Hospice Workers Were Post Officed

Strange Tony,

Kindred Hospice isn't the only place with bad management.  Consider recent changes at the post office.

“Unfortunately, our production process within the plants was not fully aligned with this established schedule. So we had some delays in the mail, and our recovery process in this should have been a few days and it’s mounted to be a few weeks,” he said. “The only change that I made was that the trucks leave on time. Theoretically, everyone should have got their mail faster.”

Pressed by Senator Jacky Rosen, a Nevada Democrat, DeJoy declined to say what kind of analysis, if any, USPS had done before implementing the changes.

Losing the 671 mail sorting machines, in combination with other cuts, has led to mail moving more slowly through postal facilities, postal workers say,  

Management making universal decrees without analysis, input, testing or feedback.  Sound familiar?  The USPS, like Kindred Hospice, has a no overtime order.

Humana and its financial rapscallion partners trashed our one nationally recognized hospice.  They foisted Curo's myopic leadership and inadequate processes on us with no input from dedicated staff.  Curo ran a bunch of small hospices.  Our hospice was over three times the size of the average Curo site.  

Our mail sorting machines were staff.  Curo cut a big number initially saying technology would replace the work these dedicated people performed.  Curo's crappy technology created drastically more work for people who wanted to be paid fairly for hours worked and miles driven.  Staff cutting never stopped.  It was hard to see the company had any standard for new hires.  Repeatedly we got unqualified new people, usually with zero input from the "team."  

Curo gave us phone and computer systems that could spy on staff.  The phone system worked poorly making it difficult for families to reach our hospice in times of crisis.  Overworked nurses tried to document admissions and visits in Homecare Homebase's Gordian Knot software.  They would be disciplined, then fired for allowing their charts to go unfinished as this cost the company money.  Nurse eventually learned to say "no" to all rabbit trails and document their findings in one place, the clinical summary.  

Supposedly customer feedback was a critical measure.  It plummeted during all the changes with not a concern from local or regional management.  They refused to acknowledge or discuss indicators showing repeated service failure.

Staff turnover soared and has remained high.  We have very few experienced staff left.  Every quality hospice nurse resigned.  Some chose not to work 60-80 hour weeks and be paid for 40. 

Another mail sorting machine removed was our site's color printer.  We used it to create veteran certificates and other special items for patients and staff.  It had brand new ink cartridges installed.  Curo would not let us run down the ink, an expense already incurred.  The machine sat idle for a year while we paid a vendor to produce those Veteran Certificates and the company paid time and mileage for a staff member to pick those up.

Humana/Curo pulled a USPS on us.  Patients and families continue to pay the price in lesser quality service.   Like the post office hospice workers are not consulted on changes.  Rewards for good service are nonexistent.  

The management bar has fallen so low.  Why don't they open their eyes and ears?  Do they not care about workers and customers like the USPS?  They simply care about money and power.  For that the people suffer.

Anonymous

Another Humana Home Investment

Strange Tony,

Humana invested $100 million in Heal, a Los Angeles based physician house call and telemedicine company.  Humana's Home Business Segment President Susan Diamond will join Heal's board of directors.

Are Humana and Heal are a perfect fit?  Here are the most recent reviews from Indeed:

I left because they were not looking out for me.

They treat the employees like options. They aren’t considerate of others time and they expect you to be understanding to constant changes. If you give a sliver of an opinion, they will say you’re not being a team player. They only care about producing the numbers for the insurance companies.

Quality care is very compromised due to greed of making money. 

There is no organization with this company. When you start, Everyone talks behind one another’s back. Some of the Dr’s are rude, to the point that MA’s cry. HR has no clue how to do his job. Would barely get breaks, and when we did the people on the office would contact you Just a horrible company as a WHOLE. No breaks.. 

Susan Diamond will blend nicely with Heal's board to further transform healthcare in the home.  Humana, TPG Capital and WCAS trashed our once nationally recognized hospice.  A longtime bereavement coordinator recently lamented how money changing owners ruined our hospice temple.  A retired social worker returned to our office to not find anything familiar in the way of office appearance or people.  She asked what happened?  I answered Humana, financial rapscallions and Curo.

