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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

CMS Holds Face to Face Call

December 18, 2014 09:47 AM

The Centers for Medicare & Medicaid Services (CMS) held a long-awaited National Provider call on the revised home health face-to-face encounter requirements for certifying Medicare home health patients. The revisions go into effect January 1, 2015. 

The CMS officials presented an overview of the requirements for home health eligibility, along with the revisions made in the final rule relative to the face-to-face encounter. CMS reiterated that the narrative requirement will no longer be required for initial certifications beginning January 1, 2015. CMS did emphasize that a brief narrative is required for certifications and recertifications for patients receiving skilled nursing for Management &Evaluation of the Care Plan. 

Although the narrative has bee eliminated, all other aspects of the face-to-face encounter are still required, such as the encounter must occur no later than 90 days prior to or 30 after the start of care; is related to the primary reason for home health service; and is performed by a physician or an allowed non physician practitioner. CMS will apply the face-to-face encounter requirements anytime a new state of care Outcome and Assessment Information Set (OASIS) is required. 

CMS confirmed that they will review the certifying physician’s record to ensure documentation supports eligibility for home health services. Agencies must obtain the physicians record if the agency’s claim is targeted for medical review.  

Additionally, the presenters provided various examples of progress notes and discharge summaries and highlighted what CMS will be looking for when reviewing the medical record to support eligibility for home health services.  As currently required, acceptable documentation would include the physician detailing why a patient needs skilled service and reason(s) for homebound. If the physician’s documentation does not substantiate a patient’s eligibility, CMS will permit the agency to fill in the “gaps” by providing the physician with information that supports the need for skilled service and homebound status.  The physician would be required to sign any documentation received from the agency and incorporate it into his/her own medical record

Although agencies are not required to obtain the physician’s documentation prior to billing, CMS recommends that agencies obtain as much information, as soon as, possible, from the physician to ensure eligibility requirements have been met. CMS also stated that they plan to initiate probe reviews for physicians who have a pattern of referring patient that do not meet the home health eligibility requirements. However, they did not provide details on how this would be implemented.

During the Q&A session of the call, CMS addressed several question related to the specifics of acceptable documentation needed to comply with the revised requirements. 

  • The agency could incorporate their findings that support eligibility for home health services in the POC for the physician to sign. What is unclear is will the agency be required to include portions of the assessments that supports theses findings.
  • The face-to-face narrative document currently used by physicians will not be required to document home health eligibility. CMS will look at the physician’s record for support of home health eligibility and must include the actual visit note from the encounter or a discharge summary if the patient is admitted to home health after an acute-post care facility stay.
  • CMS indicated that the physician’s encounter note would need to only include the date of the encounter, be related to the primary reason for home health, and be signed and dated by the certifying physician. The agency could fill in the “gaps” by supplying the physician with information from their assessment that supports eligibility, but it must corroborate with the physician’s documentation .  It still unclear what CMS will accept as sufficient corroborating documentation from the physician?

The National Association for Home Care & Hospice (NAHC) has serious concerns about some of the information conveyed and positions taken by CMS. Specifically, NAHC is concerned about the depth of documentation that CMS is expecting from physicians. NAHC is also concerned about the standard that documentation from the HHA alone is insufficient to support the physician certification and that it can be used only if it corroborates other documentation not prepared by the HHA. Lastly, CMS did not address or even seem to appreciate the burden it will be for both physicians and agencies to obtain the physician’s record. And what are agencies to do if the physician does not cooperate?

NAHC will continue to work with other stakeholders and communicate with CMS to have the concerns of home care and hospice providers addressed.

The audio recording and written transcript of this MLN Connects Call will be posted here once it is available.




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