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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 CAHPS Hospice Survey Training Call

October 6, 2015 10:11 AM

CMS held a CAHPS Hospice Survey training call on September 30, 2015. The purpose of the call was training for survey vendors as well as other interested parties. Slides from the five-hour training session and the agenda are available here.

While most of the call went over information pertinent to survey vendors, there were some items of interest for hospice providers, and these are detailed below.

Relative to public reporting of the CAHPS Hospice Survey data, CMS indicated that they must first have four quarters of data. The eligible quarters started with the second quarter of 2015 which means four quarters of data will not be available until second quarter 2016. CMS does not believe public reporting of this data will occur in the second quarter of 2016 due to other issues such as the formula to be used for calculation of the survey scores has not yet been decided and a timeline for the website for reporting this information has not yet been developed and approved.

CMS stressed that it is the successful submission of survey data that impacts the hospice’s annual payment update for the corresponding payment year and it is the hospice’s responsibility to verify successful submission of the data by the vendor. For instance, it is successful submission of data in 2016 that impacts the hospice’s FY2018 annual payment update. Vendors are encouraged to submit data sufficiently prior to submission deadlines in order to allow for any necessary reconciliation of problems. Hospices should be checking the Hospice Survey Data Warehouse monthly to ensure their vendors are successfully and timely submitting their data. Timelines for 2015 and 2015 data submission are below.

CAHPS Hospice Survey Timelines 2015 - 2016

Month of Death

Initial Contact With Sampled Decedents/Caregivers

Data Submission to the CAHPS Hospice Survey Data Warehouse

April 2015

July 1, 2015

November 11, 2015

May 2015

August 1, 2015

June 2015

September 1, 2015

July 2015

October 1, 2015

February 10, 2016

August 2015

November 1, 2015

September 2015

December 1, 2015

October 2015

January 1, 2016

May 11, 2016

November 2015

February 1, 2016

December 2015

March 1, 2016



Month of Death

Initial Contact With Sampled Decedents/Caregivers

Data Submission to the CAHPS Hospice Survey Data Warehouse

January 2016

April 1, 2016

August 10, 2016

February 2016

May 1, 2016

March 2016

June 1, 2016

April 2016

July 1, 2016

November 9, 2016

May 2016

August 1, 2016

June 2016

September 1, 2016

July 2016

October 1, 2016

February 8, 2017

August 2016

November 1, 2016

September 2016

December 1, 2016

October 2016

January 1, 2017

May 10, 2017

November 2016

February 1, 2017

December 2016

March 1, 2017


The data submission deadlines are fixed. No late submissions can or will be accepted so it is vital that hospices verify successful submission of their data by their vendor.

Some hospices are exempt from the Hospice CAHPS Survey requirement for their size and some are exempt because they are new providers.

Exemption for Size

For the CY 2016 data collection period, Medicare-certified hospices that have served fewer than 50 survey-eligible decedents/caregivers in the period from January 1, 2015 through December 31, 2015 can apply for an exemption from CAHPS Hospice Survey CY 2016 data collection and submission requirements. The Participation Exemption for Size Form must be submitted online at The Participation Exemption for Size Form must be received by August 11, 2016.

The exemption for size form is completed by the hospice once a year. CMS verifies, based on claim data, that the hospice is eligible for the exemption for size. If CMS determines the hospice is not eligible it will be dealt with on a case-by-case basis. There is no formal confirmation from CMS to the hospice that the request for exemption for size has been approved. It is only if it is not approved that the hospice should expect to hear from CMS.

Exemption for Newness

The exemption for newness is based on how recently the hospice received its CCN. The criterion for this exemption is that the hospice must have received its CCN on or after the first day of the performance year for the CAHPS Hospice Survey. For instance, for the CY 2016, hospices who received their CCN on or after January 1, 2016 are eligible for the one-time exemption for newness. Hospices eligible for this exemption will be identified by CMS

CMS reviewed the roles and responsibilities of the hospice and the vendor. The hospice responsibilities are to:

  • Participate in the CAHPS Hospice Survey
  • Authorize a survey vendor
  • Provide decedents/caregivers lists and required counts to the survey vendor
  • Understand data submission due dates
  • Review data submission reports
  • Avoid influencing caregivers as to how to answer the survey questions

Each month, each hospice must submit to its contracted survey vendor:

  • Decedents/Caregivers List
  • Count of decedents served in the month
  • Number of hospice offices covered under a single CCN (this is the number of administrative or practice offices for the CCN NOT individual facilities or settings in which hospice care is provided (i.e., homes, assisted living facilities, hospitals, hospice facilities, or hospice houses)
  • Counts of cases ineligible due to:
    • Live discharge
    • Requests for no contact (i.e., sign “no publicity” requests or otherwise directly and voluntarily request not to be contacted)

Survey vendors are required to de-duplicate patients who have more than one hospice stay during the calendar month . For example, a patient is

  • admitted on January 15,
  • discharged alive on January 18, o readmitted on January 22,
  • and dies on January 26
    • The January 26 death is included in January decedents/caregivers list
    • The January 18 live discharge should not be included in January decedents/caregivers list

The hospice is also responsible for identifying one primary informal caregiver who may be eligible to receive and respond to the CAHPS Hospice Survey for each decedent. Hospices should not necessarily prioritize an informal caregiver who is a family member over a friend, as one caregiver category does not automatically have preference over another. The CAHPS Hospice Survey should be administered to the informal caregiver most knowledgeable about the care the decedent received at the hospice. Staff members or employees of the hospice or care setting in which the patient received hospice care should not be considered primary informal caregivers.

Hospices are permitted to:

  • Inform all caregivers about the survey
  • Conduct quality improvement activities, including asking patient/family member questions to promote well-being

Hospices are not permitted to:

  • Ask any CAHPS Hospice Survey-like questions or use CAHPS Hospice Survey-like response categories
  • Attempt to influence caregivers to answer questions in a particular way
  • Offer incentives of any kind

When the vendor provides responses to the hospice it must communicate to hospices that the survey vendor scores are not official CMS scores and should only be used for quality improvement purposes.  Survey vendors are permitted to provide hospices with responses linked to a decedent’s/caregiver’s name and other identifying information only if the caregivers answers “Yes” to the Consent to Share Responses question.

One of the issues with the Survey administration, brought up by vendors, is that caregivers get confused about the role of the vendor when the Survey cover letter includes a bereavement support number. The Survey cover letters can include a bereavement support number for the caregivers to call but it is not required. Vendors reported that there are misplaced calls from caregivers to the vendor instead of the hospice for bereavement and sometimes to the hospice instead of the vendor for Survey questions. CMS acknowledged this may occur but did not have a specific solution. Therefore, hospices may want to consider this information when deciding whether to include a bereavement support number on the cover letters for their surveys.

We encourage hospices to read the CAHPS Hospice Survey Quality Assurance Guidelines Version 2.0 (QAG V2.0). This version of the QAG is applicable for submission of data beginning February 2016, which is data collection months of October, November and December of 2015. In this training call, CMS indicated it would issue a V1.3 of the QAG in order to accommodate the data submissions from now until February 2016.

Please submit questions about this Call summary to




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