Wednesday, April 3, 2019

Orange Crate Update Number 2

It's money that matters

Quick update

The sole purpose of the Death Nurse Orange Crate of Publicly-traded Corporate Hospice is to educate clinicians, caregivers, and the community about companies looking to make a profit from providing services to patients and families facing serious illness and end of life.

1. People are dying.
2. ??????
3. Profit!!

Our first lesson is that the stock prices for all of the companies are lower at the end of the Orange Crate’s first month. 

Other news

Amedisys continues its strategy for inorganic growth with its purchase of RoseRock Healthcare. “RoseRock provides specialized hospice care to approximately 200 patients daily in northeastern Oklahoma. Amedisys currently operates six home health care centers in Oklahoma, including an agency in Tulsa.” 

The company posted an announcement in Facebook with the following message from CEO Paul Kusserow, “You’ve joined a nationwide team committed to the same principles of honoring life through excellent patient care that have made your company so successful - welcome to the family!"

I asked how getting bigger makes things better for patients and families, and the company responded: “Hi Jerry - By strengthening our family, we're able to serve more patients with purpose and ultimately improve how end-of-life care is delivered in the country. In joining forces with other hospice companies, we can introduce more scale, structure, regional support, technology and professional development to allow for better patient care.”

The language sounds like something from a brochure. The reasoning is unclear to me, but the thinking seems to be that buying other hospices is a way to get stronger and leads to taking care of more people (makes sense); “with purpose” means something that isn’t explained but is supposed to impress us; and will eventually make everything better for everybody in the country somehow sometime ("ultimately improve").

They also exude the singular confidence that by getting even bigger ("more scale"); imposing hierarchies, processes, and rules ("building structure"); adding bosses ("regional support"); getting laptops and/or smartphones and/or IT nerds and/or playing with data ("technology"); and making everyone watch webcasts ("professional development"); and by somehow doing all of this by “joining forces” (how?) with “other hospice companies” (who?).

We’ll see,

I replied, “Thanks for your response. I'm a shareholder, nurse, and severe skeptic of corporate and for-profit hospice. What you're doing bears close watching. In my experience, hospice doesn't scale. Also too: you said nothing about transparency, so I hope you're prepared and willing to honestly answer questions like, What's the average caseload for a full time RN case manager working with patients and families who live in their own homes? What's your turnover for clinical staff? Patients and families are starting to know more and demand better. I look forward to talking with you more.”

Encompass surprised watchers when it announced its plans to acquire privately-held Alacare Home Health & Hospice for $217.5M. That’s more than twice the amount the company previously told investors it planned to spend on its strategy of inorganic growth (i.e., to get bigger by buying other hospices).

Founded in 1970 by the Beard family, Birmingham-based Alacare operates 23 home health locations and 23 hospice locations in Alabama, generating revenues of approximately $117 million last year.”

“John Beard, Alacare’s president and son of Alacare’s founder, Charles D. Beard Jr., said the company was “fortunate to be able to choose" Encompass Health from a number of interested partners.”

“Susan Brouillette, Beard’s sister and Alacare’s CEO, said the company and Encompass Health have had a close working relationship for many years on policy and other issues affecting the industry.”

Maybe that’s what the PR folks at Amedisys meant by, “joining forces with other hospice companies.”

Also, too: Keep reading Generic Hospice Blog.

Thanks for reading. See you next time.