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Why AI Will Never Replace Great Nurses, But It Can Make Them Better · Hearts of Excellence

• [00:00:00] Laird Russell: when I started spending more and more time in the industry, it was really like, you all are dealing with information coming from the hospitals and then home health and admitting people and discharging and like all this like there's just so much that can be done to just deliver a better patient experience. The hardest job in the world is working at a nursing home. So anything we can do to assist in that is extremely rewarding. And I started getting a lot of pride from working with people in this space um, You are listening to Hearts of Excellence, brought to you by Majestic Care, where real stories from long-term care come to life. [00:00:36] Chelsey Gheyara: Well, hello everyone. I'm your host, Chelsea Gheyara, Vice President of Growth and Experience for Majestic Care. I am joined, as always, with my host, Paul Pruitt, CEO of Majestic Care. I am so excited for this conversation today. I am just giddy, and I'm, I'm just so excited to dive in. our guest today didn't start [00:01:00] his career in senior care. He started it on a hockey rink at Brown University until a bad head injury took the game away and put him into the healthcare system as a patient for years. What he experienced there changed everything. He went on to work at Goldman Sachs and Bain & Company, but everything, he couldn't stop thinking about the gaps he lived through, so he built something. [00:01:25] Today, Laird Russell is the Co-founder and CEO of exacare ai, a platform now used by more than 2,000 facilities across the country, including Majestic Care. Hi, Laird. to the Heart [00:01:40] Laird Russell: I'm ex- excited to be here, and thank you for that awesome introduction [00:01:44] Chelsey Gheyara: Yeah. We are so excited to have you. When you said yes, I was like, "Yes, everyone's gonna wanna hear this." so I can't wait to dive into today's conversation. Paul, how are you doing today? [00:01:55] Paul D. Pruitt: I'm doing good. I just want to know, Laird, so why only two thousand? Come on. [00:01:59] Laird Russell: [00:02:00] Yeah [00:02:01] Paul D. Pruitt: There's like, what? Fif- a little over fifteen thousand nursing homes in [00:02:05] United States, and you only... Come on. You're slacking. [00:02:08] Laird Russell: know. We'll have to cut the podcast early so that I can get back to work [00:02:13] Chelsey Gheyara: Oh my gosh, it's so funny. All right, guys. Well, we'll go ahead and dive in. So, Laird, I wanna start today, you know, before exacare, before Goldman Sachs, you were a patient. You spent years navigating the healthcare system with this brain injury. So take me back to that time. What was that experience actually like? [00:02:34] Laird Russell: for the audience, I, I grew up in Canada, so Our, our biggest export is hockey players. So I of course put on the skates from a young age and did everything I could to, uh, make the, my fellow patrons, family, everybody proud skating around the ice rink. Um, and like you said, unfortunately heading into Brown University, I mean, I had played for 20 some odd years. I was on our front yard rink [00:03:00] at the age of four, um, and [00:03:02] had a really bad brain injury. I have had a number of head injuries in the past, but the last one just really r- changed a lot of things and was they're not very typical for a concussion or something that you hear. [00:03:17] I actually ended up with symptoms that they had never seen before. I couldn't, I couldn't look at a computer screen for more than five seconds. Everything from my eyes would burn. The whole world felt like it was moving around in a circle, or I was walking around on a sponge. so I navigated the healthcare system for a little under four years, really just because the brain is so com- complex, that it was really hard for these medical individuals to diagnose, understand, know what to do next. [00:03:45] And I think that that wasn't something that I was ready for, was, "Hey, there's a lot of things we don't know about a number of health conditions." And for me it was brain injuries, and it was, all right, now it's time to navigate the system head on. And that was a number [00:04:00] of, of painful years in doing so. [00:04:02] Paul D. Pruitt: to Chelsea said a point about exacare. I mean, I just think AI is the way of the future, but just what you guys have developed is phenomenal. So how many times did you have to tell your story or share your information from person to person because of the fragmentation of our healthcare system? [00:04:21] Laird Russell: Yeah, it's a really interesting thing, right? Where like I saw over 70 doctors. I saw, f- mean, they-- like, and then you can get into like the eye specialists, the, like the, the kind of like the people that help with different versions of experimental medication, like physiotherapists. and