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Franchise Times’ 2026 ranking of large U.S. franchise systems includes 16 home-based care companies, 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 specific franchise eligibility rules.
Sixteen home-based care companies earned places in Franchise Times’ 2026 ranking of large franchise systems, with Home Instead Senior Care the highest-ranked care provider at No. 43. The annual list ranks eligible systems by global systemwide sales, offering a measure of franchise scale rather than a direct assessment of care quality or outcomes.
Home Health Care News reported the placements, which include companies offering nonmedical personal care, skilled nursing, hospice, infusion and other services delivered at home. Alongside Home Instead, the companies named include Vital Care Infusion, Interim HealthCare, Visiting Angels, Right at Home and BrightStar Care. The list also includes Comfort Keepers, Home Helpers Home Care, ComForCare, FirstLight Home Care, Always Best Care, Homewatch CareGivers, Griswold Home Care, Assisting Hands Home Care and HomeWell Care Services.
Home Instead reported $2.46 billion in global sales and 1,112 locations, according to the figures published with the ranking. Vital Care Infusion ranked No. 49 with reported sales of about $1.97 billion and 145 locations. Interim HealthCare was No. 67, with $1.3 billion in sales and 563 locations; Visiting Angels followed at No. 68 with about $1.29 billion and 814 locations. Right at Home placed No. 76, reporting roughly $1.12 billion in sales across 783 locations.
Further down the ranking, BrightStar Care was No. 97, Comfort Keepers No. 106 and Home Helpers Home Care No. 181. ComForCare, FirstLight Home Care and Always Best Care appeared at Nos. 188, 194 and 200, respectively. Homewatch CareGivers ranked No. 203, Griswold Home Care No. 219, Assisting Hands Home Care No. 237 and HomeWell Care Services No. 273. The source material also lists A Place at Home at No. 493, outside the Top 400, with sales of about $31.3 million and 80 locations; it should not be counted among the 16 Top 400 placements.
Franchise Scale Across Home Care
The placements show that home-based care has a substantial presence among large franchise systems, spanning companies with different service models and geographic footprints. The sales figures and location counts give readers a way to compare the reported scale of those franchise networks, while the rankings also illustrate that the sector is not limited to one kind of care.
For prospective franchise owners, the list can serve as a snapshot of systems with significant reported sales. For families and care workers, however, a high ranking is not a substitute for checking local availability, staffing, licensing, service offerings or quality measures. Systemwide sales do not establish care outcomes, and the figures alone do not show profitability for individual franchisees, the number of clients served or how revenue is distributed across locations.
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How the Franchise Ranking Works
Franchise Times says its Top 400 is based on global systemwide sales. To qualify, a company must be a legal U.S. franchise, franchisees must own at least 10% of its total locations, and the company must either be headquartered in the United States or have at least 10% of its locations there. Those rules define which systems are eligible; they do not mean that all sales or locations are in the United States.
The companies in the care group cover varied services. Home Instead is described as providing nonmedical in-home care in several countries, while Vital Care provides pharmacy and infusion services, including home infusions. Interim HealthCare offers nursing, home care and hospice services. Other listed providers focus on personal assistance, companionship, skilled nursing, care coordination or support for people with particular needs. The rank order reflects reported sales, not a common clinical service category.
“The Top 400 list is based on global systemwide sales.”
— Franchise Times ranking criteria, as summarized by Home Health Care News
Limits of the Published Figures
The source material does not provide audited financial statements, a detailed methodology for verifying each sales figure, or a year-over-year comparison for the 16 companies. It also does not specify in the supplied account whether every sales figure uses an identical fiscal period. Readers should treat the numbers as figures reported with the ranking, not as independently verified measures of current performance.
The article does not explain why the heading refers to 16 companies while also listing A Place at Home at No. 493. That rank is outside the Top 400, so the company is presented here separately rather than included in the count of 16. The supplied information also does not establish how the companies’ rankings changed from the prior year or what those results mean for local service capacity.
Company Results and Local Services
The ranking is an annual snapshot, and later editions may show whether the companies’ reported sales and positions change. The source material does not state when a subsequent list will be released or identify further company announcements tied to these results.
For readers evaluating a provider or franchise opportunity, the next step is to look beyond the national ranking: compare the services and locations available locally, ask how care is staffed and supervised, and review relevant licensing and quality information. The Top 400 establishes reported franchise scale; it does not answer those local questions.
Key Questions
How many home-based care companies made the 2026 Top 400?
Sixteen are identified as Top 400 placements in the source report. A Place at Home is also listed in the supplied material, but its No. 493 rank is outside the Top 400.
Which home care company ranked highest?
Home Instead Senior Care ranked No. 43, the highest placement among the home-based care companies named. The reported figures were about $2.46 billion in global sales and 1,112 locations.
What does the Franchise Times ranking measure?
The ranking is based on global systemwide sales. It measures reported franchise-system scale, not clinical quality, client outcomes or the profitability of an individual franchise location.
What are the eligibility rules?
According to the criteria summarized by Home Health Care News, a company must be a legal U.S. franchise, franchisees must own at least 10% of its locations, and it must be U.S.-headquartered or have at least 10% of its locations in the United States.
Source: homehealthcarenews.com
