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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

Second Hospice CBR Set for Release Registration for July 10 Audio Conference Now Open

June 27, 2013 03:29 PM

As previously reported, a Comparative Billing Report (CBR) for Hospice Services per Care Setting is scheduled for release on or around June 27.  The CBRs will be sent to hospices via facsimile.  This is the second CBR issued for hospice. A sample hospice CBR is available online here.  To learn more or ask questions about the CBR, an audio conference is scheduled for July 10 at 2 p.m. EST (11 a.m. PST).

Registration information is available here. A national interactive map providing access to data across the nation will be available in late July on the SafeGuard Services website.

Following is a series of frequently asked questions (FAQs) from the CBR vendor SafeGuard Services regarding the hospice CBR; these FAQs are also available online

CBR027 Hospice Services per Care Setting FAQs

Q: Why are we getting this report?

A: A CBR was created for Hospice Providers as an educational tool to help prevent improper billing. This is a follow up CBR on Hospice Services that was released in January 2011 and uses the same billing comparisons based on 2012 data.

Q: Why was this topic chosen?

A: Hospice services have been identified as a vulnerability in the Medicare Program. CMS (Center for Medicare and Medicaid Services) recommended a comparative study be done.

Q: How are the peers defined?

A: A single hospice will be identified by NPI. The peer groups for comparison with the individual Hospice Providers are:

  • CMS Region: All Hospice Providers who practice in the individual provider's region. If a provider practices in more than one region, they are compared to the Hospice Providers in both regions and receive a CBR for each region.
  • Nation: All Hospice Providers in the nation

Q: How was it determined to do a CMS Region comparison?

A: In order to have a valid statistical comparison it was necessary to group hospice providers in larger groups than their states. The CMS Regions best met the criteria for geographical distribution.


The table below displays the CMS Regions:




Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont


New Jersey, New York, Puerto Rico, Virgin Islands


Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, West Virginia


Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina,
South Carolina, Tennessee


Illinois, Indiana, Michigan, Minnesota, Ohio, Wisconsin


Arkansas, Louisiana, New Mexico, Oklahoma, Texas


Iowa, Kansa, Missouri, Nebraska


Colorado, Montana, North Dakota, South Dakota, Utah, Wyoming


Arizona, California, Hawaii, Nevada, Pacific Territories


Alaska, Idaho, Oregon, Washington


Q: How was the data obtained for this report?

A: The analysis for this CBR will encompass all Medicare Part A Hospice Provider final claims data with claims from dates of service from January 1, 2012 through December 31, 2012 that are processed by March 29, 2012 and meet the criteria listed below:

  • NCH Claim Type Code = 50 (hospice claim)
  • HCPCS codes: Q5001-Q5008
  • Revenue codes: 0651, 0652, 0655, and 0656
  • Paid and denied claims

The table below displays the description of each of the eight HCPCS codes:


HCPCS Code Description


Hospice care provided in patient's home/residence


Hospice care provided in assisted living facility


Hospice care provided in nursing long term care
facility or non-skilled nursing facility


Hospice care provided in skilled nursing facility (SNF)


Hospice care provided in inpatient hospital


Hospice care provided in inpatient hospice facility


Hospice care provided in long term care hospital


Hospice care provided in inpatient psychiatric facility


The table below displays the description of each of the four Revenue codes:

Revenue Codes

Revenue Code Description


Routine home care


Continuous home care


Inpatient respite care


General inpatient care


Q: Explain why some of the graphs and tables have no data.

A: If the Hospice Providers in this study did not bill a particular level of care and/or services in a particular care setting, the data was unavailable and no comparison will appear for that category.

Q: Where can additional information, regarding Medicare guidelines for hospice billing, be found?


  • References are listed on page 1 of the Comparative Billing Report
  • References are listed under recommended links on this website
  • From your Medicare fiscal intermediary (e.g. MAC, RHHI, or FI)
  • From the CMS website

Q: Why wasn't Q5009 used in the hospice CBR?

A: HCPCS code Q5009 is defined as "Care provided in a place not otherwise specified." This code was not used in the study because CMS chose to focus the comparative analyses on the four specific hospice care settings as shown in the CBR.  In other words, we chose to focus on these 4 settings: home (Q5001, Q5002), nursing facility (Q5003, Q5004), freestanding (Q5006), and inpatient (Q5005, Q5007, and Q5008).





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