you're really starting from ground zero just because of, like you say, how fragmented that is. And it's been... It was really hard to grapple with the idea that like, "Hey, we've been doing this for four years, and there's-- I've-- we've accumulated at least... Maybe we haven't figured out what the answer is, but we've accumulated what the answer isn't to some regard." And I would often run into somebody two years in, three years in, that is taking [00:05:00] on a treatment or a medication with me, and then they hear one other thing, and they go, "Oh, whoa, that-- you have that symptom." [00:05:05] Like, oh, this wouldn't be the case then. So like you said, I'm navigating, trying so many things over so many years that I, I honestly was in so much pain that I was forgetting some of the things that we had done or... So it's like I was trying to bring my story and what I had tried and what I had carried through as much as possible. But along the way, something that I didn't realize was important to a neurologist would just turn out to be very important. Or this, "Oh, I tried that." I actually did try, a month since it was like, oh, we actually did try anti-seizure medication, and we ramped that dose up to a really high level. Oh, that didn't work for you? [00:05:40] Okay. Well, then these three months of treatments that we're about to put you on, it's a medication that's in the same family. So to your point, I just had so much information, so much that I was going through, and because that wasn't kind of following with me in a very clear way where that context could be easily shared, it just extended the amount of things that I would try [00:06:00] rather than just hopefully shooting at a more narrow, more narrow set of possibilities that would make me better. [00:06:06] Paul D. Pruitt: You know what's interesting is as I think about the journey we've all been on in this industry, Chelsea and myself obviously, um, in long-term care, and I know Chelsea worked in a rehab unit. [00:06:18] but... And again, it's not because of anybody's purpose, but it's just the healthcare system is so fragmented. So again, when I get that patient back when I was a therapist and they would, you know, send the patient through, and I would almost like feel like I'm starting from ground zero, to your point, but trying to put that picture together as much as possible because, again, the healthcare system is I might only have 20 days to work with the patient, 14 days, 13 days, whatever that is. But trying to understand the whole complexities to make sure it's the right and safest environment to discharge to, to get them to that next level. It was always complex 'cause you, w- you're right, the families don't remember everything that they've been through. So [00:07:00] then all of a sudden you find out that one conversation with that one son, you're like, "Wait, what did you just say?" [00:07:05] That changes the whole plan of care. [00:07:07] But again- you guys have really been able to help us put together a way better model of care that we can develop utilizing the system, which is quite phenomenal, [00:07:18] Chelsey Gheyara: so back then, you know, you mentioned going into college, you were, you were a young athlete, right? You were just as any other teenager, you were used to being in control of your body, of everything in your life, right? So from your perspective, what does it do, what did it do to you, or just what does it do to a person when all of that independence gets taken away from you? [00:07:39] And now, you know, suddenly you're the one that's being cared for instead of competing, on the hockey rink. [00:07:47] Laird Russell: and the idea, like I say, that the, of having a thousand issues and then you have one, you have a health issue and then you only have one, one issue. And for me, that happened really suddenly and I was headed off to college at the time and I [00:08:00] refused to give up or not progress forward. I think that my, my family was like, "Hey, let's take a second. [00:08:06] Let's try and figure this out." And I was always someone that was, uh, pretty hard-headed of like, I'm gonna keep moving things forward in my life. Um, and I showed up at school, um, with a number of symptoms. Like I said, I, I, the first night I took an ambulance to the hospital 'cause I couldn't feel half my body and didn't really know what that meant. [00:08:24] Um, and for me then as like someone that had always had this identity, always been an athlete, always kind of been the person that was, uh, for lack of a word, like chasing like a dream or, or, or, um, doing something that brought a lot of joy to me and my family and kind of others around me, uh, it was just a very, uh, stark difference being like, all right, now I'm on this completely different... [00:08:49] I'm, I'm tr- taking all this behind and I'm taking on this new battle, th- this new journey. Um, I think that I grappled with that. It was, it was really