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All posts tagged with “Hospice Provider News | Orgs NHPCO NAHC NPHI etc.”
New House resolution would throw out 2025 home health rule
02/18/25 at 03:00 AMNew House resolution would throw out 2025 home health rule McKnights Home Care; by Liza Berger; 2/14/25 Rep. Andrew Clyde (R-GA) on Wednesday introduced a resolution for Congress to disapprove of the 2025 home health payment rule. The resolution was referred to the Committee on Ways and Means in addition to the Committee on Energy and Commerce. Home health providers and advocates have been pushing for Congress to stop the rule, which gives an aggregate 0.5% bump for home health providers but inflicts a permanent behavioral adjustment of -1.975%. ... In 2023, the National Association for Home Care & Hospice (now the National Alliance for Care at Home) sued the Department of Health and Human Services to block Medicare rate cuts.
Hospice leaders applaud CMS’s decision to reevaluate Special Focus Program, call for meaningful reforms
02/17/25 at 02:00 AMHospice leaders applaud CMS’s decision to reevaluate Special Focus Program, call for meaningful reforms National Alliance for Care at Home, Washington, DC and Alexandria, VA; Press Release; 2/14/25 Effective February 14, 2025, the Centers for Medicare & Medicaid Services (CMS) has ceased the implementation of the Hospice Special Focus Program (SFP) so that CMS may further evaluate the program. This decision is a positive move acknowledging that the current approach is not working as intended. The hospice community has long advocated for strong oversight and patient protections, but the SFP, as implemented, was deeply flawed, unlawful, and harmful to the very patients it was meant to protect. A multi-state coalition of hospices and hospice associations took legal action in January to challenge the program, citing its misrepresentation of hospice compliance records, misleading data, and jeopardized access to high-quality end-of-life care. The flawed algorithm behind the SFP failed to distinguish fraudulent providers from reputable ones, disproportionately penalized well-established hospices, and ignored repeated warnings from congressional leaders and industry stakeholders. ... Now that CMS is reassessing its approach, there is an opportunity to ensure that oversight efforts truly enhance patient protections without restricting access to trusted hospice providers. The National Alliance for Care at Home (the Alliance) and the National Partnership for Healthcare and Hospice Innovation (NPHI) remain committed to protecting access to high-quality hospice care and ensuring that regulatory oversight is fair, transparent, and aligned with congressional intent. ... [Click on the title's link to continue reading.]
Former NAHC Leader Dombi joins Arnall Golden Gregory LLP
02/05/25 at 03:00 AMFormer NAHC Leader Dombi joins Arnall Golden Gregory LLP Home Health Care News; by Joyce Famakinwa; 2/4/25 Bill Dombi, former president and CEO of the National Association for Home Care & Hospice, has joined law firm Arnall Golden Gregory LLP. Dombi will serve as senior counsel in the firm’s Washington, D.C. office. He has over four decades of experience spearheading major litigation and policy matters for the home health and hospice industry. ... Dombi first stepped into the role of NAHC’s vice president for law in 1987. He became NAHC’s interim president in 2017, and was named the association’s permanent president the following year. Throughout his time at NAHC, Dombi was a key player in the advancement of the home health and hospice industries. He officially retired from his role at NAHC at the end of 2024. The association also merged with the National Hospice and Palliative Care Organization, and is now known as the National Alliance for Care at Home.
3 lessons for living well, from the dying
02/04/25 at 03:00 AM3 lessons for living well, from the dying DNYUZ; 1/31/25 What if you knew that you were at the end of your life? Would you have done anything differently? A friend of mine volunteers at a hospice, and she hears one regret over and over from patients: letting relationships wither. They wish that they had made more plans with good friends, or they thought about getting back in touch with an old buddy, and talked themselves out of it. ... Dr. Vicki Jackson, president of the American Academy of Hospice and Palliative Medicine Board of Directors, said that for the same reason, she doesn’t hesitate to tell people that she loves them. “I am not Pollyanna; I’m a big academic,” said Dr. Jackson, who has treated dying patients for a quarter century. “But I tell people I appreciate them a lot. I have a lot of deep gratitude, because I know it is dumb luck that it’s not me in that bed. And I know tomorrow it could be.” I asked Dr. Jackson and other palliative and hospice care experts about what they’ve learned from patients. They offered advice that you can apply to your life, from those at the end of theirs.
