Curo Makes Multiples for CEO

Strange Tony,

Think back to your hospice days.  Would you or any of your co-workers have found these words inspiring?

“You have very high multiples right now with the demographics that are trending; those multiples have to come down over time if you look at historical averages,” Larry Graham, founder and CEO of hospice and home health provider Curo Health Services said at Summit. “Private equity is very interested in the home care and hospice space which is driving up multiples at this point in time. I think the future changes to reimbursement, such as the [Medicare Advantage carve-in] will have an impact on multiples coming down.”  

Private equity are the financial rapscallions that partnered with Humana to buy Kindred at Home and Curo Health Services.  They crammed our hospice into Curo, and together they destroyed our level of service.

What Graham didn't say is he made big money under various financial rapscallions.  

Larry Graham co-founded Curo in April 2010 with GTCR, a Chicago based private equity firm.  He made huge profits from the next two sales of Curo Health Services to private equity owners.    Graham got a chunk of the $730 million Thomas H. Lee paid GTCR for Curo in 2015.  Three years later Curo's speculative debt rating went negative.  In July 2018 Graham got a portion of the $1.4 billion Humana, TPG Capital and WCAS paid Thomas H. Lee for Curo.

Graham partnered with financial rapscallions from day one with Curo.  His wealth is beyond what a normal person could spend in several lifetimes.  The rabid pursuit of more money does not make hospice better.  It makes it worse for employees, physicians, patients and families.

At the same conference Graham said "I am a firm believer in technology" and "the overall goal will be keeping patients out of the hospital."  Curo's technology cheats employees on paid time and mileage reimbursement.  The clinical portion of Homecare Homebase is garbage in-garbage out at our hospice as nurses don't have time to take the program's various rabbit trails. 

That's a nice stripped suit.  Over time Curo's technology may have CEO Graham switching suits to one with more white.

Anonymous

Humana CMO Shrank Our Hospice

Strange Tony,

Humana Chief Medical Officer William Shrank spoke with "Home Health Care News" about:

"Humana’s efforts surrounding social determinants of health, continuing health care trends and the ongoing alignment of the company’s in-home care operations."

Shrank failed to mention how Humana/Curo Health Services decimated our hospice by dramatically reducing staff, driving turnover through the roof and implementing garbage in-garbage out Homecare Homebase. 

Humana/Curo depersonalized our services by jettisoning or running off caring, experienced staff.  

"The future of being able to really care for vulnerable patients — ideally, in the home — is to coordinate all those resources. Coordinate them in terms of making sure everyone’s operating at the top of their license and focusing on their area of expertise, but more importantly that everyone’s working on a longitudinal patient medical record that allows them to communicate with each other."

Longitudinal record?  I didn't realize ten months of information was considered longitudinal.  Also there is nothing longitudinal about information that does not carry forward when hospice certification period ends and a new one begins.

Humana/Curo have harmed our hospice's ability to care for vulnerable patients.   They also harmed employees by not paying them fairly for hours worked and miles driven.  Humana has done nothing but hurt our hospice's care delivery.  Curo is a curse.

Anonymous

Humana Imposed Waste at Kindred Hospice

Strange Tony,

Humana led a study on healthcare waste while imposing the same on our hospice.  News reports indicated:

Researchers from Humana Inc. (HUM) and the University of Pittsburgh School of Medicine estimated the cost of waste in the United States (U.S.) health system. The study found that approximately 25 percent of health care spending can be characterized as waste – between $760 billion and $935 billion annually.

I have directly experienced Humana's wasteful management at our hospice.  Our complex payroll function within Homecare Homebase wastes numerous hours for employees wishing to be paid accurately for their work.

Every pay period the system does what used to be called a time and motion study.  Each employee must account for their time down to the minute.  Because the system won't allow you to start the next segment with the previous segment's ending time, an employee loses that minute.  At the end of the day the system could've robbed an employee of ten to fifteen minutes of actual worked time.

The robbery gets worse when Homecare Homebase's mileage reimbursement system only automatically pays for the trip to see the patient.  For an employee to be paid for their return trip to the office they must manually enter that into the mileage system.

Management did not train staff on the time or mileage system under Homecare Homebase and many employees were shorted as a result.  Five months after going live management offered to bring someone in to train staff on both functions.  Staff agreed that would be helpful.  It hasn't happened to date and I doubt it will.

Humana believes Kindred at Home will help reduce waste in its Medicare Advantage population.  My experience is they imposed significant waste.  It used to take 10-15 minutes to input worked hours.  It now takes two hours per pay period.  That's just to roll the dice and see if management will approve the submissions for payment.  More time is needed to study the check and find discrepancies (if shorted).

Homecare Homebase is a nightmare in complexity for employees wanting to be paid fairly for hours worked and miles driven.  I do not understand how hours worked in a just closed pay period can not be paid and added to a month that has long gone by.  That happened frequently at our hospice.

Another bureaucratic time waster is scheduling every visit.  This works fine for Home Health but makes no sense for hospice.  On call and regular staff wasted hours waiting for management to add the visit and push an assignment.   This also happened with our nurse practitioners needing to do face-to-face visits.  We look bad when a nurse practitioner travels to do a face-to-face visit in a facility and there is no visit note for them to complete.  It becomes a paper visit or a redo.  

Humana's study on administrative waste applies to our hospice.  It's ironic that Humana imposed the wasteful system after buying our hospice in July 2018.   Forgive them Lord, they know not what they do.  Or do they?  Lord, forgive them anyway.

Anonymous