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Attention: Bill Borne, CEO Amedisys, Inc.


Dear Bill:

I read with great horror a Reuters feed in the Baltimore Sun  this morning in which you made a statement to the effect that you along with Louisiana Home Care Group and Gentiva think it might be a good idea to accelerate the pending payment cuts to Home Health Providers.  You are on record as saying that such acceleration would give you the opportunity to exploit the ensuing financial devastation of smaller, privately held agencies with the ultimate goal of purchasing up to 53 percent of them.  You made an extremely salient point that is no fun to wake up and see your stock prices plummet and spoke of a strategy that involves sudden death to MY clients to possibly lift an overhang on the stocks.

I worked with you when you picked up shifts at the Baton Rouge General CICU 20 years ago.  I went to work for Amedisys Corporate when we were the proud owners of 5 provider numbers.  I was there when Amedisys got kicked off NASDAQ because of insufficient cash and Assets.  And I was there when the small fish bought the big fish, Columbia.  To be honest, up until this morning, this has always been a source of pride for me.  I learned a lot at Amedisys and I am grateful for the opportunity to have worked for you.

So, riddle me this, Bill.  Did Reuters somehow misquote you?  Were your words taken out of context?  Did you forget to run your opinion by your PR department?  Because let me assure you that I am so not impressed.

The industry as a whole is facing serious challenges but my clients are more than capable of handling them unless the three largest publicly traded home health care companies put pressure on CMS to hurt them.  It seems like you want CMS to lower the cost of acquisitions for you.  What a brilliant idea.  I want CMS to make being stupid a diagnosis that adds to the payment for a patient so you can be admitted and treated by one of my clients.

Make no mistake, if I believed that the Amedisys way is the best way to take care of patients, I would be out there brokering deals with my current clients right now.  But that isn’t the case as the numbers show.   The graphs below show a couple of my clients’ performance in comparison to Amedisys and LHC in areas where you coexist.    I limited the comparison to hospitalization rates because reducing hospitalizations is the greatest benefit offered to patients, families, communities and our payor sources.

Baton Rouge, Louisiana Hospitalization Rates

Houma, Louisiana Hospitalization Rates

Birmingham, AL Hospitalization Rates

I assure there are many more examples but my goal is not to say that my clients outperform you and leave you in the dust.  In the interest of transparency, I also have clients with a much higher hospitalization rate.  My purpose here is to illustrate that my clients are more than capable of holding their own against the ‘big boys’ in our industry in the only outcome that really counts – hospitalizations.

Of course, there are more than numbers to consider.  My clients hire a lot of nurses that have previously worked at Amedisys or LHC.  While I appreciate your need for standardization for management purposes, it is frequent that Directors of Nursing and Administrators are merely figureheads on paper that are given job descriptions resembling recipes.  This approach limits creativity and the ability of the nursing staff to take into consideration the particular strengths and weaknesses of their field staff.  When the most important decision they make all day is whether or not they should call Corporate it is unreasonable to expect them to be able to gracefully deal with more serious challenges like federal investigations, etc.

I can’t help but notice that your personal annual compensation package is greater than the annual revenues of many of my clients.

William Borne/Chief Executive Officer

2006 2007 2008 2009 2010
1,350,758 3,669,021 4,381,190 3,247,024 2,185,698

I do not begrudge your wealth.  The way I figure it, Bill, is that as smart as you are, you are not smarter than me.  Ergo, if you can do so well then so can I.  I would feel worse if you were chronically broke after working so hard and I do recognize the fact that you worked very hard.

What I find so offensive is that you used to be a CEO of a company that took care of sick people in their homes.  What pisses me off is that I remember when you were a nurse.

Unless you were seriously misquoted, it would seem that somewhere along the way you have evolved into just another corporate fuck-up motivated by greed and stock prices.  I feel like holding a funeral for the Bill I held in such high esteem for so long.  I hope you always remember that victory at the expense of others is a merciless taskmaster.  It is an honorable aspiration to do grow your organization by giving superior care.  It is pathetic that you prefer to build your organization by wishing harm to your competitors.  Little boys kill ants in jest but the ants die earnestly.  The ants in your world are my clients and countless other smaller providers just like them and I work just as hard for them as I ever worked for you.  Consider that.