hard for me to grapple for a while with, because I [00:09:00] went, like I said, I went off to college. I couldn't play on the team, so I was just leaving campus for weeks, seeing doctors, doing things of that nature. [00:09:07] Um, and people on the team thought that I would, was coming back at some point. but I think for the first one or two weeks, I thought like, okay, this is like, this is a nightmare and I'm gonna wake up and like it's, everything's gonna be all right. I think a few weeks, months into that, I realized like, oh, this is like, now this is the state that I am in. [00:09:26] This is extremely serious and there's no kind of going back to how I was before. So it was really in that point I went from like, hey, what is the, the new journey? What is the... For, for me, obviously, like people talk about like loss of identity and kind of like, I think that I dealt with a lot of that from like a, was I a hockey player? [00:09:47] Was I not? Like who, who kind of was I? Um, and then I think on the other side, the symptoms were just, or what I was dealing with was so, uh, extreme that I kind of also was pulled in the direction of like, hey, there's all these [00:10:00] things that you, you wanna worry about or, or, or from like a point like, hey, this is like a very serious battle that could go on many months, years. And for me, I'm pretty positive. so it was like, all right, if I am losing all these things, is there something else that is out there for me? Which is like, again, we've, we've, I've been able to find that today. But I knew there was a lot between where I was sitting and if I was ever gonna get there, and it was very unclear for the next three years after that dealing, going through the medical system. [00:10:31] Chelsey Gheyara: That's beautiful. Was there a certain person, you know, whether it be a nurse, a therapist, an aide during that time that made you feel seen instead of just processed as another patient number? [00:10:44] Laird Russell: Yeah, I think there was a number of people that-- I mean, the, the, the most helpful thing is when, people, they just take the time, they listen, they kind of... I mean, it's, it's probably the people that it's the hardest on that you can really feel that they take your case on, and they want to see you. You can really tell that [00:11:00] they want to see you come out the other end, and that gives them a lot of joy. [00:11:03] I think you can feel that as a patient. You can feel the difference between, a transactional... I'm not saying that anything in healthcare. I think that, like, people get burnt out. There's a lot going on. But the, people that really can just lean in and, like I said, kind of l-- that try and do everything they can to, like, put themselves in your shoes and then, again, are cheering for that really good outcome, those people, you just um, really connect with along the way and can be the difference between, for me, hey, at the time, going to another appointment or trying something new or feeling like, hey, we are on-- there's a potential path here. [00:11:41] And that was really from the feeling o- of others that give you kind of hope in those moments of like, oh, hey, like, I want to see this outcome, rather than like a, oh, let's check in these boxes, and it's, it's not working. I don't really know. It's like even when they didn't have the answers, it was like that extra like, oh, we want to [00:12:00] make this happen, like really added the motivation. [00:12:02] And I could point to a number of people along the way that would, um... Like, I have someone in my mind that made extra phone calls to like, "Hey, there's, there's research I saw from like a doctor in Wisconsin that had somewhat similar case. Let me call, see if we can get you in with them." people that were on forums, like doctors that were like on forums or chatting with like their community with my symptoms. [00:12:23] Have you ever heard of this? And connecting some dots. so there's definitely people along the way that I think that their hope, just like gave me more hope, especially as the years went on and it went from like a, oh, this should-- you should statistically get better in three months, nine months, one year, two years, three years. [00:12:39] It was really the people that still were-- uh, approached the case with like, oh, we-- there's hope at the end of this, that really like made you feel, okay, that's, this is worth continuing to pursue and keeping a positive attitude about. [00:12:50] Chelsey Gheyara: you say all that just gives me like full body chills because that's, that's what, you know, and I, I am-- I've been thinking about how Paul as a therapist is interpreting [00:13:00] all this because, you know, I can just speak in our industry broadly, you know, post-acute care, basically anything after that acute hospital setting, that is one of the most rewarding things is seeing someone you're cheering for and just watching them come