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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

Congress Poised to Set Minimum Hospice Survey Frequency

September 18, 2014 09:42 AM

For many years, the National Association for Home Care & Hospice (NAHC) and its Hospice Association of America (HAA) have supported greater frequency in hospice surveys.  Currently, there is no set time frame for frequency of hospice surveys, and the average length of time between surveys for hospice providers is six to eight years.  Some hospices have not been surveyed in over a decade.  More frequent surveys are a step toward helping ensure hospice provider compliance with regulations and proper administration of the hospice benefit. 

On September 16, the House of Representatives passed, by a voice vote, legislation that requires the Centers for Medicare & Medicaid Services (CMS) to survey hospices at least as frequently as every three years for the next 10 years.  The legislation also corrects a legislative drafting error that has prevented implementation of an Affordable Care Act provision requiring medical review of hospices with a high proportion of long-stay patients.  These provisions were first included in legislation introduced earlier this year by Reps. Tom Reed (R-NY) and Mike Thompson (D-CA); House Ways and Means Chairman Dave Camp (R-MI) and Senate Finance Chairman Ron Wyden (D-OR) worked in recent weeks to include these provisions as part of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014.  

NAHC President Val J. Halamandaris noted that, “NAHC applauds the efforts of Chairmen Wyden and Camp, as well as those of Congressmen Reed and Thompson, for their foresight and leadership in working to realize these important changes.”

In order to pay for the increase in surveys the legislation would alter the method for calculating the annual adjustment to the hospice aggregate cap calculation.  The aggregate cap is the annual dollar limit that hospices can receive from Medicare on a per-patient basis. If a hospice’s payments exceed its aggregate cap limit, a hospice must pay back to Medicare any payments it received beyond the cap amount.  The cap is updated on an annual basis, as are the hospice payment rates, but the annual updates are calculated using different economic indices (the cap is updated by the CPI-M, while payment rates are updated by the hospice market basket).

This legislation would make a change in the hospice cap update calculation, tying it to the net hospice market basket value, as well.  This would more closely align the methodology for the cap update amount and the hospice payment rate updates.  While we predict that the change in the calculation of the hospice cap update will not impact most hospices it is expected to slow the rate of growth in the hospice cap, which may mean that, over time, more providers exceed the cap or that those exceeding the cap do so by a higher amount than would otherwise be the case.   NAHC’s review of recent cap updates as compared with net market basket updates indicates that the impact of this change would vary from year to year, but in most recent years would have reduced the cap update by amounts ranging from 0.13 to 1.48 percentage points.  This will provide a strong incentive for those hospices with cap-related overpayments to review their admission/discharge criteria.   

The IMPACT Act would require development of a uniform assessment instrument and enhance the discharge planning process related to post-acute care.  Hospices are not included in the list of post-acute care providers that are part of the IMPACT Act.  Senate passage of this legislation is anticipated in the near future.

To read a letter sent by NAHC to Rep. Wyden on the IMPACT Act, please click here.




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