Reflection on the Potomac River Crash
01/31/25 at 03:00 AMReflection on the Potomac River Crash Hospice & Palliative Care Today; by Joy Berger, Editor in Chief; 1/30/25We are absorbing unfolding news about Thursday night’s tragic plane and helicopter crash at the Potomac River. As with many of you, I’m flooded with memories of flying in and out of this same airport: gazing out the plane’s window to delight in DC’s historic sites; delighting in the diversity of my fellow travelers and whatever their stories might be. Many of these Washington DC trips were to be with our hospice and palliative colleagues at the (then) NHPCO Conferences or other related meetings. Today, I’m grateful for our safe journeys then. Today, I hope for renewed connections: the joy of each person’s unique life-journey; the relationships we’ve developed in moments at meetings, meals, and follow-up communications; the sacredness of this profound work we are privileged to share. And—with these current Potomac River tragic deaths—we are reminded of icy currents of own traumatic losses. For me, I’m struck with the pains of a beloved family in my childhood’s home church, whose adult son was killed in the 1982 Potomac River plane crash; with the heart-wrenching death of my grandfather when he was killed by a drunk driver; and more. For you? As news continues to unfold, may we treasure anew the unknown measure of our time on this earth. Of our connections with each other—whatever our differences—profit or nonprofit, political, and more. May we sensitively tune into the life-altering traumas carried within those we serve—and the healing compassion we can give. Humbly, Joy
Teleios announces addition of Hospice of Davidson County
01/27/25 at 03:30 AMTeleios announces addition of Hospice of Davidson County Teleios Collaborative Network (TCN); by Tina Gentry; 1/24/25 Teleios Collaborative Network (TCN) announced the addition of Hospice of Davidson County as an associate member. Established in 1985, Hospice of Davidson County is an accredited end-of-life healthcare provider in North Carolina serving residents with hospice care in the greater Davidson County community, from Lexington, Thomasville, Welcome, Midway, Arcadia, and other surrounding counties, including Davie, Forsyth, Guilford, Randolph, and Rowan. Notable mentions: Laura Owen, Hospice of Davidson County CEO and Chris Comeaux, Teleios Collaborative Network President/CEO
Diana Franchitto named Board Chair as the National Partnership for Healthcare and Hospice Innovation celebrates 10 years
01/17/25 at 03:00 AMDiana Franchitto named Board Chair as the National Partnership for Healthcare and Hospice Innovation celebrates 10 years National Partnership for Healthcare and Hospice Innovation (NPHI), Washington, DC; 1/14/25 The National Partnership for Healthcare and Hospice Innovation (NPHI) proudly announces Diana Franchitto, President & CEO of HopeHealth, as the new Chair of its Board of Directors. A visionary leader in hospice and advanced illness care, Diana steps into this role as NPHI celebrates a decade of driving high-quality nonprofit care and innovation. “As we celebrate a decade of impact, we are thrilled to welcome Diana as the new Chair of our Board of Directors,” said Tom Koutsoumpas, CEO of NPHI. “Her deep commitment to community-based, nonprofit care and her proven leadership make her uniquely qualified to help guide NPHI into this next phase of growth and innovation. I have tremendous respect for Tom and our members’ vision for NPHI, and I’m thrilled to work closely with Tom and our entire NPHI leadership team to bring that vision to life,” said Diana. “It’s an honor to serve as Board Chair during this pivotal moment as we celebrate our first decade of impact. I look forward to collaborating with our members and Board to advance the incredible work our nonprofit hospices deliver every day. Together, we will shape the next chapter of compassionate care and champion innovative, community-driven solutions that prioritize the needs of patients and families nationwide.”
