Home health market growth suggests the need for models explaining home health utilization. We have previously explained state-level Medicare home health visits with reference to nursing home markets. Here we introduce a model whereby state-level Medicare home health use is a function of nursing home queues and other demand and supply factors. Medicare home health users per state population is negatively related to nursing home bed stock, positively to Medicaid eligibility levels and to Medicaid nursing home recipients per population, as well as to various other demand and supply measures. This explanation of home health users explains previously-reported findings for home health visits. The findings support the argument that home health use is explained by factors affecting lengths of nursing home queues.