out on the other side. [00:13:18] Like it's just so hearing you share that as a patient, thank you for sharing that. And you know, that does bring-- It's refreshing. You know, it it says, you know, there is hope in our world out there, right? There are people that, are cheering you on [00:13:31] Okay. So I wanna, I wanna switch gears a little bit. I wanna get more, um, we're on our way to exacare. So Laird, you had Goldman Sachs and Bain on your resume. You could have built almost anything. Um, what made you keep coming back to, you know, senior care s- specifically, and when, when did it shift from an idea to something you couldn't not do? [00:13:58] Paul D. Pruitt: when you say, when you reference like going [00:14:00] to Goldman Sachs and like starting at Bain, when I was at college, I had to do... Like I said, I had the brain injury for most of college. I dropped out for one year, before my senior year, and I spent the whole year doing rehab. and I had the internship at Goldman Sachs that you referenced, before dropping out. And for me, the like the... What it really represented was during those years, I was-- I always said, I was like, "Okay, if I get healthy and I turn around and I, I wanna make an impact on healthcare, make an impact on people," I didn't really have a good way of doing that other than like, all right, well, I'm at Brown. [00:14:32] Laird Russell: It's like, all right, well, what, what can I do other than if I complain about what's going on, like, I, I don't know. I n- I never really believed that that kinda gets you anywhere. So it was like, all right, well, I wanna finish at the top of my class and people around me, I didn't know what Goldman Sachs was or Bain & Company, some of these. [00:14:46] It was like, but there, it was some of these roles that were, if you finished at the top of your class, you had an opportunity to be at some of these companies. And for me, that was always like, okay, I'm sitting here. I, I have this bad brain injury. I have to... I can't [00:15:00] look at a computer screen, so I had to do all of tests where I would just do pen and paper. [00:15:04] I'd go to the library, read a textbook, and like regurgitate the information. I was always like, all right, I can't get a B in any class because again, I'm on this, like I've committed to when I get healthy on the other end, I want to be in a position where I have proved that I-- people should trust me with whatever version of things I'm doing. [00:15:24] And for me that always meant like, okay, well you have to do good at... You have to show that you can do good at some things in order to really prove to yourself and others that are gonna work with you that like, hey, you are worth being around. I don't know. Maybe that's a, maybe that's a, uh, uh, too harsh of a... [00:15:38] But the, the, for me, it was like a, all right, so I finished. With all that going on, I was able to finish with, yeah, one of the better grades. I spoke at graduation at Brown. I went off to these, versions of, of workplaces that other people around me on campus had been like, "Oh, this is where you would wanna go." and then heading into those, if you look at my resume, I left them really quickly 'cause the goal [00:16:00] really was just like proving to myself and proving to now ideally we have a, a team of 70 and growing, like, hey, if you work with me, no matter kinda like the hard times, I'm going to be able to get to a really good spot or outcome regardless of the circumstance. And then for this going into and building in healthcare, I just have that goal of like, hey, I want to turn around and have a really big impact on the healthcare system. I'm telling you, I've had harder blockers in the way throughout my life for a lot of other things like we just discussed. So it's like, hey, let's build something that has that big impact and there's gonna be trouble along the way. but ideally I have like a track record that I can point to of saying like, as things go wrong, if we have this goal, which for me and everybody at Bringon is exciting to make a big impact in healthcare, um, just trying to bring more and more people around that can push through hard times and like ultimately get to big outcomes or, or, or big goals [00:16:56] Chelsey Gheyara: that's phenomenal, Laird, and holy cow, like what a [00:17:00] testament to you of, you know, it's very... it's this is heart work for you, right? Because you lived this experience and, you know, as Paul was alluding to earlier, going in to tell your story, right? [00:17:12] When you're talking to investors or when you're talking to a board, you know, and you're like, " I'm in it because I lived it, and then now, you know, this was my experience at obviously Goldman Sachs and then Brown, and now I'm committed to you." And, um, it's interesting that you bring that up with your whole team fr- from exacare just, you know, using the reference you did about, you know, I'm in the arena