operating entity, not the chain or investor behind it. Two agencies with the same label can have very different corporate structures.
This is not a ranking. The averages here describe groups, not agencies. A single for-profit agency may score far above a single non-profit one, and the group averages say nothing about either.
Coverage differences have several possible causes — agency size, age, episode volume, and reporting practice all affect whether CMS can compute a star. This report measures the gap; it does not establish why it exists.

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