Greed at the Top Creates Misery Below

Strange Tony,

Humana and its financial rapscallion partners have been ceaseless in devastating our hospice.  Position eliminations continue, turnover ensures a lingering dearth of talent and management remains cruel as ever.

Responsibility falls to Kindred at Home's executive cadre of louts and its greedy board.  The new garbage in-garbage out clinical information system added mountains of non-value added work to an office of empty desk chairs.  Clinicians bypass fields to avoid time consuming rabbit trails.  There is only one place to find accurate information, the clinical narrative.  The rest is junk.

Humana embedded GI-GO Homecare Homebase but no new positions.  I've seen no improved outcomes, just newbie staff hanging on by the skin of their highly overworked teeth and management crossing their fingers that families don't complain about poor levels of service.  Corporate gits ignore customer feedback numbers as long as the financials look good and cash flow gushes.

Humana indicated our bottom line grew nearly 30% from 2018 to 2019.  The company shared 0.3% with one dedicated coworker.  That left 27% for C-suite louts.  Employees noticed. 

Board members and executives ruined our once great hospice.  Greed is rampant.  They do know they cannot take it with them and their day of judgement nears with every stuffing of their pockets at the expense of patients and staff..

My worry is for my coworkers, doing heartfelt work in an ill managed organization with earthly aims.  I don't trust financial rapscallions to do anything other than maximize their payout come summer 2022.  Their radar is on equity holders, i.e. themselves.  Staff are on their own.

Anonymous . 

Humana Borrows Big to Buy the Rest of Kindred at Home?

Strange Tony,

Humana reported the company issued $1.1 billion in debt.  The SEC filing says it is for general corporate purposes but my gut says it might be used to buy the rest of Kindred at Home from financial rapscallions TPG Capital and Welsh, Carson, Anderson and Stowe.

The recent financial implosion creates big problems for our 60% owners.  In this environment cash is king.  Washington may supply bailout money for Humana and its greedy partners, however the quickest way for our majority owners to cash up is to require Humana to buy them out.

TPG and WCAS have another reason to do the deal now.  It would be based on EBITDA prior to the coronavirus meltdown.  Humana has to pay 10.5 to 11.5 times EBITDA per the KAH buyout agreement.

The chart showed the deal as of February 2018 when Kindred CEO Ben Breier and a conflicted Board sold the company on the cheap.

Humana spent 2019 destroying our hospice by dramatically cutting staff, harming quality of care and forcing cumbersome, garbage in-garbage out technology on our site.  Other than their "investment" in crappy, unreliable technology our new owners used our hospice as a cash sluice.

It's likely $1.1 billion is not enough to buy out both rapscallions.  As of 12-31-19 Humana had over $4 billion in cash and cash equivalents.

It's ironic that Humana's borrowings could be used to save financial rapscallions.  I wonder how my former co-workers who lost jobs might feel about that.  They were sacrificed on Broussard, Causby, and Graham's altar of profits.

Anonymous.

Healthcare Workers at Risk with Coronavirus

StrangeTony,

I am worried about my hospice coworkers with the spread of the coronavirus in our country.  This disease stands to disrupt our hospice more than any corporate takeover, which is saying alot given the damage Humana and its financial rapscallion partners did to our site since July 2018.  We are down to one experienced hospice nurse and that person is looking for a new job.

An Emergency Room doctor talked about the risks to healthcare workers in the primary and acute care setting:

Nurses, doctors, and hospital and clinic staff will be regularly exposed to patients with high viral loads, increasing our personal risk immensely.

This exposure is all but inevitable, as cases are continually and rapidly slipping through screening protocols.  

Public health officials encourage people who may be ill with the virus to stay at home.  That may be a home with an elderly relative on hospice or home health.  It could be a nursing home where we have patients.

Keeping healthcare workers safe is an issue.

What is slowly starting to keep them up at night is whether the US healthcare system is prepared to properly handle an influx of cases.

Experts say there is a worrying lack of training and coordination and that the system as a whole needs to be able to communicate more effectively.

We have older hospice employees who are at greater risk for serious complications or death from the disease.  On staff we have young parents who surely do not wish to bring home the virus to their family.

“If they (healthcare workers) go down, the whole thing falls apart and destabilizes,” Hotez said. “That is the place where things could go wrong very quickly.”

