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Sixteen home-based care companies were included in Franchise Times’ 2026 ranking of large U.S. franchise systems, according to Home Health Care News. Home Instead Senior Care ranked highest among them at No. 43, with reported global sales of about $2.46 billion; the list is based on global systemwide sales and has eligibility rules for franchise ownership and U.S. presence.
Sixteen home-based care companies appear in Franchise Times’ 2026 ranking of large U.S. franchise systems, according to Home Health Care News. Home Instead Senior Care placed highest among the care providers, ranking No. 43 with reported global systemwide sales of $2.46 billion, putting home-based care businesses among the larger franchise operators measured by the publication.
The list ranks franchise systems by global systemwide sales, rather than by revenue earned solely in the United States. Franchise Times’ stated criteria require a company to be a legal U.S. franchise, with franchisees owning at least 10% of its total locations. A company must also be headquartered in the United States or have at least 10% of its locations there.
Following Home Instead at the top of the care-company group were Vital Care Infusion at No. 49, with $1.97 billion in reported global sales, and Interim HealthCare at No. 67, with $1.30 billion. Visiting Angels ranked No. 68 at about $1.29 billion, while Right at Home ranked No. 76 at about $1.12 billion. The reported figures reflect systemwide sales, not necessarily the franchisor’s own revenue.
Other listed systems include 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. Always Best Care, Homewatch CareGivers, Griswold Home Care, Assisting Hands Home Care and HomeWell Care Services also appear. The source lists A Place at Home at No. 493, outside the Top 400 rank range, despite including it among the companies discussed. That discrepancy is not explained in the supplied report.
What the Sales Ranking Shows
The entries show that home-based care is represented across a wide range of franchise-system sizes. The highest-ranked providers reported billions of dollars in global systemwide sales, while several others were ranked below No. 180. This offers a snapshot of the sector’s presence in a broad franchise ranking, though it does not measure care quality, client outcomes or the financial performance of individual locations.
For readers evaluating the companies, the ranking provides one comparison point: reported sales and location counts. It does not establish that one provider is a better care option than another, or indicate how much of a system’s sales came from home care, a particular service line or a specific country. The list’s international scope also means global sales should not be read as U.S.-only market size.
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How Franchise Times Sets Eligibility
Franchise Times’ annual Top 400 is a ranking of franchise systems, and its methodology centers on global systemwide sales. Under the criteria described by Home Health Care News, eligible companies must be U.S. legal franchises and meet both a franchisee-ownership threshold and a U.S. presence threshold. Those rules mean that inclusion is not simply a measure of how many locations a provider operates.
The listed businesses cover different services. Home Instead and Visiting Angels focus on nonmedical support in the home; Vital Care Infusion provides pharmacy and infusion services, including home infusions; and Interim HealthCare offers nursing, home care and hospice services. Several other systems offer combinations of personal, companion, medical or skilled care. The list therefore groups a varied set of businesses under the broader home-based care category.
Limits of the Published Figures
The supplied report does not explain how Franchise Times verified each sales figure, whether every company’s numbers cover the same reporting period, or how currency and international operations were treated. It also does not provide year-over-year comparisons for the 16 companies, so the rankings alone cannot establish which businesses grew or declined.
There is a specific inconsistency in the report: it describes the companies as having earned places on the Top 400 but gives A Place at Home a rank of No. 493. The available material does not clarify whether that company was included for another reason, whether the rank is a typographical error or whether the list’s scope differs from the stated Top 400.
Further Methodology Details Needed
The report presents the 2026 rankings and company figures but does not describe a forthcoming update or next publication date. Readers seeking comparisons across years would need the prior list and a consistent set of sales and location data; the source points readers to an earlier-year list but does not provide those comparisons in the supplied material.
Additional information from Franchise Times could clarify the reporting period, sales methodology and the No. 493 entry. Until then, the figures should be treated as the reported ranking data, with the eligibility criteria and limits kept in view.
Key Questions
Which home-based care company ranked highest?
Home Instead Senior Care ranked No. 43, the highest placement among the care companies identified in the report. Its reported global systemwide sales were $2,463,182,003, and it had 1,112 locations listed.
What does the Franchise Times ranking measure?
The ranking is based on global systemwide sales. That figure refers to sales across a franchise system and should not be treated as the franchisor’s revenue or as U.S.-only sales.
What does a company need to qualify?
According to the report, a company must be a legal U.S. franchise, franchisees must own at least 10% of its locations, and it must be headquartered in the United States or have at least 10% of its locations there.
Were all the companies listed within the Top 400?
The report says 16 home-based care companies earned spots on the list, but it gives A Place at Home a rank of No. 493. The supplied material does not reconcile that figure with the Top 400 description.
Source: homehealthcarenews.com
