Terrible IS/no technology; old fashioned, risk & change averse leadership - unfortunately because of significant tenured employees throughout the organization including execs, the organization is deeply committed to old fashioned and outdated practices which leads to profound inefficiencies and lack of diversity of opinion and experience. A lot of sacred cows in how the business is run ("this is how we've always done it") without awareness or consideration of root cause or full lifecycle; teams tend to wear blinders and focus only on their silo. Lots of disjointed decisions and lack of engagement at all levels. Bad culture that has appearance of caring/mission/vision but truly is just a pretense for a very superficial interest in employee satisfaction and lots of lip service type interest in patient care and caregiver engagement. My leader, for example, is not willing to praise anyone for fear of alienating someone else so as a result, never acknowledges anyone's contribution privately or publicly. No training or development and lots of behind closed doors decision making which is then rolled out to teams including core leaders vs inclusive decision making. Extremely political. Completely inefficient and nepotistic recruiting approach because of the volume of candidates. As a hiring manager, the only way to filter effectively with minimal support from recruiting is by your own recruiting using your own network. Many teams (whole teams) are stuck in positions that don't allow any growth and are really hard to get out of (revenue cycle).