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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

HOSPICE COST REPORT: Recommendations on Hospice Cost Report Revisions Submitted to CMS

October 7, 2016 02:16 PM

REMINDER:  Provider-Based Hospices Must Use Revised Cost Report Starting with 10/1/2015 Cost Reporting Year

Provider-Based Hospice Cost Report News:  In 2014, the Centers for Medicare & Medicaid Services (CMS) finalized revisions to the freestanding hospice cost report (CMS-1984-14) to reflect expanded requirements, including collection of cost data by level of care; the requirements became effective with cost reporting periods beginning on or after October 1, 2014.  These changes are intended to support CMS’ efforts to refine the hospice payment methodology.  Since finalizing form 1984-14, CMS has solicited comment on similar changes to the hospital (CMS-2552-10), home health (HHA CMS-1728-94), and skilled nursing facility (SNFCMS-2540-10) hospice cost reporting forms and instructions.   

CMS has consistently maintained that these changes for the provider-based hospice cost reports would become effective with cost reporting periods beginning on or after October 1, 2015.  The SNF​-  and home health agency-based hospice cost report changes have been finalized and displayed on the CMS Transmittals page, this week CMS has once more confirmed to the National Association for Home Care & Hospice (NAHC) that all provider-based hospices are expected to complete the revised and expanded hospice cost reporting requirements  for cost reporting periods starting on or after October 1, 2015.  The changes to the hospital-based cost report will likely be finalized next month.  In the interim, provider-based hospices may use the SNF-based hospice forms as CMS has indicated that they mirror the hospital-based changes.  NAHC will post notices to the NAHC member listservs when the final forms/instructions are posted publicly.

Following are links to the most recently available version of the hospital-based hospice cost report forms and instructions:

Hospital-based hospice forms and instructions--CMS-2552-10(under INSTRUMENT FILE column):

Experts Develop Cost Report Recommendations:  In related news, a working group of hospice cost report experts drawn from NAHC’s Home Health and Hospital Financial Managers Association (HHFMA) has been meeting throughout the summer to discuss continuing concerns with the hospice cost report changes and related matters.  The group developed a letter outlining a series of concerns and recommendations, including the following issues:

COST REPORT EDITS– The group recommends that certain cost report edits be returned to Level I edits to improve the quality of collected cost report data.

CONTRACTED INPATIENT COSTS AND COST REPORT ELECTRONIC REQUIREMENTS– The group maintains that contracted GIP and respite costs should not be included in accumulated costs used for the allocation of administrative-general expenses and requests a software change that would automatically remove contracted costs from the accumulated costs.

COST REPORT TECHNICAL CORRECTION FOR REPORTING OF DURABLE MEDICAL EQUIPMENT/OXYGEN FOR GIP/RESPITE PATIENTS– The group requested a technical change to the reporting forms to allow for reporting of DME/oxygen expenses on Worksheet A-3 and A-4. 

COSTING BY LEVEL OF CARE– The group requested guidance on reclassification of costs by level of care to address the inability of some hospice providers to separate direct patient care service costs by level of care. 

ALLOCATION OF GENERAL SERVICE COST CENTERS– The group addresses several issues of concern related to the general service cost centers.  These include issues related to Dollar Value, Nursing Administration, Staff Transportation, Pharmacy, Medical Supplies (routine and non-routine), the Order of Allocation, and Requests for a Change in the Order of Allocation and Statistical Basis. 

ENHANCING THE ACCURACY OF COSTS FOR INPATIENT FACILITIES – The group requests that hospices be permitted to segregate costs incurred by freestanding inpatient facilities from those incurred for other facilities.

PS&R – In light of the new two-tiered payment system, the group requests improvement to the statistics provided in the PS&R.

REPORTING VACCINE COSTS – The group requests that hospices be advised by CMS through instructions to the cost report that vaccine costs should be considered non-allowable costs.

MAC REVIEW OF SUBMITTED COST REPORTS – The group makes recommendations related to reviews by Medicare’s Administrative Contractors (MACs) of submitted hospice cost reports.

The letter has been submitted to appropriate members of CMS’ Division of Cost Reporting and the HHFMA experts group has requested a meeting to present its concerns, recommendations, and rationale to the staff at a mutually agreeable time.  NAHC will keep members posted on developments in this area by way of NAHC Report.

Special thanks go to the following individuals who participated in development of the recommendations for CMS:

Mark P. Sharp, CPA, BKD LLP, Chairman, HHFMA Board of Directors

Dave Macke, CHFP, FHFMA, Von Lehman CPA and Advisory Firm, and Chair, HHFMA Payment and Reimbursement Committee

Thomas Boyd, MBA, CFE, CHFP, Simione Healthcare Consultants, LLC

Ted Cuppett, CPA, The Health Group, LLC

Tony James, Hospice Compassus

Maureen Laskowski, Simione Healthcare Consultants, LLC

Gary R. Massey, CPA, CliftonLarsonAllen LLP

Emmy Nteziryayo, Hospice Compassus




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