Utah · Medicare · Home health care in 2026
Medicare Home Health Care in Utah (2026): Who Qualifies
Medicare will send a nurse or therapist to your home in Utah, and pay the whole bill, if you meet a short list of rules. Here are the rules in Medicare.gov's own words, the star ratings and patient surveys for every one of Utah's 82 certified agencies, how many Utahns actually use the benefit in each county, and exactly what to do when an agency says the visits are ending.
The bottom line
- Medicare pays $0 for covered home health services when a doctor or other allowed practitioner certifies that you need part-time or intermittent skilled nursing or therapy, you are homebound, and a Medicare-certified agency provides the care under a plan of care. You pay 20% only for medical equipment, after the Part B deductible.
- Homebound means leaving home is not recommended or takes considerable effort and help, and you normally do not leave. Trips to the doctor, adult day care, church and the occasional haircut or family event do not disqualify you.
- The limits: up to 8 hours a day of nursing and aide care combined, no more than 28 hours a week (35 for a short period if ordered). No 24-hour care, no meal delivery, no housekeeping, and no help with bathing or dressing when that is the only care you need.
- You do not have to be improving. Since the Jimmo settlement, skilled care to maintain your condition or slow decline is covered when a nurse or therapist is needed to do it safely.
- Utah has 82 Medicare-certified agencies. The state's average quality rating is 3.5 stars against a national 3; 35 of the 65 rated agencies score 4 stars or higher and 10 score 2.5 or lower. In 2025, 19,366 Utahns with Original Medicare (7.26%) used home health and Medicare paid $106,759,565 for it.
- If the agency says coverage is ending, you get a written notice at least 2 days ahead and can demand a fast appeal from Acentra Health at 888-317-0891 by noon the day before the end date.
Medicare's home health benefit is the most generous piece of the program that people know the least about. It is the only Medicare benefit that sends licensed clinicians to your house in Ogden or Cedar City, visit after visit, with no copay, no deductible and no visit limit, for as long as you meet the rules. It is also the benefit most often confused with the one thing Medicare does not pay for: ongoing personal care for someone who simply needs help getting through the day. This guide separates the two, using Medicare.gov's own language for every rule, and then does what a national guide cannot: tabulates the CMS star ratings and patient surveys for all 82 certified agencies in Utah, shows how many people in each of the 29 counties actually used the benefit in 2025, and walks through the appeal that stops an agency from ending your care too early.
Does Medicare pay for home health care?
Yes. Both Part A and Part B cover home health services, and Medicare.gov's coverage page states the cost in five words: “You pay nothing for covered services.” The catch is entirely in the word covered. Medicare covers home health when four things are true at the same time: you are under the care of a doctor or an allowed practitioner (a nurse practitioner, clinical nurse specialist or physician assistant) who establishes and regularly reviews a plan of care; that practitioner certifies that you need intermittent skilled nursing care, physical therapy, speech-language pathology services or continued occupational therapy; the practitioner certifies that you are homebound; and a Medicare-certified home health agency provides the care. A face-to-face encounter with a practitioner, related to the reason you need home health, must be documented within the required timeframe.
When those conditions are met, Medicare.gov says you can get “unlimited home health visits.” Medicare pays the agency one bundled payment for each 30-day period of care, based on your condition and needs, and you can have as many 30-day periods as your condition warrants. Your plan of care must be reviewed by your practitioner and the home health team as often as needed and at least once every 60 days. If you are in a Medicare Advantage plan, the plan must cover the same benefit but may require you to use an agency in its network and may require prior authorization; check your plan's Evidence of Coverage.
Who is homebound, and what does intermittent mean?
The homebound test has two parts and you must meet both. Medicare.gov's wording: leaving your home “isn't recommended because of your condition,” or you have trouble leaving home without help (a cane, wheelchair, walker or crutches; special transportation; or another person) because of an illness or injury; and you are “normally unable to leave your home and leaving takes a lot of effort.” The second part is where families misjudge themselves in both directions. Homebound is not bedbound. CMS's home health booklet lists the outings that do not cost you eligibility: medical treatment, adult day care, religious services, and “short, infrequent absences for non-medical reasons, like an occasional trip to the barber, a walk around the block, or attendance at a family reunion, funeral, graduation, or other infrequent or unique event.” A retiree in Sandy who is driven to dialysis three times a week and to church on Sunday can still be homebound. A retiree who drives herself to Smith's twice a week and to the senior center for lunch generally is not.
The second test is the amount of care. Medicare covers skilled nursing only on a part-time or intermittent basis, and CMS defines both halves. Intermittent skilled nursing is care needed fewer than 7 days a week, or daily for less than 8 hours a day for up to 21 days (extendable in exceptional circumstances). Part-time means that skilled nursing and home health aide services combined may be provided any number of days a week as long as they total fewer than 8 hours a day and 28 or fewer hours a week, or up to 35 hours a week “in some limited situations.” If you are expected to need full-time skilled nursing over an extended period, you do not qualify for the home health benefit; that level of need is what the skilled nursing facility benefit and, eventually, long-term care are for.
