How the scores work
Every rating on this site comes from CMS Care Compare — the quality program Medicare runs for the providers it certifies. Nothing is rated by us alone, and no provider can pay to change a number.
What CMS publishes
- Quality of patient care stars. For home health agencies, CMS combines outcome and process measures — improvement in walking, timely start of care, hospital readmissions — into a one-to-five star rating.
- Patient and family survey stars. The HHCAHPS survey asks former home health patients about communication, care and whether they would recommend the agency. The CAHPS Hospice Survey asks the same kind of questions of family caregivers.
- Nursing home five-star ratings. An overall star rating built from three parts: health inspections, staffing (from payroll records), and quality measures for residents.
- Health inspections. State surveyors visit nursing homes on a cycle and after complaints. Deficiencies, severity, fines and payment denials are part of the public record.
- Staffing. Nurse and aide hours per resident per day, reported from payroll data rather than a one-week self-report.
How the trust score combines them
The trust score puts published ratings on a single 0–100 scale so providers can be compared side by side, and weighs how recent the underlying survey and inspection data is — a rating built on a current survey cycle counts for more than one resting on older data.
- Home health: quality of patient care star 60%, HHCAHPS patient survey star 40%.
- Hospice: the CAHPS family-caregiver survey star on its own, because CMS does not publish a separate hospice quality star. These scores carry a "Survey only" flag.
- Nursing homes: a blend of the CMS five-star ratings — overall, health inspections, staffing and quality measures — with deductions for fines and penalties.
What a missing score means
CMS suppresses ratings for providers with too few patients, episodes or completed surveys. A missing rating is a data gap, not a bad result. When a score rests on a single input it is still shown, but flagged, so a high number built on one star cannot be mistaken for a full picture.
Data sources
All data is drawn from the CMS Provider Data Catalog — the same source that powers Medicare's Care Compare — and is refreshed automatically as CMS publishes new releases. Provider counts: 12,413 home health agencies, 6,463 hospices and 14,706 skilled nursing facilities.
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