Humana Execs Highlight Kindred at Home in Earnings Call

Strange Tony,

Humana held its Q4 and FY2018 earnings call today.  CEO Bruce Broussard mentioned Kindred at Home several times in his presentation to Wall Street analysts.

"Regarding the home, we established an independent home health company joining Kindred at Home and Curo that provides significant overlap with our Medicare Advantage business."

"We are now implementing care and payment models oriented to patients with multiple chronic conditions in five pilot markets. We've optimized our ability to exchange key medical history with Kindred at Home. We use this information during the home health admission process to inform the patient's treatment plan as we deploy evidence-based, disease-specific care plans to identify and prioritize the most impactful clinical interventions."

"Additionally, Kindred at Home has selected Homecare Homebase as the electronic medical record and practice management system for both home health and hospice. And we’ll begin implementing this system in 2019. This will accelerate our ability to proactively identify key clinical interventions while improving revenue capture and business and quality reporting."

His statements show how Humana is turning our hospice into a home health agency.  Homecare Homebase for hospice is "garbage in-garbage out" according to our nurses.  I'm not sure what Humana's analytics can do with an off target clinical system.  

CEO Broussard believes home health and hospice are interchangeable.  I'd heard talk of Sales being combined, that marketers would push both home health and hospice.  Gentiva tried that under its OneGentiva initiative and it turned out poorly.

Humana CFO Brian Kane, formerly of Goldman Sachs, also spoke about Kindred at Home.

As noted previously, we made investments in the home, completing the acquisition of a 40% stake in the country's largest home health and hospice operator, Kindred at Home with an option to acquire a 100% of the business in the next few years.

Recall that as a 40% owner in a highly leveraged business in Kindred, there's a lot of debt impacts there that get consolidated below the EBITDA line.

Humana and its financial rapscallion partners made Kindred at Home highly leveraged.  Broussard, Kane and the Humana board crafted the deal that places our hospice in financial jeopardy should reimbursement shift dramatically lower or utilization decline..

An important element of Healthcare Services also is Kindred, and it's important that we invest in Kindred for the long term. And so for example, implementing Homecare Homebase, while an expense for 2019, it's a decision that the Kindred board made recently because we thought it would position us better for the future and enable us, as Humana, to attain the clinical outcomes and the clinical measures that we're striving to do.  So we thought that was a smart investment to make.

The "Kindred board" is now made of leaders from Humana, WCAS, TPG Capital, Gentiva and Curo Health Services.  They foisted HomeCare Homebase on us for Humana's needs, not our patients.

In addition, Kindred at Home incurred higher-than-anticipated cost in the quarter, including investments related to enhancing the capabilities of existing branches that present a substantial opportunity to service Humana membership, costs resulting from the shutdown of unprofitable branches and other costs incurred to establish an independent company.

Our adjusted EBITDA guidance for 2019 also reflects the cost of additional investments that Kindred at Home is making to enhance the clinical model in preparation for the patient-driven groupings model or PDGM including the implementation of the Homebase Homecare system across both the home and hospice platforms that Bruce discussed in his remarks.

This is the most information I've received on our company's strategy to break our hospice and turn it into Humana home health.  Frankly, I am glad to learn it.   There are other hospices in town.  We used to be head and shoulders above them.

One nurse said last week.  "I don't want to work for another hospice, but they've turned us into another hospice."  Yes they have.

Anonymous

Humana Overlords Enrich Themselves

Strange Tony,

Christmas and the New Year saw Humana board members and senior executives enriching themselves with stock awards.  While bounty overflowed at the king's table nothing trickled down to my hospice coworkers.  Benefits deteriorated significantly in the health insurance arena.  The multi-year pattern of nonexistent pay raises continued as overlords lathered themselves with stock options.

Two paid holidays disappeared for 2019 and time-and-a-half holiday pay turned into regular pay.  I'm not sure where executives will put the riches taken from employee pockets.

Humana CEO Bruce Broussard may have spent it in Davos, Switzerland where a hamburger costs $75.  The cost of hamburger meals for Broussard's entourage likely exceeds the company's 401k match for the average Kindred at Home employee. 

Broussard is smart enough to do the math.  What will smart Kindred Hospice employees do under unbalanced, incompetent, mendacious management? KAH executives are focused solely on doing our new owners' bidding.  They want more.  I'm not sure there's anything left to extract from staff.  

Anonymous (from executive enriching Kindred Hospice)

Broussard Broke Our Hospice/Kindred at Home

Strange Tony,

Funny you characterized Humana CEO Bruce Broussard as an overlord.  CNBC interviewed Broussard from the Annual Overlord - World Economic Forum meeting in Davos, Switzerland. 

