This descriptive study examined state regulatory activities for home health agencies in California and Missouri. In California, the state survey agency was increasingly unable to meet its annual survey requirements. Missouri's survey agency was able to remain current with its survey activities. Neither state used enforcement actions to any great extent for those facilities with problems to any great during the 1983 to 1988 period. Regulatory activities for home health agencies were not given a high priority in either state, and many barriers to the effective regulation of agencies were identified. This study suggests that additional research should be directed toward the study of state regulation and its relationship to quality of home health care.