with you, or I'm, I'm gonna go through this with you and I'm not gonna give up on you. [00:17:36] So kudos to you. That's very rare and very special, so thank you for sharing that [00:17:41] Laird Russell: as soon as I was able to, I was like, "Oh, I'm healthy." And I, like I said, I jumped into some of these roles with really just like to prove to myself that like I, [00:17:50] I, I could operate at like a high level even with some of these roadblocks in the way. I then wanted to build in, in healthcare, and I turned around and I, and I tried to build in brain injuries [00:18:00] first. Um, and then just transparently, it was just too overwhelming from me from like, A, worked with a couple people from MIT, and we just don't know enough about the brain. And I-- as much as maybe hopefully sometime in my life career I'll circle back there in some way, I was just struggling with how emotional the topic was for me and how, [00:18:24] again, how much science we need to do in order to get there. so it was like, hey, where can I make an impact now? And started to look more in the-- rather than like, hey, 'cause we were doing experiments like could-- if you move your eyes to like a certain spot like, and, and almost like trying to, in a lot of ways, trying to like... I think it was a version of positivity, but it-- but like some-- they, we were taking leaps that we weren't, again, we weren't there with brain injuries. [00:18:48] So I was like, all right, what is the, what is-- It doesn't have to be me, it doesn't have to be exactly, but hey, I want to look at the scoreboard when in 40 years and be like, "Hey, how many impacts did I make on li- how much impact did I make on lives?" [00:19:00] And through dealing with brain injuries, and I had done a number of talks about mental health, you end up the-- there's like a, what comes up pretty quickly, it's like our largest vulnerable population is 65 plus, and it's doubling over the next 10 years, and there's like a loneliness epidemic. [00:19:16] All these things everybody has. I've had aging. I had grandparents that went through this system. Like you, you're, from a number of different ways, it became obvious to me like, hey, this is, something that I'm passionate about. This is like in a, really interesting, uh, band of, of people. And it wasn't a far cry to believe that a lot of this had been left behind from like a systems processes standpoint. [00:19:42] so then when I started spending more and more time in the industry, it was really like, oh, wow, there's a ton here, and got more and more excited about doing things that, again, like you all are dealing with information coming from the hospitals and then home health and admitting people and discharging and like all this like there's [00:20:00] just so much that can be done to just deliver a better patient experience. and you all, again, it's the, the hardest job in the world is working at a nursing home. So anything we can do to assist in that is just, extremely rewarding. And I started getting early on the, a lot of pride from working with people in this space, just because of that. [00:20:18] Chelsey Gheyara: I love that. So off of that, you know, families listening to this may be nervous about AI being involved in their loved one's care. What would you want them to understand about what exacare ai is actually doing, and not doing for their loved one's care? [00:20:36] Laird Russell: think that it's twofold. I think on one side the-- what I always wanted, and I think this is what everybody wants, but, like, when your loved one enters the system, you want the greatest percentage chance of them getting the best outcome. And that's kind of what I love about this new wave of AI and what it can do, is we can sit there, I can sit there and statistically say that what we're [00:21:00] doing creates the better chance for a better outcome. So it's really like, hey, we can take all that information, digest it, put it in the right f- person with like without missing things, without kind of like... And they can then turn around and know exactly what to do in like a be- in a better way than, than before. Again, you're gonna get that human that, is of course, delivering the care, being there, following through with the plan. [00:21:25] but it's really can you equip them in a better way just so that they can do their job in a better way? So AI should be nothing else other than like a tool to increase probability that that person that is like being a superhero and delivering this care day in and day out can do a better version of that job. [00:21:38] Chelsey Gheyara: absolutely. Well, we, you know, Paul can tell you this too. We love AI here at Majestic Care. We love innovation. and you know, as I mentioned earlier at the beginning of our podcast is, you know, we partner with exacare ai, and if I, anyone listening to this that is, you know, an industry leader any way involved in listening to this that is, you know, an