| Question | Medicare's answer (Medicare.gov / CMS product 10969) |
|---|---|
| Who can order home health? | A doctor, nurse practitioner, clinical nurse specialist or physician assistant who establishes a plan of care and reviews it at least every 60 days |
| What must you need? | Intermittent skilled nursing (other than drawing blood), physical therapy, speech-language pathology, or continued occupational therapy |
| Homebound | Leaving home is not recommended or requires help or considerable effort, and you normally do not leave; medical visits, adult day care, religious services and short infrequent outings are allowed |
| Face-to-face encounter | Required, documented by the practitioner, related to the reason for home health, within required timeframes; a physician, NP, CNS or PA may perform it (CY2026 rule) |
| Who provides the care? | A Medicare-certified home health agency; Medicare pays for only one agency at a time, and you may switch agencies |
| Hours | Nursing plus aide care fewer than 8 hours a day and 28 or fewer hours a week; up to 35 hours a week for a short time if ordered |
| What you pay | $0 for covered home health services; 20% of the Medicare-approved amount for durable medical equipment after the Part B deductible |
| How Medicare pays the agency | One payment per 30-day period of care, adjusted for your condition; unlimited periods while you qualify |
Sources: Medicare.gov, “Home health services” — medicare.gov; CMS product 10969, “Medicare & Home Health Care,” Section 1 — medicare.gov (PDF); CMS, CY 2026 Home Health PPS final rule fact sheet (face-to-face encounter) — cms.gov.
What does Medicare cover at home, and what does it refuse?
The covered list is longer than most people expect. Medicare.gov names medically necessary part-time skilled nursing (wound care for pressure sores or a surgical wound, patient and caregiver education, intravenous or nutrition therapy, injections, monitoring of serious illness and unstable health status); physical, occupational and speech-language therapy; medical social services; part-time home health aide care such as help with walking, bathing, grooming, changing bed linens and feeding, but only while you are also getting skilled nursing or therapy; injectable osteoporosis drugs for women who meet certain criteria; medical supplies for use at home; and durable medical equipment. The aide rule is the one that catches families. An aide can help your mother bathe and dress as part of a home health episode after her hip surgery. Once the physical therapist discharges her, the skilled service ends, and with it the aide.
The refused list is short and absolute. Medicare does not pay for 24-hour-a-day care at home, meals delivered to your home, homemaker services such as shopping, cleaning and laundry that are unrelated to your care plan, or “custodial or personal care that helps you with daily living activities (like bathing, dressing, or using the bathroom), when this is the only care you need.” That last sentence is the boundary between Medicare and long-term care. The full-schedule, hands-on help that most Utah families eventually need is on the wrong side of it, and our guide to what home care actually costs in Utah covers what fills the gap.
Two documents protect you at that boundary. Before giving you anything Medicare probably will not cover (because it is not reasonable and necessary, is only non-skilled personal care, or because you are not homebound or do not need intermittent skilled care), the agency must hand you an Advance Beneficiary Notice of Noncoverage describing the service and the likely cost, and you have the right to have the agency bill Medicare anyway for an official decision. And before the agency reduces or stops any service in your plan of care for its own reasons, or because your practitioner changed or did not renew the orders, it must give you a Home Health Change of Care Notice.
Do you have to be getting better?
No, and this is the rule most often misapplied to Utah retirees with Parkinson's disease, multiple sclerosis, ALS, advanced heart failure or dementia. For years some agencies and Medicare contractors used an “improvement standard,” ending therapy or nursing once a patient had “plateaued.” The Jimmo v. Sebelius settlement, approved by the court in January 2013, required CMS to rewrite its manuals to state a maintenance coverage standard. CMS's own summary: coverage of skilled nursing and skilled therapy in the home health setting “does not turn on the presence or absence of a beneficiary's potential for improvement, but rather on the beneficiary's need for skilled care.” Skilled nursing is covered when it is necessary to maintain your current condition or prevent or slow further deterioration, and skilled therapy is covered when a qualified therapist's judgment and skills are needed to carry out a safe and effective maintenance program.
The limit is the word skilled. If your maintenance program, say a set of range-of-motion exercises, could be carried out safely by a family member after some teaching, Medicare will pay for the therapist to design it and teach it, not to perform it indefinitely. If the agency tells you Medicare is ending your therapy because you are “not making progress,” that is the wrong test, and the fast appeal described below is how you say so.
How many Utahns use Medicare home health, and where?
Fewer than most people assume. CMS's Market Saturation and Utilization file for calendar year 2025 counts 266,685 Utahns in Original Medicare, of whom 19,366, or 7.26%, received Medicare-paid home health during the year from 66 billing agencies. Medicare paid $106,759,565 for that care, about $5,513 per person served. Nationally, 6.61% of Original Medicare beneficiaries used home health at about $6,108 per user, so Utah uses the benefit slightly more often and at a lower cost per person. The figures cover Original Medicare only; the 268,675 Utahns in Medicare Advantage plans (55% of the state's 488,797 beneficiaries in May 2026) receive home health through their plans and are not in this file.
Sources: CMS, Market Saturation & Utilization State-County, Home Health, 2025 — data.cms.gov; CMS Provider Data Catalog, Home Health Care Agencies and State by State Data — data.cms.gov; CMS Medicare Monthly Enrollment, Utah, May 2026 — data.cms.gov.
Use has drifted down. In 2020, 20,489 Utahns (8.17%) used the benefit; by 2025 the count was 19,366 even though the Original Medicare population grew, partly because more Utahns moved into Medicare Advantage and partly because the number of billing agencies fell from 79 to 66. Where you live matters too. Washington County, with St. George's large retiree population, has the highest use rate among the big counties at 8.48%, while the resort and rural counties with the fewest agencies, Summit (4.13%) and Grand (3.46%), have the lowest. Daggett County had no billing agency at all in 2025; its 11 users were served by agencies based elsewhere.
