Home Health Agencies Grading Methodology White Paper
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Health Grades, Inc.
element based on its impact on quality of care. After each person completed the survey, the
group scores were re-distributed along with each member's own scores and each member was
given the opportunity to re-classify his/her weight. Final group weights for each of the data
elements were then calculated.
Each home health agency had fifteen scores for each data element. These scores were added to
obtain an overall weighted average score. Home health agencies were sorted by state based upon
the overall score. HealthGrades applied the following rating system based on each home health
agency's overall score:
Top 30% of all home health agencies within each state
Middle 60% of all home health agencies within each state
Bottom 10% of all home health agencies within each state
Limitations of Data Analysis
It must be understood that while these analyses may be valuable in identifying home health
agencies that perform better than others, individuals should consider additional sources of
information when evaluating the quality of care provided by a home health agency. The
analytical models were limited by the following factors: 1) despite the efforts of CMS and
HealthGrades, there still may be instances of missing, outdated, inaccurate or incomplete data; 2)
the data only addresses survey and operational performance. Other home health quality
measurements, such as patient care outcomes or staffing quality, are not accounted for in this
HealthGrades does not endorse or recommend any particular home health agency; rather, it
strives to provide unbiased information regarding home health quality from licensing surveys.
Only individual patients can decide whether a particular home health agency is suited for their
Thomas Boardman, Ph.D., Professor of Statistics, Colorado State University (CSU), assisted
HealthGrades in developing this methodology and generating rankings for HealthGrades.