As home health administrators select performance evaluation systems to meet the benchmark requirements of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), a frequently asked question is: Does rural versus urban locale influence patient outcomes? To answer the question, patient outcome data were collected from rural and urban home health agencies. Data analysis showed better outcomes for rural than for urban patients. Locale predicted less than 1% percent of the variance in each of the five outcomes studied. Factors that could account for rural-urban outcome differences were suggested.