I am not aware of any preparation for the coronavirus by Kindred at Home.  There has been no information shared, much less training conducted.  Things can change quickly in a community.  Preparation is important and that time is now.   So far the silence from executives and local management is deafening.

Anonymous

Humana Wants More Profit from Kindred at Home

Strange Tony,

Humana CEO Bruce Broussard informed Wall Street analysts of plans to build a longitudinal health record.

This year, we'll be bringing on all of Kindred in that relationship as a result of them completing their EMR install.

In the home, we advanced our transformational home health initiative with Kindred at Home and Curo through the implementation of a company-wide EMR and the extrapolation of best practices for our [indiscernible] over 20,000 home health episodes.

The next phase beginning in 2020 is to provide more care services in the home, including acute care and primary care in the home, so that we may begin to generate meaningful trend vendors for our health plans in the future while improving clinical outcomes for our seniors.

Homecare Homebase's cumbersome, complex software requires multiple workarounds.  It turned into "garbage in/garbage out" as nurses refuse to check any boxes that might take them on a clinical rabbit trail.  The narrative summary is the only place to find pertinent clinical information.  It resides nowhere else in HCHB's twisted bowels.

On measure after measure our hospice is far worse under Broussard's greedy leadership.  Humana implemented a littany of worst practices.  The system robs staff of fair pay for hours worked and miles driven. That is not a best practice. It's abusive.

Humana CFO Brian Kane mentioned Kindred at Home several times in the recent earnings call with Wall Street analysts.

For Healthcare Services, we had a strong year as we saw growth in our pharmacy business, solid performance of Kindred at Home and continued improvement in our Conviva operations, partially offset by the cost incurred to continue to expand our owned JV and Alliance senior-focused primary care centers.

Our home business is also anticipated to perform well led by Kindred at Home in which the conversion to Homecare Homebase across home health and hospice in 2019 weighed on results due to the significant required one-time investment, but will drive EBITDA in 2020.

Kindred at Home is also performing well. We hope to continue to see strong EBITDA growth, not withstanding the change in the payment model.

I'm not sure what else Brian Kane can do to drive EBITDA growth.  Humana and its financial rapscallion partners already depopulated our hospice staff.  Caring people quit or were targeted for elimination by the Mean Girl managers, local and regional.

Humana executives want higher earnings and Medicare Advantage cost savings from Kindred at Home.  Greedy executives rely on complex, unreliable technology while abusing actual caregivers.  Broussard and Kane want profit growth and they don't care who gets hurt in that pursuit.

Anonymous

Hospice Staff Should Prepare to be Leveraged

Strange Tony,

"Home Healthcare News" interviewed Humana at Home President Kirk Allen.  One question targeted Humana at Home's plans for Kindred at Home, a company 40% owned by Humana.

"We have learned that there is a real depth in the clinical relationship that exists between the hospice care providers and the hospice patient and the patient’s family, as well as how holistic the benefits of hospice are. There is a medical component. There is a spiritual component. There is bereavement care for the family following the patient’s death.'

'We are learning to take a look at those interactions and consider how we can leverage that time we spend with the [Humana] member in their homes, and how we can take full advantage of that moment of influence to really help serve that member."

That depth in clinical relationship resulted in a huge pay cut for our hospice's nurse practitioner. Evolution Health implemented a similar move just prior to Kirk Allen joining the company.

The company decided to cut NP pay for an entire group of NPs. This decision was announced by email. There was no warning, no meeting, no telephone call. There was just an email stating "we are reducing your pay per visit and IF you do not sign a new contract in one week we will quit assigning you patients". For me it was a 29% pay cut. I am not sure how much of a pay cut it was for the other NPs. Several NPs quit immediately because they did not have a contract that protected them.

Humana and its financial rapscallion partners continue shedding jobs at our hospice.  Every few months they eliminate a position and overload the few remaining office staff.  Our census is roughly the same as summer 2018 when we were sold down the river.  Homecare Homebase continues to be cumbersome and overly time consuming.  Staff continue to work hours and drive miles for which they are not paid.  What kind of leaders would do that to their people?  Snakes in Suits.

"Psychopaths manipulate others to accrue power, sometimes pitting them against each other in an attempt to divide and conquer. They are often attracted to bigger, dynamic corporations with very little structure or supervision. They generally don’t work well in teams because they don’t like to share information or skills and it brings them joy to watch others fail. They are addicted to power, status and money. Sound familiar?

