How we score agencies
Our goal is simple: put the public record about each home care agency in one place, in plain English, and score it the same way for everyone. Here's exactly how.
Who gets a score
- Home health and hospice agencies get a score out of 100 if Medicare publishes at least one rating for them (a quality rating or a patient/family survey rating).
- Agencies with no Medicare ratings (for example, home health agencies that are state-licensed but not Medicare-certified, or agencies too small for Medicare to publish a rating) show “Not enough data yet.” We still show their state record and years licensed.
- Personal-care agencies (non-medical help with daily living) are not scored, because Medicare does not rate them. We list them in a directory ordered by state compliance record and years licensed instead.
- We don't add our own minimum number of surveys. Medicare already withholds star ratings when an agency has too few patients or surveys for a reliable rating, and we rely on that.
The score (home health and hospice)
Each part is converted to a 0–100 scale, then combined:
| Part | Weight | Home health | Hospice |
|---|---|---|---|
| Quality | 35% | Medicare “quality of patient care” star rating (1★ = 0, 5★ = 100) | Medicare Hospice Care Index, 0–10 (×10) |
| Patient experience | 25% | Medicare HHCAHPS patient survey summary star rating | Medicare CAHPS Hospice family survey summary star rating |
| State compliance | 25% | Starts at 100. Minus 15 for each Texas administrative penalty in state fiscal years 2023–2025 (maximum −45). Minus 40 for a license revocation or denial (initial, renewal or change of ownership) in the same period. Minimum 0. | |
| Years licensed | 15% | Years since the Texas license was first issued, capped at 15 years (15+ years = 100). | |
If Medicare publishes only one of the two ratings, the missing one counts as a neutral 50 and the agency page says so. Agencies that offer both home health and hospice get a separate score for each; the headline score is the one with more Medicare data. Agencies with the same score share a rank.
What doesn't affect the score
- “Enforcement action pending.” This is an official Texas license status. It means the license is active and HHSC has an unresolved enforcement matter on file — for example, a proposed administrative penalty or license action that the agency may still contest. The state directory doesn't say what the matter is, and it isn't a final decision, so we show it as a neutral note and do not deduct points. If it results in a final penalty or license action, that will count once it appears in the state's published reports.
- Branch office closures. Shown for transparency; they're common and not a sign of poor care.
- Payments of any kind. Claiming a listing is free, and future paid features for agencies will never change a score or rank.
- Online star ratings from other websites. We don't use them, and we don't display them.
Data sources
- Texas HHSC Home and Community Support Services Agency (HCSSA) directory — who is licensed, services, status, address, phone, date first licensed.
- Texas HHSC Long-Term Care Regulatory Services annual reports — administrative penalties and licensure actions: FY2023 (PDF), FY2024 (PDF), FY2025 (PDF).
- Texas HHSC HCSSA closures list (PDF).
- Medicare (CMS) Provider Data Catalog: Home Health Care Agencies (updated Sep 21, 2026).
- Medicare (CMS) Provider Data Catalog: Home Health Care - Patient Survey (HHCAHPS) 2025Q2 to 2026Q1 (updated Sep 16, 2026).
- Medicare (CMS) Provider Data Catalog: Hospice - General Information (updated Aug 19, 2026).
- Medicare (CMS) Provider Data Catalog: Hospice - Provider Data (updated Aug 7, 2026).
- Medicare (CMS) Provider Data Catalog: Hospice care - Provider CAHPS Hospice Survey Data (updated Aug 7, 2026).
Penalties and license actions are matched to agencies by Texas license number. When a published record has no license number, we match by exact name and city only if exactly one licensed agency fits. A license number that no longer appears in the directory belongs to a closed license and is never attached to a different agency, even one with a similar name.
Agencies are grouped by the county of their main (parent) office. Agencies with an “expired” status, or a license expiration more than 180 days past, are excluded.
Known limits
- Penalty tables are extracted from PDF reports; a small number of rows could not be read cleanly. If you spot a missing or wrong record, tell us.
- Many smaller Medicare-certified agencies have no published star rating, and the Hospice Care Index clusters near the top (most hospices score 9–10), so many hospices tie.
- Medicare ratings describe Medicare patients and may lag by several months.
How often we update
We plan to rebuild the data monthly. Medicare refreshes Care Compare data roughly quarterly; the Texas license directory is updated continuously; enforcement reports are published annually. Every page shows its “data as of” date. Current data: Oct 22, 2026.
Questions? See corrections or about us.