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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


Small Acts of Gratitude

By Tony D’Antonio


Through three simple words we can inspire, energize, and unleash the power of our staff and also be truly grateful for the people and blessings in our lives.Recently this idea came to my attention after spending some time with the CEO of a leading home care and hospice provider. He was troubled and genuinely concerned about two primary issues: employee engagement and turnover. He sensed that the two issues contributed to a general slowdown in both admissions and census, and he thought his problem of engagement and retention would be solved by enriching the marketing representatives’ compensation program. Having heard about this issue all too many times before, I was reminded of Ground Hog Day, the movie where Bill Murray wakes up every morning to find the same day repeating itself over and over again. Unfortunately I got to play the lead roll in this drama after hearing the story over and over again.

“Let me take a wild guess,” I said with confidence before hearing the entire story. “You are having a difficult time in finding, keeping, and motivating good employees. Your admissions are slowing and your census is down.”

“Yes,” the CEO emphatically responded,“We have an employee engagement and retention issue that is leading to an abnormally soft year relative to admissions and census growth…”

“And you are thinking of what strategy to keep your employees satisfied and grow your census?”

The CEO responded, “We are thinking about giving more of an incentive to our marketers to find hospice patients. We are thinking that if the marketers had more of an incentive that it would grow our admissions and keep everyone happy.”

Having a great deal of respect and admiration for this experienced and savvy executive I went out on a bit of a limb and said, “So, you really think that throwing money at the problem will enable a fix?”

He asked if I had any other suggestions to engage employees, keep them, and ultimately grow his organization.

The answer I gave him was heartfelt, honest, and direct: “I use three simple words.”

Eagerly he awaited the magic words, transfixed as if I was a guru bringing ultimate wisdom and enlightenment. A heavy silence filled the entire office until he finally guessed, “You mean, I love you?”

Embarrassed, I responded, “Not quite, although Herb Kelleher, the mastermind behind Southwest Airlines, was rumored to have kissed his staff member Ed Stewart when he turned down a great offer from a competitor.” He may have said “I love you,” but with the political correctness of 2014 I meant “thank you” (insert the employee's first name here).

What astonished me next was a flurry of note taking and head nodding. “So all I have to do is say ‘thank you?’ No, really, what else will attract and retain employees?”

Given the response I stated “let’s just start here” as I hit the rewind button to explain that the basic principles of courtesy, respect, and appreciation for small things in our lives can dramatically transform both us and our employees.

So how can we pull off a simple thank you? Start simply with the purchase of some nice note cards with either your name or monogram embossed on both the card and envelope. Stay away from company stationary and make it personal. Make sure that the handwritten thank-you note has the person’s name spelled correctly; makes mention of the reason for the thank you; and states why this person’s contribution, ideas, or hard work had an impact.

Also make sure to send it in a timely manner. Nothing is more irritating to a recipient than to have an empty thank you sent weeks after the event. It looks contrived, hollow, and manipulative. My dear friend, next door neighbor, and hospice volunteer was asked once if it was really necessary to mail a handwritten thank-you note with an actual postage stamp affixed rather than a quick email or phone call after receiving a gift. She quite boldly said that the person spent hours shopping, thinking about, and paying for a thoughtful gift. Is it so hard to spend five minutes of your time to say thank you? The answer was both embarrassing and all too obvious.

An in-person thank you is also a meaningful gesture, especially if someone higher in rank takes the time to meet with the person, either at an employee recognition event or, better yet, makes a special trip to the branch or office. Coming to the office, unannounced, to celebrate a milestone has impact, too. Invite the employee’s family to the event and you have memories to last a lifetime. As Tom Peters once said, “People don't forget kindness.” However, one caveat in the approach is worth mentioning here. Understanding the person and how they will react to any public thank you is necessary. That means a little homework on your end. For example, extroverts will love the attention; introverts will cringe and may feel embarrassed, especially in front of their peers. Analytics will want to have the facts and details, and creative or conceptual thinkers may like a little offbeat thank you. Just know your audience.

In the age of such political correctness, I am sure that any type of touching is off the grid right now. However, who cannot think back to recent examples of President Obama’s shoulder holding, or John Kennedy’s double-handed handshake? An emotional and intimate thank you coupled with appropriate and warm gestures is a powerful connector to other human beings. We work in this environment every day with our patients. But if this is unnerving, think fist pumps, high fives or just a huge, beaming, genuine smile.

