Big Picture for Kindred at Home

Strange Tony,

Two web meetings addressed Kindred at Home's future under the ownership of Humana and two financial rapscallions, TPG and Welsh, Carson, Anderson and Stowe (WCAS).  The first occurred on November 5th when KAH President David Causby and Hospice President/Curo Health Services founder Larry Graham held a fireside web meeting for employees.

Larry Graham offered information on benefit improvements, saying the company would increase PTO, holiday, disability and HSA funding benefits, while holding health insurance premium increases to a minimum for staff.  Graham did not mention executives reduced most of those benefits for 2019, nor did he say how much of the prior cuts would be restored.  He said the company intended to offer great care by great clinicians.  I wondered when that would start.

David Causby encouraged employees to elect benefits for 2020, as they will not automatically carry forward.  He then said all hospice and home health sites within the company, 787 locations, are live on Homecare Homebase.  The conversion happened in nine waves with 40-50 sites per wave.

He used the words "difficult" and "time consuming" before shifting to the expectation of seeing improved outcomes.  I expect those are financial because HCHB and all the Curo changes made our care much worse.  He expressed appreciation for all the "great work you do, despite distractions."   One regular distraction is the tremendous effort it takes in HCHB to be paid accurately for hours worked and miles driven.  Neither executive mentioned that feature.

Causby talked about November and a number of major events, National Hospice and Home Care month, Home Health Aide week, Veteran's Day and the company's annual marketing blitz "Home for the Holidays."  He spoke of key strategies and the need to grow the business beyond the 550,000 patients and families we serve per year.

David Causby talked about executives not living up to a communication plan and promised leadership communication on video in the future.  He wants to create a family atmosphere, recognized it's been a very hectic year that stressed staff in many ways.  He soft pedaled executives role in the carnage by saying we've "seen a lot of changes/challenges thrown at the organization."  Translation:  Aloof and absent executives have done a lot of tormenting of dedicated staff and destruction of quality hospice care.  .

Larry Graham shared his vision of 2020 being the year the company returns to organic growth.  Humana's 3rd quarter earnings reported referred to "slightly lower earnings from Kindred at Home operations."  Our hospice's daily census for Q3 was below last year, I believe due to the chaos the company imposed on our site.

Causby said the journey is far from over, that continued heavy lifting will be needed for eventual Humana ownership.  He reiterated the company is investing significantly in employee benefits.  That's because Kindred/Curo benefits are far below Humana's and there's great catching up to be done.  Humana knew this when they bought 40% of our company and then let Tweedledee Causby and Tweedledom Graham slash benefits for 2019.

Causby wants Kindred to be known for stellar clinical care and being innovative.  Management's priorities are to provide enhanced benefits and show appreciation.  The Curo way at our hospice has been the opposite of everything he stressed.  Humana et al delivered poor clinical care, rigidity under bad systems, benefit cuts and zero acknowledgement of hard work and high performance by dedicated staff (most of whom are now gone).

The dastardly duo ended with a dark future under Humana with artificial intelligence determining the level of care and what day that should be delivered.  The goal is to decrease hospitalizations for Humana's Medicare Advantage enrollees and decrease the live discharge rate for hospice.  That might mean only admitting patients who actually qualify for hospice.  The pressure to meet targets for admissions and average daily census had patients sneaking onto service that clearly did not qualify.  That pressure grew after Humana, TPG and WCAS bought us in July 2018.

Humana plans to have a predictive clinical modeling platform and operate integrated markets across the various organizations Humana owns.  The second web meeting occurred on November 7th.  Humana CEO Bruce Broussard addressed Kindred at Home's future in Humana's Q3 earnings call with Wall Street analysts.  I'll share those low-lights in another post.

Anonymous