Research · National Google Reviews Report 2026
What Families Actually Say About Home Care
An analysis of Google reviews of home care agencies across the 30 largest U.S. metros.
Families praise the people and complain about the system. Caregiver quality drives the most praise. Communication drives the most complaints, and it's the complaint that varies most from market to market.
- 13,247Google reviews classified
- 600home care agencies
- 30largest U.S. metros
Summary
Key findings at a glance
- Caregiver quality dominates praise. 54.2% of positive Google reviews of home care agencies are mainly about caregiver quality, nearly four times the next theme, emotional support (14.6%).
- Communication drives the most complaints. 28.2% of negative reviews are mainly about communication and responsiveness, and 24.8% about reliability, such as no-shows and schedule changes. Together they make up more than half.
- Billing is the only theme where complaints outnumber praise. Billing and admin has a praise-to-complaint ratio of 0.80, the only theme below 1.0.
- Most negative reviews go unanswered. 75% of agencies respond to at least some reviews, but only 28.4% of negative reviews receive an owner response.
- Complaints vary by market. Communication is the theme that varies most across metros. It accounts for 50% of negative reviews in Chicago and Phoenix, and none in Austin.
Finding 1
Families praise caregiver quality above everything else
The key finding
54.2% of positive reviews are mainly about caregiver quality, the highest share of any theme by far. Families write about caregivers by name, describe moments of real connection, and credit individual caregivers with giving their loved one a sense of dignity.
When families trust an agency, three themes lead what they write: caregiver quality (54.2%), emotional support (14.6%) and communication (9.6%).
What this means for your agency
Your caregivers are your marketing. Their names show up in your best reviews. Feature real caregivers, with their permission, on your website and in your social content. Show how you make families feel, not just what you do. And if your team is responsive, prove it: families notice.
Finding 2
Communication failures drive the most home care complaints
The key finding
28.2% of negative reviews are mainly about communication and responsiveness, the top complaint theme nationally. Families describe unanswered calls, unreturned messages, and agencies that go silent when problems come up.
Reliability is close behind at 24.8%: no-shows, last-minute substitutions, and schedule changes that force family members to leave work. Together, communication and reliability make up more than half of all negative reviews. Caregiver quality accounts for 21.3%.
What this means for your agency
Families are more likely to leave a bad review about how your agency communicates than about their caregiver. How fast does your team respond to a new inquiry, a missed visit or a worried call? Is that standard written down, and does anyone check it?
Finding 3
Billing is the only theme where complaints outnumber praise
The key finding
Billing and admin has a praise-to-complaint ratio of 0.80, the only theme below 1.0. In other words, for every 10 reviews that complain about billing, only 8 praise it. Families who run into billing problems feel misled and powerless.
What this means for your agency
Billing transparency sets you apart. Are your costs, minimum hours and processes explained clearly before a family signs? Would a family ever be surprised by an invoice from you?
Finding 4
Most home care agencies don't respond to negative reviews
The key finding
Across 600 agencies, 75% respond to at least some of their Google reviews, and 57.8% of all reviews receive an owner response. But only 28.4% of negative reviews get one. The reviews families read most carefully before deciding are the ones agencies answer least.
What this means for your agency
A response to a negative review, even an imperfect one, shows that someone is in charge and paying attention. Families comparing agencies notice who shows up in their reviews and who goes silent. It's one of the lowest-effort, most visible reputation moves you can make.
