Sometime in October 2026, CMS refreshes the home health star ratings on Medicare's Care Compare. Families, discharge planners and referral partners look at those stars. Most quarters, the refresh is a small shuffle. This one is different in one specific way.
It is the first refresh of 2026 built on 2025 Medicare claims. The January, April and July 2026 ratings all used claims from calendar year 2024. So the one claims-based measure in the rating, potentially preventable hospitalizations, moves by a full year's data in October. If your hospitalization rate changed between 2024 and 2025, your star can move with it.
Below are the new national cut points for all seven measures, how CMS turns them into a star, and what moved since July.
Source: CMS Home Health Quality of Patient Care Star Rating Provider Preview Reports, October 2026 (with January, April and July 2026 for comparison). The agency named in CMS's sample report is fictional. The cut points are national: CMS says they "were calculated using all HHAs with available information" and are "updated each quarter." Quotes and file hashes are in our source notes.
What Changes in October
| Report | OASIS data (end-of-care) | Claims data |
|---|---|---|
| January 2026 | Apr 2024 – Mar 2025 | Calendar year 2024 |
| April 2026 | Jul 2024 – Jun 2025 | Calendar year 2024 |
| July 2026 | Oct 2024 – Sep 2025 | Calendar year 2024 |
| October 2026 | Jan – Dec 2025 | Calendar year 2025 |
The six OASIS measures roll forward a quarter each time. The hospitalization measure sat still all year and jumps in October.
The Seven Measures
To get a star, an agency needs data for at least 5 of these 7:
- Timely Initiation of Care
- Improvement in Management of Oral Medications
- Improvement in Ambulation
- Improvement in Bed Transferring
- Improvement in Bathing
- Improvement in Dyspnea
- Home Health Within-Stay Potentially Preventable Hospitalization (PPH)
A measure only counts if the agency has at least 20 completed episodes or stays for it in the 12-month window. For the six OASIS measures, a completed episode means a start or resumption of care assessment paired with an end of care assessment. For all of them except PPH, higher is better. For PPH, lower is better.
PPH replaced the old Acute Care Hospitalization measure in May 2024.
October 2026 Cut Points: What Each Half-Star Takes
CMS sorts every agency's score on each measure into ten groups and gives each group an initial rating from 0.5 to 5.0. These are the October 2026 ranges, copied from CMS's preview report:
| Initial rating | Timely Initiation | Oral Meds | Ambulation | Bed Transferring | Bathing | Dyspnea | PPH (lower is better) |
|---|---|---|---|---|---|---|---|
| 0.5 | 0.0–82.8 | 0.0–56.5 | 0.0–62.5 | 0.0–59.1 | 0.0–66.3 | 0.0–60.8 | 14.7–100.0 |
| 1.0 | 82.9–90.7 | 56.6–71.3 | 62.6–75.1 | 59.2–74.5 | 66.4–79.3 | 60.9–77.5 | 13.0–14.6 |
| 1.5 | 90.8–94.5 | 71.4–79.5 | 75.2–81.5 | 74.6–82.2 | 79.4–85.1 | 77.6–85.1 | 12.0–12.9 |
| 2.0 | 94.6–96.5 | 79.6–84.0 | 81.6–85.3 | 82.3–86.3 | 85.2–88.3 | 85.2–88.7 | 11.2–11.9 |
| 2.5 | 96.6–97.8 | 84.1–86.9 | 85.4–87.7 | 86.4–88.8 | 88.4–90.3 | 88.8–91.1 | 10.5–11.1 |
| 3.0 | 97.9–98.7 | 87.0–89.5 | 87.8–89.7 | 88.9–90.6 | 90.4–92.1 | 91.2–92.7 | 9.9–10.4 |
| 3.5 | 98.8–99.3 | 89.6–91.6 | 89.8–91.6 | 90.7–92.4 | 92.2–93.8 | 92.8–94.3 | 9.3–9.8 |
| 4.0 | 99.4–99.8 | 91.7–94.2 | 91.7–93.8 | 92.5–94.2 | 93.9–95.6 | 94.4–96.2 | 8.6–9.2 |
| 4.5 | 99.9–99.9 | 94.3–98.5 | 93.9–96.8 | 94.3–96.9 | 95.7–98.6 | 96.3–99.5 | 7.8–8.5 |
| 5.0 | 100.0–100.0 | 98.6–100.0 | 96.9–100.0 | 97.0–100.0 | 98.7–100.0 | 99.6–100.0 | 0.0–7.7 |
Two things stand out. Timely Initiation of Care is almost all at the top. Anything under 97.9 percent is below the 3.0 band, and 82.8 percent or lower is the bottom group. And the middle is narrow everywhere. On most OASIS measures, the whole 3.0 band is less than two points wide.
What Moved Since July
Where the 3.0 band starts, July 2026 against October 2026:
| Measure | July 2026 | October 2026 | Change |
|---|---|---|---|
| Timely Initiation of Care | 97.9 | 97.9 | Same |
| Oral Medications | 86.6 | 87.0 | Up 0.4 |
| Ambulation | 87.6 | 87.8 | Up 0.2 |
| Bed Transferring | 88.7 | 88.9 | Up 0.2 |
| Bathing | 90.3 | 90.4 | Up 0.1 |
| Dyspnea | 90.7 | 91.2 | Up 0.5 |
| PPH (3.0 band) | 9.8–10.3 | 9.9–10.4 | Slightly easier |
The OASIS improvement bars keep creeping up. An agency that held exactly steady from July to October can lose ground on those measures, because everyone else moved. PPH went the other way by a tenth of a point, but your own PPH rate now reflects 2025 instead of 2024, which matters more than the cut point.
