Stand Against Management's Selfish Wind

Anonymous,

I retired from hospice at the right time.  Corporate toxicity was bad enough my last several years.  The poem below gave me solace during stressful times caused by executive whimsy, mendacity and greed.  I share it with you in the hope it serves as a balm.

The Oak Tree
by Johnny Ray Ryder Jr

A mighty wind blew night and day
It stole the oak tree's leaves away
Then snapped its boughs and pulled its bark
Until the oak was tired and stark
But still the oak tree held its ground
While other trees fell all around
The weary wind gave up and spoke.
How can you still be standing Oak?
The oak tree said, I know that you
Can break each branch of mine in two
Carry every leaf away
Shake my limbs, and make me sway
But I have roots stretched in the earth
Growing stronger since my birth
You'll never touch them, for you see
They are the deepest part of me
Until today, I wasn't sure
Of just how much I could endure
But now I've found, with thanks to you
I'm stronger than I ever knew

Distorted executive priorities and inhumane behavior are the damaging wind which feels unceasing.  Sick leadership eventually collapses from the unnecessary weight it imposes on others.  Stand strong until that day.  Listen for the voice of God for his peace and mercy are always available.  Rest in his palm when the burdens seem too great.

Strange Tony

Margin Matters Over Customer Service

Strange Tony,

Customer service at our hospice continues to deteriorate.  Regional VP's and local management are well aware of the numerous ways our care is coming up short.  Their response is not the corporate tagline, "Our Care Matters."  Bone cutting staffing models, garbage-in/garbage-out technology and robust financial margins are more important.  To their credit our hospice staff have hung in there thus far.

Humana, despite making the home one of its top five strategies, considers Kindred at Home a management distraction.  While they don't care enough to pay attention our hospice is breaking under the weight of layers of aloof and disturbing management.

Cracks are growing in the dike.  I'm not sure how much longer staff can hold back the abusive tide.  Humana/Curo's cookie cutter mantra is growth.  Our hospice is to grow by shrinking. Staff, holidays, health care coverage and mileage reimbursement are all smaller.  What will the company shrink next?  Kindred at Home is synonymous with widespread management malpractice.  The chaos continues.

Anonymous

Kindred at Home to Enrich Humana Investors

Strange Tony,

Humana's top five accomplishments at its annual Investor Day include "forming the nation's largest home health and hospice operator" via Kindred at Home/Curo Health Services.  Home Health is also one of the five most impactful areas of influence on health care utlization.

Home health is one of Humana's national platforms

The home health opportunity warranted a whole slide during Investor Day.

After splashing Kindred at Home as a key strategy/influencer/opportunity Humana cited the area as a "management distraction" which needed to be reduced.   Huh? 

Without full ownership there is no pressure for Humana to align pay and benefits across the company.  Kindred at Home employees continue to receive short shrift from executives across our ownership spectrum.

Humana's financial measures have grown substantially according to several slides, yet wages only increased 1.3%.  That did not keep up with inflation of 1.7%.  Kindred at Home has been a notorious miser in giving wage increases.  Management promised our nurses raises earlier this year.  They have not arrived yet.

This is all to enrich Kindred at Home executives, the two financial rapscallions and Humana's executive team.

Trend bender Kindred at Home is to make Humana's Medicare Advantage plans more profitable.  Our new technology is a huge barrier to serving patients and their families.  It also is a disaster for documenting continued Medicare hospice eligibility according to our nurses.  Humana's Investor Day made it clear our hospice is here to serve the greedy.

Anonymous

Humana Execs Rewarded for Buying Kindred at Home/Curo

Strange Tony,

Humana's top strategic accomplishment was buying Kindred at Home and Curo Health Services.  The SEC filing does not mention how Humana and its it financial rapscallion partners crammed Kindred's hospice division under Curo Health Services.  Curo then installed cumbersome, unreliable technology, decimated our office staff and created mountains of new non-value added work.  It is now difficult to give care, be paid fairly or accurately for hours worked and miles driven.

The filing does not state that Humana matches up to 6% for employee retirement, while Kindred at Home gives a mere 1% for those saving 4% in their 401k. 

The SEC document stated Humana made an extra $33 million thanks to its complicated buyout deal for Kindred at Home.  Before Kindred Healthcare was carved up by investment companies it contributed a mere $4,4 million toward employee retirement. 

Humana matches charitable contributions by board members up to $40,000.  We have numerous staff members that don't make $40,000 in a year.  Many of those staff members have gone years without raises. 

Humana executives recently were awarded stock compensation.  Most received multi-millions in pay for 2018.  As a fish rots from the head down so do we.  There is something significantly wrong in our hospice.

Anonymous

Humana and Rapscallion Partners Ignore Kindred at Home Employees

Strange Tony,

Why did Humana and two financial rapscallions make Kindred at Home a more difficult place to work?  Why have executives continued ignoring employees' needs by not giving raises as household expenses rose year after year?

This wave of dissatisfaction is especially perverse because corporations now have access to decades of scientific research about how to make jobs better. “We have so much evidence about what people need,” says Adam Grant, a professor of management and psychology at the University of Pennsylvania (and a contributing opinion writer at The Times). Basic financial security, of course, is critical — as is a sense that your job won’t disappear unexpectedly. What’s interesting, however, is that once you can provide financially for yourself and your family, according to studies, additional salary and benefits don’t reliably contribute to worker satisfaction. Much more important are things like whether a job provides a sense of autonomy — the ability to control your time and the authority to act on your unique expertise. People want to work alongside others whom they respect (and, optimally, enjoy spending time with) and who seem to respect them in return.  And finally, workers want to feel that their labors are meaningful.

