Bad Hospice Heartbeat

Dear Anonymous,

Generic Hospice decided to blame individual employees who'd lost their hospice heart the last two years under a series of misguided and malodorous executive decrees.  Our President had the gall to record on video his concern that Generic Hospice staff were missing their heartbeat and not claim responsibility for eviscerating our hospice's heart.

Get this, our former logo was a heart.  When we changed companies for what felt like the third time, they rammed this generic "metric centered" cross on us.  There wasn't a lick of heart in it and they knew it. 

Just when our President couldn't go any lower, he did.  This image master wrapped himself in the most pure part of hospice, a chaplain's cloth.  It wasn't the first time I'd seen our beady-eyed leader don a godly cloak, simply by close association.   

It was difficult to set poor management aside, but I tried to focus on this pure, good-hearted chaplain who worked for free for months, while our President enjoyed executive benefits, private dining, health club and concierge medical services.  The Chaplain talked about organizational trauma inflicted on his hospice site, turnover, a series of poor executive directors, marketers there - then gone.

The President abdicated his responsibility for any declared organizational failures, especially human resource systems that could not select and retain good employees.  He simply offered the chaplain's story as the tonic for demotivated hospice workers, blind to its obvious indictment of senior and corporate management.

The Chaplain wrote a song, which was in earnest a protest song.  The timing was good given the 50th anniversary of Rev. Martin Luther King's famous "I Have a Dream" speech.  

"I have a dream that one day in the corporate offices of Generic Hospice with its President, his lips dripping with executive rewards and employee manipulation, that one day in all of Generic's offices, people will appreciated for who they are, not just for how good they make superiors look or how much they drive to the bottom line.  I have a dream that all people will be paid as much as Generic can afford, allowing workers to focus on doing good work, not some byzantine extrinsic reward system that treats people like marionettes.'

'With this change, we will be able to join hands and sing the old Negro spiritual.  Free at last, free at last, thank God almighty, we are free at last."   

Part of that freedom is recognizing when the innocent have been taken in by the devious for purposes of greed and manipulation.  It doesn't demean the innocent at all, just leaders who would falsely wear their mantle.

StrangeTony

Darkness Grows

StrangeTony,

The darkness grows at our hospice site.  Turnover is a constant.  Staff come away traumatized from interactions with our site leader.  There is only one criteria to this manager's decisions, whatever is needed to maintain their image in the present moment.  That means what they told you yesterday could be completely reversed today.  Remind them of yesterday's position and they'll flat out deny it, accusing you of distorting reality.  It's a mind shattering experience, unless you realize what's happening. There is only one constant, making the executive feel superior, in control, looking good. 

I calculate our manager cost the company $750,000 in two years.  That's $25,000 each for thirty jobs.  It's crazy expensive, a fact which doesn't seem to register with Gentiva Senior Management types, normally obsessed about money and numbers.

Anyway, a handful of us will try to lift the darkness from our site.  Daily at a specified time, our crew will pray that our staff be protected from management toxicity, that God's spirit will lift our hospice team members, enabling them to provide a loving, caring presence to those on our service.  God, please hear our prayer.  Right now, no Gentiva representatives are listening.

Anonymous  

Gentiva's Q2 Earnings Call Had Tony Strange Eating Humble Pie

StrangeTony,

"Nice job in a difficult environment" was the refrain from investment house analysts to Gentive CEO Tony Strange and CFO Eric Slusser.  Gentiva's story remains essentially on the same arc.  Our highly leveraged company struggles in a declining volume and revenue environment.  Hospice admissions were down 3% year over year and average daily census even lower at 4% vs. the prior year. 

CEO Strange expected the company's home health marketing strategy could be replicated in hospice.  After five quarters with no positive impact, Strange finally believes the company needs to do something different.  I know a few people who could've saved him five quarters, had anyone asked. 

Strange believes the U.S. is back to the mid to late '90's in terms of health care financial disruption and dislocation.  Uncle Sam, as the main payor, intermittently scorches the health care earth.  In such a scenario Congress and the White House signal their sponsors that they will soon be able to buy great healthcare assets at a deep discount.  The Centers for Medicare and Medicaid, under the leadership of 25 year HCA executive Marilyn Tavenner, provides the financial pain to healthcare providers, including those specializing in post acute care.

Credit markets provide dirt cheap, easy credit, enabling the Genitva's of the world to de-lever by buying distressed health care providers.  To a normal person it makes no sense, de-levering by taking on more debt.  If one had too much debt from rent houses, how does it make sense to buy more?  Think of it like toxic chemicals, where the solution is dilution.   It's very difficult to dilute/de-lever over $900 million in debt.  That's Gentiva's formidable task. 

Strange didn't mention hedge fund investor Mario Gabelli's recent major buy of Gentiva stock.  He did mention that Sales, General and Administrative expenses went down due to lower incentive compensation payouts.  How might a major hedge fund investor with an eye on big gains combine with an executive team intent on a return to major incentive compensation payouts?  It feels like Gentiva might start swinging for the fences. 

Back to the call.  Capital expenses for the first six months were $7 million, 1% of revenue.  This is a paltry amount for a firm expected to transition to electronic health records.  Gentiva conducted a hospice marketing campaign in four Southeast markets.  Strange said admissions and ADC increased in these markets, although he did not say by how much.  The company plans to expand the TV/Radio campaign to six more markets by the end of 2013.  That's ten out of 165 locations, a mere 6%.  The capex and marketing expenditures are hardly significant investments for a firm sitting on $185 million in cash and appear to be window dressing for analysts.

