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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

Heath 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

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


Transforming Your Agency into a Professional Sales Organization

By Melynda Lee


If you could quickly implement one change inside your agency that would ensure a substantive increase in census, ALOS, and ultimately your overall profitability, what would it be? More clinical staff? A new program? An expansion in your service area’s footprint?

As the post-acute care industry’s leading sales and growth solution, we often see the answer eluding many providers due to years of industry culture passed from leadership down through the ranks of organizations. By downplaying the value of a strong sales department, home health and hospice agencies tend to rely on year-over-year growth to survive.

Deep and systematic rate cuts over the past few years have only exacerbated this issue and forced the industry to place greater focus on growing in a financially healthy manner. As reimbursements continue to decline while the demand for quality care skyrockets, meager margins can only be produced through reductions in force and expenses for predictably short periods. Agencies that keep cutting back may gravely sacrifice the quality standards and reputation they have built over years, if not decades.

No one intentionally sets their organization up for flat or negative financial results, but home health or hospice leaders often fall into the trap of doing what they have done before. Instead, they simply must position their agencies for the future by stepping away from legacy hiring practices where business development is concerned.

The key to avoiding this trap is to invest in resources that deliver quality lead generation, engender professional trust and confidence through use of reliable and current data, and consistently convert referrals to admissions. The practice of hiring “marketing” staff purely on built-in networks is now destined to fail. Succeeding in today’s highly competitive marketplace requires strategic thinking in your hiring decisions and a far more sophisticated approach to leveraging information. This means agencies must look outside traditional places for sales personnel from within the post-acute sector, and instead prioritize professional sales skills, even if that means recruiting from nontraditional verticals where these skills are typically more prominent.

“Having a lot of contacts doesn’t necessarily make you a great salesperson,” says Robin Finkelstein, founder and president of Market Insight, a national consulting firm specializing in home health and hospice marketing. “Somebody with a successful track record in sales in any referral-based environment makes a much better sales professional.”

Building Your Professional Sales Team

Smart home health and hospice leaders are starting to invest in talent across their organizations, especially when it comes to building exceptional sales teams that truly drive census growth. While you may think only for-profit conglomerates have the means to accomplish this, any health care provider can achieve success by recruiting professional sellers and providing them with the tools, data, and training necessary to grow the organization.

The first step is certainly the most difficult. Health care organizations must train their staff to think of referral sources as customers just as businesses in any other sector would. Building a sales culture in the health care environment often seems counterintuitive to people who commit their lives to caring for others. Expect to be met with some resistance within your agency and board of directors, especially if you run a nonprofit organization. The best course of action is to identify champions among both groups and arm them with undisputable facts. Be prepared to emphasize why it’s important to put greater focus on organic growth rather than cost containment or reduction. Be empathetic, but firm, in your commitment to this critical and necessary change.

Then take action! You may consider using a recruitment professional, sales consultant, or your business network to look for top sellers who already demonstrate the skills you need most to bolster an increase in the number of quality referrals made to your organization.

Focus on more than the relationships they bring to the table, and confirm they understand what it means to be a professional salesperson. Their qualities should include the ability to concisely articulate the company’s messaging and competitive differentiators, knowledge of how to interpret and leverage data to identify opportunities, and understanding of how to distinguish between referral sources that are worth a significant investment of time and those that are not. Don’t limit yourself to the post-acute care arena. Be open-minded and cast a wide net. Great salespeople are capable of crossing industries and cultures, and they are motivated by measurable results.

As a former EVP of business development with a large hospice organization, I looked for candidates from industries I knew were metric-driven, steeped in sales training, and committed to hold sellers accountable for producing financially compelling results. While most of my team came from related lines of business as was the expected practice at that time, those who had been successful selling pharmaceuticals, media, and even real estate knew how to identify leads and qualify prospects, sell with data, and close using a consultative approach that secured relationships with referral sources. While we all know managing our existing relationships is certainly important, recruiting new referral sources is the lifeblood of growth and the key to the financial health of any post-acute provider.

Many salespeople rely on food, pens, pads, and drop-in visits to maintain relationships or get in the door. Professional sales organizations in post-acute care are replacing these ineffective and cost-wasting techniques with hard facts that demonstrate the value of their agencies’ programs and services to their prospects. They seek out and use their resources wisely.

