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Franchise Times’ 2026 ranking of large U.S. franchise systems includes 16 home-based care companies. 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.
Sixteen home-based care companies appeared on Franchise Times’ 2026 ranking of large U.S. franchise systems, with Home Instead Senior Care at No. 43, the highest placement among the care providers listed. Franchise Times says the annual ranking is based on global systemwide sales, offering a snapshot of the scale of franchise networks that provide services ranging from nonmedical personal care to skilled nursing and home infusion.
According to the company figures reported by Franchise Times, Home Instead had $2.46 billion in global sales and 1,112 locations. Vital Care Infusion ranked No. 49, with $1.97 billion in sales and 145 locations. Interim HealthCare placed No. 67, reporting $1.3 billion and 563 locations, followed by Visiting Angels at No. 68, with about $1.29 billion and 814 locations. Right at Home ranked No. 76, reporting roughly $1.12 billion and 783 locations.
Franchise Times also listed BrightStar Care at No. 97, Comfort Keepers at No. 106 and Home Helpers Home Care at No. 181. The remaining entries were ComForCare Home Care, FirstLight Home Care, Always Best Care, Homewatch CareGivers, Griswold Home Care, Assisting Hands Home Care and HomeWell Care Services. Their reported rankings ranged from No. 188 to No. 273.
The Franchise Times report also names A Place at Home, with $31.3 million in global sales and 80 locations, but gives its rank as No. 493. That placement is outside a Top 400 ranking, leaving a discrepancy between the headline count and the listed entries. The report does not explain it.
Franchise Scale Across Home Care
The Franchise Times list shows the commercial reach of franchised home-based care across several service models. The companies’ descriptions and reported services include companion and personal care, nursing, hospice, pharmacy services and support for people returning home after illness or injury. The location counts published with the ranking indicate that some brands operate networks spanning hundreds of sites, while the sales figures place some among substantial franchise systems overall.
For readers tracking the care sector, the ranking is a measure of franchise-system size, not a direct measure of care quality, workforce capacity, client outcomes or the amount of care delivered at home. Global sales also combine activity across markets and may reflect business lines beyond a single service category. The figures reported by Franchise Times are useful for comparing stated scale, but they do not by themselves establish how well a provider meets local demand.
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How Franchise Times Sets Its Ranking
Franchise Times says its Top 400 ranks franchise systems using global systemwide sales. According to the publication’s methodology, qualifying companies must be legal U.S. franchises, with franchisees owning at least 10% of total locations. A company must also be headquartered in the United States or have at least 10% of its locations there.
The company descriptions in the Franchise Times report show that the care businesses do not all offer the same services. Home Instead is described as providing nonmedical in-home care in several countries; Vital Care provides pharmacy and infusion services, including home infusions; and Interim HealthCare offers nursing, home care and hospice. Other brands combine personal assistance, companionship and household support, while some also offer medical services. These differences matter when comparing reported sales and locations across the group.
Rank Count and Comparability Questions
The Franchise Times report does not clarify why A Place at Home is listed at No. 493 in an article about companies earning spots on a Top 400 list. It also does not explain whether the 16-company headline refers only to entries within the top 400 or includes that additional company. Readers should treat the stated count and the individual entries with that mismatch in mind.
The material provides no year-over-year comparisons for the companies’ sales or location counts, and it does not specify how the sales figures were independently verified. It is also unclear from the report whether all companies’ figures cover the same fiscal period. The ranking therefore confirms the placements and scale figures reported by Franchise Times, but not changes in performance, market share or care capacity.
Check the Published Ranking Details
Readers seeking a definitive count can compare the company entries with Franchise Times’ full 2026 Top 400 list and any accompanying methodology or corrections. The report does not identify a later update or provide a timetable for one. Until the No. 493 entry is reconciled with the Top 400 framing, the discrepancy remains unresolved.
For broader comparisons, future rankings or company disclosures would need to provide consistent reporting periods and comparable definitions of sales and locations. Those details would help distinguish expansion in franchise footprints from changes in revenue and make year-to-year comparisons more informative.
Key Questions
Which home-based care company ranked highest?
According to Franchise Times’ 2026 ranking, Home Instead Senior Care ranked No. 43, the highest among the home-based care companies identified in the report. The publication lists global sales of about $2.46 billion and 1,112 locations.
What does the Franchise Times ranking measure?
Franchise Times says the ranking is based on global systemwide sales. The publication’s methodology says eligible companies must be legal U.S. franchises, meet a minimum franchisee ownership share, and be headquartered in the United States or have at least 10% of locations there.
Which other care companies were near the top?
In the Franchise Times ranking, Vital Care Infusion placed No. 49, Interim HealthCare No. 67, Visiting Angels No. 68 and Right at Home No. 76. Their reported global sales ranged from about $1.12 billion to $1.97 billion.
Why is A Place at Home’s entry unclear?
The Franchise Times report lists A Place at Home at No. 493, although its headline concerns companies on the Top 400. The publication does not explain whether the entry is an error or is included for another reason.
Source: homehealthcarenews.com
