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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

CMS Provides Education on Revised Hospice Item Set Manual

June 19, 2015 10:22 AM

On June 17, 2015, CMS held a training call for the revised Hospice Item Set (HIS) Manual. The revised manual, version 1.02, is effective June 28, 2015, and it includes HIS definition clarifications as well as some revised guidance. CMS has indicated a recording of the call will be available. In the interim, providers can find out more detail by reading the NAHC summary below and viewing the presentation slides. A change table outlining the revisions is also available for providers in the downloads section of the CMS HIS webpage.

A hospice should still complete and submit HIS records even if late. The provider will receive a warning ‘error’ but the records are still accepted.

The definitions for admission and discharge are helpful in determining when an HIS needs to be submitted. 

Admission: A patient is considered “admitted” to a hospice if:

  • There is a signed election statement (or other agreement for care for non-Medicare patients) and
  • The patient did not expire prior to the effective date of the election or agreement for care and
  • The hospice made a visit in the setting where hospices services are to be initiated.

All three criteria must be met in order for the patient to be considered “admitted” for the purposes of HIS reporting.

Discharge: A patient is considered discharged when the patient is no longer receiving services from the hospice or there is an interruption in care/services. Patient discharge is the “trigger event” for completing the HIS-Discharge.

When a patient transfers from one hospice provider to another hospice provider, and those providers have different CCNs, each provider is responsible for submission of an HIS-Admission and an HIS-Discharge. If the providers have the same CCN, i.e. hospices with multiple locations and the patient’s care is being transferred from one of multiple locations to another, only the admitting hospice location is responsible for submission of the HIS-Admission and HIS-Discharge.

As long as there is no interruption in care, there is no need for another HIS. For example, a change in payor source – the hospice continues to provide care without any interruption in service but discharges the patient from one payor source and admits under another payor source in their administrative records. This often occurs when a F2F encounter is not completed timely. Some software systems require a complete discharge, an ‘administrative discharge’ if you will, when there is a change in payor source and no interruption in service. In these instances, an HIS-Discharge does not need to be completed when the patient is ‘discharged’ from the first payor source and a new HIS-Admission does not need to be completed when the patient is ‘admitted’ with a new payor source.

If the initial assessment is initiated, but the entire initial assessment was not completed before the patient is discharged, providers should enter the date the assessment was initiated. If no initial assessment was initiated, providers should enter a dash for A0205. Providers should remember that the patient must meet all three criteria for admission outlined above in order for the HIS to be submitted, and the inability to complete the initial assessment does not eliminate the need to complete and submit an HIS-Admission and HIS-Discharge.

New guidance for F3000, spiritual/existential concerns, allows a hospice to include dates that precede the patient’s admission date. This was allowed for CPR preferences, hospitalization preferences and other life sustaining treatment only. 

For item J2030, Screening for Shortness of Breath, new guidance is that providers should consider whether shortness of breath (SOB) is an active problem at the time of screening. The clinician may determine that SOB is an active problem, even if SOB does not occur during the assessment visit. If the patient is receiving treatment for SOB, that indicates SOB is an active problem. This is different than determining severity of pain in J0900C, which is determined at the time of the visit.

Many hospices continue to have questions surrounding comfort kits. There are several HIS items that ask if a treatment was initiated and the date treatment was initiated. If the treatment is in the form of a comfort kit or any type of pre-printed admission orders, treatment is “initiated” when the hospice has received the order and there is documentation that the patient/caregiver was instructed to begin use of the medication or treatment for the relevant symptoms. Both conditions must be present. Proactive education is not considered “initiation.” For non-medication interventions, providers can use the date on which the hospice first discussed the intervention with the patient/caregiver.

Hospices were hoping for some clarification regarding the HIS items related to bowel regimen. In this call and the HIS Manual revisions, it was clarified that the bowel regimen order need not explicitly state it is for the management of opioid induced constipation and the date the bowel regimen is initiated can precede the date an opioid is initiated.

Due to technical difficulties, participants were not able to ask questions on the call but questions can be submitted to HospiceQualityQuestions@cms.hhs.gov

 

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