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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

National Quality Forum Releases Measures Under Consideration

December 2, 2015 10:09 AM

Late last week, the National Quality Forum (NQF) released its plan to review standardized performance measures being considered by the U.S. Department of Health and Human Services across 16 different federal health programs including home health and hospice. The NQF’s Measure Applications Partnership (MAP) will review the measures. The list of measures under consideration (MUC) includes two specific measures for the hospice quality reporting program (HQRP) and one other specifically for oncology patients receiving hospice care while there are six measures impacting the home health quality reporting program (HH QRP). Four of these six measures are required by the IMPACT Act. There are also various other measures that mention hospice or home health (either including or excluding the population in the measure calculation) but not directly impacting hospice or home health quality data.

The measures are listed below and the first round of comments is due December 7, 2015. NAHC is submitting comments.

Please send your feedback on hospice measures to Katie Wehri at and on home health measures to Mary Carr at by close of business on December 3, 2015. We will compile comments on December 4 and submit them by the deadline of December 7.

Hospice Measures Under Consideration

  • Hospice visits when death is imminent - Assess hospice staff visits to patients and caregivers in the last week of life

Members of the hospice staff considered for the measure include: nurses (registered nurse, licensed professional nurse or nurse practitioner if acting in the role of a nurse), hospice aides, physicians (or nurse practitioner or physician assistant if acting as the attending physician), chaplains or spiritual counselors, therapists (physical therapist, occupational therapist or speech language therapist), medical social workers, and volunteers. General inpatient and continuous care visits made are excluded from this measure. Currently, the visit data required for this measure is not currently gathered and reported by hospices.

  • Hospice and palliative care composite process measure - Assess percentage of hospice patients who received care processes consistent with guidelines at admission

This is a composite measure based on select measures from 7 NQF- endorsed measures: NQF #1641, NQF #1647, NQF #1634, NQF #1637, NQF #1639, NQF #1638, NQF #1617. These measures are part of the HIS, and this composite process measure calculates the patients who meet the numerator criteria for all of the select measures of the above-referenced NQF measures.

  • Oncology measure:

Proportion of patients admitted to hospice for less than three days - Percentage of patients who died from cancer, and admitted to hospice and spent less than 3 days there

The first two measures above would be part of the HQRP. The third measure is part of the MIPS (Measures-based Incentive Payment System) and would not be part of the HQRP.

Home Health Measures Under Consideration

The Improving Medicare Post‐Acute Care Transformation Act of 2014 (IMPACT Act), signed into law by President Obama in October 2014, requires long-term care hospitals (LTCHs), Inpatient Rehabilitation Facilities (IRFs), Skilled Nursing Facilities (SNFs), and Home Health Agencies (HHAs) to report standardized patient assessment data, at a minimum with respect to certain statutorily-mandated categories, using the post-acute care (PAC) assessment instruments that these providers currently use to submit data to CMS for other purposes. The IMPACT Act further requires: the Secretary to specify quality, resource use and other measures that cover, at a minimum, certain statutorily-mandated domains; and that these providers report data on those measures. The IMPACT Act requires that the assessment data reported by these providers be standardized and interoperable to allow for the exchange of such data among PAC providers and other providers, inform person-centered discharge planning, and facilitate coordinated care and improved patient outcomes.

In order to comply with the IMPACT Act requirements, CMS has included four quality measure concepts on the 2015 MUC list with respect to the IRF, LTCH, SNF, and HHA settings for the IRF Quality Reporting Program (IRF QRP), LTCH Quality Reporting Program (QRP), SNF Quality Reporting Program (QRP), and HH Quality Reporting Program (QRP), respectively.

  • Measures pertaining to the IMPACT Act
    • Potentially Preventable 30- Day Post-Discharge Readmission Measure for Home Health Quality Reporting Program - All-condition risk-adjusted potentially preventable hospital readmission rates.
    • Discharge to Community-Post Acute Care (PAC) Home Health Quality Reporting Program - This measure describes the risk-standardized rate of Medicare fee-for-service (FFS) patients/residents/persons who are discharged to the community, and do not have an unplanned (re)admission to an acute care hospital or LTCH in the 31 days following discharge to community, and remain alive during the 31 days following discharge to community.
    • Drug Regimen Review Conducted with Follow-Up for Identified Issues- Post Acute Care (PAC) Home Health Quality Reporting Program - Percentage of stays Inpatient Rehabilitation Facility (IRF), Long Term Care Facility (LTCH), and Skilled Nursing Facility (SNF) or care episodes Home Health (HH) in which a drug regimen review was conducted at the Admission (IRF, LTCH or SNF)/ Start of Care (SOC)/ Resumption of Care (ROC) (HH) and timely follow-up with a physician occurred each time potential clinically significant medication issues were identified throughout the stay (IRF, LTCH, or SNF) or care episode (HH).
    • Medicare Spending Per Beneficiary*- Post Acute Care (PAC) Home Health Quality Reporting Program - The MSPB-PAC Measure for HHAs evaluates providers’ efficiency relative to the efficiency of the national median HHA provider. Specifically, the MSPB-PAC Measure assesses the cost to Medicare for services during an episode of care, which consists of a treatment period and an associated services period. The episode is triggered by the initiation of a 60 day HHA service period. The treatment period begins at the trigger and ends on the last day of the service period. The associated services period begins at the trigger and ends 30 days after the end of the treatment period. These periods constitute the episode window during which beneficiaries’ Medicare services are counted toward the episode. The MSPB-PAC episode includes all services during the episode window that are attributable to the HHA provider and those rendered by other providers, except those services during the associated services period that are clinically unrelated to HHA responsibilities (e.g., planned care and routine screening).
  • Improvement in Dyspnea in Patients with a Primary Diagnosis of Congestive Heart Failure, Chronic Obstructive Pulmonary Disease and/or Asthma - Percentage of home health episodes of care during which a patient with a primary diagnosis of CHF, asthma and/or COPD became less short of breath or dyspneic.
  • Falls risk composite process measure - Percentage of patients who were assessed for falls risk and whose care plan reflects the assessment and was implemented as appropriate (must meet all three of the conditions).

*This is a cost-resource use measure. All other measures are outcome measures.

Again, the first round of comments is due December 7, 2015. NAHC is submitting comments.

Please send your feedback on hospice measures to Katie Wehri at and on home health measures to Mary Carr at by close of business on December 3, 2015. We will compile comments on December 4 and submit them by the deadline of December 7.




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