Friday, November 29, 2013

Gentiva Expects Turnover


A highly respected corporate person said "I consider anyone with over one year's tenure with our company a long-timer."  Apparently, Gentiva leaders don't hold dear things like knowledge, experience, dedication, and commitment.  It's the blind leading the blind at our site given our tin eared Branch Manager (BM) and horrific turnover.

Turnover carries a steep cost, as others have to make up for the loss of experienced, capable employees.  Hospice work is hard enough, but it becomes a bear when having to do the work of two people.

It's the kind of bear that eats you, which makes for more turnover.  Beware the bears from BM level and above. The rabbit hole deepens at merger mad Gentiva.  What about Generic Hospice?


Saturday, November 16, 2013

Gentiva's Integration of Local Markets - What's Your Story?

To Gentiva-Harden Home Health & Hospice Employees:

I understand your site leaders, branch managers and executive directors are currently planning (plotting) the integration of Gentiva-Harden's local markets per orders from CEO Tony Strange. Should you have a story you wish to share, I'd love to hear it.  Send it to and be sure to use your home computer.  

I appreciate the darkness in your company, as we have it at Generic Hospice.  It's hard to do the good work of caring for patients in a company that cares so little about its employees it hasn't asked them the most basic of questions for years.  What do you like about your job?  Do you feel supported by your manager?  How could corporate leadership help you do your job better?  My Gentiva friend said "Not one of the legions of corporate fools that parade through our office has asked such a question.  As for a company-wide employee survey, they ditched that years ago."

It's difficult doing serious work of caring for hospice patients under whimsical, autocratic management.  The whimsy will soon be in overdrive as people are axed and locations closed or sold.  This tragedy of management will produce many stories, none of them fun.  Send yours, if you wish.  I'll read every one, maybe publish a few on this blog.  Godspeed.

Generic Hospice

P.S.  Prayers were requested for employees of a closed Inpatient Hospice Unit in the Houston area.  More Gentiva IPU's have been shuttered.  Many, many people face the prospect of job loss under Tony Strange's regime.  Having fun yet? 

Tuesday, November 12, 2013

Gentiva-Harden Integration Looms at Site Level


Gentiva has a number of image-obsessed leaders like the one you described at your Generic Hospice site.  What will happen when two or more orbs meet to decide how to implement corporate strategy in their overlapping market?

Will they draw straws, i.e. trade turns selecting who will stay and who'll be terminated?  That prospect looms throughout Gentiva and Harden's overlapping territories.  Gentiva CEO Tony Strange said this would occur in most markets before the end of the year.  It's the second week in November, so plans will be made quickly.

Gentiva already cut over 100 positions at the area, regional and corporate levels with their OneGentiva initiative.  I expect the number of jobs cut from overlapping market integration to be much higher.  Gentiva employees near the red and blue balloons pictured above should prepare for the possibility of being axed.  Image obsessed leaders will be the worst communicators of the company's plans. 

Gentiva's earnings call provides much more information on corporate strategy than our Branch Manager ever shares.   Might looming meetings be chock full of surprises?

How many will be staged to maintain the illusion that Gentiva has cooperative, collaborative, inspiring leaders?  The reality is my site has the exact opposite, an exclusive, autocratic, soul sucking micro-manager.  Any integration coming from this person will be based on whim and used as a weapon of motivation destruction. This management apple, as rotten as it is, doesn't fall far from the tree.

Sunday, November 10, 2013

Chaos Squared: Generic & Gentiva


The similarity of our plights, yours at Gentiva and mine at Generic Hospice, are eerie.  Our Branch Manager, who personally has driven off legions of great clinical staff, had the gall to tell me, "I feel so bad the nurses can't keep their Patient Care Supervisors."

Nurses can't keep their manager because the BM micromanages them to the point they resign or are fired.  Our Branch Manager psychologically tortures them until they quit to save their sanity or become shells of their former self, ensuring the bad end.  I've seen it over and over and over.

Talented nurses, who would be great leaders, want no part of it.  One told me recently, "Why would I want that job?  It only lasts a year."

But it's a very long year, as the BM psychologically breaks people.