Percent of Original Medicare (fee-for-service) beneficiaries who received Medicare-paid home health in calendar year 2025, twelve selected Utah counties. Source: CMS, Market Saturation & Utilization State-County — data.cms.gov.
| County | Original Medicare beneficiaries | Home health users, 2025 | Share who used it | Agencies that billed | Medicare payments |
|---|---|---|---|---|---|
| Salt Lake | 85,030 | 6,229 | 7.33% | 39 | $36,680,318 |
| Utah | 36,583 | 2,708 | 7.4% | 29 | $15,873,141 |
| Washington | 27,239 | 2,310 | 8.48% | 17 | $11,031,890 |
| Davis | 27,666 | 2,002 | 7.24% | 27 | $11,342,096 |
| Weber | 23,419 | 1,747 | 7.46% | 20 | $9,881,270 |
| Cache | 8,002 | 565 | 7.06% | 9 | $2,740,585 |
| Iron | 6,831 | 460 | 6.73% | 10 | $2,201,571 |
| Tooele | 5,919 | 444 | 7.5% | 8 | $2,770,652 |
| Box Elder | 5,131 | 424 | 8.26% | 7 | $2,038,176 |
| Carbon | 3,322 | 298 | 8.97% | 4 | $1,422,111 |
| Uintah | 3,445 | 241 | 7% | 3 | $1,646,888 |
| Summit | 5,496 | 227 | 4.13% | 6 | $1,038,658 |
| Sevier | 2,945 | 207 | 7.03% | 4 | $897,347 |
| Sanpete | 3,374 | 187 | 5.54% | 3 | $725,601 |
| Emery | 1,653 | 163 | 9.86% | 4 | $680,586 |
| Duchesne | 2,298 | 147 | 6.4% | 2 | $1,149,653 |
| Wasatch | 3,653 | 141 | 3.86% | 4 | $615,435 |
| Millard | 2,036 | 114 | 5.6% | 2 | $461,319 |
| Kane | 1,963 | 112 | 5.71% | 1 | $483,859 |
| San Juan | 2,361 | 109 | 4.62% | 2 | $611,260 |
| Juab | 1,316 | 108 | 8.21% | 1 | $659,858 |
| Morgan | 1,144 | 84 | 7.34% | 2 | $409,174 |
| Beaver | 1,159 | 82 | 7.08% | 2 | $307,338 |
| Garfield | 1,055 | 82 | 7.77% | 2 | $402,819 |
| Grand | 2,108 | 73 | 3.46% | 1 | $301,461 |
| Piute | 340 | 37 | 10.88% | 1 | $127,645 |
| Wayne | 574 | 33 | 5.75% | 1 | $116,685 |
| Rich | 348 | 21 | 6.03% | 1 | $79,595 |
| Daggett | 275 | 11 | 4% | 0 | $62,575 |
| Utah | 266,685 | 19,366 | 7.26% | 66 | $106,759,565 |
All 29 Utah counties, sorted by home health users. Original Medicare only; Medicare Advantage members are excluded. “Agencies that billed” counts home health agencies with paid claims for beneficiaries living in the county, wherever the agency is based, which is why the statewide count (66) is lower than the number of certified agencies (82). Payments rounded to the dollar. Source: CMS, Market Saturation & Utilization State-County, reference period January 1 to December 31, 2025 — data.cms.gov.
How do you choose a home health agency in Utah?
You choose; the hospital does not. CMS's booklet is direct: your doctor, hospital discharge planner or other referring agency “should honor your choice,” and a practitioner who refers you must give you a list of agencies serving your area and disclose any financial interest in them. Medicare pays for only one agency at a time, and you may leave one and choose another whenever you like with a new referral. The only real limit is a Medicare Advantage plan's network. So the question is how to compare 82 agencies, and the answer is the two star ratings on Medicare.gov Care Compare, which mean different things.
The Quality of Patient Care star is calculated by CMS from 7 measures: timely initiation of care, and improvement in managing oral medications, walking, getting in and out of bed, bathing and breathing, plus the rate of potentially preventable hospitalizations during a home health stay. An agency needs data on at least 5 of the 7 measures, and each measure needs at least 20 completed episodes, so small and new agencies often have no rating. CMS says most agencies nationally fall in the middle at 3 stars and that the rating compares agencies with one another rather than measuring absolute quality. The Patient Survey star comes from the HHCAHPS survey mailed to discharged patients and needs 40 completed surveys over four quarters. In Utah, 65 of 82 agencies have a quality star and only 40 have a patient survey star.
| Quality measure (current CMS release) | Utah average | National average | Utah vs. nation |
|---|---|---|---|
| Home health team began care within 2 days of referral or hospital discharge (timely initiation) | 98.98% | 96.51% | Better |
| Patients got better at taking their drugs correctly by mouth | 91.17% | 88.07% | Better |
| Patients got better at walking or moving around | 91.46% | 88.6% | Better |
| Patients got better at getting in and out of bed | 93.12% | 89.71% | Better |
| Patients got better at bathing | 93.08% | 90.63% | Better |
| Patients' breathing improved | 92.3% | 91.31% | Better |
| Discharge function score (met or exceeded expected function at discharge) | 79.19% | 71.74% | Better |
| Patients experiencing one or more falls with major injury | 1.33% | 0.93% | Worse |
| Transfer of health information to the next provider at discharge or transfer | 69.98% | 81.21% | Worse |
| Transfer of health information to the patient or family at discharge | 86.73% | 92.18% | Worse |
| Medicare spending per episode, relative to the national average (1.00) | 0.9 | 1.00 | Lower cost |
| Average Quality of Patient Care star rating | 3.5 | 3 | Better |
| Agencies rated 4, 4.5 or 5 stars | 42.69% | 22.82% | Better |
Utah and national averages for the publicly reported home health quality measures. OASIS-based measures cover April 1, 2024 to March 31, 2025; claims-based measures cover calendar 2024. For the falls measure, lower is better. Source: CMS Provider Data Catalog, “Home Health Care — State by State Data” and “Home Health Care — National Data” — data.cms.gov.
