Strange Tony,
David Gruber, MD, MBA wrote in HomeCareMag.com
The hospice industry has been consolidating for many years. The largest 100 competitors account for “only” 42.4 percent of hospice providers.Note the author did not cite scale as necessary to give employee raises, maintain decent benefit levels or offer a reasonable retirement benefit. Kindred Hospice offers a 1% retirement match for employees who contribute 4% of their pay to their 401(k). Humana offers a 125% match up to 6% of their employees annual pay. Humana's retirement match is 5x better than Kindred at Home's. Nothing has trickled down to Kindred Hospice employees since our hostile takeover by Humana, WCAS and TPG Capital.
However, the hospice market is changing. Scale is becoming increasingly important to fund information technology (IT) and other infrastructure requirements.
Gruber also failed to mention the quality of information technology funded. Our new Curo technology is horrific. It forces nurses to answer non-applicable clinical questions, giving them no ability to skip the question or select "does not apply." They must put down the least wrong answer in order to move on. When they reach the end of the visit note the computer program asks the nurse why it took them so long? Maybe it's because Curo turned a nurse visit into an SAT exam, please select the most correct answer.
Scale is also a crusty buildup from for-profit corporations' misplaced priorities. Humana-Curo gunked up our nearly all of our hospice's processes, trashing customer service levels. Humana and Curo imposed massive amounts of scale onto our local hospice, all which is non-value added. Home health is scheduled. Hospice happens, turning the best laid plans into shredded paper.
In addition to ineffective and inefficient computer systems our staff must now devote significant time and energy in order to be paid fairly for time worked and miles driven. Several longtime nurses stated they don't have the fight, interest or ability to deal with new payroll-mileage methods.
Meanwhile delusional local management is caught in a self congratulatory loop over how well things are going. It seems the invasive Humana-Curo scale clogged their carotid artery, reducing oxygen to their brain. I don't know how the scale only focused on managers' and regional executives' brains. Staff and our talented physicians have enough arterial flow to accurately perceive damage done by Humana-Curo scale. However, it is raising blood pressure and causing major headaches for the aware.
Our hospice has been consolidated many times and no acquisition has gone as badly as Humana-Curo. I am sure the financial rapscallions that own 60% of Kindred at Home are mostly responsible for the carnage, however Humana put down enough cash to have a major say. Humana's cash investment could've bought nearly all of Kindred Healthcare's equity. Instead Humana ended up with a fraction of half the company for their $800 million in cash.
I don't understand why Humana's Board approved the deal. Kindred Healthcare offloaded nearly all their debt onto their former Kindred at Home division. Former Kindred CEO Ben Breier is ecstatic over his much lighter debt burden, courtesy of Humana.
Dedicated to ensuring that every business decision we make reflects a commitment to improving the health and well being of our members, associates, the communities we serve and our planet.--Humana's mission statement
Financial rapscallions WCAS and TPG Capital partnered with Humana CEO Bruce Broussard, a former CEO for WCAS affiliate U.S. Oncology. Together new owners are contorting the face of hospice. That's what greed on a massive scale does. Our patients, their families, my coworkers and our community suffer for what Humana's business decision has done to our hospice.
Anonymous
The exodus continues. It's heartbreaking to see dedicated, experienced staff go.
ReplyDeleteThanks for the ongoing look at this iteration of corporate psychopathy. See also my blog, where I often point back to your most excellent work. http://www.deathnurse.com/2019/01/searching-for-hospice-at-place-in.html
ReplyDeleteAlso, too: Rule #1 about hospice - it doesn't scale.
ReplyDeleteOne of our nurses commented after being shorted on hours and mileage. They said "Do these people know what they're doing? It doesn't seem like it." Paying people accurately for hours worked and miles traveled is a management basic.
ReplyDeleteIt's a new year and my resolution is to work for an employer that appreciates good word and rewards its people. Kindred-Curo misses the mark by a long shot.
ReplyDeleteI don't think executives have the vision to see their employees, much less understand their needs. Executives can only see their earthly desire for more money and power. They do not have ears to hear, discounting legitimate feedback as negativity. Like Dickens' Jacob Marley they have earned every link in the chains they will wear. Board members and executives have ignored their charges for years. A reckoning awaits.
ReplyDeleteMore changes, some of which are clearly insane. Curo's complex systems are so bad they surely will end up on the wrong side of Medicare's hospice regulations. It's but a matter of time. Our new owners are delusional.
ReplyDeleteYou mentioned U.S. Oncology, the former employer of Humana Chief Medical Officer Roy Beveridge. Beveridge will take his millions and retire. A new Chief Medical Officer will start on April Fool's Day. Kindred at Home's Hospice Chief Medical Officer got demoted under new ownership. Once he retires it would be interesting to hear his take on the last few years of Kindred chaos.
ReplyDeleteI recently left. I used to look at this blog over the several years and say- not my experience - but Curo ruined the organization. I had hoped of staying for my career. As a leader in Gentiva and then Kindred and regrettablly Curo - I could not stand by and see patient care suffer under their staffing models, poor HR, poor payroll, poor support. It’s so sad. Many great legacy Gentiva/Kindred staff are stuck in a difficult position.
ReplyDelete