Toad Kicks Off "Gather Your Own Straw" Program

Strange Tony,

The day after Thanksgiving First Senior Regional Executive Vice President Toad introduced Kindred at Home's latest executive initiative to our hospice.  The mandatory meeting occurred on Black Friday.

FSREVP Toad:  "Our new program is based on a story from the Bible, one Kindred at Home executives and our investor dominated board discussed in a retreat.  As a group they asked 'How can we be more like that guy?'"

Employee #1: "Jesus?"

Toad: "Nope.  Think Old Testament.  Any guesses?

Employee #2:  "Moses?"

Toad:  "No."

Employee #2:  "David?"

Toad:  "Guys, it's the Pharaoh!  I'll read the verses that moved senior executives and our board of directors:"

Pharaoh gave this order to the slave drivers and overseers in charge of the people: ⁷ “You are no longer to supply the people with straw for making bricks; let them go and gather their own straw. ⁸ But require them to make the same number of bricks as before; don’t reduce the quota. They are lazy; that is why they are crying out, ‘Let us go and sacrifice to our God.’ ⁹ Make the work harder for the people so that they keep working and pay no attention to lies.”¹⁰ Then the slave drivers and the overseers went out and said to the people, “This is what Pharaoh says: ‘I will not give you any more straw. ¹¹ Go and get your own straw wherever you can find it, but your work will not be reduced at all.’” ¹² So the people scattered all over Egypt to gather stubble to use for straw. ¹³ The slave drivers kept pressing them, saying, “Complete the work required of you for each day, just as when you had straw.” ¹⁴ And Pharaoh’s slave drivers beat the Israelite overseers they had appointed, demanding, “Why haven’t you met your quota of bricks yesterday or today, as before?”

Employee #1:  "Since we don't use straw in caring for hospice patients what is it executives want from us?"

Toad:  "We want you to complete the work required of you each day.  We demand you meet productivity quotas established by top leadership.  Straw is symbolic of whatever barrier you face in getting your daily work completed."

Employee #2:  "How can you hold us to higher productivity standards after management eliminated key positions and gave us systems that hurt productivity?"

Toad:  "Straw!  You have to find your own.  It's your responsibility to figure it out.  The plan is to build institutional resilience from the ground up.  Employees are the bricks."

Employee #2:  "That makes no sense given the extra work management added.  We spend more time scheduling.  I have to wait for my work to be scheduled so I can actually do it.  I spend hours now entering my time and mileage in order to be paid correctly.  That usually doesn't happen so I spend hours figuring out how the company shorted me and how to resubmit time and mileage."

Toad:  "What you described is the work required of you every day.  Get 'er done."

Employee #3:  "There aren't enough hours in a day to do what the company expects."

Toad:  "Time is straw.  Straw is time.  Make your own."

Employee #4:  "Under Kindredlink it took me two hours to prepare for IDG.  Homecare Homebase increased that to a full eight hour day.  That's time eating, not time saving."

Toad:  "Homecare Homebase was a strategic decision made by our board of directors, the same people who admire and emulate Pharaoh.  Your personal inefficiency is very concerning.  I will make a note of it and ask your direct overseer (DO) to beat, (clears throat) verbally berate you."

Employee #4:  "Why did I open my mouth?"

Toad:  "Any more questions on this new exciting executive initiative?  Seeing none, I'd like to turn it over to the people in charge of ensuring this program is a success.  The Bible calls them slave drivers but executives call them Area VP's and DCO's."

Employee #1 (under their breath):  "We call them Mean Girls."

Mean Girl #1 (looking at Employee #1):  "Speak up if you have something to say..."

Employee #1 slinks down in their chair.

Mean Girl #1 (pause):  "Nothing?  Didn't think so.  (shifts gaze to whole group)  You guys must be so proud.  Your hospice is the first to pilot the "Gather Your Straw" program.  I am so honored FSREVP Toad selected one of my hospices to start this exciting effort.  Our fantastic Director of Clinical Operations is here to help you, so I will turn it over to her." 

Mean Girl #2 DCO:  "It's all about the employee experience which you now get to live 24 hours a day, seven days a week, although we only pay you for 40.  As of today all nurses are salaried and hourly employees are prohibited from submitting overtime.  If a employee submits overtime they will be disciplined for not using your time, straw, effectively.  That discipline could result in termination.  (Staff groan)

Toad:: "Gather Your Straw" puts you in charge of solving your own problems, so solve away."