Healthcare is clearly broken as people avoid care due to absurdly high deductibles.  I joined this group in 2019 after Humana and two financial rapscallion partners purchased Kindred at Home last summer.

Broussard mentioned acquisitions from Davos Billionaire Boys' Club.  He cited Humana's home strategy, the rationale for buying our hospice and our newest overlord, Curo Health Services.  Nothing good has happened for patients, physicians or staff under Humana/Curo.  The company shifted millions away from people to paying interest and installing value destroying technology.

Time is spent trying to correct "garbage in - garbage out" systems that purport to document patient care, order supplies, pay people for hours worked and miles driven.  Our accuracy rate must be close to zero.  Everything requires a workaround or redo.

Hospice staff are breaking their necks and backs trying to serve patients and their families.  It gets more difficult every day.  No leader at any level in our company has asked office staff or clinicians how things are going.  They must be with Bruce Broussard's entourage in Davos.  Someone has to mix the beverages.

Anonymous (from down and out Kindred at Home)

Protect us Lord from Our Overlords

Anonymous,

I was going through comments from Kindred employees and ran across this:

"Cut to a few years later and we were bought by ..... More of the same.  Just a slightly further away sociopath in charge. 

Branches will have the same story about their managers as you do for yours.  They're incompetent at best, destructive at worst. But as long as they make numbers and run the business line, nobody will change anything.

Tons of bullying and cliques up and down the corporate chain, lots of infighting and competition, over the same scrap.  If only they realized that the fight wasn't with each other, but with the overlords."

I thought you might appreciate this comment given the turmoil you and your peers are experiencing at the hands of new Overlord Humana.  Retirement remains highly satisfying.  No overlords or their investor partners.  I pray God opens their hearts in order to free you and your co-workers. 

Strange Tony

Humana Loads Scale onto Kindred Hospice

Strange Tony,

David Gruber, MD, MBA wrote in HomeCareMag.com

The hospice industry has been consolidating for many years. The largest 100 competitors account for “only” 42.4 percent of hospice providers.

However, the hospice market is changing. Scale is becoming increasingly important to fund information technology (IT) and other infrastructure requirements. 

Note the author did not cite scale as necessary to give employee raises, maintain decent benefit levels or offer a reasonable retirement benefit.  Kindred Hospice offers a 1% retirement match for employees who contribute 4% of their pay to their 401(k).  Humana offers a 125% match up to 6% of their employees annual pay.  Humana's retirement match is 5x better than Kindred at Home's.  Nothing has trickled down to Kindred Hospice employees since our hostile takeover by Humana, WCAS and TPG Capital.

Gruber also failed to mention the quality of information technology funded.  Our new Curo technology is horrific.  It forces nurses to answer non-applicable clinical questions, giving them no ability to skip the question or select "does not apply."  They must put down the least wrong answer in order to move on.  When they reach the end of the visit note the computer program asks the nurse why it took them so long?  Maybe it's because Curo turned a nurse visit into an SAT exam, please select the most correct answer. 

Scale is also a crusty buildup from for-profit corporations' misplaced priorities.  Humana-Curo gunked up our nearly all of our hospice's processes, trashing customer service levels. Humana and Curo imposed massive amounts of scale onto our local hospice, all which is non-value added.  Home health is scheduled.  Hospice happens, turning the best laid plans into shredded paper.

In addition to ineffective and inefficient computer systems our staff must now devote significant time and energy in order to be paid fairly for time worked and miles driven.  Several longtime nurses stated they don't have the fight, interest or ability to deal with new payroll-mileage methods.

Meanwhile delusional local management is caught in a self congratulatory loop over how well things are going.  It seems the invasive Humana-Curo scale clogged their carotid artery, reducing oxygen to their brain.  I don't know how the scale only focused on managers' and regional executives' brains.  Staff and our talented physicians have enough arterial flow to accurately perceive damage done by Humana-Curo scale.  However, it is raising blood pressure and causing major headaches for the aware.

Our hospice has been consolidated many times and no acquisition has gone as badly as Humana-Curo.  I am sure the financial rapscallions that own 60% of Kindred at Home are mostly responsible for the carnage, however Humana put down enough cash to have a major say.  Humana's cash investment could've bought nearly all of Kindred Healthcare's equity.  Instead Humana ended up with a fraction of half the company for their $800 million in cash.

I don't understand why Humana's Board approved the deal.  Kindred Healthcare offloaded nearly all their debt onto their former Kindred at Home division.  Former Kindred CEO Ben Breier is ecstatic over his much lighter debt burden, courtesy of Humana.

