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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

Hospice Quality Reporting Program Update

New Report on HQRP Data
September 16, 2014 09:17 AM

Earlier this year hospices submitted data to CMS on two quality measures that impacted the 2015 payment year.  Specifically, hospices had to submit data on two measures – a structural measure and the NQF #209 pain measure – by April 1, 2014.  The data was collected by the hospices during calendar year 2013.  On August 18, 2014 CMS released the analysis of this data, Hospice Quality Reporting Program Fiscal Year 2015 Reporting Cycle Data Analysis.  Approximately 3500 hospices submitted and attested to the data for both measures.

Nearly 100% of hospices answered “yes” to the only structural measure question: “Does your QAPI program contain 3 or more patient care related quality indicators?”  This is consistent with the prior year’s response.

The NQF #0209 measures the percentage of patients who report being uncomfortable because of pain at the initial assessment and who report that pain was brought to a comfortable level within 48 hours.

The main purpose of the FY 2015 analysis for NQF #0209 is to answer the following questions about the NQF #0209 measure:

  • How many hospices can correctly report the (quality measure) QM, and what is the extent of data errors?
  • What is the extent of patient exclusion from the QM? How does the number of patients included in the measure denominator compare to the number of patients admitted to hospice?
  • Were there any changes in findings related to errors and patient exclusions between FY 2014 and FY 2015?
  • Were there any changes in the QM scores from FY 2014 to FY 2015?

NQF #0209 has been removed from the HQRP for FY 2016 and subsequent years because analysis of the FY 2014 reporting cycle data revealed two critical concerns with the measure. The first is that the measure does not easily correspond with the clinical processes for pain management, resulting in variance in what hospices collect, aggregate, and report. The second (and more important) concern is the high rate of patient exclusion due to patient ineligibility for the measure and patients reporting they are not uncomfortable due to pain at the initial assessment. This high rate of patient exclusion from the measure results in a small and non-representative denominator and creates validity concerns.

As with FY 2014, the majority of errors (2,270) for FY 2015 were due to providers having “missing” patient-level data that cannot be accounted for. Forty-one hospices (1.1%) had one or more errors that resulted in exclusion of their data from the NQF #0209 analysis, a slight decrease compared to FY 2014. The mean QM score was 64.8% (S.D. 23.9), indicating that on average nearly two-thirds of patients who were admitted with discomfort because of pain report that their pain was brought to a comfortable level within 48 hours of the start of hospice care. Our data shows that 9.1% of hospices had a “perfect score”; all of their patients that reported being uncomfortable because of pain on initial assessment reported that their pain was brought to a comfortable level within 48 hours.  The findings for FY 2015 confirmed those of the FY 2014 data and reaffirm CMS’s decision to no longer require the NQF #0209 measure as part of the HQRP. Data errors affected 43.4% of all hospices’ data submissions, a 12.3 percentage point increase from the prior year, suggesting that hospices are not improving with time.

The findings from the FY 2015 closely mirror those from FY 2014 for both the structural measure and the NQF #0209 measure. This is true despite the fact that FY 2014 was based on one quarter of data and FY 2015 was based on four quarters of data. These findings support CMS’s decision to discontinue both measures for future reporting cycles in favor of implementing patient-level data collection using the Hospice Item Set (HIS) in the HQRP to collect standardized data to calculate seven QMs (six NQF-endorsed QMs and a modification of one NQF-endorsed QM).




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