The pattern in that table is worth a sentence. Utah's agencies start care faster and get more patients walking, transferring, bathing and managing medicines than the national average, at 90% of the national cost per episode. Where Utah trails is paperwork and safety: Utah agencies are less likely to send your health information to the next provider or to you at discharge, and Utah's rate of falls with major injury is higher. Ask any agency you interview how it hands off to your doctor when it discharges you, and what its fall-prevention routine is.
Patient surveys tell a similar story. From 9,340 completed Utah surveys (a 23% response rate), 86% of patients rated their agency 9 or 10 out of 10, a point above the national 85%, but only 77% would definitely recommend it, two points below the national 79%.
| Percent of patients who reported that their home health team… | Utah | Nation |
|---|---|---|
| Gave care in a professional way | 89% | 89% |
| Communicated well with them | 85% | 86% |
| Discussed medicines, pain and home safety | 80% | 82% |
| Rated the agency 9 or 10 out of 10 | 86% | 85% |
| Would definitely recommend the agency | 77% | 79% |
HHCAHPS patient survey results, surveys from January to December 2025. Source: CMS Provider Data Catalog, “Home Health Care — Patient Survey (HHCAHPS) State Data” and “National Data” — data.cms.gov.
Every Medicare-certified home health agency in Utah, with its ratings
The table below lists all 82 agencies CMS certifies in Utah, grouped by the county where the agency is based, with both star ratings, the number of completed patient surveys behind the survey star, the share of surveyed patients who would definitely recommend the agency, ownership, and the year the agency was first certified. Agencies are based in 16 of Utah's 29 counties: 27 in Salt Lake County, 15 in Utah County, 12 in Washington County, 8 in Davis, 4 in Weber, 4 in Cache, and one or two in each of Box Elder, Iron, Sanpete, Juab, Sevier, Beaver, Carbon, Uintah, Duchesne and San Juan counties; most serve a wider area than their home county, and Care Compare will show you which ones serve your ZIP code. 75 agencies are for-profit, 2 are nonprofit and 2 are government-operated. A dash means CMS did not publish a figure, usually because the agency had too few episodes or surveys, or is a pediatric agency.
| Agency | City (county) | Quality of care star | Patient survey star | Surveys | Would definitely recommend | Ownership | Certified |
|---|---|---|---|---|---|---|---|
| Auburn Crest Home Health | Draper (Salt Lake) | — | — | — | — | For-profit | 2015 |
| Auburn Crest Home Health Utah, LLC | Draper (Salt Lake) | 3.5 | — | 18 | 61% | For-profit | 2019 |
| Quality Solace Services Lifecares (HH) | Holladay (Salt Lake) | 2.5 | 5 | 53 | 83% | For-profit | 2012 |
| Refined Healthcare Services LLC | Midvale (Salt Lake) | 4.5 | 4 | 46 | 76% | For-profit | 2004 |
| Aspen Ridge Home Health | Murray (Salt Lake) | 3.5 | 4 | 325 | 82% | For-profit | 2005 |
| BrightenLife Home Health | Murray (Salt Lake) | 5 | 2 | 49 | 76% | For-profit | 2012 |
| Canyon Home Care | Murray (Salt Lake) | 4 | 4 | 350 | 84% | For-profit | 2006 |
| Enhabit Home Health | Murray (Salt Lake) | 4 | 4 | 247 | 83% | For-profit | 1996 |
| Harmony Home Health | Murray (Salt Lake) | 3 | 3 | 93 | 79% | For-profit | 1996 |
| Horizon Home Health- Salt Lake | Murray (Salt Lake) | 1.5 | — | — | — | For-profit | 1995 |
| Renew Home Health | Murray (Salt Lake) | 3 | 3 | 40 | 79% | For-profit | 2011 |
| Superior Home Care | Murray (Salt Lake) | 3 | — | 7 | 78% | For-profit | 1996 |
| Symbii Home Health South | Murray (Salt Lake) | 4.5 | 3 | 461 | 73% | For-profit | 2014 |
| Valeo Home Health | Murray (Salt Lake) | 4 | 4 | 117 | 80% | For-profit | 2005 |
| Valeo Home Healthcare Services, LLC | Murray (Salt Lake) | — | — | — | — | For-profit | 2004 |
| Caregiver Support Network, Inc. | Salt Lake City (Salt Lake) | 4 | 3 | 76 | 79% | For-profit | 2003 |
| Cascade Springs Home Healthcare | Salt Lake City (Salt Lake) | 2.5 | — | 29 | 80% | For-profit | 2011 |
| Solstice Home Health, LLC | Salt Lake City (Salt Lake) | 4.5 | — | 8 | 51% | For-profit | 2014 |
| Active Home Health | Sandy (Salt Lake) | 5 | 4 | 101 | 75% | For-profit | 2011 |
| Maxim Healthcare Services, Inc | Sandy (Salt Lake) | — | — | — | — | For-profit | 2004 |
| Ability Home Health | South Jordan (Salt Lake) | 3 | — | — | — | For-profit | 2007 |
| Intermountain Homecare Home Health Salt Lake | South Jordan (Salt Lake) | 4 | 4 | 1266 | 78% | For-profit | 1984 |
| True North Home Health | South Salt Lake (Salt Lake) | 4 | 3 | 373 | 70% | For-profit | 2006 |
