Thursday, November 26, 2020

Humana Gave Kindred Hospice Cost Controls During Pandemic


 

Strange Tony,

Under COVID-19 Humana has been making money hand over fist.  CFO Brian Kane was the only executive to mention Kindred at Home in the Q3 earnings call.  Kane said:

Regarding Kindred at Home, you'll recall we mentioned on our first quarter earnings call that new home health admissions have been adversely impacted by COVID. As the year has progressed, volumes have stabilized and early signs of a rebound in demand are beginning to materialize. Further, the Company has been able to offset these initial challenges with strong clinical and overhead cost controls across the organization.

On Home Health Humana CEO Bruce Broussard offered:

We do continue to also want to grow the value base from us building our clinics and our home health side. So, you see with the primary care -- the partners in primary care product and the Conviva product, along with some of our home solutions, moving more and more to value-based payment models that are really oriented to the ability to do it, whether we do it internally with our providers or externally through our partnerships there.

There was no mention of hospice on the call even though Americans are dying from COVID-19 in droves.

Oddly, Broussard mentioned a program Papa that provides support to lonely Medicare Advantage patients.  

While registering Otis for the Papa program, the case manager noticed it was Otis' birthday and began singing happy birthday to him over the phone. Otis was overcome with emotion, noting it had been years since someone had even wished him a happy birthday. His reaction impacted his case managers so much that she reached out to Papa's corporate team and Humana, who immediately took action and had a birthday cake delivered to Otis' home. Sometimes, the smallest action can make a big difference in someone's life. Programs like Papa now are important element in addressing the holistic needs of our members.  

Our hospice did this very thing for years for our patients.  It ended when Humana and its financial rapscallion partners bought Kindred at Home and forced our hospice into Curo's penny pinching operating model.

Curo does not allow a color printer in the office.  Thus we stopped making personalized birthday cards for patients.  We could no longer print custom certificates honoring veterans for their military service.  These cost our hospice pennies to produce.  For years patients and their families expressed heartfelt appreciation for birthday celebrations (often with cake) and military service recognition (with veterans pins and balloons).

Management said "Ink is expensive."  Our Medical Directors offered to pay for the ink.  Management declined.  Our office just installed new cartridges which would last a year.  We asked if we could just use up the ink in the printer.  Management said "that is forbidden." 

Our office paid over $2 a page for veterans certificates at an outside vendor.  Add staff time and mileage reimbursement and each certificate cost over $12.  Before Humana we produced those for pennies in a fraction of the time.

I recall a meeting with Jeff Shaner, Senior VP of the Hospice Division under Gentiva.  Shaner told a story about a chaplain who'd gotten "employee of the year" for his region.  The chaplain stayed with the patient and family all night because it felt like the right thing to do.  

After Shaner finished his story our hospice chaplain said he would've been fired for doing that very thing.  The award winning chaplain was salaried, thus his extended hours of service had no additional cost to Gentiva.  Our chaplain was hourly and would've been fired for working overtime without permission.  I know he regularly stayed with patients and families off the clock.  That too could have gotten him fired.

Humana's CEO bragged about Papa to Wall Street analysts.   Our hospice did the same thing for years and Broussard's managers nixed it, doing so with contempt and disdain.   

Humana contracts for Papa's services.  Our celebratory work with patients was done by hospice volunteers, i.e. for free by people with big hearts and love to share.  Contrast that with Humana's executive team which has to be motivated by complex reward schemes to do their job.

The spoils of this earth lies in the hands of Broussard and his executive team.  Hospice angels get their rewards by doing God's work on this earth.   Humana cut our once award winning hospice service levels.  During the pandemic Broussard et al gave us cost controls.  Kindred at Home owners and executives are loath to share.

Anonymous 

Saturday, November 21, 2020

Destroyer Leaving


 

Strange Tony,

To resounding applause Regional-Local Assistant Vice President of Operations Minus Marketing Savanna Heartless Banshee announced her acceptance of a job with another hospice company so she could make more money.  

Heartless Banshee (aka Mean Girl #1) destroyed our once great hospice with her arrogant, disconnected and arbitrary decisions that hurt patient care but gave her bosses what they wanted, buckets of cash and high staff turnover.  There is no institutional memory at our hospice, not that Banshee respected it when it existed.  

Heartless Banshee is executive material in a world where the spoils go to the top and nothing trickles down to hard working staff.

I suggest her new company consider Banshee's real resume:

  • Stole pay from nurse case managers by making them salaried and requiring they take call in addition to their regular hours.
  • Implemented Homecare-Homebase, a garbage in-garbage out software suite that claims to automate all hospice operations but does nothing well.  
  • Stole mileage reimbursement from staff by having HCHB automatically include mileage to the patient's home but not add the return trip.
  • Caused turnover of at least 30% per year at our hospice location, over 100% in the nursing area over her tenure
  • Treated employees like they were inferior in intellect and/or personality.  Extremely dismissive of legitimate concerns expressed by employees. This behavior was emboldened by Humana/Curo.
  • Fired qualified, hard working staff simply because she did not like them
  • Leader of Mean Girl executive group that tormented the most outstanding areas of our hospice 

I had the displeasure of Banshee doing my performance review as we had no Branch Manager at the time.  She did not acknowledge any of the outstanding outcomes achieved in the prior year.  When I tried to raise them Banshee said "I are evaluating you, not your job."  Heartless Banshee told me the many reasons she did not like me.  I burned her evaluation after using it for toilet paper.

RLAVPOOMM Savanna Heartless Banshee may make more money but she cannot take it with her when she leaves this world.  She will face her maker and answer for her earthly deeds.  .Hospice taught me to say, "Lord, it's in your hands now.  Thy will be done."

While there might be hope that Banshee's replacement will be better, Humana/Curo repeatedly showed me that is not likely.  Change benefits those at the top.  The rest of us patiently wait for crumbs to fall from their table.

 Anonymous

Management review on Indeed showed Savanna's dastardly deeds at Abode:

  • Corporate management is the worst. They treat everyone as disposable. Corporate management treat local staff like they are elementary students but want them to perform like big company executives. Stay away from this employer to avoid regrets
  • Pros--Free coffee, lunch room, free parking
  • Cons--Treat staff poorly. Just another overhead cost that can be easily replaced