You may not know this but my office is now less than a mile from your corporate headquarters.  It is next to the first Corporate Building that you and I worked at together on South Sherwood.  I am upstairs in suite 300 and would love to give you an opportunity to clarify your outrageous statements.  Call me at 225-253-4876 if you want to schedule a time to talk or email me a response.

julianne

36 Comments Post a comment
  1. Mike #

    Julianne…

    Right on!, but you’re wasting your breath. Bill has gone over to the dark side. The only thing he understands is $$$$!!!!. Hurt him there and he’ll respond. Otherwise, he’s laughing at you all the way to bank. He doesn’t care what you or anyone else thinks of him.

    Mike

    Like

    September 27, 2011
    • I really hope you are wrong, Mike. Frankly, I do not have the power to hurt him financially, nor do I have any desire to bring harm to Amedisys. But, if the article is correct in reporting Bill’s position, it does seem like he wants to hurt other providers. Even with the cuts, there are still opportunities in home health for everyone to do well. There is no shortage of elderly sick people and there is no single agency that is right for every one of them.

      Like

      September 27, 2011
  2. Kathleen Saucier RN, COS-C, HCS-D #

    Fantastic post!
    You definitely tell it like it is!
    It’s ashame that someone would have such greed and have no remorse for those of us that would be affected by such actions by CMS.

    K. Saucier RN, COS-C, HCS-D.

    Like

    September 27, 2011
    • Ropes End #

      Hmmmmm, from your signature line I’d give it a guess that you are a former QCC???
      Well, me too….I just love to read these posts…they enforce what I’ve thought all along…something has gone by the wayside with that company – and the wearing of the Superman costume put the cherry on that sundae LOL!!

      Like

      May 7, 2012
  3. Matt Sempre #

    Wow, Julianne. Thank you so much for sticking up for us “little guys.” I hope that his statements were misconstrued as well, because it is a very sad thing to wish ill will upon any of us. Friendly competition is a good motivator for agencies to spur one another on and do a better job of caring for our patients, yet blasting one another does not amount to any good. It is tough enough to do business with the reimbursement changes ahead, while living amongst competetitors who commit fraud and abuse but get away with it. Thanks again for your support!

    Matt, Assistant Administrator

    Like

    September 27, 2011
  4. Jnon #

    Julianne

    You obviously worked with him Pre-greed. He has stepped foot in one of the Birmingham agencies and had the gall to say that all other providers would be part of amedisys because they will be the ONLY provider. Funny that I still have friends that work there, and while Louisiana is a southern state, there is nothing like good old Alabama friendship. I hope his words were misquoted but fear not. Wonder why we have no voice as an industry on Capitol hill? Because we continue to tear each other apart and seek to devour rather than becoming one to fight for what is right….good quality patient care. As a nurse, Bill’s disregard of that saddens me

    Like

    September 27, 2011
  5. Barbara Cleland RN #

    You go girl ! BRAVO. Very well said, it is a shame what GREED will do to a person and an organization(s). Being in Home Health for 28 years, I am saddened at the direction that the “big boys” want to take us in….but I truly believe….”What goes around, comes around!

    Like

    September 27, 2011
  6. Susan #

    I heard recently that GHS was in serious financial trouble from their purchase of Odyssey and if things didn’t look up they would be looking for a buyer or possibly bankruptcy. Have you heard anything about that? It seems to go against them being a part of this madness.

    I have also known people who went to work for Amedisys and stayed only days. They said it was the most horrible place to work for. I guess it depends on your honor and ethics.

    Like

    September 27, 2011
    • I havent heard anything about the Odyssey acquisition. However, since they are publicly traded, all of their financials should be online. Search for their SEC filings. Easy to find.

      Genitiva bought a client of mine a couple of years ago. So far they have not hit my radar good or bad. It is almost inevitable that when something bad happens, people have an irrepressible impulse to make sure I know about it. So whatever may or may not be happening is or is not happening here.

      Like

      September 27, 2011
  7. As someone who works for a small hospital based agency I applaud you. I have worked for one of these large profit-based agencies and never again. I will leave home health first. Someone somewhere needs to take notice of what is happening when profit becomes the sole motive. What happened to serving the community? What happened to care?

    Like

    September 28, 2011
  8. sahily #

    Great report!!!

    Like

    September 28, 2011
  9. Gail #

    Barbara, I believe it too, but how many people have to suffer until it “comes around”? (And Ms. Haydel used the “big dirty” in an appropriate, non-gratuitous, manner. Impressive.) What happens to people like Bill? Could it happen to me? I really don’t think so, I’m not that smart, but it’s scary. Jim and Tammy Faye Bakker started out in a little rented store-front church back in the day. They had no money, but had a message. They became rich and famous and ruined. Bernie Madoff was rich and famous and is ruined, but how many people who trusted him did he take with him? I don’t begrudge anyone their wealth either, unless they made it off the suffering of others. I’ve always heard, “The rich getter richer and poor get poorer.” I guess the middle group gets screwed.

