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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

NAHC Participates in a CMS Home Health, Hospice and Durable Medical Equipment Open Door Forum

July 12, 2013 09:43 AM

Earlier this week, the Centers for Medicare & Medicaid Services (CMS) held a Home Health, Hospice, and Durable Medical Equipment (DME) Open Door Forum. The Natioanl Association of Home Care & Hospice (NAHC) participated in the Forum, during which the following issues in hospice and home health care were discussed.

Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS)

On July18, three important events will occur related to HHCAHPS:

  • Home Health Compare will be update to reflect data reported from January 2012 through December 2012 (CY 2012 Q1-Q4).
  • Patient mix adjustment factors are scheduled to be updated; and
  • Data submission deadline for the 1st quarter of 2013 are due.  

Medicare-certified home health agencies (HHAs) that served 59 or fewer unduplicated patients from April 1, 2012 through March 31, 2013 who met HHCAHPS survey-eligibility criteria are eligible for an exemption from participating in the HHCAHPS Survey for the calendar year (CY) 2015 annual payment update (APU).

The deadline for requesting an exemption from HHCAHPS for CY 2015 is January 16, 2014.

Home Health Prospective Payment System (HHPPS) Rate Update: Proposed Rule

CMS issued a proposed rule to update Medicare's HHPPS  payment rates and wage index for CY 2014.  As required by Section 3131(a) of the Affordable Care Act (ACA), this rule proposes rebasing adjustments - with a 4-year phase-in - to the national, standardized 60-day episode payment rates, the national per-visit rates, and the NRS conversion factor.

Payments to HHAs are estimated to decrease by approximately 1.5 percent in CY 2014, reflecting the combined effects of the 2.4 percent home health payment update percentage, the rebasing adjustments to the national, standardized 60-day episode payment rate, the national per-visit payment rates, the NRS conversion factor, and the effects of ICD-9 coding adjustments. 170 ICD-9 codes have ben removed that are for conditions either too acute to be appropriately cared for in a home health setting or would not impact the home health POC or result in additional resource use.

This proposed rule would also establish home health quality reporting requirements for CY 2014 payment and subsequent years and would specify that Medicaid responsibilities for home health surveys be explicitly recognized in the State Medicaid Plan, which is similar to current regulations for surveys of Nursing Facilities (NF) and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF-IID). 

Additionally, this proposed rule also seeks comment on a methodology for calculating state Medicaid programs’ fair share of HHA survey costs.  Finally, this rule proposes to describe the transition to ICD-10-CM coding and announces the release of draft lists of ICD-10-CM codes to be included in the HH PPS Grouper.

Comments are due August 26, 2013. To view the proposed rule click here.

Home Health Quality Update

  • The draft Outcome and Assessment Information Set (OASIS) C-1 has been released and can be found here. Comments on the draft OASIS-C1 are due August 20, 2013
  • The technical specifications for the Process Quality Measures have been revised, and are available here
  • The technical specifications for the Outcome Based Quality Improvement measures have been revised and are available here
  • An OASIS Guidance Manual errata  has been posted and is available here

 Continuous Positive Airway Pressure (CPAP) documentation

Suppliers have been having difficulty obtaining all the required documentation for CPAP with the implementation of Round 2 of competitive bidding. Round 2 of the competitive bidding program went in to effect July 1, and expands the competitive bidding areas for certain DME items to 91 MSA areas. 

CMS is permitting a 120-day grace period for written physician orders for CPAP in order to help with the transition. Suppliers are encouraged to review the Medlearn Matters (MLM) document that provides guidance to the required documentation for CPAP for Medicare beneficiaries.

Click here to view the MLM guidance document.

Home Health Advanced Beneficiary Notice (HHABN)

The revised HHABN which replaces Option Box 1 with the General ABN and Option Box 2 and 3 with the Home Health Change of Care Notice (HHCCN) has been cleared by the Office of Management and Budget and should be available on the CMS web site soon. Agencies will have 60 days after its’ release to transition to the new forms.

Hospice Quality Update

The next Hospice Quality Reporting Program (HQRP) reporting deadline is April 1, 2014. Hospices will be required to have submitted both the NQF pain measure (#0209) and a modified structural measure by that date or risk a 2 percentage point reduction in their fiscal year 2015 payment update.

Providers should be collecting data on #0209 for all patients, and should continue to collect such data through December 26, 2013 for submission.  

A user guide and presentation to assist hospice providers in fulfilling the 2014 reporting requirements will be available later this summer.  Additional details will be published in NAHC Report and on the NAHC member listserv as they become available. 

Hospice Vendor Call

CMS’ Division of National Systems has scheduled a technical information call for hospice software vendors and developers for the Hospice Item Set (HIS) on Tuesday, July 16, 2013, from 2:00 P.M. to 3:30 P.M. EST. 

The call-in number is 1-866-712-2205 and the conference code is 4260581739. 

CMS strongly recommends that all hospice software developers/vendors participate in this call and review the Technical Data Submission Specifications (v1.00.0) related to the submission of Hospice Item Set (HIS), anticipated to be required effective July 1, 2014.

Software developers/vendors are also encouraged to submit questions in advance to the Hospice Technical Issues Mailbox by 6 P.M. EST on Friday, July 12, 2013. Please note that the subject line must read: “VENDOR CALL”

Please note that a previous notice indicated questions must be submitted by COB of July 9. CMS has since extended the deadline. 

Additional information about the call is available here.

Requirements for Long-Term Care Facilities and Hospice Services

Late last month, CMS published a rule finalizing requirements for a written agreement betweenl ong-term care facilities (LTCF) that choose to arrange hospice services and a hospice provider. 

The agreement specifies the roles and responsibilities for each provider type.  While the LTCF rule was developed to be mirror image of the requirements established for hospices under the 2008 Conditions of Participation, it did undergo some changes through the notice and comment process, including a revision that requires the LTCF to alert the hospice immediately when any transfer of a hospice patient occurs - rather than just when a transfer occurs that is related to the terminal diagnosis, as was included in the proposed rule. 

Hospices are encouraged to coordinate with their LTCF partners to ensure that the written agreements meet both the hospice and LTCF requirements.

During the question and answer period, one listener commented that some hospice providers have indicated that LTCFs are requesting separate written agreements that govern care for each patient rather than a single written agreement that governs care of all patients that are provided hospice services in the facility, and asked if CMS has any guidance or position on the issue. 

CMS responded that as long as the contracts meet the requirements, LTCFs may structure them as they see fit.  CMS is interested in hearing any concerns that may result from this type of arrangement. 

NAHC is seeking additional guidance from CMS on this issue.




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