1.  A year with lots of written counselings.  How's that for coaching?
2.  A year with interminably long supervisor meetings with BM.  This court is a chance for the BM to show their brilliance, receive compliments from underlings, setup future scapegoats and deride staff who through their dedication and caring make the site and its managers look good.
3.  A year where the BM delegates virtually all their work to underlings, especially patient care supervisors who would be happy to do the work, only they have more than they can handle, being new or covering two jobs.  Also, item #2 makes it difficult, given the many hours eaten each day by the BM's Royal Court.
4.  A year where the BM repeatedly instructs the patient care supervisor what to do and say, as if they have no brain.  This applies to the patient care supervisors' one-on-one meetings, nurse team meetings and all employee meetings.
5.  A year where the BM moves through the office like a shark, looking for someone to bite.  The shark frequently attacks patient care supervisors, but is known to bite any employee with little to no notice.
6.  A year where the patient care supervisor is not allowed to communicate with staff on BM initiated firings or the plan to cover that person's work.
7.  A year of surprises where staff believe they've kept the BM informed, only to have the BM say "You never told me that."  When this happens to a new patient care supervisor, it's their first clue they're on a frightening ride in the BM's whack-job nuthouse.
8.  A year where the BM tells corporate by phone how great they are, blaming underlings, especially patient care supervisors, for any performance shortfalls.
9.  A year where the BM pushes whatever corporate initiative they have a role in to the exclusion of employee desires.  The pressure to do something "voluntary" grows exponentially to enhance the BM's image.  Employees exist to make the BM look good.
10.  The BM will get their way.  It may take time and support from clueless human resource representatives, but the BM will prevail.

Our BM could take a dump and corporate would fawn over it like a truffle.  Frankly, that's what they've done repeatedly when we've complained about it's size and odor. 

Good luck with the Harden integration.  I'd be interested to know if you've experienced anything like my manager.  Would Gentiva's ongoing chaos help or hurt someone like that?


Tuesday, November 5, 2013

Wrecked Gentiva to Get New Paint


Gentiva held their earnings call today.  Gentiva CEO Tony Strange encouraged Wall Street analysts to look at this shiny new Harden acquisition and pay little attention to the company's subpar third quarter.  The crew of financial analysts seemingly bought into the Harden talk, treading lightly on Gentiva's deteriorating revenues and volumes.  It's clear investors didn't buy the spin, driving Gentiva's stock price down nearly 10%.  

Prior to closing the Harden deal Gentiva announced OneGentiva, where area and regional leadership, both sales and operations, support home health, hospice and community care services.  Strange indicated 100 field operating and sales positions were eliminated in creating OneGentiva.  These cuts should more than fund Gentiva's consulting deal with CapStar, Harden's former private equity owners.

OneGentiva's focus will be:
OneGentiva -  Key strategies shared in October
1)  Realign mission across all three divisions
2)  Redefine operating model and structure
3)  Improve hospice results
4)  Create a culture of field focused support for our corporate organizations
5)  Achieve sustainable growth in all of our businesses

Strange said something odd in his description of the new regional structure post Harden transaction closing.

"Harden's Chief Operating Officer Chris Roussos has been named the Regional President of our new South Central Region.  This region includes Texas and the majority of the current Harden geographies, thereby reducing the integration risk for most of their existing businesses."
Does that raise the integration risk for Gentiva operations in Harden territory?
As for Gentiva Hospice branches:

"We are going through each and every branch, evaluating the rate reduction models for 2014, the impact of overlapping territories and our ability to create market density.  As a result, we have or will be consolidating branches, as well as exiting certain markets and/or certain business offerings where it is no longer feasible to fulfill our commitment to our mission.  We expect the majority of this work to be completed in the remainder of this year."
Tony Strange beat the "hospice marketing equals home health marketing" drum for nearly two years on investor calls.  When hospice volumes didn't go up as predicted, Strange finally admitted they weren't the same. Yet, the OneGentiva reorganization includes:

"Each region will have a single-sales organization focused on the delivery of a unified comprehensive service offering to our referral sources. However, the product delivery systems for the 3 business lines will continue to function separately as they do today."
If Gentiva hadn't unlocked the key to hospice marketing as a stand alone group, how will it do so in a unified offering?

Gentiva refinanced existing debt and added more to fund the Harden deal:

Our blended interest rate based on outstanding balances on the term loans at closing came down from 6.45% to 6.36%....  The first principal payments on the term loans are due in March 2014.
Gentiva added debt to buy Harden, which CEO Strange admitted came at a premium price.  This small break in the interest rate cannot compensate for the hundreds of millions of new debt financing.  Gentiva previously had a cash crunch around principal and interest payment time.  How will things look come March 2014? 
On an annualized basis, Harden-related synergies are expected to be approximately $28 million by 2015. This includes approximately $16 million from the elimination of overlapping corporate costs, and the remainder from the consolidation of regional area and branch organizations, as well as other cost-savings initiatives 
More jobs are at risk for current Gentiva/Harden employees.  It goes beyond the 100 operating and sales positions.

As you would expect, with the Harden acquisition integration, branch closures and consolidation and our One Gentiva initiatives, there will be a lot of moving parts in the fourth quarter. The final results for the fourth quarter of 2013 will be subject to a number of factors, including the impact from additional closed or sold locations, the timing of branch consolidation, the timing of synergies, the timing of One Gentiva initiatives, the final results from the Harden business valuation and the balance sheet accounting treatment of various items related to the Harden consolidation.
It remains to be seen how quickly the axe falls.  Will Gentiva fire more employees between Thanksgiving and Christmas?  Might some chose to leave first?  Watch the moving parts.  Beware what drops from above, like manipulation schemes.