    Like

    September 28, 2011
    • Gail, first of all I always find that strong language reserved for strong occasions drives home a point when it is used by someone who generally stays away from such unladylike vocabulary.

      Bill Gates gives away more money than anyone in the world. Bono and he won a Nobel Peace Prize. Mother Theresa had access to an enormous amount of money through donations that all went to taking care of the poor in India. Money is money. It is neither good or bad. It is greed that ruins people. Every year thousands of wealthy doctors and not so wealthy nurses board airplanes and render services in third world countries where there is no health care. Some very successful physicians use their wealth and love of airplanes to fly sick children to hospitals where they can receive specialized treatment or transplants or whatever.

      In our professional circles, the prior owner of Lewis Computers, Jeff Lewis, was enormously generous with his personal wealth. Also in our circles, I have to sometimes advise clients that in spite of their good intentions, giving away free care and medicine is not acceptable. They are not trying to ‘buy’ referrals but just make sure a failure patient has enough meds to last the weekend. So, we have learned to beg from MD offices, pharmaceutical companies, etc. to get what our patients need without violating regulations. The people who set up NeedyMeds.org do not make money by making it easy for nurses to get medications for their indigent patients.

      In my personal life, my parents have set an example and continue to set an example of generosity both with their financial resources and their time. In their 80’s, they still cook for the homeless twice a month, make rounds at the hospital to give communion for hospitalized Catholics and Daddy volunteered at Habitat for Humanity until he was fired for cause but that’s another story for another time.

      So, yes, there are greedy people but there are also fantastically generous people. Could it happen to you, Barbara? I don’t think so. Character is not bought or sold with money.

      Like

      September 28, 2011
  10. Michelle #

    THANK you!! I hope he reads it. Can you link us to the actual article? Keep up the fight.

    Like

    September 28, 2011
    • Here is the link again. There should also be a hyperlink in the article embedded in the words, ‘Baltimore Sun’.

      https://haydelconsultingservices.com/2011/09/27/attention-bill-borne-ceo-amedisys-inc/

      Like

      September 28, 2011
  11. Julianne,

    My company works with over 1200 providers and most are independently owned agencies. I echo your sentiments in that they are absolutely capable of providing outstanding care.

    People sometimes overlook the personal nature of the relationship between a homebound patient and their nurse. When that nurse has a direct channel of communication to the Owner of the agency (thay many times is a nurse also), patient care is never sacrificed and modifications to the plan of care occur timely and for the patients’ benefit.

    I have hundreds of examples of my customers going above and beyond, for their patients and have specific examples of agencies that are excelling in leading the charge to more efficient care, with exceptional outcomes.

    CMS is looking for answers to bring costs down, while improving outcomes. Homecare is the answer, but they will not see this if they only listen to 3 or 4 publicly traded provider organizations.

    Best regards,

    Bobby

    Bobby Robertson, CEO
    HEALTHCAREfirst, Inc.
    http://www.healthcarefirst.com

    Like

    September 28, 2011
    • Thanks, Bobby. We share a few clients and they have always done well with Lewis. I, personally, am enjoying the opportunity to help clients remotely at my desk on your POC program. Tell your developers to call me. I have ideas and a burning desire to share.

      Like

      September 28, 2011
      • Deal. Let’s plan a visit after NAHC.
        Best,
        Bobby

        Like

        September 28, 2011
        • Absolutely. I can be reached via email at julianne@Haydelcs.com or 225-253-4876

          Like

          September 28, 2011
  12. Gail #

    Bill Gates and Mother Theresa…two of my favorite people in the world. I have a framed quotation from Mother Theresa at home on my bedroom wall. Now that you’ve mentioned her, I think I’ll bring it to my office for inspiration. I think we are all going to need it…inspiration, that is.
    And, I think you are right; “IT” won’t happen to me. True…Money isn’t good or bad and it is the lust for it that is bad and is the ruination of what was probably pretty good folks at one time. Sometimes when we see all the greed and lust for riches become the topic of news headlines and tabloids, we forget that there are good and generous people in the world such as the ones you mentioned. (Thanks for the reminder.) And thanks for continuing to keep all us “little guys” informed and prepared.

