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 . 

Humana Borrows Big to Buy the Rest of Kindred at Home?

Strange Tony,

Humana reported the company issued $1.1 billion in debt.  The SEC filing says it is for general corporate purposes but my gut says it might be used to buy the rest of Kindred at Home from financial rapscallions TPG Capital and Welsh, Carson, Anderson and Stowe.

The recent financial implosion creates big problems for our 60% owners.  In this environment cash is king.  Washington may supply bailout money for Humana and its greedy partners, however the quickest way for our majority owners to cash up is to require Humana to buy them out.

TPG and WCAS have another reason to do the deal now.  It would be based on EBITDA prior to the coronavirus meltdown.  Humana has to pay 10.5 to 11.5 times EBITDA per the KAH buyout agreement.

The chart showed the deal as of February 2018 when Kindred CEO Ben Breier and a conflicted Board sold the company on the cheap.

Humana spent 2019 destroying our hospice by dramatically cutting staff, harming quality of care and forcing cumbersome, garbage in-garbage out technology on our site.  Other than their "investment" in crappy, unreliable technology our new owners used our hospice as a cash sluice.

It's likely $1.1 billion is not enough to buy out both rapscallions.  As of 12-31-19 Humana had over $4 billion in cash and cash equivalents.

It's ironic that Humana's borrowings could be used to save financial rapscallions.  I wonder how my former co-workers who lost jobs might feel about that.  They were sacrificed on Broussard, Causby, and Graham's altar of profits.

Anonymous.

Healthcare Workers at Risk with Coronavirus

StrangeTony,

I am worried about my hospice coworkers with the spread of the coronavirus in our country.  This disease stands to disrupt our hospice more than any corporate takeover, which is saying alot given the damage Humana and its financial rapscallion partners did to our site since July 2018.  We are down to one experienced hospice nurse and that person is looking for a new job.

An Emergency Room doctor talked about the risks to healthcare workers in the primary and acute care setting:

Nurses, doctors, and hospital and clinic staff will be regularly exposed to patients with high viral loads, increasing our personal risk immensely.

This exposure is all but inevitable, as cases are continually and rapidly slipping through screening protocols.  

Public health officials encourage people who may be ill with the virus to stay at home.  That may be a home with an elderly relative on hospice or home health.  It could be a nursing home where we have patients.

Keeping healthcare workers safe is an issue.

What is slowly starting to keep them up at night is whether the US healthcare system is prepared to properly handle an influx of cases.

Experts say there is a worrying lack of training and coordination and that the system as a whole needs to be able to communicate more effectively.

We have older hospice employees who are at greater risk for serious complications or death from the disease.  On staff we have young parents who surely do not wish to bring home the virus to their family.

“If they (healthcare workers) go down, the whole thing falls apart and destabilizes,” Hotez said. “That is the place where things could go wrong very quickly.”

I am not aware of any preparation for the coronavirus by Kindred at Home.  There has been no information shared, much less training conducted.  Things can change quickly in a community.  Preparation is important and that time is now.   So far the silence from executives and local management is deafening.

Anonymous

Humana Wants More Profit from Kindred at Home

Strange Tony,

Humana CEO Bruce Broussard informed Wall Street analysts of plans to build a longitudinal health record.

This year, we'll be bringing on all of Kindred in that relationship as a result of them completing their EMR install.

In the home, we advanced our transformational home health initiative with Kindred at Home and Curo through the implementation of a company-wide EMR and the extrapolation of best practices for our [indiscernible] over 20,000 home health episodes.

The next phase beginning in 2020 is to provide more care services in the home, including acute care and primary care in the home, so that we may begin to generate meaningful trend vendors for our health plans in the future while improving clinical outcomes for our seniors.

Homecare Homebase's cumbersome, complex software requires multiple workarounds.  It turned into "garbage in/garbage out" as nurses refuse to check any boxes that might take them on a clinical rabbit trail.  The narrative summary is the only place to find pertinent clinical information.  It resides nowhere else in HCHB's twisted bowels.

On measure after measure our hospice is far worse under Broussard's greedy leadership.  Humana implemented a littany of worst practices.  The system robs staff of fair pay for hours worked and miles driven. That is not a best practice. It's abusive.

Humana CFO Brian Kane mentioned Kindred at Home several times in the recent earnings call with Wall Street analysts.

For Healthcare Services, we had a strong year as we saw growth in our pharmacy business, solid performance of Kindred at Home and continued improvement in our Conviva operations, partially offset by the cost incurred to continue to expand our owned JV and Alliance senior-focused primary care centers.

Our home business is also anticipated to perform well led by Kindred at Home in which the conversion to Homecare Homebase across home health and hospice in 2019 weighed on results due to the significant required one-time investment, but will drive EBITDA in 2020.

Kindred at Home is also performing well. We hope to continue to see strong EBITDA growth, not withstanding the change in the payment model.

I'm not sure what else Brian Kane can do to drive EBITDA growth.  Humana and its financial rapscallion partners already depopulated our hospice staff.  Caring people quit or were targeted for elimination by the Mean Girl managers, local and regional.

Humana executives want higher earnings and Medicare Advantage cost savings from Kindred at Home.  Greedy executives rely on complex, unreliable technology while abusing actual caregivers.  Broussard and Kane want profit growth and they don't care who gets hurt in that pursuit.

Anonymous