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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

NAHC Submits Comments on the Five Star Rating System

January 23, 2015 10:50 AM

The Centers for Medicare and Medicaid Services (CMS) held a Special Open Door Forum on December 17 to solicit stakeholder feedback on the proposed five star rating for home health agencies scheduled to start in 2015. During the call, CMS announced the quality measures it plans to use along with the proposed methodology for obtaining the five star rating. Comments were due Jan. 16.

The National Association for Home Care & Hospice (NAHC) submitted comments which addressed three main areas of concern with CMS proposed star rating system: the selected measures; the calculation methodology; and the next steps.

NAHC has concerns with CMS’ decision to include five measures that show improvement in functional status or clinical condition. The expected outcome for many patients admitted to home health care is to stabilize or prevent decline of a condition or functional limitation. In addition, the recent settlement in the lawsuit in Jimmo v. Sebelius   further confirms that the improvement standard does not apply to all Medicare home health patients. Further, an agency’s ability to affect a patient’s improvement in any measure depends largely on the services provided and the length of time the patient spends on service with the agency. The quality measures for home health agencies include data from four different payment sources: Medicare Fee for Service (FSS); Medicare Advantage (MA); Medicaid; and Medicaid managed care. Each such patient population and the applicable payers have widely varying utilization patterns.

NAHC recommended CMS include outcome measures reflecting care to patients who cannot and will not improve in any ADL or IADL function and add measures from the Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) survey.

NAHC also expressed concerns with a star rating model that requires providers be placed in quintiles even when the performance variation between the providers may be slight. It compounds that weakness by grading “on a curve,” resulting in moving all agencies to a middle, 3 Star grade regardless of their unadjusted star rating. Poor performers could rate higher than their actual performance while good or excellent performers could rate lower than their actual performance, with the potential for both performers to be rated as the same 3 star grade.

A 3 star rating is universallyis universally recognized to mean an “average” rating. Using 2013 data, CMS projected that 58 % of agencies would receive a 3 star rating, with only 22% rating a 4 or 5. The resulting five star rating system is misleading and could have significant consequences for patients and home health agencies. Not only will consumers be misled, but private insurance plans, referral sources, and state survey agencies could misjudge the quality of care the agency provides.

NAHC recommends that CMS use a model that projects a star rating which more accurately reflects the agency’s actual performance. CMS should avoid using star ratings for measures where the distribution of scores lacks variation and is skewed.  CMS must also recognize that whatever model it chooses to use, it must measure consumer comprehension and interpretation based on like-kind models.

Going forward NAHC recommended that CMS use the formal rulemaking process for public notice and comment on any 5 star system. In addition, CMS should clearly disclose the schedule for publication of the star ratings and any updates. Finally, NAHC requests that CMS offer agencies sufficient time to review their star ratings prior to releasing this data to the public

 To view the comments click here.




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