Kindred at Home/Curo's Hospice Staffing Model

Strange Tony,

Last August I gathered comments on Curo Health's hospice staffing model.  Their words ended up as accurate predictions for changes at our hospice over the last year.   Over 50% of staff left, voluntarily or involuntarily.

A former executive shared Curo's staffing model.  It is sparse and not capable of delivering good customer service, at least that has been my experience.

Kindred at Home home health locations are undergoing the same decimation process as our hospice.  They are converting to Homecare Homebase which was supposed to save our hospice lots of work.  It did not.  Homecare Homebase added significant busy work and it underpaid my co-workers for time worked and miles driven.

My vision was to work for a company that could accurately pay employees and staffed for outstanding customer service.  That is not Kindred at Home/Curo Health Services under the ownership of Humana and two financial rapscallions.  That is a tragic development.

Anonymous

Curo's Sick Model and Bad Technology

Strange Tony,

I'm afraid our hospice is terminal from severe management disease.  It began a year ago when Humana purchased our hospice and placed us under Curo Health Service CEO Larry Graham. What they've done together to our site is a crying shame.

Executives knew the plan and the corresponding carnage it would cause.  Step One:  They handcuffed a few people they thought critical to the company's success with retention bonuses.  Step Two:  Once these people were strapped down the firings began.  The terminations haven't stopped.  In an employee update call executives referred to their mendacious plans as a "bumpy year for employees."

Nothing about their plan respected teamwork, once a hallmark of our hospice.  In our heyday everyone mattered.  There were experienced people with time and patience to shepherd new employees.  People were trained to do the job.  No more.

Step Three:  Leave few to no standard bearers.  The few that remain hate what Humana/Curo has done to our hospice.  Curo management has a unique inability to listen.  Step Four:  Label those speaking out as "negative" and deride them for sharing their employee experience.   Ignore that these people were recently the "go to" people for their discipline.

Secure leaders would view what was shared as feedback.  Staff know and have experienced consequences of ongoing management greed and callousness. We just can't honestly share our experiences with anyone up the chain without retaliation.

Executive greed cut nearly everything in the last year, health insurance benefits, holiday pay, staffing, space, color printer, employee appreciation day, floating holiday, post it notes, cellphones, IPADS, computers, employee going away parties and parking spaces.  We just learned some pinhead in Mooresville wants us to pay for parking.  Shaming the Future Together - Curo and Kindred at Home.

They use spreadsheets to underpay staff for miles driven and hours worked.  Loss of pay is compounded by mean girl management, which can viciously cut a hospice heart.  I pray God return to them tenfold what they have foisted on others.

Anonymous

Kindred at Home/Curo Health Employees Tell Friends to Stay Away

Strange Tony,

Management's obsession with measures, big data and artificial intelligence only apply to their greedy priorities.  One year ago Humana bought Curo Health Services, a collection of regional hospices established by financial rapscallions in 2010.   Humana placed Kindred at Home's hospice division under Curo's "innovative" management.  In the last year Curo decimated our once great hospice.

Glassdoor collects data from employees about their experience.  One can look at three companies on Glassdoor to get a feel for Humana's Home portfolio, Kindred at Home, Kindred Hospice and Curo Health Services.  As Curo management has been innovative in the ways they've tortured our hospice let's start there.

Less than half of Curo's employees support its leadership, believe in its future and would recommend a friend work alongside them:

Roughly a third of Kindred at Home employees would recommend the company to a friend (35%) and have a positive business outlook (36%).

Leadership leaves Kindred at Home and Curo employees uninspired, which can be seen in Curo's overall rating trend from employees:

I did not see one regional executive visit our office from July 2018 to July 2019.  Feedback, like excrement, only goes one way, downhill.

Homecare Homebase's garbage in-garbage out hospice system has been a time killer for staff, both clinical and office.   

The company's answer to overworked nurses was to make them salaried.  Humana/Curo Executives get an A in Abusive Management 600, a course required by our 60% financial rapscallion owners.  Abuse leads to no hope.

Yet employees know who is responsible.

Each graph peaked as Humana bought Kindred at Home and Curo Health Services.  Employees experienced harm after these deals and the ratings slide began.

The company has a consistent artificial response to those raising issues of no raises, horrible management and declining quality care. 

