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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

Heath 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

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

CMS Posts New FAQs on Medicare Care Choices Model for Hospice-Eligible Patients

June 5, 2014 01:13 PM

On March 18, 2014, the Centers for Medicare & Medicaid Services (CMS) announced the launch of its Medicare Care Choices Model (MCCM).  Under the MCCM, as many as 30 Medicare-certified hospices will be selected to provide palliative support services in the form of routine home care (RHC) and inpatient respite to patients with advanced cancers, chronic obstructive pulmonary disease, congestive heart failure and HIV/AIDS who meet hospice eligibility requirements. 

Since announcement of the model, CMS has received numerous inquiries from hospices interested in participating in the model; in response, CMS has issued a series of frequently asked questions (FAQs) to address those inquiries.  The latest version was issued on May 30; the FAQs are reprinted below for the convenience of interested hospices.

May 30, 2014

Can a networked group of hospices that are under State Action Immunity combine to apply for the Medicare Care Choices Model?

Yes. By law, or under State Action Immunity, none of these applicant hospices may compete for service. All agencies must serve everyone, regardless of where they live in the service area and regardless of payment source. Combined applicants must explain in their application their past experience working with other Medicare certified and enrolled hospices to provide coordinated care services with other providers in their service area. For these applicants, data must be shown separately by each applicant’s National Provider Identifier (NPI) number and then totaled across all of the applicants’ provider numbers. This combined application will be reviewed and determination for awards will be based on the merits of the group of applying hospices as a whole. Payment to hospices selected to participate in the Model will be made directly to the hospice utilizing its NPI number. Each hospice in the networked group remains responsible for its unique beneficiaries.

If a Medicare certified and enrolled hospice has exceeded the aggregate cap limit in the years specified in the Request for Applications and is currently in good standings with repaying monies back to Medicare, can that hospice apply for the Medicare Care Choices Model?

No. A hospice that has exceed their aggregate cap limit for the time period stated in the Request for Applications does not meet the qualifying criteria specified in the section Basic Requirements of Eligible Applicants. The applicant must demonstrate it is in good standing as demonstrated by not exceeding the inpatient hospice cap or the aggregate hospice cap for the cap years (11/1-10/31) 2012, 2011, and 2010 for which data are available.

Would the hospice agency be able to limit the number of beneficiaries they enroll in the Model?

Yes. The request for applications Model Design section requests information on the number of beneficiaries the applicant anticipates enrolling in the Model as well as an explanation of how the applicant arrived at this estimate.

Is review of the individualized care plan that includes the patient centered goals required every 15 days or every 30 days?

As per the Conditions of Participation at §418.56 (d) Standard: Review of the plan of care, the hospice interdisciplinary group (in collaboration with the individual's attending physician,) must review, revise and document the individualized care plan as frequently as the patient's condition requires, but no less frequently than every 15 calendar days.

Does the Model require a Hospice RN Case Manager (RNCM) to complete an in-person assessment for the purposes of updating the patient-centered goals and plan of care or, under this Model; is it acceptable to make updates based on telephone check-ins with the patient and patient’s team of healthcare providers?

The Conditions of Participation at §418.56 require the interdisciplinary group, as a whole, to update the comprehensive assessment at least every 15 days, and more frequently as the patient’s condition requires. While not explicit in the Conditions of Participation, the process to update the plan of care requires a face-to-face visit and assessment by the RN as the revised plan of care must include information from the patient's updated comprehensive assessment and must note the patient's progress toward outcomes and goals specified in the plan of care.

Is a RN case manager required for this Model, or could a hospice develop a model utilizing a Social Worker case manager?

The Conditions of Participation at §418.56 require that the hospice interdisciplinary group must designate a registered nurse, who is a member of that interdisciplinary group, to provide coordination of care and to ensure continuous assessment of each patient’s and family’s needs, and to ensure continuous implementation of the interdisciplinary plan of care. Whether the hospice chooses to add a social worker as a case manager, in addition to the required RN coordinator, is up to the Model participant.

Can a main hospice with multiple other hospices, each having their own National Provider Identifier (NPI), submit one application or must each hospice apply individually to participate in the Model?

Each hospice location participating in the Model must have an individual National Provider Identifier and must apply individually using its provider number. Each application will be reviewed and evaluated on the merits of that particular hospice. Payment to hospices selected to participate in the Model will be made directly to the hospice utilizing its provider number. CMS seeks to enroll geographically diverse hospices of differing sizes that serve demographically different populations.

The Request for Applications uses the term “traditional home”; does this include a group or boarding home?

Under the Medicare Care Choices Model, “home” is defined as a location or residence, other than a hospital or other facility, where the patient receives care in a residence. A beneficiary residing in a group home, defined as a residence, with shared living areas, where clients receive supervision and other services such as social and/or behavioral services, custodial service, and minimal services (e.g., medication administration), or a boarding home, defined as a home or facility (often a larger converted residence) where an individual rents a room and receives no supportive services would be eligible to participate. In order to be eligible for the Model, the qualifying beneficiary must have resided in a home, not an institutional setting for the purposes of receiving nursing or aide services, for a period of at least 30 days prior to their enrollment in the Model.




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