Notice that I have not used email as a proper thank you. That’s because it is electronic, easy, and quick, offering the most in convenience for the writer and the least amount of impact for the receiver. Again, let’s personalize our approach. We work in a high-touch and intimate industry. Make it memorable and make it real. However, a phone call into a branch or office meeting is a good solution to thank an employee publicly with a human touch.

Let’s face it. We don't do this type of work for money. We do it because we believe in it and know the positive impact it has on both patients and families. That is why I struggle with the concept of paying more money to caregivers since I don't believe that is the primary motivator. Should we pay fairly, even above market rates? Yes. Although money isn’t everything, it helps to attract and retain high-performing individuals. At the same time, cash, prizes, and gift cards do not provide any intrinsic value and can be detrimental in the long term. Having run many sales and business development organizations, I can say with 100 percent certainty that the short-term gain builds expectations of a future rewards, usually with a higher payment or more exotic trip. I also know that some of my staff members find any type of incentives to be insulting and out of line with their values.

After a great deal of discussion with my friend, the CEO of that major home care and hospice, the question still lingered: “What else can we do to attract, retain and inspire our employees, given our small budgets, besides say thank you”?

Dank Je, Merci, Toda Rabah, Grazie, Danke all say the same thing but in different languages and as you may have surmised it is thank you. Saying thank you in any language will work if it is sincere, well timed, and specific. Write one thank-you note, every day, to anyone in your company and the blessings from that simple note will come back to you tenfold. However, there are some tools in my toolbox that you can borrow that are a variation of thank you. They don't cost a lot, but like any tools, choose the right one for the job. No matter what you do or how often you say thank you, it cannot help if your organization is not grounded in basic tenets of human dignity, respect, and ethics. Having just returned from Vegas, I like to call these values table stakes.

Thank you and the on-boarding process. Many organizations have web sites, brochures, and materials that scream a certain culture. What do yours say? Many clinical and non-clinical staff members are attracted to slogans such as “it’s all about care, compassion, our people, our guiding vision and culture.” However, once you are in the organization, reality sets in after a poor experience of on-boarding. Nothing says more to a new employee than thanks for joining our company and as we say in Chicago, we’re glad that you are here

Thank you during the employee attraction process. Research has consistently proven that people leave companies because they do not feel valued by their boss or by their organization. Create happy and content employees who feel valued and they will, in turn, find others to join the team. Simply saying thank you to your employees increases the odds that your employees will feel valued and spread the word that this is a great culture to work in.

Thank you and why the suggestion box never has anything in it. Checked the employee suggestion box lately? Rather than a box that is emptied monthly and sanitized of any politically incorrect or inflammatory remarks and read at the staff meeting, why not actively seek out complaints or comments daily and thank people for the courageous act of speaking up?

Thank you and I really want to know what my people think of our company and how we can improve. Outside the usual party line of we have a great culture, passionate people, and caring individuals, what would your employees really say, given the chance? Here’s a solution. Invite six people to have breakfast with the CEO. Listen, really listen at an active level, meaning that you probe, focus, and ask questions that invite dialogue. Avoid, at all costs, being defensive, making excuses, or placing blame. Watch your body language and remain open. Thank the participants after the meeting and take action.

Thank you and little things say a lot during pot luck Friday. Breaking bread with the staff is fun, intimate, and sometimes even nutritious. Keep it family style. Rather than ordering out, try another spin and “bring a dish to pass.” Even more interesting is an outside BBQ hosted by your leaders in the parking lot.

Thank you and working at the car wash. One of the most interesting thank-you actions that I had the pleasure of observing was when an executive thanked his inside sales staff by washing their cars in the company parking lot. Talk about fun and different.

Thank you and here’s a small gift at Sheriff Tony’s BBQ blast. During one very long and hot summer season, the staff was getting the summertime blues due to staffing issues. So we kicked off a summertime program by sending each employee a bottle of my personal BBQ sauce, a note that said thank you, and a challenge to hang tough during the summer. I was amazed at the positive response and laughs over my picture on the jar of sauce.

Thank you in the name of. One clever executive noticed that one of his clinicians felt bribed and manipulated when they received a gas card or Target card. She did something totally different and contributed $50 in the clinician’s name to a local animal shelter after hearing about how this nurse worked at a local no-kill shelter.

Thank you and the James Brown Principal. I feel good. It’s pretty simple. People who feel good about their work, contributions, and environment look forward to Monday morning. How many of you practice saying “I feel good?” If you knew what it does, I know that you would.