Employees may be the heart in that we keep pumping but the company has shown us no love.   How long will workers stay under executive disdain, hollow phrases and false embraces?

Anonymous

Kindred Barely Mentioned in Earnings Call

Strange Tony,

Humana held its Q2 earnings call and Kindred got but a few mentions.  Most of those are below:

In the home through our minority investment in Kindred at Home, we are piloting value-based care models in multiple markets and continue to see encouraging results from a standalone financial perspective for Kindred at Home, and from the standpoint of delivering improved clinical outcomes for our members. To usher in the next wave of integration, Humana and Kindred at Home have invested in an interdisciplinary team of clinicians responsible for taking the best practices gleaned from pilot markets and applying those learnings across Kindred’s broad geographic footprint.

... healthcare services is performing above expectations and we increased our adjusted EBITDA guidance for the full year by approximately $40 million ...  Our home business, including Kindred at Home, is performing well.  

....having new distribution channels that we’ve created, whether it’s Kindred or a PIPC or other areas where we can engage our members in different ways, that’s why we continue to invest those channels and in the technology that supports it so we can continue to manage our medical costs.   

All of our costs are estimated, and so it’s important to identify these early warning systems that can allow us to identify the issues and then create the clinical programs and the customer engagement platform, and frankly the analytics to be able to identify who needs the intervention. We continue to invest in that. We’re nowhere near where we need to be.  

I would say that the outperformance is pretty balanced across the board...  Where we’re seeing, I’d say, greater percentage outperformance is on the Kindred side.   ... the Kindred team is really executing on the business plan.

Humana's 40% interest in Kindred's earnings grew 300% from Q1.  Historically the first six months delivered stronger hospice volumes and revenues than the latter half of the year.  

Humana/Curo operated our Kindred Hospice as a cost center that needs massive ongoing cuts.  So far dramatic reductions in service levels have not translated to reduced patient census.  They have hurt billing.  At one point our hospice had $750,000 in unbilled care.  That's been cut in half.   

Before Humana/Curo foisted cumbersome Homecare Homebase on our hospice our unbilled revenue rarely reached $75,000.  That was under higher volumes.  

Humana and partner financial rapscallions milk our hospice at the expense of quality clinical care.  We're nowhere where we used to be. 

Anonymous

Under Chief Consumer Officer Humana/Curo Consumes our Hospice

Strange Tony,

Humana's Chief Consumer Officer Jody Bilney will leave the company at the end of 2019.  She recently offered:

“What I do know is consumers. I understand how people make decisions. I understand how well-run companies are well run; the importance of corporate culture and governance; and the importance of employee engagement. Those are (all) transferable skills that are relevant across industries.”

Humana transferred none of those skills to Curo Health Services after last year's buyout.  Humana teamed with Curo to consume our once great hospice with repeated, intrusive cuts.  Together they destroyed our customer service levels, trashed our high quality hospice culture and drove away scores of employees/medical directors.

Curo is well run for one consumer, its financial rapscallion owners.  Curo was created from a primordial mix of greed, leverage and political connections.

Bilney's boss CEO Bruce Broussard prioritized bad technology and high interest expenses over customer service.  It placed no emphasis on Kindred at Home employees.  If Bilney knows anything about KAH she realizes the ash heap our company has become.

Consumed by financial rapscallions, Kindred at Home is now managed by an accountant.  I would say things can't get any worse but Humana keeps upping the scale.

Humana's Bruce Broussard, WCAS Tom Scully (former Medicare Chief) and TPG's Dr. Mansukani (former Kindred Board member) can make things much worse for the average KAH employee.  We are but ants they step on because they do not see us.

Workers are units of production, many replaceable by machine learning and artificial intelligence.  I'm not sure what AI can do with Homecare Homebase's "garbage in-garbage out" software.  I can predict it will lead to huge paybacks/refunds to Medicare as the system does not help nurses show decline and continuing hospice eligibility.  That is if the system bills Medicare in the first place.

Humana consumed our hospice and its Chief Consumer Officer.   Bilney will leave Humana a multi-millionaire.  Most of us left with the clothes on our back after years of hard work with no raises.  That's employee abandonment, a disheartening form of disengagement.

Anonymous

Humana Home Division Led by Accountant: Bad Sign

Strange Tony,

Humana announced the promotion of a finance person to lead its home operations:

Humana Inc. (HUM), one of the nation’s leading health and well-being companies, announced the promotion of Susan Diamond to Segment President, Home Business.