During your search, stay focused on these top traits of highly successful salespeople and be selective:

  • Confident
  • Results-driven
  • Consultative
  • Disciplined
  • Naturally curious, intent listeners, great communicators
  • Intelligent and eager to learn
  • Able to grasp concepts and articulate value
  • Resilient
  • Empathetic

Next, be prepared to implement an incentive plan that truly motivates your salespeople to not only work hard, but work smart. For a plan to be truly effective, it must motivate your sellers to do the things necessary to grow the business. Truly great salespeople expect to be recognized — both financially and emotionally — for their efforts. You won’t attract the level of sales talent you need to produce significant growth unless you make this commitment and structure it around your growth goals. If you expect them to recruit new referral sources, then recognize that this is harder work with much greater long-term value to the organization, and pay your sales staff accordingly.

Consult with your leadership team and legal counsel before rolling out an incentive plan if you have questions or concerns, and look for tools to help you track the return on your investment in sales personnel and programs, while simultaneously pushing them to the places where they can be most successful.

“When we developed the incentive compensation module for HomecareCRM, we had in mind agencies that needed a way to monitor the referral pipeline while measuring sales activities and performance,” said Keagen Brown, senior vice president of product and strategy with HomecareCRM. “Our clients have found that once they begin the shift to a sales-oriented culture, the need for accountability metrics and recognition of sales success housed in one system is quickly accelerated. The change in the behavior these plans drive in our clients’ sales teams ultimately redefines what levels of census growth are possible.”

Measuring Your Sales Team’s Results

What does sales success look like to your agency? Engage your leadership team in this conversation early in the recruiting process. Establish and communicate the key performance indicators (KPIs) most critical to your organization’s success. They will likely be related to census, ALOS, and ultimately ROI. While these KPIs represent the overall health of your agency and the type of referrals your sales team is delivering, it’s important to measure the results of the behavior, training, and satisfaction of your sales team to ensure your program’s continued success.

Consider what motivates your sellers and what a day in the life of a salesperson looks like. Then put metrics in place to answer these questions:

Have you provided the best tools? Do your salespeople have timely marketplace data to study the competitive landscape?

If your sellers have mobile devices (and we suggest they do), are the devices synced properly? Are they using the most current application? Are the salespeople using the devices effectively to prepare for sales calls and document activities? Are the appropriate devices being optimally leveraged for the relevant tasks?

When was the last time your sales team had credible and meaningful training with impact? Was it relevant? What evidence exists that it’s being applied in the field? Was it delivered by experts who truly understand the need for a professional sales culture?

What is the composition of your referral pipeline? What is the mix of your patient population, payor sources, and referral sources?

How many times is a salesperson calling on a referral source to generate a referral and what is the real potential of that prospect? How many of those referrals are converting to admissions? These should be measured by salesperson, territory, and referral source. Include NTUCS in this analysis and look for trends. Do you frequently see your referrals migrating to the same competitor over your agency?

Talk with your financial team in terms of measuring the ROI of your sales and marketing investment. You should consider cost per case, as well as margin generated by salesperson, service line, referral source, patient, diagnosis, and payor. They can also be a strong ally in determining the factors of your incentive compensation plans since they are in the best position to understand the financial challenges of the organization. This area of partnership is often neglected by providers in today’s market.

Measure and look for trends relative to the retention and turnover of your sellers, but don’t be afraid to hold your salespeople accountable for producing results. Just because they’ve built vast networks of contacts doesn’t mean they are focused on employing the best techniques to grow the business. Be committed to making adjustments as necessary. We tell our clients the cornerstone of CRM is managing the data associated with the activities and results of relationships with referral sources. Dashboards and reports help managers monitor what the sales staff is accomplishing in real time, but the history of the relationships is there for perpetuity.

Nurturing Your Sales Team for Continued Success

Coaching and training your sales staff should be a daily priority proctored by your leadership team. Salespeople crave feedback and assurance that their efforts are truly supporting your organization, as well as helping those your organization cares for in the community. Ensure that your sales team has a strong manager who will not only hold them accountable, but will promote opportunities for professional development and learning, recognition of accomplishment, and career path planning.

Include your salespeople in your agency’s strategic planning process. After all, they are face-to-face with your customers more than any other employees in your organization and know the critical details about your marketplace. Ask your sellers to present data supporting their ideas and be sure they know how to use it to make the case for additional change or investment.

Ensure your salespeople have the most sophisticated tools at their disposal like predictive modeling using market data, giving your stakeholders insight into referring practices, market share, demographics, diagnosis mix, patient mix, and ROI to help your agency develop a superior sales and marketing program that drives real, sustainable growth.

And in closing, to be successful, the confidence and loyalty of the referral source MUST be with the service provider rather than the individual salesperson. This is the topic of our next article in this series dedicated to helping you professionalize your sales force.



About the Author: Melynda Lee is the Vice President of Marketing and Public Relations with HomecareCRM and a former hospice executive. HomecareCRM is the leading premier growth partner of post-acute care providers. Melynda can be reached at or 404-314-0431.







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