Employee #3:  "Can we have our time here not count against our productivity measures?"

Toad:  "I'm afraid that's not possible.  Any meeting with an executive like myself is considered optimal use of your time by the company.  Remember the whole company is looking at this hospice.  You'd better perform.  Executives are counting on you."

Employee # 2 (spoken under their breath):  "for their giant paydays while we break our backs."

Toad:   "I would like to close with a prayer asking God's blessings for abundant admissions, census and margin.  Is a chaplain willing to do that?"

None volunteered so we exited the meeting room deflated and diminished.  It was the Blackest of Fridays.  We'll see how many more leave the toxic wasteland fouled by Humana/Curo.  The Bible says they will reap what they've sown  Lord, deliver us from evil.

Anonymous

VP Toad Ignorant, Arrogant and Condescending

Strange Tony,

Your encouragement to be a blessing came at a critical time.  Kindred Vice President Toad visited our hospice site recently.  He carried a large leather briefcase.  Staff did not know why he'd returned.  Such information is closely held by management.

Toad holed up with our Branch Manager, cooking up plans to deal with secret issues.  He did break often to use the restroom and at odd times to eat lunch.  Our VP went directly to his destination with little chit chat.  He avoided people doing actual hospice work.  Most of the time Toad walked briskly, head down while speaking into his blue tooth.  This posed a potential safety hazard, especially at corners near the rest rooms.

Management's marathon sessions culminated with a mandatory staff meeting.  Toad opened his leather bag and threw a folder on the table.  The gullible among us envisioned a pay raise or restoration of looted benefits that migrated into executive pocketbooks with each buyout.  The idealistic were fooled again.

Toad told us our site was under performing because it was not making as much money as the company demanded.  He attributed that to low morale in office personnel and accumulated grief/loss within our nurse and clinical ranks.  He tackled each of these problems separately.

"This office has many long tenured employees.  Kindred views that as a two edged sword.  One edge has experienced employees frequently stuck in their ways and resistant to change.  Kindred made many improvements that employees failed to appreciate, like the harmonization of our 401k retirement match.  Yes, some of you saw that contribution fall 67% but others in our company experienced a 100% increase.  Good employees are happy when other people win.  Other employees failed to appreciate the elimination of the copay benefit for doctor's visits in company provided health coverage.  Kindred gave you an opportunity to experience the full value of your physician relationship by having you foot the whole bill.  That is a direct reflection of management's magnanimous care and appreciation.' 

'The second sword edge for experienced employees is Kindred pays you more than we would for your replacement.  It's not much more given years without raises but every penny digs into executive incentive pay.   The company exists to maximize management's pay, not yours.  As a result we will eliminate this site's long tenured employees at the end of the month.  There will be no severance and your health and life insurance will stop the day of your termination." 

 
One of our four chaplains asked, "How do we know who among us will be let go?"  Toad replied, "It's based on the definition of a long tenured employee."  The chaplain said "Yes, and what is a long tenured employee?"  Toad replied, "You'll have to call the KindredHub line to obtain that information."

VP Toad continued:

"For our nurses Kindred will institute a new bereavement hour after an accumulated twenty patient deaths.  Kindredlink will track your deaths and when you reach twenty our payroll system will automatically clock you out for an hour.  You are to use this hour to get over your grief, drop your negativity and give management the appreciation it deserves for meeting margin and EBITDAR targets.  Got it?

Silence, until our longtime receptionist raised her petite hand.  She asked, "Of our 70 some employees how many did you talk with?"  Toad offered, "Four."  She followed up, "How many outside the management level?"  Toad said, "None."

"And what is the cumulative tenure of those four managerial employees?"  He said, "Two years."

"How many patients and family members did you speak to?"  Toad confessed, "Zero."

Her final question was "Did you consult our last Pwc employee survey results, the ones never shared with our staff?"  Toad said "No, I didn't need to.  Those surveys are not legitimate feedback.  It's more on the level of a female dog."