Humana’s Home Solutions Business aligns Humana’s home care elements into a single operating unit, continuing to recognize the strategic importance of home care in bringing to life an integrated care delivery model that meets consumers where they want to be, in the more comfortable, accessible and lower cost setting of their home. In her new role, Susan will lead Humana At Home as well as our home nursing and in-home assessment operations. In addition, she will lead Home Operations, our transition management office with Kindred at Home.

Diamond joined Humana in 2006 as a strategic advisor focused on investment and acquisition opportunities before moving into strategic, financial and operational leadership positions for Humana’s Medicare and corporate finance organizations.  

This bodes unwell for dedicated hospice professionals within Kindred at Home.  A bean counter is in charge, one that has no clue about hospice.

In between sits ethically challenged Larry Graham, and corporate cutthroat David Causby.  They have plans for Kindred at Home, drastically cutting costs to fund our $3 billion in debt and saving Humana money on its Medicare Advantage business.

That's not the mission of hospice. 

Anonymous

Carnage at Our Hospice: One Year After Buyout

Strange Tony,

Our hospice is unrecognizable on the one year anniversary of our latest buyout.  We went from time efficient technology that met Medicare regulations to garbage in-garbage out Homecare Homebase.

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.--Humana CFO Brian Kane

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.--Humana CEO Bruce Broussard

Humana made an investment in Homecare Homebase as part of its big data, artificial intelligence plans.  Who knew big data and AI were a euphemism for not paying employees for hours worked and miles driven?

On the clinical side Homecare Homebase is a time eater for nurses who say the system does a poor job of documenting decline and how the patient continues to meet hospice eligibility.  The system can't do anything without orders and scheduling.  Home health is scheduled.  Hospice happens.

Few experienced hospice nurses remain.  Some recall Kindred's effort to predict a patient's decline and death.  The predictive service index score was so inaccurate clinicians stopped looking at it.  On-call staff laughed at it and said, "that number is worthless." 

Who trashed our hospice?  It's been a group effort led by financial rapscallions who own 60% of our company and Humana, which owns the other 40%.  Kindred at Home executives will have a lottery level payday when Humana acquires the other 60%.

Kindred at Home President David Causby and Hospice President Larry Graham foisted Curo's bad technology and miserly staffing models on our once great hospice.  This wobbly platform harmed customer service levels.  Dedicated hospice professionals could not get the attention of anyone in the company.  Their issues and concerns went unheard despite repeated requests. 

Humana considers the home a whole new ecosystem, a distribution platform that no other insurer has today.  Kindred at Home provides the opportunity for Humana to bring integrated technology into the home.  Humana plans to use big data/AI to personalize care for those it insures.  I don't believe it after seeing how executives used our hospice data.

Data showed an employee drove too much, therefore management cut the mileage reimbursement rate (lower than the rate paid to other employees) as an incentive for the high mileage employee to pay Kindred at Home for a company car.  Translation:  The company (which gave patient assignments) no longer wanted to pay staff mileage to drive to fulfill those assignments.

Data showed our hospice had too much square footage, too many computers, too many phones, too many parking spaces and too many bathrooms.  The aforementioned areas were cut 50 to 75%.  They did add cameras to spy on the few employees left.

Data showed it cheaper to take away company provided cell phones so employees could pick up and pay for that personal expense (over $800 pay cut in my case).  Staff who desire a clear boundary between work and personal phones are unreasonable and not team players.  Company apps for employee personal phones have tracking/monitoring capabilities.

Humana's data mining has proven harmful and offensive to Kindred at Home employees.  If someone wants to personalize my care then talk to me.  Ask me about my dreams, my desires, my gifts, my faith and my heart. 

Data mining already produced impersonal decisions that benefit our greedy owners.  Heartless artificial intelligence will reduce hospice headcount past the point of no return.  When that happens, when the Kindred/Curo combination becomes the least preferred hospice provider, God will strike Broussard, Kane, Causby, Graham and our 60% owners where it hurts the most, in their pocketbooks.

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 CFO Bryan Kane

Retribution will come for the harm executives have done to our once great hospice.  They are responsible for the deep drop in customer care and destroying teamwork at our site.  It may be in this life or when executives meet their maker. They will atone for their grievous sins.

Anonymous