This cohort study used Outcome and Assessment Information Set (OASIS) data to describe home health care episode variation for patients ( N = 103 869) with heart failure (HF), according to prior site of care. The most common episode is admission followed by discharge home, occurring for 63% of patients in the hospital, and 58% of patients at home, prior to home health care admission. Hospitalization with no return to home health care comprised the next most frequent pattern, occurring most often (16%) for patients with skilled nursing facility as prior site of care, and least often (11%) for patients at home prior to admission. Home health care episodes vary for patients with HF according to prior site of care, perhaps a reflection of variation in patients’ care needs (restorative, maintenance, palliative).