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

This measure asks a plain question: of the patients your agency discharged, how many were still home, not back in a hospital or a facility, 31 days later? CMS adjusts each agency's rate for how sick its patients were and compares it with the nation. The current numbers cover discharges from January 2024 to December 2025.

The middle Texas agency's adjusted rate is 70.8%. Nationally, the middle agency is at 84.6%. Even Texas's top quarter, which starts at 81.2%, sits below the national middle. No state with 100 or more agencies has a lower middle; Oklahoma is next at 72.0%.

Of the 991 Texas agencies CMS could score on this, 465 did worse than the national rate, 339 were no different and 187 did better. Potentially preventable hospital stays during care point the same way: 179 Texas agencies did worse than the national rate and 15 did better.

The gap sits mostly with small agencies

We split every scored agency in the country into thirds by how many discharges CMS counted: 118 or fewer, 119 to 418, and more. Texas's largest agencies come close to the nation, at a median of 83.4% against 87.3%. Its smallest agencies don't: 57.7% against 78.1%. And small agencies are most of Texas, 515 of the 991 scored, where nationally they're a third.

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

Beyond the table, Texas also trails on getting in and out of bed, falls with major injury (1.15% against 0.93%) and passing health information along when a patient moves to another provider or goes home. It ties the nation on pressure injuries and leads on following up on medication issues in time. That's 9 measures behind, 3 ahead and 1 even, out of 13.

At the bottom of the star scale, 221 of its 1,006 rated agencies, 22%, have 1 or 1.5 stars, against 9% of rated agencies nationally. 313 have 4 stars or more.

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 Texas agencies with a 2026 adjustment, set by 2024 performance, the median got -0.14%, close to even. Nationally, the median was +0.19%. On $1 million a year of traditional Medicare home health revenue, -0.14% is $1,400.

CMS's HHVBP file lists 1,852 Texas agencies. 922 have a 2026 adjustment: 440 went up, 481 went down and 1 stayed flat. The others don't have one; CMS's footnote says the agency is ineligible "due to Medicare certification date and/or no or insufficient data on at least five measures."

Discharge to community is one of the measures HHVBP scores. Our chapter on what HHVBP does to your payment walks through the dollars.

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, and put your rate for patients staying home after discharge next to 81.2%. The rows where you're furthest below are the places to start.

Enzo is a home health EHR. Staying home after discharge is counted from Medicare claims, not from anything an agency charts. Most of the care rows in the table come from OASIS. 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.