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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.


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