Tuesday, December 7, 2021

Humana Selling Curo-Kindred Hospice to "Free Up" Capital


Strange Tony,

Humana CFO Susan Diamond spoke at the Bank of America Securities Home Care Conference.   The moderator expressed his excitement about Diamond's background heading Humana's Home Division.  Before perusing a summary of her remarks, recall Humana served as the operating partner of Kindred at Home since July 2018.  Humana purchased the remaining 60% it did not own in August 2021.

The moderator asked why Humana would not hold onto Kindred at Home's Hospice Division?  Diamond said:

Given the amount of capital invested in the asset there is an opportunity to monetize the value of that asset, spin it off or set it up for independent operation.  It will free up capital, allow us to de-lever more quickly, allow capital to be deployed where we have stronger conviction that we need to own the asset.

Diamond indicated durable medical equipment as one such area.  She said Humana will eventually provide DME for all the people it insures.  Not so with the hospice division.

We will divest a majority stake and sell the rest of the company over time.

The moderator asked about the financial impact of selling the hospice division on Kindred at Home.

We intend to update disclosures in 2022.  It is hard to see the impact under current disclosures.  At the time of the buyout KAH had annual revenues of $3.2 billion and full year EBITDA of $650 million.  EBITDA is split close to 50/50 between Home Health and Hospice.  Hospice had a higher profit margin than Home Health.

She referred to the hospice division as "Curo - Kindred's hospice business."  In talking about the future of Home Health Diamond talked about staff.

Home Health could have top line organic growth of 6%.  Mergers and acquisitions could accelerate that.  The challenge comes in hiring/recruitment/retaining clinicians to take on that volume.  The industry just accepted higher turnover as a cost of doing business.  I have been challenging the Kindred team to buck that theory.  There are systemic challenges underneath.  Demand for nurses outweighs supply.  We need to train more nurses.

Humana has been the operating partner for Kindred at Home for more than three years.  Humana fomented massive turnover at our hospice via Curo Health's crappy, unreliable technology and sparse staffing model.  Humana ran off competent, well trained hospice nurses to the point our hospice census dropped 50% from July 2018.

Under Diamond's leadership Kindred at Home cut holidays 33%, reduced holiday pay 50%, rarely gave a pay raise, and consistently shorted staff on hours worked and miles driven.  That may have contributed to high employee turnover.

Humana wants to be the employer of choice in all areas of the home.  We are offering sign on bonuses and retention bonuses but are trying not to impact run rates (overall salary costs).  We expect to see some wage inflation but that will work its way into reimbursement.
Hesitant to raise wages until the very end, that's executive greed nowadays.  How dare the little people be paid like the Diamonds in the C Suite. 

CFO Susan Diamond had a HP Printer in clear view behind her.  I'm sure the boys at Bank of America know Humana CEO Bruce Broussard sits on HP's Board of Directors.  It's but one more handsome check for Bruce as his company conducts wage and mileage theft from hospice workers.

 Anonymous

18 comments:

  1. Florida Curo affiliated hospice employee said:

    This company had potential to be great. Unfortunately, this company has a high turn over rate . With nurses and aides coming and going constantly. Office staff seems to not realize what field staff are doing. Nurses are on call with out adequate compensation. Most staff are unfamiliar with other staff members. Staff hear all about what they are doing wrong with no compliments on performance. Moral is at an all time low. Nurses do not have consistent patient loads and consistent patients.

    Pros
    Schedule flexibility

    Cons
    Stated above.

    ReplyDelete
  2. Home Health employee for KAH said on Glassdoor:

    They continue to expect more and more without any compensation. Spent more time doing nursing skills than actual PT with patients. Continued to expand driving area with multiple field staff all crossing over in the same areas

    Management does not listen and does not want any input. They say they want input and have meetings and take that time to tell you everything you do wrong

    People leaving in drones yet they do not try to figure out why and fix it but instead continue to add more to the plates of current employees.

    Documenting off the clock all night and weekends.

    They used to have a ton of continuing Ed opportunities but not any more.

    Kindred used to be Gentiva and Gentiva was an amazing company to work for and you felt heard and you had great education and really felt like you were doing great things. All that has gone away through multiple changes in ownership now owned by Humana, all they care about is making money.

    ReplyDelete
  3. Hospice RN in Michigan said "A for-profit company"

    To the office managers, patients are just numbers. They expect the aides to see between 8-10 patients a day. Time and numbers of visits seem to be all they really care about.
    A big lack of empathy from the managers to their workers.

    Pros
    Field workers make own schedule, however it changes quickly

    Cons
    Office managers look down on you for having medical time off

    ReplyDelete
  4. Private Equity Is Gobbling Up Hospice Chains And Getting Involved In The Business Of Dying

    https://news.yahoo.com/private-equity-gobbling-hospice-chains-182313481.html?fr=sychp_catchall

    ReplyDelete
  5. Hospice Nurse Case Manager said Kindred Hospice "Pushes Employees to Breaking Point"

    Pros

    Enjoy the actual job getting to take care of patients and build rapport with them

    Cons

    High Turnover Rate, not concerned about keeping employees happy.
    Unrealistic expectations and job demands.
    No work/life balance

    Advice to Management

    Listen to your field staff if you want to keep them.

    Susan Diamond is supposedly listening....

    ReplyDelete
  6. Florida LPN said "Management is No Good"

    Not a good experience with the branch director, management is no good at all. I will only work there again if they have new management. But I missed my patients.