Tony said Gentiva plans to use its cash to buy down debt or grow through consolidation.  That leaves employees, who he thanked at the end of the call, waiting for dressing crumbs to fall from the executive table.  My fellow employees say it's been a rough three years under the Gentiva banner.  How're things at Generic Hospice?

Anonymous

Race to the Bottom on Human Resources

StrangeTony,

After reading your note about the drive to the bottom in treatment of employees, I too sought out a nonhospice Human Resources manager and asked him a few questions.  I recalled the time when HR tried to strike a balance between economic and employee concerns.  Together, we lamented its dying.

The human resources profession is not what it was.  In the last ten years, he'd seen human resources become a tool for senior management to further tilt the power scale in their favor.  He found new programs provided lip service to caring for employees.  Some lacked substance and capability, while others actually cut valuable pay or benefits.

This Human Resource disingenuousness is rife at Gentiva, which recently cut paid time off by 40 hours per year for employees hired after January 1, 2013.  The company did not come clean by announcing the change to all employees and stating critical, strategic reasoning behind such a move.

I assume they did it because they could.  Maybe it will help Senior Executives get their executive incentive compensation.  Anyway, it sent the message that Gentiva has two classes of employees.  Those hired before 1-1-13, are more valuable and need more time off to refresh, recharge.  Those hired after 1-1-13 are less valuable.

Gentiva's new clinical ladder is clearly a lip service program.  Human Resources is no longer responsible for ensuring employees are paid fairly based on their education, experience, skills and training.  That burden falls to the employee.  Employee must spend 40 hours putting together an application notebook, then submit that to a review committee where they have a 50-50 chance of garnering the reward or being determined a failure.  The process has a Roman Coliseum like feel.

Gentiva has 8,000 nurses and horrific employee turnover.  The Clinical Ladder has a fraction of clinical employees participating, less than 200 company wide.  The company bragged that in one region retention among 25 clinical ladder participants was 100%.  The 100% retention applied to one third of one percent of Gentiva employees.  This brings to mind the story of the Emperor with No Clothes as the program covers the teeniest percent of the company's human workforce. 

Gentiva has a compliance hotline for employees.  I know a number of people have contacted this hotline with ethical concerns.  One nurse was told "if you don't provide your name, your issue will not go forward."  This person did not feel supported in the least.  There was literally nowhere to share a confidential concern.

To sum up Gentiva Human Resources has a two tiered class of employees, a system for "fair pay" that 99.7% of staff aren't getting, and offers a tin ear to employees with ethical concerns.  This explains why it's been years since the company did an employee survey.  It's also been years since employees got a raise.

Gentiva is one face in the race to bottom on Human Resources.  The rabbit hole deepens...

Anonymous 

Gabelli Ups Gentiva Stake at Bad Time

NASDAQ reported:

Mario Gabelli increased his holdings in Gentiva Health Services ( GTIV ) by 8.96% on June 13. Gabelli purchased a total of 73,400 shares at an average price of $11.50 per share. Since this transaction, the price per share has decreased approximately 10% and is currently trading around $10.39 per share. Gabelli now owns 892,300 shares of Gentiva, representing approximately 3.1% of the company's shares outstanding. Gabelli's holding history of Gentiva as of March 31.

This conflicts with a June 21 SEC filing showing Gabelli owns 5.2% or 1.6 million shares of Gentiva.  Gabelli funds lost nearly $2.5 million today.

Update 7-9-13:  Gabelli spoke on CNBC at the noon hour.  No mention of his untimely investment in Gentiva.

Generic Hospice Transfers Responsibility to Worker

Anonymous,

Generic Hospice continues its downward slide, which began with employees having to justify compensation through a complex, convoluted clinical ladder program built on scarcity.  Employees doing human resources work continued with a new self-evaluation, which has little to do with the actual work I perform.  Now I get to do the accounting function as well.  As I already help with marketing, I'm doing my job plus:

Human Resources
Accounting
Marketing

All for the same pay I was hired in at   My last plane trip I sat next to a Human Resources professional.  I asked him about the race to the lowest common denominator in Human Resources.  He agreed wholeheartedly, lamenting how HR had become a tool to control expenses and people, while dramatically offering less services to employees.  Human Resources = Employee Abuse, for sure at Generic Hospice, but also at many other companies.

StrangeTony

Human Resources = Employee Abuse

Anonymous,

The last time our Corporate HR person visited they said corporate chiefs "loved us like our Hospice Nurse Aides love their patients".  I nearly blew coffee out my nose.  The more I thought about this attempted pander, it turned into an insult.  How dare this HR bear hug our nurse aides, (who actually know their patient's names and care for them)!

Our Nurse Aides don't conduct exit interviews.  Neither does the company.

Our Nurse Aides don't give raises, much like Generic Hospice sitting on millions in corporate cash.

Our Nurse Aides didn't eliminate the company subsidy for dental and eye insurance, before cutting 40 hours in vacation time for new employees.

Our Nurse Aides are not months late on evaluations, which are verbally positive but lack a corresponding rating.  Evaluations have become a tool for abuse.

Our Nurse Aides didn't rip employees off on mileage reimbursement by shorting them distance and offering a paltry rate per mile. 

Our Nurse Aides have the longest tenure of any group and care deeply about people, not so much about numbers. 

Generic Hospice cares about one thing and one thing only, metrics.  They've proven it repeatedly.  Our site suffered under an abusive, micro-manager for five years. Turnover, especially among clinical people who don't have to take abuse, has been obscene.  Every HR person to visit turned a deaf ear to stories of physical, mental and emotional abuse.

Our Nurses Aides are the antithesis of Generic Hospice.  They care and they give.

StrangeTony  .