Skip to Main Content
National Association for Home Care & Hospice
Twitter Facebook Pintrest


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

CMS Proposes New Home Health Conditions of Participation

October 8, 2014 09:35 AM

The Centers for Medicare and Medicaid Services has issued the long-awaited Home Health Conditions of Participation (HHCoPs).

Home health agencies (HHAs) must meet the Medicare HH CoPs in order to participate in the Medicare program. Agencies that fail to meet any of the HH CoPs are at risk, at a minimum, for the imposition of a number of sanctions and potentially at risk for program termination.

Although CMS has made several significant revisions to the HH CoPs throughout the years, many of the current CoPs have remained unchanged since their inception. In 1997, CMS attempted to revise the HH CoPs with a proposed rule that focused on patient-centered outcome oriented quality standards. However, since CMS did not publish a final rule within the required three years time frame, the proposed rule was rescinded and CMS must issued anther proposed rule.

CMS maintains it commitment to revise the HHCoPs with a focus on a patient-centered, data driven, outcome-oriented process that promotes high quality of care, while at the same time eliminating unnecessary procedural burdens on HHAs.

CMS proposes to transform the HHCoPs using the following principles:

  • Develop a more continuous, integrated care process across all aspects of home health services, based on a patient-centered assessment, care planning, service delivery, and quality assessment and performance improvement;
  • Use a patient-centered, interdisciplinary approach that recognizes the contributions of various skilled professionals and their interactions with each other to meet the patient's needs;
  • Stress quality improvements by incorporating an outcome-oriented, data-driven quality assessment and performance improvement program  specific to each HHA;
  • Eliminate the focus on administrative process requirements that lack adequate consensus or evidence that they are predictive of either achieving clinically relevant outcomes for patients or preventing harmful outcomes for patients;
  • Safeguard patient rights.

CMS proposes the most significant changes with the following new or revised CoPs:

  • The CoP for “Patient rights” emphasizes a HHA's responsibility to respect and promote the rights of each home health patient.

This revision expands the current patient right CoP at §484.10 by requiring the agency inform the patient of their rights both in writing and verbally; focuses on accommodating and complying with Limited English Proficiency requirements; and  increases patients rights in regards to care planning. The CoP is organized into six standards: 1) Notice of Rights; 2) Exercise of rights; 3) Rights of the patient; 4) Transfer and Discharge; 5) Investigation of complaints; and 6) Accessibility.        

  • The CoP for “Care planning, coordination of services, and quality of care” would incorporate the interdisciplinary team approach to provide home health services focusing on the care planning, coordination of services, and quality of care processes.

This proposed CoP combines and revises the current CoP at § 484.18 “Acceptance of patients, plan of   care, and medical supervision” and the standard at §484.14(g) “Coordination of patient services”. The CoP is organized into five standards: 1) Plan of care 2) Conformance with physician orders; 3) Review and revision of the plan of care; 4) Coordination of care; and 5) Discharge and transfer summary.      .

  • The CoP for “Quality assessment and performance improvement” (QAPI) would charge each HHA with responsibility for carrying out an ongoing quality assessment, incorporating data-driven goals, and an evidence-based performance improvement program of its own design to affect continuing improvement in the quality of care furnished to its patients.
  • The CoP for “Infection prevention and control” would require HHAs to follow accepted standards of practice to prevent and control the transmission of infectious diseases and to educate staff, patients, and family members or other caregivers on these accepted standards. The HHA would be required to incorporate an infection control component into its QAPI program.

The proposed CoPs for the QAPI program and infection control plan are new to HHAs and will likely require significant adjustments for most agencies in terms of resources and operations. Although many agencies have some form of a QAPI program and infection control plan, the proposed CoPs provide detailed components of what CMS expects from a HHA QAPI program and infection control plan.

The QAPI CoP replaces the current HHCoPs at §484.16 “Group of professionals and §484.52 “Evaluation of the agency’s program”. This CoP has been organized into five standards: 1) Program Scope; 2) Program data; 3) Program activities; 4) Performance improvement projects and; 5) Executive responsibilities.

The proposed CoP for an infection prevention and control program is organized into three standards: 1) prevention; 2) control; and 3) education.

CMS also proposes to consolidate and revise the CoPs at §484.30 Skilled nursing services, §484.32 therapy services; and §484.34 Medical social services, into one CoP titled “Skilled professional services.”

Rather than specifically identifying tasks, CMS proposes to broadly describe the expectations of the skilled professionals who participate in the interdisciplinary team. This CoP is organized into three standards: 1) provision of skilled services; 2) responsibilities of skilled professionals; and 3) supervision of skilled professional assistance.

Additionally, CMS has reorganized the order of the CoPs and assigned a new numbering system.  The proposed CoPs are divided into three sections: A. General Provisions -§ 484.1 and §484.2; B. Patient Care-§484.40-§484.80; and C. Organizational Environment - §484.100- §484.115. 

Lastly, CMS proposes to eliminate “subunits” designations and eventually require current subunits to be converted to either a parent agency or a branch.

NAHC continues with its analysis of the proposed rule for the HHCoPs and will provide additional insights in future NAHC report articles.

To view the proposed rule click here.

Comments are due 60 days from the October 9 publication date in the Federal Register.




©  National Association for Home Care & Hospice. All Rights Reserved.