The corporate world is set up to favor psychopathic traits such as fearlessness, dominant behavior and immunity to stress. Because of this, psychopaths often find themselves in these types of positions, and then have an easier time climbing the corporate ladder and obtaining positions of great power. This is where they can do real damage to society as we see it today."

Kindred at Home executives have skin in the game, i.e. an ownership stake in the company.  They will make a king's ransom when Humana buys the rest of the company from TPG Capital and Welsh, Carson, Anderson and Stowe.  They stand to make more by robbing the people who do the clinical and office support work.  Pathological, earthly leaders are widespread in healthcare as more and more companies come under the ownership of financial rapscallions.  Greed is omnipresent and it kills.

Anonymous

Humana Has Two New Executives from CMS

 Strange Tony,

"Yahoo Finance" reported on two new senior executives at Humana:

Humana Inc. has detailed how it will put two former federal government personnel that it hired recently to work.

Drs. Kate Goodrich and Mona Siddiqui will lead efforts to better integrate the company's clinical efforts, according to a statement from the Louisville-based health insurance company.

Earlier in the month, news broke that Humana (NYSE: HUM) had hired Goodrich and Siddiqui to unspecified senior vice president roles. Goodrich left the chief medical officer role at the Centers for Medicare & Medicaid Services. Siddiqui left the chief data officer position with the U.S. Health and Human Services Department.

Goodrich will take on the title of senior vice president of trend and analytics. Siddiqui will take the title of senior vice president of clinical strategy and quality, enterprise clinical management, the statement reads.

Specifically, Goodrich will be accountable for developing and implementing Humana's clinical trend strategy; leading the clinical business analytics needed to deliver the work of the ECOM strategy; work with various analytics units in Humana including the recently created digital health and analytics division.

Siddiqui will be accountable for Humana's integrated clinical strategy and establishing the direction for the company's clinical quality measures. 

Humana has two new executives to enrich as they continue robbing my hospice coworkers of fair pay for hours worked and miles driven.  Homecare Homebase continues to be a garbage in/garbage out system.  

The two new executives can advise CEO Bruce Broussard on ways to optimize payment under Medicare's complex extrinsic motivation schemes.  Broussard and his fellow executives will take any windfall while Kindred at Home employees struggle.  Crumbs rarely fall from the king's table.

Anonymous

Humana Enriches More Executives

Strange Tony,

Humana CEO Bruce Broussard sold company stock before Christmas as did thirteen other executives.  Broussard received $21.7 million for his shares.  Broussard's stock sale is 4.6 times more than the $4.7 million Kindred contributed to employee 401(k) retirement accounts in 2018.

Humana enriched former Homecare Homebase Chief Operating Officer Tom Maxwell when it announced it would buy specialty hospice pharmacy provider Enclara Healthcare.  Maxwell is an Enclara board member and owns healthcare consulting firm Maxwell Healthcare Associates.

Over a year ago Humana influenced the Kindred at Home board to go with Homecare Homebase.  Maxwell Health Associates assisted our hospice with its Homecare Homebase  go live.  Maxwell consultants ensured staff was not be paid fairly for hours worked or miles driven.

While valuable staff members were laid off Tom Maxwell made big money from Kindred at Home's conversion to Homecare Homebase.  He will make big money again when Humana closes the Enclara deal.

Two former Medicare Chiefs are directly involved with Humana/Kindred at Home or Enclara.  Obama Health Reformer Nancy Ann Deparle will profit handsomely in her role as founder of financial rapscallion Consonance Capital.  Bush II Medicare Chief Tom Scully owns a chunk of Kindred at Home via financial rapscallion Welsh, Carson, Anderson and Stowe.  He will make massive profits when Humana buys the rest of Kindred at Home from Humana at grossly inflated prices.  Broussard once worked for another Welsh Carson affiliate, U.S. Oncology and traded Concentra with WCAS as Humana's CEO.

Kindred Hospice workers toil under bad management and ineffective computer systems.  The spoils do not trickle down to the people doing the billable work.  Workers vote with their feet daily by leaving.  Executives have neither eyes to see or ears to hear.  They do have fingers to count their earthly gains which remain on this planet when they receive God's final judgement.

Anonymous