I've watched as hospice physicians, once respected valuable partners in care delivery, become order takers from Curo's petty tyrants.  I've seen garbage in-garbage out Homecare Homebase rob employees of fair pay for hours worked and miles driven.  I've watched as local management carried out unethical orders from corporate chiefs.  Their charge now is keeping the money changing going.

Moving information around quickly may be one element of quality healthcare.  If a company cannot be in mutual, respectful relationship with its employees, I suggest it is not capable of doing the same with patients and their families.

Heal may be the perfect fit for Humana, unhealthy, even toxic.  That's the management norm in our age of greed.

Anonymous

Battered Hospice Division Holds Up Kindred at Home

Strange Tony,

Kindred Hospice executives continued cutting positions at our hospice.  I couldn't see how they could elimiate any more, given the number of people they've reduced since financial rapscallions and Humana bought us two years ago. 

Moody's had this to say about Kindred at Home (Gentiva New) in their June 2020 review of the company's debt.

KAH will continue to have elevated debt/EBITDA in 2020 due in part to volume declines from the coronavirus pandemic. Home health saw approximately 20% volume declines in the last week of March 2020, whereas hospice experienced about 15% declines.

Executives have no patience.  Volume down, headcount cut.  Moody's mentions our garbage-in/garbage-out hospice computer program, Homecare Homebase.  It underpaid staff for hours worked and miles driven.   

KAH has identified about $138 million in synergies, of which around $93 million has already been achieved. KAH has performed well since completing the spin off from Kindred and acquiring Curo in 2018, however there has been some delay in realizing the last of the synergies particularly related to cost savings benefits from procurement and the shift to Homecare Homebase. We expect the remaining $45 million synergies to be realized by the end of 2020, and will include some newly identified savings related to insourcing the call center and improvements to the IT platform. We believe that increased centralization will lead to opportunities for additional cost savings, including improvements to KAH's IT infrastructure, as well as the centralization of purchasing which will continue to provide benefits throughout 2020.

My coworkers will be disturbed to know more synergies loom.  Hospice provided the lion's share of earnings within the company for Q1 2020.

Laid off staff might be upset to learn the company took federal funds while cutting jobs.

KAH had $315 million of cash as of May 2020, which includes about $150 million of cash from the CARES ACT for grants, about $89 million of advanced accelerated payments, and about $10 million of the approximately $60 million estimated for fiscal year 2020 of deferred employer social security taxes. KAH continues to evaluate guidance from the Department of Health & Human Services with respect to the use of funds and has not made a final decision if it will be keeping any or all of the CARES Act funds. KAH plans to fully repay the accelerated payments in June of 2020, given their solid liquidity, which is 2 months ahead of schedule per federal guidelines.

Flush with federal cash Kindred Hospice jettisoned valuable, loyal co-workers.  Humana, TPG and Welsh Carson trashed a great hospice after they bought us in July 2018.  There's no end in sight to their carnage.  A giant executive payday awaits.  For that we suffer.

Anonymous

Heartless Owners Continue Hurting Our Hospice

Strange Tony,

Financial rapscallion TPG received money from the federal government to protect jobs.  TPG owns 30% of Kindred at Home, as does Welsh, Carson, Anderson & Stowe.  Yet our 60% majority owners  continued cutting positions at our hospice, a depressing process that began shortly after Humana, TPG and WCAS bought us in July 2018.  News reports revealed:

TPG co-Chief Executive Officer Jon Winkelried acknowledged the controversy around the use of taxpayer funds to prop up private-equity investments. TPG decided it didn’t qualify for the Small Business Administration’s forgivable loans under the Paycheck Protection Program and returned that money, he said. It did take advantage of Health and Human Services Department programs that provide advances on expected revenue from the government.

“We had a number of health-care companies that are providing vital essential services to the constituents that they serve and were impacted by the situation with Covid,” Winkelried said. “It allows them to stay in business and continue providing the services that are critical and important services.”

That is not the case at our hospice.  Financial rapscallions reduced and eliminated critical important services in a series of profit maximizing moves.  TPG applied for federal funds to protect jobs while our hospice cut the same.