Our staff left the meeting with disturbing insight into our company.  Kindred has in charge the ignorant, arrogant and condescending.  Lord bless them, they know not what they do.  As one reaps, so shall they sow.

Anonymous (Trying to be a blessing inside Kindredful)

Line Formed to Influence Toad

Strange Tony,

Kindred Vice President Toad visited our hospice site recently.  He set up in a conference room and invited staff to meet with him in one on one sessions.  The line formed on the sign up sheet with its half hour increments, which our office manager guarded as if it were gold bars from Fort Knox.  Management added a special partition to enable confidential entry and egress for staff.

Years ago Toad would have had no takers.  Back then staff knew better than to give bad leaders any information that could be used, twisted, or distorted to harm fellow employees.  That wisdom is long gone, replaced by an egotistic, self serving sickness which likely will be terminal for our hospice if it persists long enough.

One does not rise by stepping on the heads of co-workers.  Fellow employees sink under the feet of those under the illusion they benefit from divisive and unproductive behavior.  The tragedy is corporate management who listens to one side of any story and decides to act.   In such cases the race is to be the first one heard.  That race unfolded with Toad's open door sessions (which always occurred behind a closed door).

It is such a management basic to hear multiple sides of a story to learn what happened and develop strategies to address the issue.  Kindred, and Gentiva before it, ignore this simple dictum.

Executive Toad will do something with the myriad of misinformation made available to him by those who pretend to be victims in their perpetration.  If he's like the executive line before him Toad will support the lazy and unethical who point fingers elsewhere so they won't be found out.  He might even hit on our attractive staff as did a former HR VP, who professed to being happily married.

It is astounding how much incompetence, silliness and unprofessional behavior they willingly overlook.  Yet, management writes up the smallest transgression from hard working, patient focused staff who purposely protect themselves from untrustworthy management.

Kindred executives do not have eyes to see and ears to hear.  They have partial stories, often distorted beyond recognition.  These fictions stimulate executive adrenaline and vengeance as those coming up short under the micromanagement microscope must be punished.

Will Toad overlook the burning forest of conflict at our hospice site, doing the bidding of those who ignited and continually stoke the fires?  I'll wager he's at the head of the fire hose following instructions from the crew that ran to him first.  It's been the Kindred way to burn the innocent at the bidding of the arsonist. I expect Toad to follow this deeply entrenched pattern.

Anonymous (from Kindredwarts)

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

Toad Now Curo Level Executive

Strange Tony,

Executives held a conference call on Kindred at Home's progress in splitting from mother ship Kindred Healthcare.  Kindred bought Gentiva in February 2015.  Hospice, home health and community care were strategic post-acute care services until December 2017 when Kindred executives and the board decided to cash in, lever up the subsequent companies and roll the dice that they could make yet another fortune in a few years time by partnering with financial rapscallions.

Thirty four and a half months of integrating companies had to be undone.  Executives planned the split with change in control compensation and new equity positions swimming through their greedy heads.

KAH President David Causby updated the hospice division by introducing new senior executives, all from Curo Health Services.   After a few moments of technical difficulties hospice employees heard the voice of our new chief, Larry Graham.  He shared a lot of words about people he's worked with a long time and trusts, i.e. not Kindred.  Graham and his predecessor made two different financial rapscallions big money, Thomas H. Lee Partners and GTCR Golder Ranuer.  Larry enters the new arrangement with outsized pay, an equity stake not available to employees and massive incentive compensation. 

Regional positions have both Kindred Hospice and Curo Health executives sharing roles.  I expect the Curo people will mine the unbalanced brains of Kindred Hospice executives before sending Kindred leaders packing.  Gentiva-Harden and Kindred-Gentiva employed a similar strategy of milking knowledge then jettisoning excess leadership.

Nearly every executive spoke about the importance of our people but not one mentioned fair pay, competitive benefits or the possibility of a raise.  Fellow hospice employees at our site have gone years without a raise.

I learned after the call VP Toad is Curo material and been promoted.  His new title is Senior Assistant Executive Vice President of Market Finance Compliance.  Toad will hop in and inflate himself in any situation that threatens the future financial success of our Senior Executive Team, be it severe competitive disadvantage, financial peril from paying employees fairly or legal jeopardy from admitting and keeping patients that do not qualify for hospice.