    Like

    September 28, 2011
  13. Terri #

    You go girl!!! You know what they say, what goes around comes around!

    Like

    September 28, 2011
    • You will see I edited your comment, just a little. Since I own the domain, I will be responsible for anything that is said. I do not want to give anyone a legitimate reason to have my blog removed from WordPress. So, everyone, please note. It is in no one’s best interest to name call. I am also leery of posting reports of incidents that you may have witnessed but that I cannot independently verify. This does not mean that I doubt your credibility but rather that I do not want to be put in a position to answer for things that I can not.

      I have opinions and a right to share them. My reticence to be openly incendiary is to protect all of us so we can still have a voice. By the way, I hear that some pretty influential folks in Washington have read my post. Thanks to all who shared.

      Like

      September 29, 2011
  14. M #

    FYI, I shared a link to this blog on the NAHC Listserv and got quite a reprimand from Bill Dombi, who disagrees with the information. Not sure the link there, but I am sure there is one. I know the listserv is maintained by NAHC, therefore not a “public domain”, however we do still live in America, right?

    Like

    September 28, 2011
    • Yes, I received a ton of emails within the three or four minutes after it posted. I did respond to Mr. Dombi and asked him specifically what was factually false. Like you, I was confused. In a few minutes, I will be posting a response from Keith Myer of LHCG who responded respectfully. I also heard from Bill Borne – wait for post in a few minutes. I had no earthly idea this even affected Bill Dombi. I can understand that he may want to leave the discussion about a specific company off of the listserv. I get that. But to declare my information factually false based upon his personal knowledge was not polite at all!. To his credit, he did send a reply. It not short or sweet and will take some time to fully understand. I will post my understanding of his reply when I have one:) I am unwilling to have an opinion before then.

      Like

      September 28, 2011
      • Terri #

        I am attending NAHC and would be curious to know Bill’s take on this. I would think NAHC would not want the big guys gobbling up the little guys due to the fact that they have a lot of little guys who are members. Very Interesting!

        Like

        September 29, 2011
        • Bill Dombi is in house counsel to NAHC and Val the director of NAHC is long time friends with Bill Borne. That is, in fact the reason my small independent agency is not a member of NAHC. If what is in the letter is true, and I for one suspect that it is, it does not surprise me. Bill Dombi’s reticence to publish a link does not surprise me either.

          Thanks for sticking up for the small guys!!

          Like

          September 29, 2011
  15. Julianne,
    I read your blog the evening it was posted and was HAPPY to hear someone speak for all the “Little Guys”. My partner and I started our HHA after being fired from a Big Guy who did it wrong, lost billions and we were standing on the street corner looking for a job. And after seeing a quote from Bill Borne about “looking forward to being the big gorilla standing” after healthcare reform, I’m sure he was not misquoted. And I’m not surprised by Bill Dombi’s reaction. I too am a provider who no longer supports NAHC after attending their meeting for many years and hearing each time how the “Little Guys” should get out now as hospitals and the big 4 will be the only ones able to take on all the regulations heading our way. After three years, we knew where NAHC stood on those of us who came into this business not making decisions based on $$, but on what is right for the patient. I’m proud to continue to do that everyday after 10 years in this business and proud to see your post. Thank you.

    Like

    September 29, 2011
  16. Cerdwyn #

    You had something else asking about Alliance for Home Health Quality and Innovation. I can’t read your blog at work, websense, sigh. So I send stuff home to read. I have been up to my eyeballs in computer stuff and didn’t read it until today.

    So I cheated. I looked them up. And yes, I have heard of them before. I worked for TLC before the Amedisys buy out. I think I can remember hearing about this group, founded by the big guys. I think initially it was the intention that it compete with NAHC (If it is the same group) but that never happened.

    I actually know one person on their board, I won’t say who, and know well of another. But most of them are the big national players.I don’t think they had the quality and innovation in their title back then, it was about 5 or 6 years ago.

