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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 Its November Home Health and Hospice Open Door Forum

November 7, 2015 09:38 AM

The Centers for Medicare & Medicaid Services (CMS) held its Home Health, Hospice & DME Open Door Forum on November 4, 2015. A summary of home health and hospice issues are provided below.  

2016 Final Rule for the Home Health Prospective Payment System (HHPPS) Rate Update 

CMS officials provided an overview of the 2016 final rule for the HHPPS. The rule implements the third year of the four year phase-in of the rebasing adjustments to the HHPPS payment rates as required by the Affordable Care Act.  In addition, CMS will decrease the national, standardized 60-day episode payment amount by 0.97 percent in each year for CY 2016, CY 2017, and CY 2018 to account for nominal case-mix growth between CY 2012 and CY 2014. CMS estimates that the net impact of the payment provisions of the final rule will result in a decrease of 1.4 percent ($260 million) in Medicare payments to HHAs for CY 2016.  

Home Health Value-Based Purchasing (HHVBP) model 

Effective 1/1/2016, a HHVBP program will be implemented in 9 states: Massachusetts, North Carolina, Maryland, Florida, Washington, Arizona, Iowa, Nebraska, and Tennessee. All certified agencies within the state will be required to participate in the HHVBP program. In the final HHPPS rule, CMS modified the maximum payment adjustment percentage range from 5% - 8% to 3% - 8%, which will be phased-in over the length of the program. The selected measures were decreased to 24 from 29. Four process measures and one of the new measures have been eliminated.

CMS recommend participating agencies begin selecting a contact person for the HHVBP program and submit the contact name, phone number, email address and associated agency CCN number to In addition, agencies may submit question regarding the HHVBP program to the same email address or dial 844-280-5628.    

CMS will hosting a webinar on the HHVBP program on Dec. 2, 2015 from 2:00pm - 3:00pm EST. Details on the webinar will be announced on the CMS website and the CMS learning email list.

Home Health Quality Reporting Program

CMS finalized one measure under the skin integrity domain required by the Improving Medicare Post Acute Care Transformation (IMPACT) Act. National Quality Forum (NQF)-endorsed measure: Percent of Residents or Patients with Pressure Ulcers That Are New or Worsened (Short Stay) (NQF #0678) will be included in the HHQRP with the measure reporting period beginning in 2016 impacting payment year 2018. 

CMS also finalized an 80% Pay-for-Reporting Performance Requirement for Submission of OASIS Quality Data for Year 2 reporting period July 1, 2016, to June 30, 2017, and a 90%  Pay-for-Reporting Performance Requirement for Submission of OASIS Quality Data for the reporting period July 1, 2017, to June 30, 2018, and thereafter.

ICD-10-CM coding guidance

CMS is revising the ICD-10-CM translation list and adding certain initial encounter codes to the HHPPS Grouper based upon revised ICD-10-CM coding guidance. Based upon the 2015 revised coding guidance, certain “initial encounters” codes are appropriate when the patient is receiving active treatment during a home health episode. The HHPPS Grouper logic will be revised to award points for certain initial encounters codes for M0090 dates on or after 10/1/2015. Agencies may resubmit claims for episodes affected by the revised coding guidance once the Grouper is revised. 

Home Health Compare (HHC) and Star Rating System  

Agencies that have questions related to HHC should contact the ASPEN coordinator for their state. The ASPEN coordinators and contact information can be found here.  

The next HHC update is scheduled for Jan, 21, 2016. This refresh will include the initial roll out of the HHCAPHS Star Rating. 

Claims Processing 

CMS clarified that the new G codes to distinguish between services provided by a registered nurse (G0299) and a licensed practical nurse (G0300) will be effective for dates of service on and after 1/1/2016. At that time, code G154 “Direct skilled nursing services of a licensed nurse (LPN or RN) in the home health or hospice setting” will be retired. For claims that span 2016, if  the service date is before 1/1/2016 G154 will used and for service dates on or after 1/1/2016 agencies are to use G0299 or G0300.  


The IMPACT Act requires the reporting of standardized patient assessment data with regard to quality measures, resource use, and other measures. It further specifies that the data be standardized and interoperable so as to allow for the exchange of data among post-acute care providers to facilitate coordinated care and improve Medicare beneficiary outcomes.

CMS announced opportunities for agency engagement related to the IMPACT Act measure development activities. CMS will post measures that are under development and public comment periods, along with announcements for Technical Expert Panel participation on the Measures Management System website. CMS is currently seeking public comments on the IMPACT Act measure for Potentially Preventable Readmissions for Skilled Nursing Facilities (SNFs), Inpatient Rehabilitation Facilities (IRFs), Long-Term Care Hospitals (LTCHs), and Home Health Agencies (HHAs). The measure description and specifications are located  here. Public comments are due November 16, 2016. 

In addition, the National Quality Forum, Measures Application Partnership will be holding a web meeting on November 13, 2015, from 2:00pm-3:00 pm EST. The web meeting is open to the public. To register go here

Hospice Issues: 

CMS encouraged hospice providers to review their HIS Final Validation reports in CASPER following submission of HIS records and to print and retain these reports as evidence of successful submission and processing of HIS records.  If the hospice finds that there is no Final Validation Report or there is a Final Validation Report with fatal errors, the HIS records were not successfully submitted and the hospice may not be in compliance with reporting requirements and may be subject to a 2% reduction in its annual payment update.

CMS reminded hospices that there are four new HQRP training modules available to assist providers in successfully submitting their Hospice Item Set admission and discharge records to CMS.  Each module provides helpful tips including submission instructions, top ten errors, how to access and review the hospice final validation reports, available CASPER reports and suggested uses, as well as where to locate useful technical documentation and QTSO help desk contact information. Providers may access each of the four modules in the downloads section here.

The next data submission deadline for the CAHPS hospice survey is November 11, 2015.  CMS suggested that all hospice facilities contact their vendors to be sure the vendor is ready to submit data.  Hospices should also check the Hospice Survey Data Warehouse to ensure the data was submitted successfully.  It is the hospice’s responsibility to ensure the vendor is submitting data on its behalf timely and that the data is received by CMS.  This can be checked through the Hospice Survey Data Warehouse.  If a hospice does not have access to the Warehouse, it can apply for credentials for access on the CAHPS hospice website at

The hospice CAHPS manual has been updated to V2.0 which can also be accessed on the hospice CAHPS survey website.  The CAHPS Hospice Survey XML File Specification V1.3 has been released and is available on the survey website as well.  The Specification manual is primarily for vendors and contains technical information.  Also primarily for vendors, but open to the public, was a training call for the CAHPS hospice survey on September 30, 2015.  The training slides from this call are available for reviewing or downloading from the CAHPS hospice website (link above). 




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