NPHI supports lawsuit to ensure proper implementation of Hospice Special Focus Program
01/17/25 at 02:30 AMNPHI supports lawsuit to ensure proper implementation of Hospice Special Focus Program National Partnership for Healthcare and Hospice Innovation, Washington, DC; Press Release; 1/16/25Today, a lawsuit was filed by the Texas Association for Home Care & Hospice; Indiana Association for Home & Hospice Care; Association for Home & Hospice Care of North Carolina; South Carolina Home Care & Hospice Association; and Houston Hospice. The lawsuit challenges CMS’s implementation of the hospice Special Focus Program (SFP) as unlawful and arbitrary. We acknowledge that Houston Hospice, an NPHI member, is one of the plaintiffs in this legal action, and we are committed to supporting them and others impacted by the SFP or the accompanying excel files. The hospice Special Focus Program (SFP), conceived and passed on a bipartisan basis as a part of the HOSPICE Act in 2021, was designed to address poor-quality hospice providers by offering them additional support and technical assistance to ensure compliance with the Medicare Hospice Conditions of Participation. NPHI is extremely disappointed that CMS has departed from that Congressional intent, transforming the hospice SFP into a burden for many well-meaning hospices, with an algorithm for identifying providers based on inaccurate data and including elements that are not referenced in the statutory language. ... NPHI fully supports the litigation filed today, which aims to direct CMS to comply with the spirit and intent of the statute and regulations. [Click on the title's link to continue reading.]
The Alliance on CMS Hospice Special Focus Program Implementation: “Doubling down on a dangerous decision, eager to work with incoming administration to fix”
01/17/25 at 02:15 AMThe Alliance on CMS Hospice Special Focus Program Implementation: “Doubling down on a dangerous decision, eager to work with incoming administration to fix” National Alliance for Care at Home, Alexandria, VA and Washington, DC; Press Release; 1/16/25 The National Alliance for Care at Home (the Alliance) issued the following statement in response to the news of hospice providers filing litigation against the Centers for Medicare & Medicaid Services (CMS) over their flawed implementation of the Hospice Special Focus Program (SFP). The Alliance and the broader hospice community, who have been engaged on this program since its inception, have repeatedly shared concerns directly with CMS staff at all levels. They warned that this approach would inflict unnecessary harm to patient care, cause confusion to families when selecting a hospice provider to care for their loved ones at the end of life, and will cause some providers to sustain irreparable damage. These concerns have been echoed by lawmakers, providers, and the leading national hospice trade organizations. “With CMS doubling down on a dangerous course of action by proceeding with the Hospice SFP in its current state—and offering no due process or administrative recourse to address or mitigate its flaws—some hospice providers will suffer irreparable harm and have no choice but to seek justice through the courts on behalf of their patients and mission,” said Dr. Steve Landers, CEO of the Alliance. [Click on the title's link to continue reading.]
NPHI welcomes Robin Shultz as Vice President for Member Programs and Engagement
01/15/25 at 03:00 AMNPHI welcomes Robin Shultz as Vice President for Member Programs and Engagement National Partnership for Healthcare and Hospice Innovation (NPHI), Washington, DC; Press Release; 1/8/25 The National Partnership for Healthcare and Hospice Innovation (NPHI) is proud to welcome Robin Shultz, LCSW, ACC, ACHP-SW, to the team as Vice President for Member Programs and Engagement. With her proven track record of leadership and a passion for innovation, Robin’s expertise is set to deepen connections among our members and drive meaningful engagement at all levels. Robin brings significant experience in hospice and palliative care to NPHI. ... In her new role with NPHI, Robin will focus on strengthening member engagement, ensuring active participation across forums, and fostering deeper inclusion for member staff at all levels. Her efforts will build on NPHI’s mission to advance the work of nonprofit hospice providers, empowering them to deliver exceptional care and services to their communities.
2025 begins with growth: NPHI adds Hospice of Hope and North Hawaii Hospice
01/09/25 at 02:30 AM2025 begins with growth: NPHI adds Hospice of Hope and North Hawaii HospiceNational Partnership for Healthcare and Hospice Innovation (NPHI), Washington, DC; 1/7/25The National Partnership for Healthcare and Hospice Innovation (NPHI), the voice for nonprofit hospice and advanced illness care, is thrilled to commence 2025 by announcing the addition of two new outstanding members to our compassionate, mission-driven community: Hospice of Hope and North Hawaii Hospice. ... Tom Koutsoumpas, NPHI CEO remarked: “We are thrilled to welcome Hospice of Hope and North Hawaii Hospice to our mission-driven, innovative community. Their commitment to delivering compassionate, high-quality, community-based care reflects the core values of NPHI, and we’re excited to join forces in advancing innovative care for patients and their families.”
