Saturday, August 2, 2014

Generic & Gentiva Hospice Hurts: Real and Present


I appreciate your posts on the business side of hospice.  It's something I don't resonate with.  As a matter of fact, it generally makes me very uncomfortable.  But I do have some understanding of people and the ways we cause harm to one another.

Most of us act out programs from earlier in life and do so completely unaware.  Some courageous people become aware of and face hurts from the past, which can be deep.  Others are so damaged they cannot.  They built psychological structures to protect themselves as children and see maintaining these structures as core to their safety in each and every moment.

Unfortunately, these structures cause them to project their torments onto others.  I venture your hospice director is such a person.  This is very hard to detect in a corporate structure which relies on surface interactions and generally has no understanding or tolerance for depth. 

Your leader utilizes those longstanding psychological structures, which saved them as a child, to maintain their image with their corporate bosses.  This means any negative is externalized to subordinates who've failed, despite this manager's best efforts.  Facts don't matter.  An employee could be an outstanding nurse, chaplain, marketer, social worker, volunteer coordinator but they can quickly have their character assassinated by a site manager with a pristine image to maintain. 

Corporate, with its over reliance on surface matters, cannot detect human resource patterns, whether it be in this person's evaluations of others (generally abusive).  Corporate processes and reprocesses job openings where this manager repeatedly hires "stars," later firing those who haven't already quit for gross inadequacies.   The bureaucracy does not monitor employee satisfaction, but rapidly circles wagons when enough staff quit or express widespread concern. Corporate ignores exit interviews or allows the abusive leader to conduct their own, the final torment for many.  Even in leaving the employee cannot be heard.  

Should pressure rise on this manager blame is delegated in sprinkler life fashion.  Everyone can and will be sacrificed to maintain their image and status.   Yet, corporate does not see this.  Why?  Because in one on one sessions with their bosses this manager will pretend to be vulnerable.  They will cry, highlighting how hard they work and how consistently others let them down.  They pretend to accept responsibility, but only in the most surface manner.  When their boss is gone there's hell to pay for the humiliation they've had to endure.

Bosses like this can give an order.  If it goes badly, thirty minutes later they can deny they ever gave the order.  That happened to me more than once.  I quickly realized this manager and I literally live in different worlds.

How can corporate love someone like this?  It's resonance.  They mirror one another.  Both care solely about surface images.  Damaged managers know whose approval is needed and how to curry it.  Substance and nuance, the very things hospice patients and families need, aren't wanted. 

Hospice work is difficult enough.  Layer a psychologically damaged leader and uncaring corporate structure and it becomes hell.  I expect this is where your site remains.

You've shared that the buyout has likely steered management attention away from discovering the Gordian knot spun by your manager.  Yet, someone commented here that top leadership is trying to identify me and you.  It seems we've tarnished the shiny image they wish to portray.  I couldn't care less about Gentiva, but that's your bread and butter.

My focus is hospice and its dire state of service, which I see driven by bad management, obsessed with money and metrics.  You are trying to provide caring, supportive service in one hospice community and are handcuffed by a tormented manager and clueless corporation.  Godspeed.  This too shall pass, possibly after it all implodes.



  1. It's not just on the hospice side but home health side as well. "Surface" is the perfect term. As long as someone(s) make the boss look good, they can get away with the most atrocious bullying behavior. Gentiva used to care about their employees but in the last two years I have seen a swift and dramatic decline in treatment and morale. And we go yet another year without raises. Many employees are now having to work two jobs because Gentiva is not paying their employees appropriately. Many employees are desperately looking for work elsewhere and those who aren't are hoping for a buy out of the company. Ah, a sweet release and the joy of seeing these management types being out of a job, because it will happen if there is a buy out.

    1. Pretty sure the Hicks brothers are going to follow right along with their former Harden holdings. As long as they are around, it will be more of the same. Genetics is very aligned with Harden as a company, under it's current incarnation.

      You can bet your bottom dollar that the Hicks boys will ensure "more of the same", buy out or no, as long as they are on the board of directors. They are very much concerned with maintaining their pile of money to worry about "the employee"

  2. I also have to add this- what does it say to everyone to host the extravegant chairmans council at 5+ star resorts, spend tens of thousands of dollars on the venue, the meals, the wine and then give them tiffany jewelry at a couple hundred bucks a pop only to find out that under it all it was a sham. the senior leaders had no intention of listening to and acting on what feedback was provided by the field teams. it was a sham to keep people distracted away from the real issues like a lack of leadership top down, poor skills and experience even at the top, abusive management practices, betrayals of trust and attacks on morale and people's character.
    what a pile. what a lie. I too look forward to announcement day even though the top guys will parachute away with millions the key word is they will pbe away. We can all hope that the next generation is better and more experienced than the current for eveyrones sake. I kind of like the sound of " CEO of none"