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National Association for Home Care & Hospice
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In the various roles he has undertaken through the years, Val J. Halamandaris has been a singular driving force behind the policy and program initiatives resulting in the recognition of home health care as a viable alternative to institutionalization. His dedication to consumer advocacy, which enhances the quality of life and dignity of those receiving home health care, merits VNA HealthCare Group’s highest recognition and deepest respect. 

VNA HealthCare Group

I have the highest respect for them, especially for the nurses, aides and therapists, who devote their lives to caring for people with disabilities, the infirm and dying Americans.  There are few more noble professions.

President Barack Obama

Home health care agencies do such a wonderful job in this country helping people to be able to remain at home and allowing them to receive services

U.S. Senator Debbie Stabenow (D-MI) Chair, Democratic Steering and Outreach Committee

Home care is a combination of compassion and efficiency.  It is less expensive than institutional care...but at the same time it is a more caring, human, intimate experience, and therefore it has a greater human’s a big mistake not to try to maximize it and find ways to give people the home care option over either nursing homes, hospitals or other institutions

Former Speaker of the U.S. House of Representatives Newt Gingrich (R-GA)

Medicaid covers long-term care, but only for low-income families.  And Medicare only pays for care that is connected to a hospital discharge....our health care system must cover these vital services...[and] we should promote home-based care, which most people prefer, instead of the institutional care that we emphasize now.

Former U.S. Senator Majority Leader Tom Daschle (D-CD)

We need incentives to...keep people in home health care settings...It’s dramatically less expensive than long term care.

U.S. Senator John McCain (R-AZ)


Home care is clearly the wave of the future. It’s clearly where patients want to be cared for. I come from an ethnic family and when a member of our family is severely ill, we would never consider taking them to get institutional care. That’s true of many families for both cultural and financial reasons. If patients have a choice of where they want to be cared for, where it’s done the right way, they choose home.

Donna Shalala, former Secretary of Health and Human Services

A couple of years ago, I spent a little bit of time with the National Association for Home Care & Hospice and its president, Val J. Halamandaris, and I was just blown away. What impressed me so much was that they talked about what they do as opposed to just the strategies of how to deal with Washington or Sacramento or Albany or whatever the case may be. Val is a fanatic about care, and it comes through in every way known to mankind. It comes through in the speakers he invites to their events; it comes through in all the stuff he shares.

Tom Peters, author of In Search of Excellence

Val’s home care organization brings thousands of caregivers together into a dynamic organization that provides them with valuable resources and tools to be even better in their important work. He helps them build self-esteem, which leads to self-motivation.

Mike Vance, former Dean of Disney and author of Think Out of the Box

Val is one of the greatest advocates for seniors in America. He goes beyond the call of duty every time.

Arthur S. Flemming, former Secretary of Health, Education, and Welfare

Val has brought the problems, the challenges, and the opportunities out in the open for everyone to look at. He is a visionary pointing the direction for us. 

Margaret (Peg) Cushman, Professor of Nursing and former President of the Visiting Nurses Association

Although Val has chosen to stay in the background, he deserves much of the credit for what was accomplished both at the U.S. Senate Special Committee on Aging, where he was closely associated with me and at the House Select Committee on Aging, where he was Congressman Claude Pepper’s senior counsel and closest advisor. He put together more hearings on the subject of aging, wrote more reports, drafted more bills, and had more influence on the direction of events than anyone before him or since.

Frank E. Moss, former U.S. Senator

Val’s most important contribution is pulling together all elements of home health care and being able to organize and energize the people involved in the industry.

Frank E. Moss, former U.S. Senator

Anyone working on health care issues in Congress knows the name Val J. Halamandaris.

Kathleen Gardner Cravedi, former Staff Director of the House Select Committee on Aging

Without your untiring support and active participation, the voices of people advocating meaningful and compassionate health care reform may not have been heard by national leaders.

Michael Sullivan, Former Executive Director, Indiana Association for Home Care

All of us have been members of many organizations and NAHC is simply the best there is. NAHC aspires to excellence in every respect; its staff has been repeatedly honored as the best in Washington; the organization lives by the highest values and has demonstrated a passionate interest in the well-being of patients and providers.