HPNA and HPNF announce 2025 Board of Directors
01/08/25 at 03:00 AMHPNA and HPNF announce 2025 Board of Directors HPNA and HPNF; Press release; 1/2/25 The HPNA 2025 Board of Directors consists of:
The Alliance celebrates the Dole Act becoming law, expanding access to care and benefits for veterans
01/08/25 at 02:00 AMThe Alliance celebrates the Dole Act becoming law, protecting burial benefits for veteransNational Alliance for Care at Home, Alexandria, VA and Washington, DC; Press Release; 1/7/25 The National Alliance for Care at Home (the Alliance) issued the following statement in response to President Biden signing S. 141, the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act, into law on Thursday, January 2. This landmark legislation includes Section 301, Gerald’s Law, which addresses a critical gap in benefits for Veterans. Gerald’s Law ensures that families of terminally-ill Veterans receiving Veterans Affairs (VA)-furnished hospice care—whether at home, in a nursing home, or in another non-VA setting—retain access to their full VA burial allowance. “We are deeply grateful for the bipartisan support of Gerald’s Law and its inclusion in the Dole Act,” said Dr. Steve Landers, CEO for the Alliance. “This legislation ensures that Veterans and their families can choose hospice care in the setting that best meets their needs without risking the loss of crucial burial benefits. We thank Senators Moran, Tester, and Hassan, Representatives Ciscomani, Bost, Brownley, and Takano, and many others for their leadership, as well as President Biden for signing this important bill into law.”
National Alliance for Care at Home, Transcend Strategy Group release hospice report
01/06/25 at 03:00 AMNational Alliance for Care at Home, Transcend Strategy Group release hospice report HomeCare, Alexandria, VA and Washington, DC; HomeCare; 1/3/25 The National Alliance for Care at Home (The Alliance) and Transcend Strategy Group, a marketing agency for homecare companies, published the results of their Rural American Hospice Insights report, a new study that explored perceptions of hospice care among rural and small-town communities. The Alliance said the survey, which included 400 participants, aims to provide health equity and break down barriers to accessing hospice and homecare through knowledge sharing, data collection and collaborative discussion. “Ensuring access to high-quality hospice and homecare in rural communities is critical,” said Steve Landers, CEO of The National Alliance for Care at Home. “These communities deserve care that is tailored to their unique needs, and in an America where more and more health care desserts are arising due to provider closures from inadequate reimbursement, maintaining quality care and continuing to build trust in the care provided is of the utmost importance."
[TCN] Year in Review for 2024 and One Word
01/03/25 at 02:15 AM[TCN] Year in Review for 2024 and One Word Teleios Collaborative Network (TCN); podcast by Chris Comeaux; 1/1/25 In this podcast episode, host Chris Comeaux does a recap of the top podcasts of 2024. First for TCNtalks with amazing guests like New York Times best-selling author John Burke, Peter Benjamin, Dr. Ira Byock, and Judi Lund Person. Chris then does a recap from our first year of our new podcast, Anatomy of Leadership, with great guests such as Quint Studer, Meridith Elliott Powell, John Locke, and Brian Jaudon. Additionally, Chris introduces the intriguing concept of the "One Word," which serves as a thematic or guiding principle for the upcoming year. This is a great piece of wisdom Teleios and many of its members practice every year.
Tributes to President Jimmy Carter
12/31/24 at 02:00 AMTributes to President Jimmy Carter
Statement on the passing of former President Jimmy Carter
12/30/24 at 02:00 AMStatement on the passing of former President Jimmy Carter National Partnership for Healthcare and Hospice Innovation (NPHI), Washington, DC; by Matt Wilkinson; 12/29/24 With profound sadness, Tom Koutsoumpas, CEO of the National Partnership for Healthcare and Hospice Innovation (NPHI), the leading advocate for not-for-profit advanced illness, hospice, and palliative care providers, today released the following statement on the passing of former President Jimmy Carter: “With heavy hearts, NPHI joins the nation in mourning the passing of former President Jimmy Carter — an incredible statesman and humanitarian. His long and impactful life, spanning almost a century, is reflective of a steadfast dedication to service. As a Nobel Peace Prize recipient, he will be remembered for his persistent efforts in seeking peaceful solutions to conflicts, advancing democracy and human rights, and promoting economic and social development. When President Carter chose to receive hospice care in his hometown of Plains, Georgia, he and his family made the decision that countless others do — to receive care in the comfort and solace of their homes, surrounded by the love and support of family. President Carter’s nearly two-year journey in hospice care highlights its profound value, challenging the misconception that hospice is solely for the final days of life. His experience illustrates how hospice can provide comfort, dignity, and compassion for those navigating life’s final chapter. Our heartfelt condolences are extended to the entire Carter family and to those who drew inspiration from his life’s extraordinary work.”