Finding 5
Home care complaints vary by market
The key finding
Communication is the theme whose share of complaints varies most across metros. The national pattern holds in most markets, but the details differ enough that a national playbook will miss what families in your city care about.
| Metro | Top complaint (share of negative reviews) | Negative reviews answered |
|---|---|---|
| Chicago | Communication (50%), tied with Phoenix for the highest communication share | 71.4% |
| Phoenix | Communication (50%) | 39.1% |
| Boston | Communication (42.1%) | 41.7% |
| San Diego | Communication (33.3%) | 57.1% |
| Dallas | Communication (32.4%) | 65.2% |
| Los Angeles | Communication (31.8%), nearly tied with caregiver quality and reliability (27.3% each) | 57.1% |
| Seattle | Reliability (31.8%), the only market where reliability leads | 62.1% |
| Baltimore | Billing (27.6%), the only market where billing leads | 7.7% |
| San Francisco | Caregiver quality (40%) | 16.7% |
| Austin | Caregiver quality and reliability (33.3% each); communication 0% | 41.2% |
| Washington, DC | Caregiver quality (31%) | 11.1% |
Response rates vary just as widely: from 71.4% of negative reviews answered in Chicago, the highest in the study, to 7.7% in Baltimore, the lowest. In Austin, San Francisco and Washington, DC, caregiver quality is both the top source of praise and the top complaint.
What this means for your agency
What families complain about depends on where you operate. Read your own reviews, and your competitors', the way a family in your city would. What do they praise, what do they complain about, and who answers?
Your agency's next steps
What to do with this
| This week | This month | This quarter |
|---|---|---|
| Search your agency name on Google and read your last 10 reviews as if you were a family evaluating you for the first time. | Time how fast your team responds to a new inquiry. Communication is the top complaint nationally. | Write a response-time standard for inquiries, calls and care concerns, and make it visible to families. |
| Find every unanswered negative review and respond. | Ask three satisfied families for a Google review. Mention their caregiver by name in the ask. | Start a caregiver spotlight series for your website and social media. |
| Check how your website talks about your caregivers. Do they have names and faces? | Review your billing communications. Are costs and processes explained before families sign? |
See where your agency stands
How do your reviews, response times and trust signals compare?
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Frequently asked questions
What do families praise most in home care reviews?
Caregiver quality. In an analysis of 13,247 Google reviews of 600 home care agencies, 54.2% of positive reviews were mainly about caregiver quality, followed by emotional support (14.6%) and communication (9.6%).
What do families complain about most in home care reviews?
Communication and responsiveness. 28.2% of negative reviews of home care agencies were mainly about communication, followed by reliability (24.8%) and caregiver quality (21.3%). Billing is the only theme where complaints outnumber praise.
Should a home care agency respond to negative reviews?
Yes. Only 28.4% of negative Google reviews of home care agencies receive an owner response, even though 75% of agencies respond to at least some reviews. A response, even an imperfect one, shows families that someone is in charge and paying attention.
How should a home care agency respond to a bad Google review?
Keep it short and kind, invite the family to call you directly, and never share client details. Respond to every negative review, not just some: the reviews families read most carefully are the ones agencies answer least.
Methodology
How this research was done
RaisedCare collected Google reviews for 600 home care agencies across the 30 largest U.S. metros in May 2026, for a total of 13,247 reviews. Reviews rated 4–5 stars are counted as positive (11,143 reviews) and 1–2 stars as negative; 3-star reviews are neutral and not included in the praise or complaint shares.
Each review was classified by its single most prominent theme from a fixed list of seven: caregiver quality, communication and responsiveness, reliability and consistency, billing and admin, intake and onboarding, care management, and emotional support. Classification was done with an AI model (Claude) using written definitions for each theme. Reviews too short or vague to classify were excluded from theme shares.
A theme's praise-to-complaint ratio is the number of positive reviews about that theme divided by the number of negative reviews about it. "Varies most across markets" means the theme with the widest range in its share of negative reviews from metro to metro. Owner response rates count reviews with a visible reply from the agency. Metro figures rest on smaller samples than the national results and should be read as directional.
How to cite this report
RaisedCare. What Families Actually Say About Home Care: National Google Reviews Report 2026. 2026. raisedcare.com/insights/what-families-say-about-home-care
Related research: The State of Home Care 2026 · How to Get More Clients for Your Home Care Agency
