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Sixteen home-based care companies are listed in Franchise Times’ 2026 ranking of the largest U.S. franchise systems. Home Instead Senior Care ranked highest among them at No. 43, with reported global systemwide sales of about $2.46 billion.
Franchise Times’ 2026 ranking of the largest franchise systems in the United States lists 16 home-based care companies and is based on global systemwide sales. In the ranking, Home Instead Senior Care led the care providers at No. 43, with reported sales of $2.46 billion and 1,112 locations.
According to the Franchise Times ranking, the next-highest-ranked care companies were Vital Care Infusion at No. 49, with $1.97 billion in sales and 145 locations, and Interim HealthCare at No. 67, with $1.3 billion and 563 locations. Visiting Angels followed at No. 68, reporting nearly $1.29 billion in sales across 814 locations. Right at Home ranked No. 76, with about $1.12 billion and 783 locations.
The ranking also listed BrightStar Care at No. 97, Comfort Keepers at No. 106, Home Helpers Home Care at No. 181, ComForCare Home Care at No. 188 and FirstLight Home Care at No. 194. Franchise Times’ company entries also named Always Best Care, Homewatch CareGivers, Griswold Home Care, Assisting Hands Home Care and HomeWell Care Services. Their reported global sales ranged from about $164 million to $304 million, with rankings between No. 200 and No. 273.
Franchise Times says the list includes 16 home-based care companies, but its itemized entries also name A Place at Home at No. 493, with $31.3 million in sales and 80 locations. That rank is outside the Top 400, so the published company count and the full set of entries do not align. The ranking materials do not explain the discrepancy.
Franchise Scale Across Home Care
Franchise Times’ ranking offers a snapshot of the scale of franchise operations in home-based care, spanning nonmedical support, skilled nursing, hospice, infusion services and senior-care referrals. Its reported sales and location counts allow readers to compare the listed systems, although they do not show how much care each company provides or how services are distributed geographically.
For prospective franchise owners, the figures may help identify the size of established networks. For families and care workers, the ranking is not a measure of service quality, affordability, staffing or local availability. It concerns franchise-system sales, not patient outcomes or the experience of individual clients.
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How Franchise Times Sets Eligibility
Franchise Times describes its Top 400 as a ranking of large franchise systems based on global systemwide sales. The publication’s report says a company must be a legal U.S. franchise, and franchisees must own at least 10% of the company’s locations. The company must also be headquartered in the United States or have at least 10% of its locations there.
The companies included in the ranking operate across different service categories and markets. Home Instead, Visiting Angels and several others focus on in-home personal or companion care; Interim HealthCare offers nursing, home care and hospice; and Vital Care Infusion provides pharmacy and infusion services, including infusions at home. The list therefore brings together companies with different business models rather than comparing identical services.
A Published Count Discrepancy
Franchise Times says 16 companies made the list, but its company-by-company details include A Place at Home at No. 493, below the ranking’s stated Top 400. The published materials do not clarify whether that entry was included in error, whether the company appeared in another part of the original material, or whether the reported count needs correction.
The ranking presents global sales and location totals, but the supplied Franchise Times report does not provide a methodology for independently verifying each company’s numbers or explain how the sales period compares with prior years. It also does not give a year-over-year comparison for the home-based care firms, so the rankings alone do not establish whether a company grew or declined.
Check the Underlying List Details
The next point to watch is whether Franchise Times or the report publisher clarifies the A Place at Home listing and the discrepancy between its No. 493 rank and the stated Top 400. Readers seeking company-level comparisons can consult Franchise Times’ full ranking for its methodology and details, while treating the reported sales and location totals as list figures rather than measures of care quality or performance at a local franchise.
Key Questions
How many home-based care companies were reported on the list?
Franchise Times says 16 companies were included. Its itemized details also name A Place at Home at No. 493, which is outside the Top 400, leaving the published count unclear.
Which home-based care company ranked highest?
According to Franchise Times’ ranking, Home Instead Senior Care ranked highest among the listed care providers, at No. 43, with reported global sales of $2,463,182,003 and 1,112 locations.
What does the ranking measure?
Franchise Times says the Top 400 is based on global systemwide sales. The figures do not measure care quality, client outcomes or local service availability.
What are the list’s franchise eligibility requirements?
According to Franchise Times’ report, companies must be legal U.S. franchises, franchisees must own at least 10% of total locations, and the company must be U.S.-headquartered or have at least 10% of its locations in the United States.
Source: homehealthcarenews.com
