Friday, September 30, 2016

Kindred Pays Record CIA Fine


Just in case you missed it.  The Office of Inspector General for Health and Human Services announced:

Kindred Health Care, Inc., the nation's largest provider of post-acute care, including hospice and home health services, has paid a penalty of more than $3 million for failing to comply with a corporate integrity agreement (CIA) with the Federal Government, Department of Health and Human Services' Inspector General Daniel R. Levinson announced today.

It is the largest penalty for violations of a CIA to date, the Office of Inspector General (OIG) said.

The record penalty resulted from Kindred's failure to correct improper billing practices in the fourth year of the five-year agreement. OIG made several unannounced site visits to Kindred facilities and found ongoing violations.

The message from on high is to grow and there's significant pressure to admit patients.  It's been that way for years, under both Gentiva and Kindred.

CIA-required audits performed by Kindred's internal auditors in 2013, 2014, and 2015 found that the company and its predecessors had failed to implement policies and procedures required by the CIA and that poor claims submission practices had led to significant error rates and overpayments by Medicare.

Kindred was billing Medicare for hospice care for patients who were ineligible for hospice services or who were not eligible for the highest level and most highly paid category of service, OIG said.

That level would be general inpatient care or GIP.

A higher up shared the company refunded over $1 million to Medicare.  That fits with the over $3 million penalty as the government levels treble damages.  So that's a $4 million hit, all of it due to bad management.

I wonder if this will impact Kindred at Home President David Causby's $1 million bonus due September 2017?  He became Gentiva's COO in October 2013.  That means Causby was "leading the day-to-day operations of our business" for all but ten months of the period covered in the settlement.

Meeting admission criteria and accurate billing are critical day-to-day operations. For much of the review period Causby was the accountable leader.

Anonymous (from Kindred at Home)

Saturday, September 24, 2016

Yet Another Visit from Kindred VP of Some Sort


Our hospice site had another visit from a Kindred high up. I offer coaching from their recent visit, plus comments shared from other Kindred hospices. 

1.  "Pick up the pace" & "Close hard"

Census drives revenue, plain and simple.  Any recognition of excellent service meant nothing to the hierarchy of number obsessed executives.  Executive exhortations are barked out in a manner based on their unchecked assumptions.  My co-workers are already working hard, doing their best, with love, care and passion.  What might they feel pressured to do to meet management's numbers expectations?  Executives cared not the consequences as long as patient headcount rose. 

2.  "Senior leaders love us the same way our nurse assistants love their patients."

Our nurse assistants don't take things away from patients, like senior executives did with PTO, health insurance and retirement benefits.  All three benefits have been reduced in the last few years by Gentiva/Kindred executives.  One is slated for elimination, if it hasn't already disappeared.  That's the company retirement match.

I do see the love shown Gentiva COO/Kindred at Home President David Causby in his serial $1,000,000 bonus opportunities.

The company does treat us like our site treats our nurse assistants (overworked, underpaid and at best underappreciated)  Local management consistently tells our NAs they are the low men/women on the totem pole.

3.  "Your site makes the company a lot of money."

Never have they shared how the monstrous amount of money our site made the company comes back to those of us doing the actual revenue generating work.  I assume this money ends up as bonuses for people up the chain.  We, the people supposedly being "Taken Care of", aren't seeing any of our monstrous profits.

4.  "Get it together folks.  Census matters.  Profit matters."

Apparently employees need to be motivated from above to work harder, jump higher, and recruit more patients in order to save the jobs of people sitting on either side of our chair.  It was fitting that barbecue was served given our site is under performing.

I've never heard a sacrifice senior management has made to keep things going in difficult times.  They show up, bark out their prized financial metrics, launch a few platitudes, rarely offer a sincere thank you,  readily dispense brow-beatings, and move on.  It's a relief when I can exit the building.  Kindred executives have a way of using up all the oxygen.  

A few never bothered to ask my actual role at our hospice.  I've been called nurse and social worker and I'm neither.  When Kindred executives leave breathing and sphincters can return to normal.  Seeing a patient or family member is the balm for exposure to toxic leaders, as is hearing from other dedicated hospice workers.  Thanks to Generic Hospice readers who e-mailed me their experiences.

Anonymous (from Causby's baby)

Thursday, September 1, 2016

Health Insurance Drivers for 2017


Chief People Officer Stephen Cunanan received 36,000 shares of Kindred stock on March 24, 2016.  That same day the company awarded Kindred CEO Ben Breier 283,0000 shares.   Breier recently told Wall Street analysts he feels "pretty good" about getting back to over $1 billion EBITDAR in 2017.

What kind of health, dental and vision insurance benefits do you think they're working to bring Kindred employees for the coming year?  Expect to pay more for less coverage, especially if Mr. Cunanan wants to increase the value of his 83,500 shares of Kindred stock or if Mr. Breier desires to maximize the worth of his 678,000 shares.

The company is "still working on health benefits."  Generally, their work is our pain.  Consistently, executives focus on personal gain.