Patient Survey Star Rating
The Patient Survey Star Rating is a 1 to 5 star score on Care Compare that summarizes a home health agency's performance on the HHCAHPS patient experience survey. CMS publishes star ratings for key survey measures plus a summary rating, giving referral sources and families a quick read on how patients rate the agency's care.
Where the rating comes from
The Home Health Care CAHPS (HHCAHPS) survey asks recent home health patients about their experience: how the team communicated, how professionally care was delivered, whether specific care issues like medications and safety were addressed, how they rate the agency overall, and whether they would recommend it. CMS converts survey results into star ratings for the key measures and a summary star rating, published on Care Compare and refreshed quarterly. Results are adjusted for patient mix and survey mode so agencies serving different populations can be compared fairly.
The 40-survey threshold
An agency generally needs at least 40 completed HHCAHPS surveys across the four-quarter reporting period to receive a Patient Survey Star Rating. Agencies below that volume may display survey results without stars, or no survey data at all. This makes response rates an operational lever, not just a statistical footnote: an agency with marginal survey volume can gain or lose its public rating based on how consistently patient contact information is captured at admission and passed to the survey vendor. Very small agencies with too few eligible patients can qualify for an exemption from HHCAHPS participation entirely.
Why patient experience scores move payment now
Patient experience is no longer only a marketing concern. Under the expanded Home Health Value-Based Purchasing (HHVBP) model, HHCAHPS results count for 20% of the Total Performance Score in the CY2026 measure set, concentrated in just two measures, Overall Rating of Care and Willingness to Recommend, at 10% each. That concentration means a handful of dissatisfied patients in a small survey pool can move both the public star rating and a payment-relevant score. Agencies that treat survey results as a quarterly readout rather than a managed outcome are leaving both referrals and revenue exposed.
What good survey performance looks like
Agencies with strong survey stars tend to share a few habits:
- Set expectations at start of care about visit frequency, scheduling, and who to call
- Standardize communication scripts for schedule changes and clinician substitutions
- Close the loop on complaints within days, before the survey arrives
- Review vendor-level survey results monthly and share verbatim comments with field teams
- Confirm accurate patient phone numbers and addresses at intake so eligible patients actually receive surveys
Frequently asked questions
Who administers the HHCAHPS survey behind the star rating?
CMS-approved third-party survey vendors administer HHCAHPS on the agency's behalf. Agencies cannot survey their own patients for this purpose, and they are prohibited from coaching patients on how to answer.
Why does my agency show quality stars but no patient survey stars?
The two ratings have separate data requirements. If your agency has fewer than roughly 40 completed surveys in the reporting period, or is exempt from HHCAHPS due to low patient volume, Care Compare will not display a Patient Survey Star Rating even if OASIS and claims measures support a Quality of Patient Care rating.
Can we improve survey scores without more staff?
Usually yes, because most low scores trace to communication and expectation-setting rather than clinical quality. Consistent scheduling communication, a reliable after-hours phone experience, and rapid complaint resolution move scores more than adding visits does.