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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

2016 Hospice PEPPER Now Available

Reminder: 2016 Hospice PEPPER Report Educational Training Set for April 28
April 13, 2016 11:19 AM

The TMF Health Quality Institute has issued its annual hospice-specific Program for Evaluating Payment Patterns Electronic Report (PEPPER) that identifies areas where the provider may be vulnerable to potential improper payments. The PEPPER includes statistics for “target areas” that compare the performance of the hospice with state, Medicare Administrative Contractor (MAC) jurisdiction, and national statistics. Reminder: training related to the new PEPPER will be held on April 28 from 2 to 3 p.m. Eastern (1 to 2 p.m. Central). For more information about the training, see below or previous NAHC Report article here.  

As reported previously in NAHC Report, the 2016 Hospice PEPPER includes data from the fourth quarter for Fiscal Year 2015 and the following new target areas: 

  • Live Discharges - Revocations
  • Live Discharges with Length of Stay between 61 and 179 days
  • Claims with a Single Diagnosis Coded
  • No General Inpatient Care or Continuous Home Care

All of the new target areas are ones which CMS has identified (through its data analysis on hospice payment reform) as areas of concern, making the new Hospice PEPPER a useful tool for agencies that want to know how they compare in these areas to peers in their state and MAC jurisdiction, as well as how they rank on a national basis. 

Following is additional information from TMF Health Quality Institute regarding the PEPPER:

New Release of Hospice PEPPER Now Available 

The Q4FY15 release of the Hospice Program for Evaluating Payment Patterns Electronic Report (PEPPER) with statistics through September 2015 is now available for download through the PEPPER Resources Portal. To obtain your hospice's PEPPER, the Chief Executive Officer, President, Administrator or Compliance Officer of your hospice should:

  1. Review the Secure PEPPER Access Guide
  2. Review the instructions and obtain the information required to authenticate access. Note: A new validation code will be required. A patient control number or medical record number from a claim for a traditional Medicare FFS beneficiary with a “from” or “through” date in September 1-30, 2015 will be required. 
  3. Visit the PEPPER Resources Portal
  4. Complete all the fields. 
  5. Download your PEPPER.

The Hospice PEPPER will be available to download for approximately two years. 

Updated in this release

The method to create hospice episodes to report services has changed. Previously, a gap of 30+ days between the last “through” date and the next “from” date on a claim triggered the ending of one episode and the beginning of a new episode of care. The gap has been changed to 60+ days. As a result, there are fewer hospice episodes identified (a decrease of about 0.6%). However, for the “live discharges” target areas, there is a decrease in episodes of approximately 8%. 

There are 4 new target areas: 

  1. Live Discharges – Revocations
  2. Live Discharges with Length of Stay 61-179 Days
  3. Claims with a Single Diagnosis Coded
  4. No General Inpatient Care or Continuous Home Care

Following is information on a Hospice PEPPER Update WebEx presentation being offered by the TMF Health Quality Institute AT NO CHARGE.  Please mark your calendars for this important session.

WHAT: Hospice PEPPER Update WebEx, Presented by Kimberly Hrehor, TMF Health Quality Institute

WHEN: Thursday, April 28, 2016 from 1 to 2 p.m. CENTRAL (2 to 3 p.m. EASTERN)

CONTENT:  An update on what is new in the Q4FY15 Hospice PEPPER 

REGISTRATION IS NOT REQUIRED -- Click here to join the event

Event number: 921 780 666

Event password: lavender

HANDOUTS: Will be posted on the website on the Hospice Training and Resources page by April 27, 2016

Please join the event 15 minutes before the start time in order to ensure you are able to participate.


PEPPER is an educational tool that summarizes provider-specific data statistics for Medicare services that may be at risk for improper payments. Providers can use the data to support internal auditing and monitoring activities. Visit the Hospice Training and Resources page at to access updated resources for using PEPPER, including recorded web-based training sessions, a sample Hospice PEPPER and the current Hospice PEPPER User’s Guide. PEPPER is distributed by TMF® Health Quality Institute under contract with the Centers for Medicare & Medicaid Services. 

Do you have questions or comments about PEPPER or need help obtaining your report? Visit TMF’s Help Desk to request assistance with PEPPER.




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