The alignment of the incentive plans in each market between operations of home health and operations of hospice and community care, I think, will be the last component to really try to marry those businesses up in the individual markets.

When people don't have good work to do, they must be bribed to perform.  I hope Generic Hospice isn't as broken as Gentiva.    


Saturday, November 2, 2013

Recently Fired Gentiva Employees Should Know

Dear StrangeTony,

A number of area and regional staff members lost their job when Gentiva purchased Harden Healthcare.  They became expendable as the acquisition neared closing.  They may want to know the severance package for Gentiva's senior leaders as outlined in a SEC filing:

(i) The Company shall pay to the Executive (A) base salary at the rate then in effect through the date of the Executive’s termination of employment in accordance with the standard payroll practices of the Company or such earlier date as required by applicable law, and (B) any earned but unused paid time off (“PTO”) in accordance with the Company’s general PTO policy, which shall be paid in a lump sum ten (10) business days after the date of such termination of employment;

(ii) The Company shall pay to the Executive an amount in cash equal to two times (2x) the sum of (A) the Executive’s annual base salary in effect immediately prior to the date of the Executive’s termination of employment or the date of the Change in Control (whichever is higher), and (B) the higher of (x) the Executive’s target annual bonus for the year that includes the date of the Executive’s termination of employment or (y) the annual bonus of the Executive averaged for the three (3) years immediately prior to the year that includes the date of the Executive’s termination of employment; and such amount shall be paid, subject to Section 10 below, in a lump sum ten (10) business days after the date of such termination of employment;

(iii) The Executive shall be entitled to a pro rata share of the target annual bonus for the year that includes the date of the Executive’s termination of employment based on the number of days of such year that the Executive was employed by the Company, which shall be paid, subject to Section 10 below, in a lump sum ten (10) business days after the date of such termination of employment;

(iv) The Company shall continue to cover the Executive and his or her dependents under, or provide the Executive and his or her dependents with insurance coverage no less favorable than, the Company’s life, health and dental plans or programs (as in effect on the day immediately preceding the Protection Period or on the date of termination of his or her employment, whichever is more favorable to the Executive) for a period equal to the lesser of (x) two years following the date of termination or (y) until the Executive is provided by another employer with benefits substantially comparable to the benefits provided by such plans or programs, provided, however, that the provision of this benefit shall be contingent upon the cooperation of the Executive (or his or her spouse or dependent, as applicable) with any reasonable request by the Company to facilitate the provision of such benefit, including responding to questionnaires and submitting to minimally intrusive medical examinations. Executive shall be responsible for any Federal, state or local tax with respect to such benefit coverage described in this subsection (iv);

(v) All options to purchase Company stock held by the Executive and all restricted shares of Company stock, restricted Company share units, performance share units, performance cash awards and other equity-based compensation awards held by the Executive shall become immediately vested in full upon such termination of employment, and all such stock options shall be exercisable for the longer of (x) one year following such termination of employment (but not beyond the original full term of the award) or (y) such period of time as may be provided for in the plan under which such awards were granted; 

(vi) All of the Executive’s benefits accrued under the pension, retirement, savings and deferred compensation plans of the Company shall become vested in full; provided, however, that to the extent such accelerated vesting or benefits cannot be provided under one or more of such plans because of nondiscrimination requirements under the Code, a cash amount equivalent to any unvested benefits shall be paid to the Executive outside the applicable plan in a lump sum, subject to Section 10 below, ten (10) business days after the date of termination of employment; provided, further, however, that, to the extent any such unvested benefit constitutes nonqualified deferred compensation for purposes of Section 409A of the Code, the payment of a cash amount equivalent to such nonqualified deferred compensation shall instead be made at the time the underlying benefit was otherwise scheduled to be paid under the applicable plan; and 

(vii) The Executive shall be entitled to outplacement services with an outplacement firm of the Executive’s choice for up to twelve (12) months or until the Executive obtains comparable employment (as determined by the Company), whichever is shorter; provided, however, that (i) the Executive must select an outplacement firm and commence the outplacement services no more than ninety (90) days following the Executive’s termination of employment, (ii) such outplacement services must be reasonable and commensurate with the Executive’s position with the Company (as determined by the Company), and (iii) in no event, shall the aggregate amount the Company incurs to provide such outplacement services exceed more than thirty thousand dollars ($30,000)

How many employees who lost their job in a change of control move got any kind of severance package?  How does their severance compare with this agreement's generous provisions?