| Aspire Home Health, Inc. | Taylorsville (Salt Lake) | 3.5 | 5 | 105 | 87% | For-profit | 2011 |
| Choice Health at Home | Taylorsville (Salt Lake) | — | — | 1 | 7% | For-profit | 2005 |
| Community Nursing Services | West Valley City (Salt Lake) | 4.5 | 4 | 610 | 78% | For-profit | 1966 |
| Mission Home Health of Salt Lake City | West Valley City (Salt Lake) | 3 | — | 7 | 32% | For-profit | 2010 |
| Dignity Home Health of Utah | American Fork (Utah) | 2.5 | — | 27 | 78% | For-profit | 2007 |
| Star Kids Pediatric Home Health | American Fork (Utah) | — | — | — | — | For-profit | 2019 |
| A-Plus Healthcare at Home - Home Health | Lehi (Utah) | 3.5 | 4 | 152 | 77% | For-profit | 2001 |
| Elite Home Health LLC | Lehi (Utah) | 3.5 | 3 | 48 | 61% | For-profit | 2019 |
| Elite Home Health Utah, LLC | Lehi (Utah) | — | — | — | — | For-profit | 2007 |
| Primary Home Health | Lehi (Utah) | 3.5 | — | — | — | For-profit | 2006 |
| Axis In-Home, Inc (Belle Vie Home Health) | Orem (Utah) | 3 | — | — | — | For-profit | 2003 |
| First Choice Home Health | Orem (Utah) | 3 | 3 | 103 | 76% | For-profit | 1993 |
| Health Watch Provo, Inc. | Orem (Utah) | 4 | 4 | 43 | 86% | For-profit | 1996 |
| Horizon Home Health (Horizon Pediatric Home Care) | Orem (Utah) | 1.5 | — | — | — | For-profit | 2008 |
| Loving Hands Home Health | Orem (Utah) | — | — | — | — | For-profit | 2007 |
| Utah Home Health | Orem (Utah) | 5 | 4 | 56 | 76% | For-profit | 2006 |
| Serenity Home Health of Utah LLC | Pleasant Grove (Utah) | — | — | — | — | n/a | 2024 |
| Maple Creek Home Health | Spanish Fork (Utah) | — | — | — | — | For-profit | 2011 |
| iCare Home Health | Springville (Utah) | 3 | 3 | 55 | 82% | For-profit | 2011 |
| Symbii Davis Home Health | Bountiful (Davis) | 5 | — | 28 | 79% | For-profit | 1994 |
| Utah Home Health - North | Bountiful (Davis) | 5 | 3 | 93 | 69% | For-profit | 2019 |
| Inspiration Home Health, LLC | Clearfield (Davis) | 2.5 | 3 | 182 | 76% | For-profit | 2008 |
| AFI Advanced Care Home Health, LLC | Layton (Davis) | — | — | — | — | For-profit | 2008 |
| Atlas Home Care | Layton (Davis) | 5 | 3 | 311 | 73% | For-profit | 2007 |
| Symbii Home Health | Layton (Davis) | 5 | 4 | 344 | 76% | For-profit | 2007 |
| Independence Home Health | Woods Cross (Davis) | 3.5 | — | 14 | 85% | For-profit | 2012 |
| Rocky Mountain Home Health - Utah | Woods Cross (Davis) | 2.5 | 3 | 609 | 68% | For-profit | 1992 |
| Specialty Nursing Services | Huntsville (Weber) | — | — | 16 | 100% | For-profit | 1997 |
| Amazing Care Home Health Services LLC | South Ogden (Weber) | — | — | 9 | 80% | For-profit | 2006 |
| Applegate Homecare | South Ogden (Weber) | 4 | 4 | 300 | 83% | For-profit | 1984 |
| Intermountain Health Home Health - Ogden | South Ogden (Weber) | 4.5 | 4 | 449 | 82% | For-profit | 1966 |
| Ascend Home Health | Logan (Cache) | 4.5 | 4 | 89 | 78% | For-profit | 2006 |
| Intermountain Health Home Health - Logan | Logan (Cache) | 4 | 4 | 219 | 85% | For-profit | 1984 |
| Sunshine Home Health | Logan (Cache) | 2 | — | 12 | 100% | Nonprofit | 2002 |
| Primrose Home Care | Providence (Cache) | 4.5 | — | 22 | 83% | For-profit | 2007 |
| Symbii Home Health Bear River | Brigham City (Box Elder) | 5 | 3 | 70 | 75% | For-profit | 2005 |
| Southern Utah Home Health | Hurricane (Washington) | — | — | — | — | For-profit | 2009 |
| Advanced Home Health of St. George | St. George (Washington) | 4.5 | — | 38 | 76% | For-profit | 2018 |
| Canyon Home Care of Southern Utah | St. George (Washington) | 3 | — | 22 | 85% | For-profit | 2013 |
| Dixie Home Rehab | St. George (Washington) | 4.5 | 5 | 268 | 82% | For-profit | 2007 |
| Enhabit Home Health of Southern Utah | St. George (Washington) | 4 | 4 | 162 | 80% | For-profit | 1990 |
| Integrated Senior Care Home Health (Peak Home Health) | St. George (Washington) | 2.5 | — | 14 | 75% | For-profit | 2016 |
| Intermountain Health Home Health - St. George | St. George (Washington) | 4 | 4 | 353 | 76% | Nonprofit | 1984 |
| Mission Home Health of St. George | St. George (Washington) | 4 | 4 | 120 | 72% | For-profit | 2015 |
| Red Mesa Home Health | St. George (Washington) | — | — | — | — | n/a | 2022 |
| Summit Home Health St. George | St. George (Washington) | 2.5 | — | 16 | 84% | For-profit | 2020 |
| Zion's Way Home Health | St. George (Washington) | 4.5 | 4 | 333 | 80% | For-profit | 2008 |
| Atlas Homecare of Southern Utah | Washington (Washington) | 4 | — | — | — | For-profit | 2020 |
| Horizon Home Health-SG | Cedar City (Iron) | 3 | — | 9 | 82% | For-profit | 1993 |