How did an executive with poor people skills and unbalanced priorities get promoted?  Apparently Toad's father-in-law works for one of the financial rapscallions intent on making a fortune from flipping Kindred at Home and the Kindred Hospital company. Greed is all in the family and our hospice is square in the middle of it.

A few long term employees are determined to keep hospice service levels up but it gets harder with each new hire.  Experience out, question mark in.  I wish I could identify the criteria for bringing new people in but at this stage it is not discernible.

With Toad's promotion our hospice will get a new Vice President.  Unfortunately they can be worse.  It seems improbable with Toad's multiple failings but Glassdoor comments indicate Larry Graham is up to the task of appointing someone less appealing.

Anonymous (at Southern KAHtivacare Hospice)

Our Care Matters Award Goes to Money Changer

Strange Tony,

VP Toad visited again and creeped out our hospice by walking around with his hands in his front pockets.  You could hear him jingling something.  It sounded like clinking coins but we've also heard rumors of his brass balls.  He did talk to office people.  Once again, I didn't see him speak to a single patient caregiver.

At the end of his visit staff attended an "Our Care Matters" celebration.  He showed a video that could have starred any of our site's nurses, given the heartfelt work they perform.  One of our caring nurses said she'd rather be out seeing patients, delivering actual care, than watching a polished video.

Our nurses were kind to Toad.  They did not bring up the many ways the company shows it does not care about employees, knowing it would make Toad mad.  They recalled how Kindred executives send forcefully and don't receive very well.  It's a form of mental blocking.

The climax came in the staff meeting when Toad started jingling.  He said, "The winner of an 'Our Care Matters' Kindred coin is.... drumroll please.......the Biller.  Huh?   Yep, they picked someone who does not provide a lick of patient care.

Toad was silent on news from Wall Street that Kindred could be sold.  Not again!  A seemingly endless series of executives over promised and under delivered to Wall Street analysts.  When it became clear they had no strategy for success each group sold out, taking a king's ransom in change in control payments and leaving employees to endure the next mendacious set of executives.

VP Toad had no information and no words of assurance for our team.  His attempt to inspire did the opposite.  That's the Kindred way.

Anonymous (from Kindredful)

Toad to Join Farber at Mednax

Strange Tony,

We learned our Vice President Operations (VP Ops) Toad has left the company to join former Kindred Chief Financial Officer Stephen Farber at Mednax.  Toad will take his pocket coin jingling to the neonatal medical practice company where Farber stands in line to take over as CFO in November.   

Kindred purchased Farber's house at a premium after our CFO's neighborhood turned into War of the Roses.  Farber received two moving packages from Kindred's executive enriching board.  Mednax is in Sunrise, Florida not Louisville, Kentucky.  Farber's Kindred buyout winnings of $2.1 million meant he could afford his own move. 

It's not clear where Toad will be or what his new role is with Mednax.  Open benefit enrollment for 2019 looms and executives used "sustainable" and "harmonize" in their announcement.  These are not good words for employees who've gone years without raises.  Did Toad get an early peak at benefit cuts and bolt?

Humana offers employer sponsored insurance products and our 40% owners could reverse our ever declining coverage for outrageous sums of money trend.   There's no mention of that only the need to harmonize benefits between Kindred at Home and Curo Health Services.  That usually means settling on the lower benefit between the two companies.

Curo Health's Larry Graham heads our Kindred at Home hospice division.  Under his leadership at Amedisys and Curo unethical acts occurred.  As COO at Amedisys Graham oversaw operations during a period of fraudulent Medicare home health billing.   Amedisys settled with the Justice Department for $150 million in 2014.

Curo, founded in 2010, paid a $12.2 million settlement with the Justice Department in April 2017 for paying kickbacks in exchange for hospice referrals.  The illegal practice began in 2007 but continued until 2014, four years after Curo purchased Dallas based HospicePlus.  The settlement does not mention Curo's compliance program or why CEO Larry Graham did not catch this practice.

Admittedly Graham was busy with the sale of the company from financial rapscallion GTCR to fellow rapscallion Thomas H. Lee.  Holding onto revenues is paramount in a sale evaluation process.  It would be interesting to know if GTCR disclosed Curo's paying for referrals or if Thomas Lee's due diligence discovered anything shady.  Financial rapscallions are not forthcoming on those issues.

