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Testimonials

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. 

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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.

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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

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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 element...it’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

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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.

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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.

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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.

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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.

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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.

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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.

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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. 

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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.

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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.

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Frank E. Moss, former U.S. Senator

Anyone working on health care issues in Congress knows the name Val J. Halamandaris.

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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.

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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.

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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.

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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.

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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.

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Former President Bill Clinton

Latest Hospice PEPPER Report Set for April Release

New “Target Areas” Include Days of CHC, RHC in Assisted Living and Nursing Facilities
March 13, 2015 01:08 PM

In 2012, the Centers for Medicare & Medicaid Services (CMS) began development and release of Program for Evaluating Payment Patterns (PEPPER) reports for Medicare-certified hospices through its PEPPER contractor, TMF Health Quality Institute.  As part of the PEPPER process, specific “target areas” within the Medicare hospice benefit that could be at risk for improper payment are identified, and data related to those target areas are analyzed.  The PEPPER reports supply an individual hospice’s data over three years’ time and also provide, for comparison, the same data for hospices nationally, within the same Medicare Administrative Contractor (MAC) jurisdiction, and within the same state as the subject hospice.  This data allows a hospice to assess how its performance (and potential risk) in the target areas compares with others.  Initial hospice PEPPER reports were hard copy, but beginning in April 2014 hospice PEPPERs became available to the hospice CEO, president or administrator by way of an electronic PEPPER Resources Portal.

 

TMF Health Quality Institute is gearing up for release of the latest hospice PEPPER in mid-April.  The PEPPER target areas for hospice have been expanded to include several measures that have been the subject of scrutiny by CMS, the Office of the Inspector General (OIG) and others, relative to potential overutilization of hospice care for beneficiaries residing in assisted living facilities (ALFs) and nursing facilities (NFs).  The PEPPER Target Areas for Hospices anticipated in the forthcoming report are as follows:

PEPPER Target Areas for Hospices

*Note: Target Areas may be added or modified at the discretion of the Centers for Medicare & Medicaid Services.

TARGET AREA

TARGET AREA DEFINITION

Live Discharges

(Live Discharges)

 

For discharges prior to July 1, 2012:

Numerator (N): count of beneficiary episodes discharged alive by the hospice (patient discharge status code not equal to “40” (expired at home), “41” (expired in a medical facility) or “42” (expired place unknown)) with occurrence code "42" (date of termination of hospice benefit)

 

Denominator (D): count of all beneficiary episodes discharged (by death or alive) by the hospice during the report period (obtained by considering all claims billed for a beneficiary by that hospice)

 

For discharges beginning July 1, 2012:

Numerator (N): count of beneficiary episodes who were discharged alive by the hospice (patient discharge status code not equal to “40” (expired at home), “41” (expired in a medical facility) or “42” (expired place unknown)), excluding:

·       beneficiary transfers (patient discharge status code “50” or “51”)

·       beneficiary revocations (occurrence code “42”)

·       beneficiaries discharged for cause (condition code “H2”)

·       beneficiaries who moved out of the service area (condition code “52”)

 

Denominator (D): count of all beneficiary episodes discharged (by death or alive) by the hospice during the report period (obtained by considering all claims billed for a beneficiary by that hospice)

Long Length of Stay

(Long LOS)

N: count of beneficiary episodes discharged (by death or alive) by the hospice during the report period whose combined days of service at the hospice is greater than 180 days (obtained by considering all claims billed for a beneficiary by that hospice)

 

D: count of all beneficiary episodes discharged (by death or alive) by the hospice during the report period

Continuous Home Care Provided in an Assisted Living Facility

(CHC in ALF)

*new as of the Q4FY14 release

N: count of beneficiary episodes discharged (by death or alive) by the hospice during the report period where at least eight hours of Continuous Home Care (revenue code = “0652”) were provided while the beneficiary resided in an Assisted Living Facility (HCPCS code = “Q5002”)

 

D: count of all beneficiary episodes ending in the report period that indicate the beneficiary resided in an assisted living facility (HCPCS code = “Q5002”) for any portion of the episode

Routine Home Care Provided in an Assisted Living Facility

(RHC in ALF)

*new as of the Q4FY14 release

N: count of Routine Home Care days (revenue code = “0651”) provided on claims ending in the report period that indicate the beneficiary resided in an assisted living facility (HCPCS code = “Q5002”)

 

D: count of all Routine Home Care days (revenue code = “0651”) provided by the hospice on claims ending in the report period

Routine Home Care Provided in a Nursing Facility

(RHC in NF)

*new as of the Q4FY14 release

N: count of Routine Home Care days (revenue code = “0651”) provided on claims ending in the report period that indicate the beneficiary resided in a nursing facility (HCPCS code = “Q5003”)

 

D: count of all Routine Home Care days (revenue code = “0651”) provided by the hospice on claims ending in the report period

Routine Home Care Provided in a Skilled Nursing Facility

(RHC in SNF)

*new as of the Q4FY14 release

N: count of Routine Home Care days (revenue code = “0651”) provided on claims ending in the report period that indicate the beneficiary resided in a skilled nursing facility (HCPCS code = “Q5004”)

 

D: count of all Routine Home Care days (revenue code = “0651”) provided by the hospice on claims ending in the report period

 

 

TMF notes in its PEPPER Hospice User’s Guide (Fourth Edition):

 

These PEPPER target areas were approved by CMS because they have been identified as being potentially at risk for improper Medicare payments. For example, hospices that discharge alive a high proportion of beneficiaries from the hospice benefit may be admitting beneficiaries who do not meet the hospice eligibility criteria. This may also be an indication of quality of care concerns.

 

Similarly, hospices that have a high proportion of beneficiaries with a long length of stay may be admitting beneficiaries who do not meet the hospice eligibility criteria. In addition, in its June 2013 Report to Congress, the Medicare Payment Advisory Commission (MedPAC) raised concerns regarding longer lengths of stay and higher frequencies of patients being discharged alive in hospices.

 

The OIG reviewed hospice services provided to beneficiaries residing in AFLs (see Medicare Hospices Have Financial Incentives to Provide Care in Assisted Living Facilities,” OEI-

02-14-00070, January 2015). The OIG found concerns relating to overutilization of hospice services for beneficiaries residing in an ALF. Hospice services to beneficiaries residing in a SNF or NF are also at risk for overutilization. Therefore, there are target areas focusing on these concerns.

 

Additional information about release of the hospice PEPPER and educational opportunities will be provided in NAHC Report and on the NAHC member listservs as it becomes available. 

 

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