Another view into our 60% owners hearts came from "Home Healthcare News":

Kindred Healthcare LLC has cut wages for many of its employees by 10%, and CEO Benjamin Breier is taking a 15% pay cut, a Louisville, Kentucky news station reported. Kindred Healthcare is owned by two private equity firms, Welsh, Carson, Anderson & Stowe and TPG Capital. It doesn’t appear that there have been any pay cuts at Kindred at Home, which is separate. 

Pay cuts and job eliminations in a time of crisis when healthcare workers risk their lives by going to work---Heartless.  This is so financial rapscallions and Kindred at Home executives can have a giant payday to add to their overflowing bounty of wealth.

What would Dame Cicely Saunders think if she were here to witness what happened to her hospice movement?  I imaging she would strongly suggest this is the wrong transformation. 

Management tormenting hospice professionals for their financial gain is an ugly picture and unworthy of hospice's roots.  It is a symptom of our society, where the haves are unsatisfied with their vast wealth, always needing more.  I don't recall Jesus proclaiming that in his Sermon on the Mount.
 
Anonymous

Toad Shares "Gather Your Own Straw" Story

Strange Tony,

First Senior Regional Executive Vice President Toad visited our hospice and gave a six month update on Kindred at Home's "Gather Your Own Straw" program.

FSREVP Toad offered, "I am proud to announce an innovation recently pioneered at your hospice.  Branch Manager Asperger took the bold initiative and reduced headcount by combining disciplines."

Our only longtime employee left shook their head.  They'd seen the cycle of staff reductions for corporate profits and knew the negative impact past moves had on patient care.

Toad noticed the nonverbal, made a mental note to find out that employee's name.  He would suggest they be eliminated as soon as BM Asperger could make something up with the coaching of Kindred at Home's human abuse department.

"Moving on."  Toad continued.  "Your local leader not only combined disciplines, BM Asperger did it in a manner befitting the Pharaoh of the Bible.  She gave the work to the lowest paid, least qualified people and did so with zero training.  Sure, more qualified people were available but their hourly rates are far higher.  Had the work been given to the higher paid, qualified staff then less straw would have to be gathered."

The longtime employee raised their hand.  "Aren't we supposed to hire qualified people to do hospice?"

Toad replied, "We hire company people, those willing to utilize their background, skills and experience to achieve our objectives.  It matters not if they have done hospice before."

The employee said, "OK, but the situation you are praising is one where we've lost ground, customer service wise."

Toad cut in, "Hospice can be trained and that is the point of BM Asperger's "Gather Your Own Straw" innovation.   The lowest paid, least qualified people had to train themselves in their new discipline.  They had to gather their own straw to learn their new responsibilities."

The longtime employee said,  "At one point in my career leaders would've been embarrassed to state that we hire unqualified people and don't train them."

Toad smiled, knowing this employee would be the next to experience job consolidation.  "This innovation saves the company money and gets me closer to my big payday, when Humana buys the rest of our company.  That's all that matters.  In the meantime I want to hear more straw stories from your hospice."

Branch Manager Asperger stood and applauded.  She had another Bottega Veneta purse she wanted to buy.

How far has the managerial bar fallen?  Precipitously in a mere 23 months.

Anonymous

Kindred Got One Mention in Humana Earnings Call

Strange Tony,

Humana CEO Bruce Broussard mentioned Kindred at Home one time in the Q1 earnings call with Wall Street analysts.  He said:

"Kindred has been adversely impacted by the virus, in particular, as new home health admissions slowed dramatically." 

He did mention the home several times during the call and offered this:

I also would say home is continuing to be an area where we're seeing a lot more interest in and the ability to provide more acute services. Those services that are primary care services that would normally be in an office setting, even getting to having a hospital in the home area, even a step [Phonetic] in the home.  

Broussard said Humana would apply analytics to determine these areas.  Analytics brought our hospice a computer system that rips off staff for hours worked and miles driven.  

During a time when people are perishing Humana's executives made not one mention of hospice.

Anonymous 

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 .