    But don’t quote me on that

    Like

    September 30, 2011
  17. Beverly Dexter #

    I am deeply disappointed in Bill Borne of Amedisys not standing by his Core Belief system. I am not a big believer that he honors his own “Core Belief” system. He has allowed people in management that have no follow-through with his Core Belief system. The little guy always gets “put out” & the people who do the dirty-underhanded practices stay employed at Amedisys. This only tells me he is NOT for patient care or treating good employees with “dignity & respect”. Bill Borne is for the $$$$$ & keeping the deceitful management carrying out wrong discriminatory practices. I know what goes around does come back around. I don’t know how he can sleep at night. When things are going wrong, you try to notify him & you never hear back from him. I guess he likes to “hide” when things are going wrong. If he was the person I thought he was ( when I hired on as an employee ) he would have at least acknowledged the wrong-doing & made it right. He did not do this. He allowed the wrong-doing to happen & ignored it. This is just typical of the money-hungry executive type this day & time. I guess you can sell your soul to the almighty dollar—– Bill Borne has done this. He should be more involved before it gets him in more trouble.

    Like

    November 25, 2011
    • I took serious issue with Bill stating that he hoped to expedite the cuts so that other agencies would be for sale. When I did some research into the Alliance and other related political lobbying groups, I was nothing short of disappointed in a man who used to be my friend. Obviously things aren’t going his way these days and I don’t want to kick anyone when they are down. As best as I can see, he is no longer a threat to our industry and my clients.

      Having said that, I do know how very closely guarded he is. I am also involved in a situation with a small client and when someone wants to hide something from an owner or CEO, there is an endless list of imaginative obstacles they can put up to block access.

      So, as far as the senate investigation and other ‘allegations’ of fraud, I am on the fence. First of all, there have been no indictments thus far. The feds have a way of never being wrong. Seriously. When someone is indicted, you can pretty much bet that the feds have an airtight case. As far as the senate finance committee report goes, I am not sure that Amedisys did anything that everyone else tried to do – maximize reimbursement by following the rules of an overly complicated payment system. Nobody said the patients were not homebound. Nobody said that the therapy wasn’t ordered. To the best of my knowledge all of the patients were under the care of a physician. So that leaves the question of reasonable and necessary which could be argued from now until eternity.

      CMS encourages contractors to always try to deny on statutory grounds – home bound, signatures, etc. If a care plan isn’t signed or a patient wasn’t visited the day that a note was handed in, it is easy to prove fraud and abuse. If therapist A says the patient needed care and therapist B says he didn’t, it becomes difficult to prove either way. The only other person who was there was the patient and the patients love their therapy. Furthermore, if ten visits are good and 14 are better and the patient continues to make progress towards goals then maybe it was UNDER utilization when 10 were provided. How do you go back and find out?

      Next year promises to be an interesting in our industry. I am shopping for a crash helmet and a seat belt that matches my office chair.

      Like

      November 28, 2011
  18. John #

    Outstanding post. i worked for this company and saw the creed and total disrecard of patient care. Thanks for the truth!

    Like

    April 4, 2012
  19. no real surprise. Sorry to say he “was” a nurse

    Like

    April 6, 2012
  20. once burned twice shy #

    I wish Bill Borne was more active in the field & he could witness for himself how the small offices were being operated. It is so sad that a company with such advertisements of having “core beliefs” is not the reality. It is sad that really good field staff can be “taken advantage of” by being replaced by younger staff as the pay per visit increases for the staff that has “been around” a while. You suddenly become a number with this company as you age. Do not dare call the HR hotline, it puts you on the fast track to unemployment. BEWARE of Amedimonster if you are looking for a long career because this company will chew you up & spit you out. Message to Bill: Please pay closer attention to employee surveys.

    Like

    April 11, 2012
  21. Nurse C #

    Wow! great post! I worked for Amedisys in Houma and boy did I find out how corporate minded they really were. I saw the inner workings of this company…and it was rotten to the core. All about money and most of the referrals…well, lets just say they were more than just a tad bit bogus!! I decided to leave based on my moral and ethical principals which seemed to be lacking completely from this company. Both they and I knew that I was never going to be able to compromise myself to go over to the dark side…so I had to go. There was a lot of “turning a blind eye” which I just could not do and sleep well at night. Straight up fraud!! I will never suggest someone work for this company as there are many other smaller, honest HH companies in our community that don’t treat their employees like shit and patients like a $$ sign.

    Like

    February 17, 2013
    • If you drive across the state on I-10, I have several clients in different locations all south of the interstate. My Daddy is from Vacherie. I love that whole area. For the most part, the people are incredibly intelligent, humble and honorable.

      Usually people who are inbred are a little short of IQ points. Not in South Louisiana. My grandparents were cousins. (I probably shouldn’t have said that on the internet, huh?) Everyone is a Haydel, a Waguespack or a Borne.

      Of course, there are always reversions to the mean and outliers to disprove any theory.

      Like

      February 18, 2013

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