| Iron County Home Health Agency | Cedar City (Iron) | — | — | 17 | 100% | For-profit | 1969 |
| Gunnison Valley Hospital Home Health | Gunnison (Sanpete) | 4 | 4 | 74 | 77% | Government | 1984 |
| Intermountain Health Home Health - Mt. Pleasant | Mt. Pleasant (Sanpete) | 4 | 4 | 116 | 81% | For-profit | 1980 |
| Central Valley Home Health | Nephi (Juab) | 3.5 | 5 | 40 | 81% | For-profit | 1984 |
| at Home Health Care | Salina (Sevier) | 4 | — | 21 | 83% | For-profit | 1997 |
| Beaver Valley Home Health | Beaver (Beaver) | 3 | — | 36 | 94% | Government | 1986 |
| Elevate Home Health, LLC | Price (Carbon) | 4 | — | 33 | 89% | For-profit | 2019 |
| Good Shepherd Home Care | Vernal (Uintah) | 3 | — | 35 | 77% | For-profit | 2007 |
| Home Help Care Services | Roosevelt (Duchesne) | — | — | — | — | n/a | 2023 |
| Home Nursing For Utah | Montezuma Creek (San Juan) | — | — | — | — | For-profit | 2022 |
All 82 Medicare-certified home health agencies in Utah as listed by CMS on September 15, 2026, sorted by county and city. Quality of Patient Care star: OASIS assessments April 2024 to March 2025 and Medicare claims for calendar 2024; Patient survey star, completed surveys and “would definitely recommend” percent: HHCAHPS surveys January to December 2025 (a survey star requires at least 40 completed surveys; the percent is shown even when fewer surveys make it unreliable). Names are as registered with CMS and are public data shown for comparison, not endorsements or recommendations. Sources: CMS Provider Data Catalog, “Home Health Care Agencies” — data.cms.gov; “Home Health Care — Patient Survey (HHCAHPS)” — data.cms.gov.
A few things the table shows. 8 Utah agencies hold a 5-star quality rating and 4 hold a 5-star patient survey rating, but they are mostly different agencies: a high clinical score and a high patient-experience score do not travel together, so look at both. Several of the largest agencies by episode volume, including Intermountain's home health branches and Community Nursing Services, score 4 or 4.5 on quality with hundreds or thousands of surveys behind their patient star, which makes those numbers more stable than a 5-star rating built on 40 surveys. And the lowest quality scores in the state, 10 agencies at 2.5 stars or below, sit in the same Wasatch Front cities as the highest, so a Murray or Orem address tells you nothing by itself.
What happens when the agency says Medicare is ending your care?
Every Medicare home health episode ends with a notice, and the notice is your leverage. The agency must give you a written Notice of Medicare Non-Coverage at least 2 days before your covered services end. It states the last covered date and how to ask for a fast appeal. If you think the services are ending too soon, whether because you still need skilled care or because the agency is applying the improvement standard that Jimmo abolished, you have the right to an independent review by the Beneficiary and Family Centered Care Quality Improvement Organization for your state. For Utah, which sits in federal Region 8 with Montana, the Dakotas, Wyoming and one other Mountain state, that reviewer is Acentra Health, toll-free 888-317-0891 (TTY 711). Utah's home health hotline for quality complaints, which the agency must also give you when care begins, and the Utah Office of Licensing at (801) 890-2007 handle complaints about the care itself rather than coverage.
- Call Acentra Health no later than noon on the day before the termination date on the notice. Miss that deadline and you can still ask for a review, but the automatic protection against paying for care during the appeal is gone.
- The agency must give you a Detailed Explanation of Non-Coverage by the end of the day it hears from the reviewer, stating why the care is no longer reasonable and necessary and which Medicare rule it is applying. You can also request copies of everything sent to the reviewer.
- Tell the reviewer why you still need skilled care. The reviewer will look at your medical records and talk to your practitioner, so it helps to have called your doctor first. If the agency's reason is that you are not improving, say so and cite the Jimmo maintenance standard.
- The decision comes by close of business the day after the reviewer has what it needs; CMS's booklet says to expect a response generally within 3 days of the notice's effective date. If the reviewer agrees with you, Medicare keeps covering your care. If not, you owe only for services you chose to receive after the date on the notice, and the agency must give you an Advance Beneficiary Notice with a cost estimate before providing them.