CMS names first Hospice Special Focus Program Cohort, delays list of future candidates
12/26/24 at 03:00 AMCMS names first Hospice Special Focus Program Cohort, delays list of future candidates Hospice News; by Jim Parker; 12/23/24 Finalized in the 2024 home health payment rule, the program is designed to identify poor performing hospices, mandate quality improvement and in some cases impose additional penalties. However, stakeholders in the hospice space have contended that the agency’s methodology for selecting hospices for the program is deeply flawed. For this reason, they have argued that the list of operators should not be made public. Though CMS published the list, it delayed the release of a second that would point to future candidates for the program. “CMS has also generated a list of future SFP candidates. We are not publishing the candidate list at this time, but we are sharing the underlying data used to create both lists to allow for external review, thereby ensuring transparency in the process by which low-performing hospices are identified,” the agency indicated on its website. “We will continue to work with providers, patients and their families, and industry, to improve hospice care across the nation.” Stakeholders applauded the delay, including the National Alliance for Care at Home. [Click on the title's link to continue reading.]
National Alliance for Care at Home and Transcend Strategy Group publish Rural American Hospice Insights Report
12/20/24 at 03:00 AMNational Alliance for Care at Home and Transcend Strategy Group publish Rural American Hospice Insights Report National Alliance for Care at Home, Alexandria, VA and Washington, DC; Press Release; 12/19/24The National Alliance for Care at Home (the Alliance) and Transcend Strategy Group published the results of new research exploring perceptions of hospice care among rural and small-town communities. This survey of 400 people is part of the Alliance’s commitment to health equity and to breaking down barriers to accessing hospice and home care through knowledge sharing, data collection, and collaborative discussion. Along with key research findings, the Rural American Hospice Insights report offers recommendations for hospice providers to help increase understanding of hospice care and help overcome barriers to access. Key findings and recommendations include:
Fierce 50 Award presented to NPHI CEO at New York Gala
12/11/24 at 02:00 AMFierce 50 Award presented to NPHI CEO at New York Gala National Partnership for Healtcare and Hospice Innovation - NPHI, Washington, DC; Press release; 12/9/24The National Partnership for Healthcare and Hospice Innovation (NPHI) and Tom Koutsoumpas, CEO, were honored with a Fierce 50 Award at the 2024 Fierce 50 Awards Gala in New York City on December 5. Hosted by Fierce Life Sciences and Fierce Healthcare, the event celebrated fifty trailblazers—individuals and organizations driving transformative change in healthcare, biopharma, and biotech. NPHI and Tom were recognized in the Innovation category for a bold commitment to healthcare innovation and for leadership in hospice, palliative, and advanced illness care through NPHI’s network of mission-driven, nonprofit providers. ... “It was such an honor to be in New York to celebrate this outstanding achievement, and to be surrounded by other major innovators across healthcare,” said Tom Koutsoumpas, NPHI CEO who gave an acceptance speech. “This recognition reflects the passion and dedication of our nonprofit members in setting standards of quality for hospice and end-of-life care. It was inspiring to share the evening with leaders who, like us, are deeply committed to transforming healthcare to better serve patients, families, and communities.” Editor's note: NPHI is a sponsor of our newsletter.
The International Association for Hospice & Palliative Care has a new website
12/10/24 at 03:00 AMThe International Association for Hospice & Palliative Care has a new website IAHPC, The International Association for Hospice & Palliative Care; Email communication; 12/3/24 The IAHPC team is delighted to announce the launch of our brand-new website. It’s quite a change from the old one! We think this is a great way to close out a very fruitful year that included the implementation of several research projects, new online courses, public webinars, and multiple news bulletins about the accomplishments of our members worldwide.... [Content] is organized around our four core areas of work: Advocacy, Education, Research and Communications. And as before, you can learn About Us, explore Resources, and the get to know Members through the topline tabs. This design allows you to navigate more easily to the topics that interest you and lets us keep you better informed about our progress in those areas.
