How do California home health agencies compare on quality in 2026?

Higher is better on every row. If your agency's number is at or above the last column, you're in California's top 25% on that measure.

Patients rate California agencies a couple of points lower than the nation, too.

California does come out ahead on five measures: the flu shot check in the table, fewer pressure injuries (0.19% against 0.23%), fewer falls with major injury (0.58% against 0.93%), and passing health information along when a patient moves to another provider (82.8% against 81.9%) or goes home (93.0% against 92.4%). Medicare also spends about 10% less per episode here (0.90 against the national 1.00, for 2023 and 2024).

Here's what the score asks: when your patients leave home health, did they do as well on everyday self-care and getting around as CMS expected for patients like them? It's the share of your episodes where the answer is yes, built from the OASIS answers your clinicians record at start of care and discharge, then adjusted for each patient's starting function, age and health.

California's state score is 61.5. The middle California agency, though, scores 48.8. The gap is a weighting story. CMS's state figure pools every patient episode in the state, so big agencies carry more weight. The middle agency nationally scores 66.4.

So the bar to the top quarter is lower in California. At 68.2 you're in the state's top 25%, a number that sits just above the national middle. The score also counts toward HHVBP, starting with 2025 care, which is where it touches your Medicare payment. Our chapter on what HHVBP does to your payment walks through the dollars.

1,856 of California's 3,196 agencies, 58%, were certified in 2020 or later. Put another way, California holds 1,856 of the 3,348 agencies certified anywhere in the US since 2020. Texas added 187 in that time and Florida 381.

So far, the newer agencies score lower. Their median star rating is 3, against 3.5 for older California agencies, and their median discharge function score is 36.7 against 59.2. Many have no rating at all yet: only 1,063 of the 1,856 have a star rating in this release.

If you've been around longer, that's worth knowing when you sit down with a referral source. Your rating shows on Care Compare right beside theirs.

Under Home Health Value-Based Purchasing (HHVBP), Medicare raises or cuts each scored agency's payments by up to 5% based on its quality. Among California agencies with a 2026 adjustment, set by 2024 performance, the median got +0.64%. Nationally, the median was +0.19%. On $1 million a year of traditional Medicare home health revenue, 0.64% is $6,400.

CMS's HHVBP file lists 3,020 California agencies. 1,520 have a 2026 adjustment: 903 went up, 616 went down and 1 stayed flat. The other 1,500 don't have one. For each of those, CMS's footnote reads that the agency is ineligible "due to Medicare certification date and/or no or insufficient data on at least five measures."

1. Look up your agency on Medicare's Care Compare by name or ZIP code, and open the quality and patient survey tabs.
2. Put your numbers next to the top-quarter column. The rows where you're furthest below it are the places to start.
3. Pull a handful of recent discharges and read the self-care and mobility answers at start of care and at discharge. Do they tell a believable story of the patient's progress?

Enzo is a home health EHR. The discharge function score is built from OASIS answers, and Enzo's tools work on the OASIS side, where the answers a clinician records are the data. Enzo Scribe turns the visit into complete, OASIS-ready notes and flags gaps against OASIS requirements before anything goes to review. Enzo QA reviews every chart before submission, including OASIS responses and Plan of Care alignment, and explains what needs attention and why.