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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

HHA Listing Requirements Reissued in Revised Hospital Discharge Planning IGs

May 30, 2013 04:37 PM

On May 17th the Centers for Medicare & Medicaid Services (CMS) issued Revision to State Operations Manual (SOM), Hospital Appendix A - Interpretive Guidelines for 42 CFR 482.43, Discharge Planning, which is available online here.

Although the major focus of revisions is to consolidate the prior twenty-four discharge planning tags into thirteen, the guidelines emphasize the importance of appropriate hospital discharge planning to ensure smooth transitions. Additionally, consideration of pre-hospital setting, patient participation on the process, and patient choice are emphasized.


CMS published a final rule in August 2004, as mandated by the Balanced Budget Act of 1997, requiring hospitals to inform patients of their choice in home health agencies (HHA) and to disclose any financial interests in home health agencies. Under the rule, hospitals must provide all appropriate patients with a list of available Medicare participating HHAs that serve each patient’s area of residence. The list must include all HHAs that request to be included and may be constructed by the hospital or as available through Home Health Compare. Hospital developed lists must be updated annually.

Although the revised Interpretive Guidelines (IG) do not change hospital discharge requirements, this article will serve as an overview of major elements of them.

Hospital Discharge Planning Requirements

Hospitals are required to carry out discharge planning functions for all inpatients. Discharge planning is a four-stage process:

  • Screening
  • Evaluation of post-discharge needs
  • Development of a discharge plan
  • Initiation of the discharge plan

Hospitals may develop a discharge plan of all patients or, in accord with policy, develop a plan for those identified as likely to need discharge planning. Once screening is carried out and person identified as needing discharge planning, a more detailed evaluation of functional status and needs is conducted. This evaluation must include identification of available family and caregivers, community resources, traditional health care services (e.g. home health, hospice, therapy, dialysis, etc.) and nontraditional services such as those for environmental modification, transportation, meals and household services.  Persons who cannot receive required care in the community must be screened for appropriate inpatient settings.

Hospitals are required to provide discharge planning by or under the supervision of a nurse or social worker or other appropriately trained person. Patients or their representatives must be actively engaged in the development of the discharge plan, which must incorporate patient’s goals and preferences. Once needed services are identified, the hospital is required to arrange for the initial implementation of the discharge plan. In addition, education, written discharge instructions, provision of supplies needed immediately post-discharge, and a list of all medications are required. Necessary medical information must also be sent to providers to whom patients have been referred. Additional information should include diagnoses and reason for hospitalization, condition on discharge, allergies, pending lab work, advance directive information, follow-up appointments, and referrals.

Required Provision of List of HHAs

In accord with the regulation requiring hospitals to include in the discharge plan a list of HHAs that request to be on the list (as well as skilled nursing facilities) that are available to the patient. The list must be presented to all patients for whom home health services are indicated. According to the IG, the hospital must inform the patient or family of their freedom of choice among participating Medicare providers and, “when possible, respect patient and family preferences when they are expressed.” Further, “the hospital must not specify or otherwise limit the qualified providers that are available to the patient.” Finally, the discharge plan must identify any disclosable financial interest a hospital has with an HHA or HHA has with a hospital.




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