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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 Second Open Door Forum on Proposed Home Health Star Rating System

February 10, 2015 10:26 AM

The Centers for Medicare & Medicaid Services (CMS) held its second Open Door Forum (ODF) call for the proposed five star rating system for home health agencies. The presenters reviewed the star rating system, the comments received from the previous an ODF call, the revised methodology for calculation, and the next steps in developing the star rating system.

CMS reviewed their initial plans to implement a five-star rating system for home health agencies (HHAs), similar to the system used for skilled nursing facilities. The plan was officially announced on an ODF call held back in December. During that call, CMS presented ten selected measures and a preliminary methodology to be used for the five-star rating system.  

Many of the comments CMS received from the initial ODF call were related to the selected measures, the methodology for calculating the star rating, and concerns regarding consumer interpretation of the rating system. Several comments addressed the robustness of risk adjustment and the request for CMS to issue changes through the rule making process.

The ten measures originally selected will be used. CMS rejected several requests for the inclusion of stabilization measures and measures from the Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS). According to CMS, the stabilization measures do not meet the criteria for selection. None of these measures are reported on Home Health Compare nor do any have NQF endorsement. Additionally, the scores for these measures do not have enough variation.

CMS revealed plans to apply a separate star rating for the HHCAHPS measures and eventually incorporate these scores into the outcome measure rating system. However, CMS did not have any concrete plans for this initiative.  

During the most recent ODF call, CMS also presented a revised methodology for the rating system. Rather than place agencies in quintiles with ratings from 1-5 stars, agencies would be sectioned into deciles and be rated in half star increments between 1 and 5 stars.

By distributing agencies among deciles the ratings distribution are “flattened”, allowing for less clustering around 3 stars. However, CMS plans to apply the same approach with the calculation as in the previous method. The score for each measure will be adjusted towards a rating of 3 if the score for that measure is not significantly different from the median across all agencies. 

CMS plans to begin publishing the star ratings on Home Health Compare (HHC) in mid-July 2015. The ratings will be based on Outcome and Information Assessment Set (OASIS) data from January through December 2014 and claims data from October 2013 through September 2014. These are the same data that will be published on HHC in April 2015 under the usual schedule. The star ratings will be updated quarterly.

Agencies will be able to review their reports in March and will have several weeks to review and provide feedback on any data errors identified that affect the final star rating.

CMS is accepting another round of comments that are due Friday, February 13, 2015. CMS will also be drafting and testing consumer language, and plans to continue to solicit additional input on the rating system through informal stakeholder group.

The National Association for Care & Hospice (NAHC) has the same concerns with this proposal as it did with CMS’ initial proposal. NAHC has a general concern with using a star rating system framework to communicate to consumers the difference in quality of care among HHAs.

NAHC also maintains that measures other than those selected should be used. Additionally, the revised methodology continues to divide agencies in sections - now ten rather than five - even when performance variation between providers may be slight. This is compounded by ranking agencies on a “curve” that moves agencies towards a 3 star rating. Lastly, CMS will not likely be able to develop language that will effectively communicate to consumers how this star rating system differs from other consumer star rating systems.

The approach CMS has taken to inform stakeholders of their intent to apply a star rating system for HHAs is also of concern. NAHC has requested that CMS use the formal rulemaking process for public notice and comment to communicate this initiative to stakeholders.

A separate web page has been set up for the home health five sat rating system on the Home Health Quality Initiative page. On this page, agencies will find the handouts for the ODF call and the revised methodology for the rating system along with other information on the star rating system.




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