The National Post-Acute and Long-Term Care Study, recently published as part of the National Health Statistics Report series, provides essential data on home health agencies in the U.S., covering operations, patient demographics, workforce composition, and service delivery based on 2020 data. This comprehensive report includes information from approximately 11,400 Medicare- and Medicaid-regulated home health agencies.

Published by the Centers for Disease Control and Prevention (CDC), the report series offers data summaries, in-depth analyses of key health topics, and insights into new methods and measurement issues. This report is part of the CDC’s broader initiative to monitor and analyze health statistics across the U.S., supporting public health policy development and health care improvements.

Overview of Home Health Agencies in 2020

Home health agencies made up 16.7% of the 68,150 regulated post-acute and long-term care providers in the U.S. These agencies play a vital role in post-hospital care, providing skilled nursing, therapy (physical, occupational, speech), medical social services, and personal care services, all aimed at preventing rehospitalization and supporting long-term health outcomes.

Key Findings from the 2020 Data

• Patient Care Volume: 42.9% of home health agencies served 1-100 patients annually, while 31.3% served over 300 patients, illustrating a broad range in patient capacity.
• Skilled Nursing and Therapy Services: 100% of agencies provided skilled nursing, and 95.7% offered therapy services, essential for recovery from illness or surgery.

Workforce Composition

The home health workforce plays a critical role in care delivery. Key staff includes registered nurses (RNs), licensed practical nurses (LPNs), and direct care workers such as certified nursing assistants (CNAs) and home health aides:

• RNs comprised 51% of the workforce.
• LPNs made up 21.7%.
• Direct care workers, including CNAs and home health aides, accounted for 24.8%, focusing primarily on assisting with activities of daily living (ADLs) like bathing, dressing, and eating.

Direct care workers are essential for day-to-day patient support, especially for those who require personal care rather than intensive nursing services.

Demographics of Home Health Patients

In 2020, the majority of home health patients were older adults:

• 65-74 years old: 27.9%
• 75-84 years old: 32.5%
• 85 years and older: 29.3%

Health Conditions and Functional Status

Home health patients often had multiple chronic conditions:

• Hypertension: 94%
• Heart disease: 60.4%
• Diabetes: 54.5%
• Alzheimer's/dementia: 25.6%

Additionally, 94.9% of patients required help with bathing, and 67.9% needed assistance with eating — highlighting the critical role of CNAs and home health aides in supporting patients’ quality of life.

Geographic Distribution of Home Health Agencies

• The South had the highest concentration of agencies, at 42.1%.
• The Northeast and Midwest had fewer agencies but focused more on other long-term care services.

Impact of COVID-19 on Home Health Agencies

The report noted the challenges brought on by the COVID-19 pandemic in 2020, including staffing shortages and new care protocols. Providers had to adapt rapidly to meet evolving safety requirements and patient care needs, especially for vulnerable, older adults at home.

For a more detailed analysis and additional insights, you can read the full National Post-Acute and Long-Term Care Study here.