- If you are in a Medicare Advantage plan, the same notice and fast-appeal rights apply, with the plan's reconsideration process behind them.
Sources: Medicare.gov, “Fast appeals” — medicare.gov; CMS product 10969, “Your right to a fast appeal” — medicare.gov (PDF); CMS, Beneficiary and Family Centered Care QIOs — cms.gov; Acentra Health contact page (Region 8) — acentraqio.com; Utah DHHS Office of Licensing, “Submit a concern” — dlbc.utah.gov.
What changed for 2026?
Three things from CMS's calendar-year 2026 home health payment rule, issued November 28, 2025, touch patients. First, the money: CMS finalized a 2.4% payment update offset by a permanent adjustment of -1.023% and a temporary adjustment of -3%, for an estimated net cut of 1.3%, or about $220 million, in Medicare payments to home health agencies compared with 2025. Lower payments do not change your $0 cost, but they are one reason Utah's count of billing agencies keeps shrinking and why some agencies are slower to accept new referrals in rural counties. Second, the face-to-face rule was broadened so that a physician, as well as a nurse practitioner, clinical nurse specialist or physician assistant, may perform the required encounter even when they are not the practitioner who certifies your home health or the one who treated you in the hospital. That removes a paperwork snag that used to delay starts of care after a hospital stay. Third, CMS revised the HHCAHPS patient survey beginning with the April 2026 sample month, so the survey stars published from 2027 on will not be strictly comparable to the ones in this article.
Source: CMS, “Calendar Year (CY) 2026 Home Health Prospective Payment System Final Rule (CMS-1828-F)” fact sheet — cms.gov.
Where home health ends and long-term care begins
The honest summary of everything above is that Medicare home health is a recovery and disease-management benefit, not a caregiving benefit. It is at its strongest in the weeks after a hospital or skilled nursing facility stay, when a nurse is managing a wound or new medications and a therapist is getting you back on your feet, and it can continue for as long as skilled care is needed to hold the line on a chronic condition. What it cannot do is provide the daily help with bathing, dressing, meals and supervision that a person with advancing dementia or frailty needs, and for that Utah families rely on their own hands, private-pay home care, long-term care insurance, or, once assets are spent down, Utah Medicaid's home and community-based waivers. Knowing the line in advance is what lets a family plan for the second half instead of discovering it on the day the nurse stops coming.
We help Utah families map what Medicare home health will pay for, where it stops, and how to fund the care that comes after: long-term care insurance, hybrid policies, and income planning that keeps the house and the spouse protected. Plain English, no pressure. Education, not advice. We do not offer every plan available in your area.
Talk to a planner →Frequently asked questions
Does Medicare pay for home health care in Utah?
Yes, when you meet the rules. Medicare Part A and Part B cover part-time or intermittent skilled nursing care, physical therapy, occupational therapy, speech-language pathology, medical social services and part-time home health aide care at home, delivered by a Medicare-certified home health agency under a plan of care from your doctor or another allowed practitioner. You pay $0 for the covered home health services themselves. To qualify you must need skilled care on a part-time basis and be homebound, and your doctor must have seen you face-to-face for the reason you need home health. Medicare does not pay for 24-hour care, meal delivery, housekeeping, or personal care when that is the only care you need.
What does homebound mean for Medicare?
Medicare.gov says you must meet both of two conditions. First, leaving your home is not recommended because of your condition, or you have trouble leaving home without help such as a cane, wheelchair, walker, crutches, special transportation or another person, because of an illness or injury. Second, you are normally unable to leave home and doing so takes a lot of effort. Homebound does not mean bedbound: you may still leave for medical appointments, adult day care, religious services and short, infrequent non-medical trips such as a haircut, a family reunion or a funeral.
How many hours of home health care will Medicare cover?
In most cases part-time or intermittent means up to 8 hours a day of skilled nursing and home health aide care combined, and no more than 28 hours a week. Your provider can order up to 35 hours a week for a short period if it is medically necessary. Medicare defines intermittent skilled nursing as care needed fewer than 7 days a week, or daily for less than 8 hours a day for up to 21 days, with extensions in exceptional circumstances. If you need full-time skilled nursing over an extended period, you generally do not qualify for the home health benefit.
Do I have to be improving for Medicare to keep paying for home health?
No. Under the Jimmo v. Sebelius settlement, CMS clarified that coverage of skilled nursing and skilled therapy at home does not turn on whether you are expected to improve. Skilled care to maintain your current condition, or to prevent or slow decline, is covered as long as a nurse or qualified therapist is needed to provide it safely and effectively and the other coverage rules are met. What Medicare will not cover is maintenance care that could safely be provided by a non-skilled person, such as a family member.
How do I compare home health agencies in Utah?
Use Medicare.gov Care Compare, which lists every Medicare-certified agency serving your ZIP code with two star ratings. The Quality of Patient Care star is calculated by CMS from seven measures of timely care, functional improvement and preventable hospitalization; the Patient Survey star comes from the HHCAHPS survey and requires at least 40 completed surveys. In the current CMS data, 65 of Utah's 82 certified agencies have a quality star and 40 have a patient survey star; the Utah state average quality rating is 3.5 stars against a national average of 3. Your doctor or hospital discharge planner must honor your choice of agency, though a Medicare Advantage plan may limit you to agencies in its network.