Thank you and get an early start to your time off. When our staff is overly stressed and a holiday is coming up, we frequently let people go home earlier or get a couple hours head start on their vacation. Want to really make a thank you work? Plan to have a bottle of champagne or flowers sent to the employee’s home or hotel upon check in. Just say “THANKS and enjoy yourself!”

Thank you and servant leadership. Take this a step further by serving your staff lunch, ice cream sundaes, or any other meals at the potluck. Again, one of my favorite and irreverent motivators, Herb Kelleher of Southwest, has been known to serve as a flight attendant and serve drinks on a plane. If he can do it, you can do it. Surprised flight crew and passengers never forgot this act or gratitude.

Thank you and purging Friday or Major Tom to ground control. During a particularly stressful time, I invited my staff to participate in a “purging” Friday where they could dump whatever they wanted on me for 15-20 minutes on the phone. I listened and acknowledge the issues and said a prompt thank you and I appreciate YOU. It worked wonders in defusing difficult situations.

Thank you and here’s more training for you. Have a great employee who thrives on learning? Send them out for a day to Skill Path, or have them attend a conference and get CEUs. People don't care that you know; they know that you care. Thank them and send them out for more training to make them more confident and more effective.

Thank you and giving back to the community. Organize a walk for Alzheimer’s, American Cancer Society, or even spend a night working as a team in a soup kitchen. It will make you all appreciate each other.

Thank you, but really I don't have time for this. No time to find one person a day to thank? If you are that busy, try sticky notes. If fact, in one organization, I observed dozens of thank-you notes on multi-colored sticky pads applied to every square inch of a supervisor’s office. They were simple thank-you notes or inside jokes.

Thank you and the undercover boss. We’re not talking quite at the television show level where the CEO goes undercover to work a day in the life, but sort of. Ride a day with your staff, and watch everyone who takes care of your patients and clients. At the end of the day thank them and rest assured that your referral sources would be thanking YOU for having such as a compassionate nurse or aid taking care of their patients. It will ground and focus you on the hospice and home care mission.

Thank you and special awards. ABCD, or above-and-beyond-the-call-of-duty, cards were dropped into a box every day to recognize employees. At the end of the month they were publicly read in front of the entire staff.

Thank you for letting me be myself again. (Thanks to Sly and the Family Stone) Celebrate diversity and the depth of thought that all employees can bring to the problems we face every day. Encourage mistakes, fast, furious and well intended, so people can live in a non-punitive and risk-taking work environment. Encourage the mistake of the week by thanking and celebrating the Golden Gaff of the week or say thank you during a Golden Pig Award Ceremony. We have often used our staff meetings to celebrate mistakes or funny moments by awarding the Golden Pig (a spray-painted small ceramic pig) to the person who has had the craziest idea or taken a risk to serve customers, referral sources or patients. This gesture of thanks makes it “safe” to take risks and think outside the box. Again, it’s another time to say thank you and make the environment fun, positive, and vibrant.

Thank you and special recognition. As mentioned before, a staff member’s entire family can share in the celebration. However, if this is not practical, or for a totally different option, consider sending a note home to the person’s significant other or their family outlining how you appreciate the employee’s contribution. A nice touch would be flowers, candy, or any other mail-order treat.

Thank you and what it can do for the boss. Simple acts of kindness and three little words are what it’s all about. Making others feel happy, good about themselves, and proud of their contributions reminds us all to slow down and get centered on what truly matters.

Thank you, too, for listening to me today. Let me share a

Gratitude Prayer…

Be Thankful
Be thankful that you don’t already have everything you desire,
If you did, what would there be to look forward to?

Be thankful when you don’t know something
for it gives you the opportunity to learn.

Be thankful for the difficult times.
During those times you grow.

Be thankful for your limitations
because they give you opportunities for improvement.

Be thankful for each new challenge
because it will build your strength and character.

Be thankful for your mistakes;
they will teach you valuable lessons.

Be thankful when you’re tired and weary
because it means you’ve made a difference.

It is easy to be thankful for the good things.
A life of rich fulfillment comes to those who are
also thankful for the setbacks.

GRATITUDE can turn a negative into a positive.
Find a way to be thankful for your troubles
and they can become your blessings.
~ Author Unknown ~

About the Author: Tony D’Antonio is a senior business development leader and veteran alternate site provider. His articles about servant leadership and business issues impacting hospice, home care, and health care providers have appeared in several publications. Currently he is the senior director of business development for Sodexo.

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