New alliance steps up as voice for providers & patients
12/06/24 at 03:00 AMNew alliance steps up as voice for providers & patients HomeCare; by Hannah Wolfson; 12/3/24 Stopping Medicare cuts, ensuring Medicare Advantage beneficiaries have good access to care, passing groundbreaking hospice legislation and bringing homecare into the forefront are all priorities for the newly-formed National Alliance for Care at Home, said CEO Steve Landers. “We’ve got to start improving access to home health care, and the way that we do that is we end this march of payment cuts that are being set forward by Medicare,” Landers said at the Alliance’s Homecare and Hospice Conference and Expo, which was held in October in Tampa, Florida. ... The alliance has automatically enrolled members of both legacy organizations, but Landers said that for renewals or new members, participants will be required to sign an attestation that says they have a program in place for quality and compliance, that they monitor the Office of Inspector General’s expulsion list and don’t take referrals or staff from organizations on that list and that they strive to participate in Medicare’s quality reporting programs.
Top News Stories of the Month Nov 2024 - TCN Podcast
12/05/24 at 03:00 AMTop News Stories of the Month Nov 2024 - TCN Podcast Teleios Collaborative Network (TCN); podcast by Chris Comeaux with Mark Cohen; 12/4/24 What if the future of Hospice and Palliative Care depends on understanding the intricacies of industry integration and regulation? Join us for an insightful journey through November's most compelling stories that have captured the attention of Hospice and Palliative Care Today's readership. Our conversation reveals the significant impact of national events, from elections to regulatory changes, on shaping news cycles and industry priorities. Also, rising workforce demands and political changes, such as immigration restrictions, paint a concerning picture for the future labor pool in Hospice Care. We provide a comprehensive analysis of the month's key themes that may have been missed, like tackling issues from CMS payment cuts to the Justice Department's stance on UnitedHealthcare Group's acquisition of Amedisys. This episode is a must-listen for those seeking a deeper understanding of the critical yet often overlooked issues in Hospice and Palliative Care today, and Mark delivers another excellent masterclass on creating compelling headlines.
Don’t let CMS publish list of lowest-performing hospices, Alliance tells lawmakers
12/02/24 at 02:00 AMDon’t let CMS publish list of lowest-performing hospices, Alliance tells lawmakers McKnights Home Care; by Liza Berger; 11/26/24 Acting on its plan to keep the hospice Special Focus Program in the spotlight until the end of the year, the National Alliance for Care at Home has sent congressional leaders a letter urging them to remedy the grading system for the Centers for Medicare & Medicaid Services’ program targeting underperforming hospices. “CMS is on the verge of publishing a list of what they claim will be poor-performing hospices based on this flawed grading system,” Ken Albert, president and CEO of Andwell Health Partners and chair of the Alliance, wrote in a Nov. 22 letter to chairmen and ranking members of House and Senate finance committees. “When you see this list, you should view it skeptically, because CMS will have committed a grave error that risks steering patients away from reputable hospices that may be on the list and toward providers that — because they may not have been surveyed at all — could be low-quality or completely fraudulent.”
National Alliance for Care at Home lays out 2024, 2025 priorities
11/25/24 at 03:00 AMNational Alliance for Care at Home lays out 2024, 2025 priorities HomeCare, Washington, DC; 11/21/24 As 2024 starts to wind down and a new administration and Congress begins to take over in Washington, home health advocates are focused on two primary priorities: reversing planned reimbursement cuts for home health and reforming plans that target underperforming hospices. As Americans gather for Thanksgiving, “these are major family issues and also major national public policy issues of the highest level of strategic importance for our country,” said Dr. Steve Landers, CEO of the National Alliance for Care at Home, the organization formed by the recent merger of the National Association for Homecare and Hopsice and the National Hospice and Palliative Care Organization. “We’re not done with 2024 yet,” Landers said Thursday, Nov. 21. “We’ve got a lot that we want to accomplish right now, this year—and we’re looking to the future.” The number one priority, he said, is for Congress to intervene and stop home health payment cuts as outlined in a final rule from the Centers for Medicare and Medicaid Services (CMS). He said that the cuts would impact patient outcomes, reduce visits and hurt providers—and that they were implemented based on a Congressional mandate saying CMS should support home health.