Dedicated to ensuring that every business decision we make reflects a commitment to improving the health and well being of our members, associates, the communities we serve and our planet.--Humana's mission statement

Financial rapscallions WCAS and TPG Capital partnered with Humana CEO Bruce Broussard, a former CEO for WCAS affiliate U.S. Oncology.  Together new owners are contorting the face of hospice.  That's what greed on a massive scale does.  Our patients, their families, my coworkers and our community suffer for what Humana's business decision has done to our hospice.

Anonymous

Kindred at Home's Declining Online Reputation

Strange Tony,

Kindred at Home's new owners seem not to care at all about employees despite offering language like this:

"The impact of sharing your concerns is crucial to the future experience of other employees."

I saw zero impact of employee survey feedback before senior executives dropped it like an offensive waste product.  Many employees shared their concern about going years without raises, also no impact.

The hope that partial Humana ownership would help employees has evaporated at our hospice site.  There is a trend line to observe.

We've returned to the endurance days where employees come to work solely for their love of hospice.  The challenge is providing good hospice service within bad corporate systems that show no appreciation for experienced, dedicated staff.  Humana's buyout delivered our darkest days since our hospice founding.

Anonymous

Employees Moving Backward under Humana Ownership

Strange Tony,

Employees received a "Moving Forward" communication last December.  It said:

Q. What should I do during the transition?

A. It is business as usual for all of us at Kindred and your responsibilities will not change. Please continue to act with the same dedication and focus that you always have as you deliver compassionate care to your patients and support your fellow colleagues. 

Leaders cut five critical office positions under the ruse that technology would fill the gap created by their absence.  Unstable cloud technology and a home health medical record system created gobs of scheduling work that did not exist previously.  The company obstructed the delivery of compassionate care to the point that talented, dedicated, long-term employees are talking of leaving.

Our local director shared our owners Humana/WCAS/TPG cut our holidays 25% for 2019.  We no longer have an Employee Appreciation Day or our Floating Holiday.  Curo pays straight time, not time and a half, for holidays.  That change would mean a 33% holiday pay cut in addition to the 25% decrease in the number of paid holidays.

Last December executives informed employees:

Q. What changes will Kindred employees experience?

A. At the field level, we expect there will be little to no change. At this early stage we do not yet know the effect on support-level positions, but we expect that the separation into two new companies will create exciting opportunities for many of our employees. A team consisting of members of Kindred leadership as well as leaders from our other partners in this transaction is hard at work to determine how best to position these two new companies for success. 

Little to no change turned into decimating our hospice.  Co-workers learned other sites are experiencing the same destruction in service levels.  As stated above our leaders and new owners determined these changes which cause suffering for patients, families and employees.

Our leaders hold significant equity positions in our company.  Disturbingly, they will be enriched by the harm they have inflicted.  Cutting two benefit days and paying straight time on holidays will save the company at least $12 million.  That will flow to the bottom line as measured by EBITDA.

Humana will buy the rest of our company (60%) by paying a multiple of EBITDA.  The holiday benefit cut will add $100 million to Humana's purchase price.  C Suite executives will get a chunk of that.

Humana, WCAS, TPG and our executives inflicted employee pain for their earthly gain.  The cuts come after years with no raises.  Recent Kindred/Curo/Humana corporate moves indicate more cuts are likely.

Humana's new Chief Strategy Officer comes from another financial rapscallion, The Carlyle Group.

In the role of Chief Strategy and Corporate Development Officer, Agrawal will report directly to Humana President and CEO Bruce Broussard, and will serve as a member of Humana’s Management Team. Agrawal will be responsible for advancing the company’s strategic insights and planning process, establishing direction for merger, acquisition and joint venture activities, while maximizing capabilities to create competitive advantage.

Agrawal brings more than 20 years of experience in planning and implementing strategies to drive growth and performance improvement across publicly traded and privately held health care organizations. He comes to Humana from The Carlyle Group, a Washington, D.C.-based financial services and investment firm, where he served as Senior Advisor.

Previously, Agrawal oversaw strategy for Ciox Health, a health care information management company, as President and Chief Growth Officer. Agrawal has also served as President of Harris Healthcare Solutions and Partner at McKinsey and Company.  

In the same press release Humana announced that CFO Brian Kane, originally from Goldman Sachs, would lead Humana's Care Delivery efforts, likely the future home of Kindred at Home should Humana eventually buy the remainder of our company.

Humana's buyout brought staff cuts, worse health insurance and holiday benefit cuts which stand to further enrich our senior executives.  Employees are clearly moving backwards.  Those with standards will fight back or leave.  Our employees want to work for a local hospice that provides outstanding care.  It's a shame we have to look outside our company to find one.

Anonymous   (from a once great hospice site with lots of heartbroken staff)