Tuesday, March 4, 2014

Earnings Call a Downer for Hospice Staff


Gentiva surprised with poor earnings and a huge asset write down for the 4th quarter.  Wall Street analysts must be tired of hearing promises from CEO Tony Strange, especially in the hospice arena.

If Gentiva's corporate chiefs couldn't understand hospice as a single division, how will they gain a greater understanding by placing hospice with home health and community care?  Add that Area Vice Presidents saw the number of sites they support doubling or tripling under OneGentiva and the learning curve steepens.

Generally confusion precedes higher order learning, however I don't hear anyone from corporate asking questions.  I'll offer a few that apply to our particular hospice:

1.  Why is our site losing good, caring, talented hospice nurses by the carload?
2.  Why aren't nurses beating at our doors to work with the best hospice physicians in town (by far)?
3.  Why is staff leaving our hospice to work for other nearby hospices, when they used to leave hospice altogether?
4.  What impact does our obscene level of turnover have on patients, families and referral sources?
5.  How do staff, the people providing the care, feel about the support they receive from above, site level and corporate?
6.  How do our hospice physicians feel about high nursing turnover and their endless job of helping to train new hospice nurses (with the good ones lasting but a year)?
7.  Why do talented, caring staff continue to work hard despite miniscule salary increases and a 40 hour cut in PTO accrual at each step?
8.  How many ways and in what manner has corporate cut the quality of our hospice service via top down edicts in the last three years?
9.  What, if anything, has corporate actually done to be the employer of choice for hospice in our community?  How many ways and in what manner has corporate ensured our site is not the hospice employer of choice locally?
10.  How many times does corporate plan to take away over a decade of brand recognition with yet another name change?
11.  Why does communication only go one way in this company, top down? 

Answers to these questions, properly heard, could be transformational.  Here's the only measure I believe corporate uses to evaluate our site:  Are you meeting budget and EBDITA targets?  If not, CEO Tony Strange spoke of the consequence:

While the elimination of jobs and the abandoning of underserved markets has always been painful for organization, we enter 2014 much better aligned across our platform with the added value of an improved cost structure to help offset some of the impact of the rate cuts.
Anything else is fluff, window dressing, stuff Gentiva executives say to sound like regular human beings, like the hearty thanks to employees at the end of Strange's prepared remarks.

In closing, I want to thank all of our employees for the compassion that you bring to our patient's home each and every day. 
How many employees' received a 2013 W-2 that was less than their 2012?  I'd venture those employees don't feel the least bit appreciated by the company. 

Today's earnings call let me know corporate manages as poorly as our site leader.  Corporate chiefs disappointed on the only measure they seemingly care about. 

Our company's picture could not be bleaker for those who care about delivering great hospice service.  How long can caregivers with talent and standards endure?  Not much longer at our site.


  1. I've been followng these postings for some time now and I'm wondring if the issues are unique to the location where you work? It sounds like you may be a former VistaCare Hospice program based upon your posts. Do others from Odyssey and Gentiva Hospice programs face similar challenges?

  2. Anonymous responded: "We're OneGentiva (stock price down $2.04 per share in two days), roughly 20%. Other OneGentiva sites have to speak for themselves, but every now and then StrangeTony from Generic Hospice will weigh in. It's his blog that I've monopolized lately."

    I personally have nothing to add, other than how saddened I am to hear of serious trials facing any hospice. The work is hard enough. Burdens are magnified from insensitive and uncaring local and corporate managers.

    1. Not limited in scope, not limited to hospice, not limited to a specific location. Gentiva as a whole, under the helm of strange, Hicks, Hansen, et al, this is SOP.

  3. Yeah, I get One Gentiva. But, I think people that have come from other companies that have been acquired have a harder time adjusting. Have you considered an anonymous survey at your local program that can capture everyone's thoughts and then giving that to the program manager (anonymously of course)? At another company, we did this with a boss that was simply not aware of her behavior. Once confronted with the collective sentiment of the staff (there were over 20 of us), it was a tough for her to get through but she was able to see she needed to change. The surveys also work with 3rd-party partnersa and customers. It's a nice way to quickly get some feedback and work on change. It appears if you can get your program manager aware it would be a step in the right direction. People tend to be reasonable if addressed in a reasonable way. Best of luck!

  4. That sounds like great advice for Anonymous to use. Thank you for sharing it with Generic Hospice readers.

  5. Anonymous said "We would love the opportunity to offer our thoughts via an anonymous survey. That opportunity has not presented in the last four years, despite several requests made to higher ups. It seems leaders above our Branch Manager wish to remain uninformed or the BM has painted a very different picture. My guess is they have undertaken one or more of these strategies: 1) Led their bosses to believe the BM is the sole reason for our site's successes 2) Delegated blame for any failures to other staff, therefore staff are not worth listening to 3) That the BM, despite their heroic nature, needs corporate to quell the few bad actors that prevent our site from being perfect 4) Therefore, corporate should identify the bad actors and help the BM eliminate them (thus an anonymous survey is useless)

  6. Supervisors, managers and directors do not care. Management always sides with management. At least at Gentiva. And the hospice FSU is a joke! Many of the supervisors there only got their position because they were friends with manager outside of work as well as at work. I've been told by several former supervisors that the supervisor meetings are nothing but a gossip fest and the director is the biggest instigator. I was told to watch what you tell your supervisor because it will be gossiped about in the supervisor meetings.

  7. This is not nothing new and is very true. Most of the supervisors did not receive their postions based upon experience or true demonstrated leadership skills. Each had a hand up in their position from one vote of a existing supervisor/friend to the next vote supervisor/friend. One supervisor had never been a collector and managed to get promoted to such position. And does not do much when it comes to supervising her own team. The team manages themselves. None of them worthy of the position or the title. Managers of each KS FSU dept are not worthy of their positions or title. Most of the negativity is all instigated by the Director who stimulates this behavior in the managers and supervisors. Always starts at the top!!!! No one trusts any of them. Such a disgrace. Lots of change especially with the management team would be refreshing.