    ReplyDelete
  7. Georgia Hospice RN said:

    High turnover of management , nurses, aides : constant chaos little structure : little focus on patient care from staff related to high turnover of staff - completely disorganized. Difficult for patients to be cared for properly /thoroughly when the staff is running from one county to another related to lack of organization by management. They are more worried about the number of patients on census than the quality of the care.

    Pros
    Not many

    Cons
    Poor care of patients, employee stress, turnover of staff is huge, poor training of staff, promise one thing and completely opposite

    ...This is what Humana and financial rapscallions did to our hospice.

    ReplyDelete
  8. Home Health RN in Virginia said:

    This was by and far the WORST company I have ever had the displeasure of working for. Management was only concerned about budget and patient quotas. There was no regard for good patient outcomes. When I voiced my apprehension about coming off orientation, my concerns fell on deaf ears because 8 other nurses had quit in a month's time, and I was needed to see patients even though I did not even have access to several medical supply companies. There is NO work - life balance. There is no such thing as an 8-hour day. 14-hours is more accurate. Micromanaging is an understatement! It was the worst time in my 13-year nurse career that I ever have gone through. There were empty promises over and over again. I would rather have 1000 paper cuts then take an alcohol bath and set on fire than ever work for this company again.

    Pros
    Nope. No pros. Not one.

    Cons
    Worst management ever, empty promises, severally overworked, extremely high caseloads, 14-hour days, no management support, not given the tools needed to do the job, dishonest, only concern is patient census, employees taken advantage of.

    ....CenterWell, more like CenterHell.

    ReplyDelete
  9. Kindred at Home Occupational Therapist from Seattle said

    "We use to have some gatherings but they were all stopped in 2020. Morale has fallen and there is no feeling of a team."

    Many, many, many Vice Presidents and very top heavy company. While they send us corporate emails we have no time to read them. At least 60% of the work is unpaid for workers in the field. I have had two performance reviews in six years. It is all done now electronically.

    Pros
    They pay on time. With six years with the company I now receive a month of leave time.

    Cons
    Underpaid for visits only, No advancement for an OT, They removed our salaries but we are dependent upon how many referrals our account executives obtain, 60% of work is unpaid

    ReplyDelete
  10. New Mexico Kindred Hospice RNCM said "One of the worst places I've ever worked"

    Manager is concerned for herself only. They verbalize being there for you but when you really need the help it’s not there. Manager plays favorites. All work no balance.

    ReplyDelete
  11. Georgia Office staff member for Kindred at Home said "Management Sucks"

    Not a good company to work for
    the training sucks
    management sucks as well
    no compassion no empathy
    choose a different company to work for.
    The many changes and non consistently
    no true direction

    ReplyDelete
  12. Home Health LPN said "Not worth the pay"

    Great staff and support, but the pay is not worth all that is involved at all. LPNs only get paid per visit and none of the charting done outside of visits is compensated.

    ReplyDelete
  13. Admission Nurse for Kindred Hospice said:

    Extremely hard work scheduled. No set territory that you may work in with extremely long work hours. have to finish paperwork at night during your own personal off hours due to due by the next morning no matter what time you finished working the night before.

    Pros
    Flexibility between work assignments. not a set routine. Able to independently apply skills.

    Cons
    No assigned or promised breaks or lunch hours. Long work day, and hours per week with only paid for 40hrs. Does not give promised raises. No room for growth.

    ReplyDelete
  14. California Personal Care Assistant for KAH said:

    I wouldn't recommend this agency to work for. Very uncommunicative. Most of the time the "staffing managers" don't know what's going on.

    They don't care about Home Care Providers. No acknowledgement or recognition for birthday anniversaries. No acknowledgement or greetings during major holidays (Christmas, Thanksgiving, New Years, etc)

    No one to express complaints, concerns, or grievances to.

    HR department is non existent.

    ReplyDelete
  15. KAH/CenterWell OT in Washington State said "Do not work for this company no matter what name they use"

    Pros

    Direct co-workers. Ability to make your own schedule.

    Cons

    Everything else. The Tacoma and Puyallup Washington branches have little to no respect for Occupational Therapists nor the Occupational Therapy Assistants. The managers do not care about you as an individual whatsoever. The company is horrible, allows horrible management and turns a blind eye to all complaints. Pay is horrible. Gas prices are skyrocketing and the best this multimillion dollar company offers is a temporary 2 cent raise for mileage!! Yet they spend millions in rebranding. Go to any other company. Do not believe the empty promises, especially from the Tacoma branch.

    Advice to Management

    Actually do what you say. Understand the therapy disciplines and their differences and values. Increase mileage pay, increase pay per visit rate! Be decent humans.

    ReplyDelete
  16. Susan Diamond's 2021 compensation was $4 million. She may enjoy that on this earth but someday she will have to answer for the harms she caused to hospice patients through her decisions.

    https://www.sec.gov/Archives/edgar/data/49071/000119312522069894/d209426ddef14a.htm#toc209426_18

    ReplyDelete
  17. This RN case manager cited the "wage theft" mentioned:

    Con --Don’t get paid for all your work

    Advice to Management --Treat employees with respect and pay them for all the work they do.

    https://www.glassdoor.com/Reviews/Employee-Review-Kindred-at-Home-RVW64785531.htm

    ReplyDelete
  18. A review of Kentucky corporations reveals Susan Diamond has position with 40 organizations:

    https://web.sos.ky.gov/ftshow/(S(qehrkr3sea3dz3mcxkgdlb34))/offsearch.aspx

    ReplyDelete