Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Rhode Island for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Rhode Island only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Rhode Island (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Hope Nursing Home Care, LLC (NPI 1609955822)

Field	Value
Entity Type	Organization
Organization	Hope Nursing Home Care, LLC
Address	1049 Park Ave
City	Cranston
State	RI
ZIP	02910
Taxonomy	Home Health Agency
NPI Enumerated	November 6, 2006

Payer Source	Total Paid
Medicaid	$70.6M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and reports $70.6M in lifetime Medicaid revenue, making it effectively a single-payer, Medicaid-focused operation. Its NPI was enumerated 2006-11-06 (~20 years ago), indicating long tenure in the market and an established presence in Rhode Island home-care services.

Revenue is highly concentrated: the precomputed top three Medicaid codes account for 99.6% of the provider's total Medicaid revenue. The top driver is S5125 at $62.2M revenue (88.1% of this provider's total Medicaid revenue), followed by S5130 at $7.3M (10.3%), and T1001 at $847.1K (1.2%).

The code mix—dominated by S5125 and S5130—indicates a business model focused on hands-on personal care and homemaker/attendant services delivered in the home rather than episodic skilled Medicare home health. T1001’s smaller share suggests routine nursing assessments are performed primarily to support those personal-care services rather than to drive revenue as a standalone skilled-care line.

S5125 performance marks the provider as a major statewide participant in attendant care: 474.6K claims, $131 avg paid/claim, $62.2M revenue, and a rank of #4 of 83 providers in-state (96th percentile). That code is labeled an 'extreme outlier, far above typical state volume for this code,' which signals exceptional scale in attendant care relative to Rhode Island peers.

S5130 and T1001 also show strong competitive standing within their peer groups: S5130 ranks #2 of 34 providers in-state (97th percentile) with 71.9K claims and $7.3M revenue and is described as 'notably above typical state volume for this code.' T1001 ranks #2 of 42 providers in-state (98th percentile) with 8.2K claims and $847.1K revenue and is likewise 'notably above typical'—these ranks indicate the provider is among the largest in-state for homemaker services and nursing assessments.

The provider’s heavy reliance on a narrow set of Medicaid codes creates concentration risk for payer contracting and utilization trends: because the top three codes drive 99.6% of Medicaid revenue, policy or reimbursement changes affecting S5125 or S5130 could materially affect overall revenue. Analysts should treat this provider as functionally specialized in attendant/homemaker care when modeling exposure or negotiating rates.

All other billed codes are small by comparison and operationally unremarkable: S9122 shows 2.6K claims, $107 avg paid/claim, and $283.2K revenue (typical, unremarkable volume), while X0043 registers 79 claims and $0 revenue. These low-volume lines are likely ancillary or administrative and do not meaningfully diversify the provider’s revenue base.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5125	Attendant care services; per 15 minutes	474,570	$130	$62.2M
S5130	Homemaker service, nos; per 15 minutes	71,850	$100	$7.3M
T1001	Nursing assessment / evaluation	8,220	$100	$847.1K
S9122	Home health aide or certified nurse assistant, providing care in the home; per hour	2,650	$110	$283.2K
X0043	N/A	80	$0	$0

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Rhode Island providers billing the same CPT/HCPCS codes.

Claims Volume vs. Rhode Island Distribution

Hope Nursing Home Care, LLC — 3 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Rhode Island

Full comparison — all codes billed, vs. Rhode Island median

5 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5125	Attendant care services; per 15 minutes	4	80	13,620	$120	$7.8M
S5130	Homemaker service, nos; per 15 minutes	2	30	10,010	$100	$1.9M
S9122	Home health aide or certified nurse assistant, providing care in the home; per hour	7	10	2,650	$130	$1M
X0043	N/A	4	10	80	$260	$279.7K
T1001	Nursing assessment / evaluation	2	40	460	$100	$164.4K

Nearby Providers

Other providers in the same ZIP code as Hope Nursing Home Care, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Joy Home Care Inc.	RI	Home Health Agency	$0	$75.4M
Codac Inc	RI	Substance Use Disorder Rehabilitation Clinic/Center	$0	$54.3M
Spurwink Ri	RI	Developmentally Disabled Services Day Training Agency	$0	$39.1M
Alee Behavioral Healthcare	RI	Behavior Analyst	$0	$22M
Homecare Advantage Inc.	RI	Nursing Care Agency	$0	$12.9M
Ocean State Dental Group Inc	RI	Dentist	$0	$7.9M
Home Care Networks, LLC	RI	Home Health Aide	$0	$5.7M
Park Avenue Senior Care, Inc	RI	Adult Day Care Clinic/Center	$0	$3M
Cranston Public Schools	RI	Local Education Agency (LEA)	$0	$2.7M
City Of Cranston	RI	Land Ambulance	$573.8K	$1.8M

Hope Nursing Home Care, LLC — Billing Profile & Reimbursement Data

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Hope Nursing Home Care, LLC — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References