How CMS Turns Seven Scores Into One Star
From CMS's preview report, in four steps:
- Group. Your score on each measure lands in one of the ten groups above, giving an initial rating from 0.5 to 5.0.
- Adjust toward the middle. CMS tests whether your score is statistically different from the national middle (a one-sided binomial test at p 0.05). If it is not, your rating on that measure moves 0.5 toward the middle categories of 2.5 or 3.0. With fewer episodes, a difference is harder to prove, so smaller agencies tend to be pulled toward the middle more often.
- Average. CMS averages the adjusted ratings across up to seven measures and rounds to the nearest 0.5.
- Map to stars. The rounded average maps to one of nine star categories, from 1 to 5 in half stars:
| Rounded average | Star rating |
|---|---|
| 4.5 and 5.0 | 5 stars |
| 4.0 | 4.5 stars |
| 3.5 | 4 stars |
| 3.0 | 3.5 stars |
| 2.5 | 3 stars |
| 2.0 | 2.5 stars |
| 1.5 | 2 stars |
| 1.0 | 1.5 stars |
| 0.5 | 1 star |
Notice the last step. A rounded average of 3.0 shows as 3.5 stars, and both 4.5 and 5.0 show as 5 stars. Three stars is the middle category.
Can You Still Change the October Number?
No. CMS's October preview report set August 7, 2026 as the deadline for review requests, with decisions by August 21. Earlier quarters followed the same rhythm: May 1 for July, February 6 for April.
Even then, a review only covers a calculation error. CMS is blunt: "inaccurate OASIS data recording is not a valid reason to submit a request for review." If your OASIS data is wrong, the fix is the Review and Correct Report in iQIES (My Reports, HHA Provider Preview Reports folder), before each quarter's data correction deadline. CMS uses only corrections made by that deadline.
If Your Agency Shows No Star
CMS's preview report gives two usual reasons:
- Fewer than 20 episodes or stays for enough measures, so fewer than 5 of 7 could be calculated
- The agency has been certified or re-certified for less than six months
What to Do With the Next Quarter
- Pull your Review and Correct Report every quarter, not just before a refresh. It shows your OASIS measures for the past four quarters and whether each quarter's correction window is still open.
- Look at your weakest measure's band, not your average. Moving one measure from 2.0 to 3.0 raises the average of seven by about 0.14. That is often enough to cross a rounding line.
- Watch Timely Initiation. The top groups are packed within about two points, so a few late starts can cost you a band or two. The clock rules are in our 48-hour rule guide.
- Hospitalizations hit both scores. PPH is in the star rating, and it was the heaviest single measure in HHVBP scoring for 2025. See what the October 1 HHVBP report means for your 2027 payments.
This article covers the Quality of Patient Care rating. Care Compare also shows a separate Patient Survey star rating, built from HHCAHPS.
Key Takeaways
- The October 2026 Care Compare refresh is the first of 2026 on 2025 claims, so the hospitalization measure moves by a full year.
- OASIS data now covers calendar year 2025.
- The OASIS cut points rose again since July. Standing still can cost you a band.
- The review deadline for October passed on August 7. OASIS errors are fixed through Review and Correct before each quarter's correction deadline.
- An agency needs 5 of 7 measures with at least 20 episodes each to get a star.
Frequently Asked Questions
When do the October 2026 home health star ratings go live?
CMS says the Quality of Patient Care Star Ratings "will be available on the Medicare.gov Compare Tool for home health services in October 2026." CMS has not published a specific day in the preview report.
What data is behind the October 2026 star rating?
End-of-care OASIS assessments from January 1 to December 31, 2025, and Medicare fee-for-service claims from January 1 to December 31, 2025. It is the first 2026 refresh that uses 2025 claims. The January, April and July 2026 ratings all used 2024 claims.
How many measures are in the home health Quality of Patient Care Star Rating?
Seven: Timely Initiation of Care, Improvement in Management of Oral Medications, Improvement in Ambulation, Improvement in Bed Transferring, Improvement in Bathing, Improvement in Dyspnea, and Home Health Within-Stay Potentially Preventable Hospitalization. An agency needs data for at least 5 of the 7 to get a rating.
Can I still ask CMS to review my October 2026 star rating?
No. Review requests for the October 2026 rating were due August 7, 2026, and CMS says inaccurate OASIS data recording is not a valid reason for a review. Errors in your OASIS data have to be fixed before each quarter's data correction deadline.
Why is my agency's star rating not showing?
CMS's preview report says it is usually because fewer than 20 episodes or stays were available for enough of the measures, or because the agency has been certified or re-certified for less than six months. An agency needs data for at least 5 of the 7 measures.
Is the HHVBP payment adjustment part of the star rating?
No. CMS says the expanded HHVBP model's performance data is supplemental to the Quality of Patient Care and Patient Survey Star Ratings and does not form a part of them. They are scored separately, on different measure sets.
Sources
- Quality of Patient Care Star Rating Provider Preview Report, October 2026 sample (CMS)
- Same, July 2026 (CMS)
- Same, April 2026 (CMS)
- Same, January 2026 (CMS)
- Home Health Star Ratings (CMS)
- Expanded HHVBP Model Guide, December 2025 (CMS)
Start every patient on time
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