Our hospice awaits a new executive and our new benefits.  It's hard to believe but both can be worse than what we have now.  Jingle, jingle go executive pockets (filled on the backs of workers).

Anonymous (from Curo at Home HospiceMinus)

New Kindred Executive: Venemous Toad?

Strange Tony,

Corporate assigned a new junior executive to our hospice site.  I'll call him Toad.  So far he's been very quiet.  That can be a sign of someone who prefers to watch and learn, but that's been a rare practice of prior Kindred vice presidents.  Toad's predecessors preferred to:

A.  Talk over listening
B.  Jump to conclusions over researching issues
C.  Shoot any messenger raising legitimate concerns
D.  Foster or avoid conflict rather than manage and reduce it.
E.  Play favorites
F.  Beat people up over numbers

Our new VP arrived at a time of incredible division within our hospice.  Conflict increases when leaders use strategies that keep people separated and uninformed. Ninety five percent of conflict can be resolved with one simple intervention, help people complete communication. This solution has been a mystery to Kindred managers who sow division and manage by whim.

Our hospice divide deepened when staff sold their soul to horrific management for the illusion of personal protection and connection to power.  Kindred leaders took information nuggets from soul-selling staff, instantly twisting and misusing them as weapons.  Enough hospice staff made this sick deal that our hospice culture could be terminal.

It will take a sophisticated VP with deep leadership skills and experience to save our historically great hospice.  Such people are rare in today's EBITDAR obsessed, capital optimizing, human abusing, compliance lip service-oriented world of healthcare mismanagement.

Kindred does not have systems to find and employ such leaders.  It's just not in them.  We'll see how bad Toad's venom is.  Will it be more or less toxic than those who came before him?

Anonymous (Waiting for next Kindred axe to fall)

Toad Returns to Head Up New Executive Initiative

Strange Tony,

I learned that former Vice President Toad has rejoined Kindred at Home to head up a new program.  He and the Mean Girls will be at our hospice site soon to kick it off.  I understand we are the pilot for this new executive program.

Toad left shortly after the buyout by Humana and two financial rapscallions.  At Mednax he helped trash a vibrant culture.  That makes him a perfect fit as Humana/Curo decimated our hospice over the last year.

I am curious what mendacity Toad and his Mean Girls will foist on our already stressed to the max site.  Lord, give us strength and peace in the coming maelstrom.

Anonymous

VP Toad to Join Curo's Dubious Executives?

Strange Tony,

It's been one week since Humana and two financial rapscallions purchased Kindred at Home, the Old Gentiva plus Integracare and Professional Medical's home health and hospice agencies.  There's a slight unease at our hospice.  We've not seen hide nor hair of VP Toad.

With the Curo Health Services buyout looming I expect Kindred hospice area/regional managers are rather nervous.  Our new owners plan to put Kindred's hospice division under Curo, despite our having nearly twice the revenue and much larger hospices by volume.  Their rationale is Curo's management is more entrepreneurial.

Curo Health Services, Inc. have agreed to pay $12.21 million to resolve allegations that they violated the False Claims Act by paying kickbacks in exchange for patient referrals.

Curo's  leaders settled for $12.2 million with the U.S. Department of Justice in April 2017.

First, from 2007 through 2012, kickbacks were allegedly paid to American Physician Housecalls, a physician housecall company, in exchange for patient referrals to these hospice companies. The alleged kickbacks took the form of sham loans, a free equity interest in another entity, stock dividends, and free rental space. 

Second, from 2007 through 2014, kickbacks were allegedly paid to medical providers, including doctors and nurses as well as hospitals and long-term care facilities, in exchange for patient referrals to these hospice companies. The alleged kickbacks took the form of cash, gift cards, and other valuable items.

Hospice employees don't have the means to offer sham loans, free equity, stock dividends or free rental space.  Those are all the auspices of management.

Curo spent years under the ownership of financial rapscallions.  Their executives are well trained in giving sponsors what they want, steady streams of cash and a huge final payday.

What changes await our hospice?  Is Toad Curo material?  I sense they share the same distorted values but only so many area/regional managers are needed in the combined company.

Anonymous (from KAHtivacare Hospice)