Kindred at Home's Human Abuse Department is strategic and employs big data that somehow misses repetitive social media comments on the lack of raises for years on end.  Basic financial security has deteriorated for employees at our hospice.  One tenth of our jobs disappeared after executives promised no changes.  Our sense of autonomy has been displaced with Homecare Homebase, a huge time eater that takes time away from patient care and family support.

My dedicated coworkers are tired of receiving no respect from above.  We know our labors are meaningful and grateful for the opportunity to perform hospice work.  It's a calling.  I wish our executives and new owners a calling to pay staff fairly, stop the heavy erosion of health insurance, and be in real relationship with employees.

Anonymous (from Humana's independent home health company)

HR Analytics Avoid Employees True Needs

Strange Tony,

Kindred at Home is searching for a key Human Resource leader:

As a HR Reporting & Analytics Manager, you will support Kindred at Home’s Human Resources Team by managing the end-to-end reporting process and producing a suite of internal reports and dashboards. The ideal candidate is extremely organized and an effective project manager who continually evaluates the current state and drives continuous improvement efforts related to technology, reporting process, service levels and prioritization.

You will collaborate with all HR Teams on a consistent basis to align on data infrastructure, definitions, artifacts, and deliverables. You should be able to articulate well to all levels of the organization (VPs, Directors, Consultants & Analysts) and possess excellent comprehension skills.

You have a working knowledge of HRIS systems, preferably SAP, general knowledge of human resource functions and data gathering, storing and retrieving requirements. In addition, you should have a high level of technical aptitude and basic project management skills in order to facilitate data requirement needs and manage large data extraction tasks.

This position reports directly to the Division Vice President of HR Employee Services.

Missing from this job solicitation?  It's any mention of employee satisfaction or retention of experienced staff.  There is no pegging of where the company wants to stand in competitive pay and benefits.

There is a Kindred at Home Glassdoor page where Eric B., Director has been unable to pass on to his bosses that many dedicated associates have gone years without raises.  Is there a dashboard for that?

The same Eric B. is on Indeed"s Kindred at Home page.

"The CEO is only out to line his pockets taking huge million dollar bonuses while employees have not seen a raise in years."   2-2-19

His response on 2-4-19:

Would you be willing to share your experience in more detail? We can be reached at experience@kindredathome.com. Thank you, Eric B, Director, Kindred at Home

Other employees wrote

"One pay raise in 9 1/2 years." 2-1-19

"I have been here over 9 years only received 2 raises but work is constantly being added to me."  10-2-18

 A former HR assistant wrote on 1-26-19:

"They do not promote within they prefer to hire a new person instead and no raises!  I know of employees being there 5+ and never received a raise."

One doesn't need artificial intelligence to detect a long term pattern of the company not rewarding dedicated employees.  Eric B's entreaties for information are not genuine.

One newer comment reflects what our hospice staff recently experienced.  Employees must monitor their time and mileage as the company can't seem to pay them accurately for either.  Is there an internal report with that error rate?  Does an HR Analytics dashboard reflect increased employee time spent making sure they are paid fairly?

Humana, our 40% owner, is searching for a "Director, Human Capital Analytics."

Humana is committed to advancing the employment experience and vitality of the associate community. Through offerings anchored in a whole-person view of human well-being, Humana embraces a focus on stimulating positive individual and population changes while nurturing a sense of security, enabling people to live life fully and be their most productive.  

Once again there is nothing on pay or benefit competitiveness.  Job satisfaction could fit within Humana's "commitment to advancing" the employee experience while it "embraces a focus on stimulating" while "nurturing" and "enabling." 

Employees wrote about the reality of their Humana experience on Glassdoor:

"The company was laying off at the time I left, which caused insecurity. There were too many changes all at once- salaried employees changed to hourly, reduced mileage reimbursement, increased required territory coverage."  1-26-19

"Inconsistency and uncertainty, always laying off good employees, unreasonable matrix, changes are not focused on the actually clients, they are only focused on numbers. They lay off the bottom first instead of all the six-figure leaders. There are great programs but no time to take advantage of them."  2-6-19

"Constantly worried about layoffs. They happened almost every year I was there. Survived 8 rounds in 10 years."  1-31-19

"Micromanaged to the next level, heavy case load, no raises, constant unrelenting change-not normal change-its neverending."  2-8-19

"Benefits could be a little better, a lot of micromanaging, past layoffs, “big brother” always watching, switching from salary to hourly and being watched down to the minute"  12-13-18

Our hospice site experienced layoffs under Hamana/Curo which dramatically reduced our customer service levels.  .Garbage in-garbage out Homecare Homebase has the ability to watch employees down to the minute.    Humana CEO Bruce Broussard and CFO Brian Kane highlighted Homecare Homebase as a strategic tech investment for Kindred at Home.  It should provide a lot of garbage for the two new Analytics chiefs to root through.  Unfortunately, that bad information will be used to impact people's lives through micromanagement and future layoffs.

Humana has more than one source for information without engaging employees in actual conversation.  It's called Workday.

Workday provides tools to reduce company turnover. Its software analyzes around 60 factors—such as pay, time between holidays taken, and turnover in managers to whom the employee reports—and then flags those employees at risk of leaving so the company can try to retain them.

Humana's layoff culture could use such a tool to get people out the door.

Humana's Kindred at Home cannot destroy the resiliency of the human spirit which makes up our hospice.   Through lack of relationship it can cause that human spirit to move to another hospice.   I detect a migration.

Anonymous (from Humana's independent home health company)

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