What can I do if my home health agency says Medicare will stop covering my care?
Ask for a fast appeal. The agency must give you a written Notice of Medicare Non-Coverage at least 2 days before your covered services end. Follow the instructions on that notice and call the Beneficiary and Family Centered Care Quality Improvement Organization no later than noon on the day before the termination date. For Utah that organization is Acentra Health, toll-free 888-317-0891 (TTY 711). The agency must then give you a Detailed Explanation of Non-Coverage, and the reviewer decides by the close of business on the day after it receives the information it needs. If you win, Medicare keeps paying; if you lose, you owe only for services you chose to receive after the date on the notice.
Sources
- Medicare.gov — Home health services (covered services, homebound definition, provider requirements, $0 cost, 20% for equipment, 8 hours a day / 28 hours a week, up to 35): medicare.gov — home health services
- CMS — “Medicare & Home Health Care,” product 10969 (eligibility, intermittent definition, 30-day periods of care, ABN, Home Health Change of Care Notice, Notice of Medicare Non-Coverage, choosing an agency, plan of care reviewed every 60 days): medicare.gov — publication 10969 (PDF)
- Medicare.gov — Fast appeals (Notice of Medicare Non-Coverage at least 2 days ahead; request by noon the day before; Detailed Explanation of Non-Coverage; decision timing; Commence Health and Acentra Health by state): medicare.gov — fast appeals
- CMS — Beneficiary and Family Centered Care Quality Improvement Organizations: cms.gov — BFCC-QIOs; Acentra Health contact page (Region 8, which includes Utah, Montana, North Dakota, South Dakota and Wyoming; 888-317-0891): acentraqio.com
- CMS — Jimmo Settlement (maintenance coverage standard for skilled nursing and therapy in home health): cms.gov — Jimmo settlement
- CMS — Home Health Star Ratings (Quality of Patient Care: 7 measures, 5 required, 20 episodes per measure; Patient Survey star: 40 completed surveys): cms.gov — home health star ratings; January 2026 Quality of Patient Care star rating provider preview (measure list): cms.gov (PDF)
- CMS Provider Data Catalog — Home Health Care Agencies (all 82 Utah agencies with quality star, measures, ownership, certification date): data.cms.gov — 6jpm-sxkc; Home Health Care — Patient Survey (HHCAHPS) 2025Q1–2025Q4: data.cms.gov — ccn4-8vby; State by State Data: data.cms.gov — tee5-ixt5; National Data: data.cms.gov — 97z8-de96; HHCAHPS State Data: data.cms.gov — m5jg-jg7i; HHCAHPS National Data: data.cms.gov — vxub-6swi
- CMS — Market Saturation & Utilization State-County, Home Health, reference period 2025 (Utah: 266,685 fee-for-service beneficiaries, 19,366 users, 66 providers, $106,759,565; nation: 39,524,879 beneficiaries, 2,613,941 users): data.cms.gov — market saturation
- CMS — Medicare Monthly Enrollment, Utah, May 2026 (488,797 total; 220,122 Original Medicare; 268,675 Medicare Advantage and other): data.cms.gov — monthly enrollment
- CMS — CY 2026 Home Health Prospective Payment System final rule (CMS-1828-F) fact sheet, November 28, 2025 (2.4% update, -1.023% permanent and -3% temporary adjustments, net -1.3%; face-to-face encounter change; HHCAHPS survey revision from April 2026): cms.gov — CY 2026 HH PPS fact sheet
- Medicare.gov — Care Compare, home health services: medicare.gov — care compare
- Utah DHHS Office of Licensing — Submit a concern ((801) 890-2007): dlbc.utah.gov; Utah Insurance Department — Medicare consumer page (Utah SHIP (877) 424-4640): insurance.utah.gov; Eldercare Locator (1-800-677-1116) for the long-term care ombudsman: eldercare.acl.gov
About this article. Written by the Utah Retirement Income Data Desk and reviewed by Brian Penner, Retirement income & long-term care planner. Educational only — not medical, financial, or legal advice. Coverage rules are quoted from Medicare.gov and CMS product 10969 as of September 15, 2026; the agency ratings, quality measures and patient survey figures are our own tabulation of the CMS Provider Data Catalog home health datasets downloaded that day, and the county utilization figures are from CMS's Market Saturation and Utilization file for calendar 2025. CMS updates star ratings quarterly and the utilization file periodically, so check Care Compare for current figures; agency names are public CMS data shown for comparison and are not endorsements or recommendations, and a star rating is not a guarantee of the care you will receive. Confirm your own eligibility with your doctor, the agency, or 1-800-MEDICARE before you act. Utah Retirement Income is a licensed independent insurance agency (NPN 16493717) and is not a government agency; we are not connected with or endorsed by Medicare, the Centers for Medicare & Medicaid Services, the Social Security Administration, the Utah Department of Health and Human Services, or any government program, and nothing here should be read as an endorsement by them. We do not provide home health care and are not affiliated with any agency listed. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area; please contact Medicare.gov, 1-800-MEDICARE, or your State Health Insurance Assistance Program — in Utah, the Utah SHIP at (877) 424-4640 — to get information on all of your options. A $0-premium Medicare Advantage plan is not free; you still pay Part B premiums and cost-sharing, and long-term care insurance and annuity guarantees depend on the claims-paying ability of the issuing company, with no promise of savings. If you call or text us, you consent to be contacted at the number you provide about your options; message and data rates may apply, and you can opt out at any time by replying STOP.