Elaine Stephens, Director of Home Care of Steward Home Care/Steward Health Systems and former NAHC C

Home care increasingly is one of the basic building blocks in the developing system of long-term care.  On both economic and recuperative bases, home health care will continue to grow as an essential service for individuals, for families and for the community as a whole.

Former U.S. Senator Olympia Snowe (R-ME)

NCOA is excited to be part of this great event and honored to have such influential award winners in the field of aging.

National Council of Aging

Health care at home…is something we need more of, not less of.  Let us make a commitment to preventive and long-term care.  Let us encourage home care as an alternative to nursing homes and give folks a little help to have their parents there.

Former President Bill Clinton

Sequestration Impact on Survey and Certification Activities

April 19, 2013 11:56 AM

In response to the across-the-board federal budget reductions under the sequester as mandated by the Balanced Budget and Emergency Deficit Control Act the Centers for Medicare & Medicaid Services (CMS) Survey & Certification (S&C) Group announced plans for certain budgetary adjustments. CMS notified State Agency (SA) Directors of planned adjustments that affect State operations in an April 5, 2013 letter.

In the letter, CMS advised SA Directors that the overall FY2013 S&C Medicare budget was reduced by 5 percent, with the expectation that State allocations will be reduced by 2.5 - 3 percent.  CMS announced that the remaining reductions will be accommodated by reducing expenses, suspending additions to the workload, reducing time spent on lower risk areas and reducing CMS Central Office services.  In order to accommodate this reduction, certain survey activities are to be placed on hold.

CMS prioritizes survey activities according to four tiers. Tier I is comprised primarily of statutorily-required surveys of nursing homes and home health agencies, as well as potential immediate jeopardy complaint investigations and certain validation surveys. Tier II is comprised primarily of other complaint investigations and targeted surveys of a sample of providers whose past performance data indicate a high likelihood of non-compliance with CMS quality of care or safety requirements. Tier III is comprised primarily of survey frequency intervals for all providers whose frequency is not specified in law, together with initial surveys of providers newly seeking Medicare participation and who do not have the option of seeking deemed status through accreditation by a CMS-approved accrediting organization. Tier IV consists primarily of additional survey frequencies for providers, as well as initial surveys of providers newly seeking Medicare participation who do have the option of seeking deemed status through accreditation by a CMS-approved accrediting organization. 

SAs were advised in the April 5 letter to continue to adhere to CMS survey priorities necessary to ensure quality, including onsite complaint investigations and surveys of existing providers. The following are changes to SA survey activities applicable to home health and hospice providers:

Purchasers that Elect to Decline Medicare Assignment

CMS instructed SAs to inform providers that seek to purchase other providers, but decline assignment of Medicare certification, that there may be longer wait times for onsite surveys and certification work necessary before Medicare participation may be resumed. These waits will apply regardless of who might conduct the survey (State, accrediting organization, or CMS). In addition, SAs must obtain CMS Regional Office (RO) agreement before conducting surveys where a provider is not accepting assignment.

Revisit Surveys

With respect to onsite revisit surveys that are conducted to confirm that a provider has remedied all health and safety noncompliance and restored its program to compliance with CMS requirements, SAs must obtain CMS RO approval before conducting any onsite revisit surveys after an initial revisit found that the provider had still not restored its program to substantial compliance. In addition, SAs must inform affected providers of a longer than normal wait time for revisits.

Home Health Targeted Surveys

Specific to home health agencies, CMS instructed SAs to discontinue all further Tier II targeted surveys of home health agencies that have been identified as having the lowest performance, unless directed to do so by CMS. However, SAs must continue to ensure that no more than three years elapse without an onsite recertification survey of all home health agencies.

These new reductions to S&C activities are in addition to those outlined in a CMS letter issued to SAs from December 9, 2011 directing them to:

  1. Continue to follow the longstanding directive to ensure that all other surveys take precedence over surveys of providers that newly seek Medicare participation - i.e. Tier IV surveys.
  2. Expand the Tier III maximum time interval between surveys of any one Hospice facility to once every 7 years from once every 6.5 years.



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