Quality of Patient Care Star Rating
The Quality of Patient Care Star Rating is a 1 to 5 star summary score, in half-star increments, that CMS publishes for each home health agency on Care Compare. It condenses a defined set of OASIS-based and claims-based quality measures into a single consumer-facing rating, updated quarterly.
What feeds the rating
The rating is built from a subset of the publicly reported home health quality measures, spanning process performance such as Timely Initiation of Care, OASIS-based functional outcomes such as improvement in ambulation and self-care activities, and claims-based utilization outcomes tied to hospital use. CMS periodically revises the component list as measures are adopted or retired, so agencies should confirm the current components in the technical documentation rather than assume last year's list. Each component is risk-adjusted where applicable, so ratings are meant to reflect agency performance rather than patient acuity.
How the stars are calculated
CMS converts each component measure into a score based on where the agency falls in the national distribution, averages the component scores, and maps the result to a star value in half-star increments. Most agencies cluster in the 3 to 4 star range, which means small measure movements can shift a rating up or down a half star. An agency must have enough qualifying episodes on enough of the component measures to receive a rating at all, so low-volume agencies may show no stars. Agencies receive preview reports before each quarterly refresh and can review their data, and request correction of calculation errors, before publication.
Why the rating matters commercially
Star ratings are one of the few quality signals visible to everyone in your referral chain. Hospital discharge planners and e-referral platforms surface them when building referral lists, Medicare Advantage plans and ACOs use them in network decisions, and families increasingly check Care Compare directly. A half-star gap against the agency across town is a recurring, silent factor in referral conversion. Agencies with 4.5 or 5 stars routinely lead with the rating in liaison conversations, which means lower-rated competitors are being sold against whether they know it or not.
How to move your stars
Because the rating blends OASIS and claims measures, improvement runs through both documentation and care delivery:
- Audit OASIS accuracy at start of care so baseline function is not overstated, which suppresses measured improvement
- Tighten intake-to-first-visit workflows to protect Timely Initiation of Care
- Target avoidable hospitalizations with risk stratification and front-loaded visits
- Review the quarterly preview report every cycle and trace any decline to specific measures and clinicians
Frequently asked questions
How often does the Quality of Patient Care Star Rating change?
CMS refreshes Care Compare quarterly, and each refresh uses a rolling window of assessment and claims data. Because the window overlaps prior periods, improvements show up gradually over several quarters rather than all at once.
Why does my agency have no star rating?
Agencies must have a minimum number of qualifying episodes on a minimum number of component measures to be rated. New agencies and very low-volume agencies often fall below those thresholds and display measure data without a summary star rating.
Is the Quality of Patient Care rating the same as the Patient Survey star rating?
No. The Quality of Patient Care rating comes from OASIS and claims measures, while the Patient Survey Star Rating comes from HHCAHPS patient experience surveys. Care Compare displays both, and referral sources often look at the pair together.