industry leader or any way involved [00:22:00] in decision-making in the post-acute, um, referral space, I can't say enough good things about exacare ai. [00:22:06] Um, it just, you know, obviously our team is so involved, right, in, in the platform. they're using it as a partner, right? It's a tool and it's a partner. and it can give us, it gives us so many great insights and, and I'm not just, you know, saying this because you're on here, Laird, but it truly is. [00:22:23] I mean, it just gives us great data analytics, and it has completely been a game-changer. And I love hearing you. I love a good experience for patients, and I just love hearing you saying that as you're, you're acknowledging that, hey, we're not just using AI AI to use AI. We're not just using this because this is where the industry's going. [00:22:41] The seniors are, we're getting more seniors. They're getting older. You know, this is the silver tsunami coming, right? We're using it because it's, it's creating that true end-to-end experience, and I know that you guys are just geniuses over there. So who knows what you're gonna think of next. [00:22:56] but I, I could not say enough good things about [00:23:00] exacare ai. So wonderful. Well done. [00:23:02] Laird Russell: Well, I was gonna say, like Chelsea was, like Laird and you were talking about that experience for our families that are listening, it allows the clinician to have a more holistic view of what's going on with their loved one than trying to read, you know, 90 pages of a medical record. [00:23:18] Paul D. Pruitt: You know, when I think about our, our nurses out on the floor, or I think about the therapists or whoever's out there having to provide that hands-on care, if we go back to those days where they bring in that admission packet, and it's just volumes of information, and you're trying to go through it as fast as you can, and hopefully you catch all the, the most critical elements. Do they need a wheelchair? Do they need a walker? Do they need this? What type of meds do they need? What other diagnosis? That is what the AI system is removing, that white noise, as I call it, so the clinician can really put together a good formalized plan of care that really is meaning for that outcome that we all want, [00:24:00] which is excellence. Now, excellence I use very broad because excellence could be, here is your prognosis, here is what's going on, and maybe mom after her stroke isn't gonna walk again, but here's what I understand. Here's what I know about your care. Here's what I know about your home environment. [00:24:16] I can help put a plan together that's gonna give you that excellent level of care that you deserve, or this is your outcome because of this. [00:24:25] So again, Laird, I think you guys done a phenomenal job because if I go back to watching as an administrator, when I was administrator, my nurses on the floor taking care of rehab, [00:24:36] trying to get... They-- Here comes the patient with that packet. They give it to the nurse. The nurse is literally trying to scramble through this packet to tr- put together what's going on. Do I have all the right things? And you guys have really simplified that into a couple pages, so the nurse truly can be at the bedside providing that high-level quality care versus at a med cart [00:25:00] trying to shift through 90 sh- pages of just information. So again, [00:25:04] hats off to that for what you guys have built [00:25:07] Laird Russell: Awesome. And Like you say, a lot of credit to you all. I think that, like, the cool part is seeing groups that, like, if you're-- I mean, adopting there's-- it's a choice to take on AI and new technologies to try and, hey, can we make processes better? Can we have a better inside look into our operations? I think that's really what-- I mean, my goal of a, well, what's the future of exacare and what are we trying to do here? [00:25:27] It's like a lot-- Because of the amount of just sh-sheer volume of care going on and patients and day-to-day and things, it's like, what can we do with this? It's like, has been a, a more opaque just again, because there's how much is just flow-flowing through the system. and You all, can we create a better transparency window into everything that's happening and, uh, like, and intervene at the best times, create the best outcomes, and understand, Again, what did we do with the patients? [00:25:54] Did we do with them-- So by inviting this innovation and technology in, you all are, and you all have been, like [00:26:00] like I said, on the forefront of wanting more and more. It's really just, hey, can we have better insight into our buildings? Can we have better insight into our care? 'Cause there's like, this is a lot of people flowing through, and this is like, hey, the better we understand the patient population, the better we understand what we're doing with them, is just gonna just lead, lead to better outcomes. [00:26:16] So it's, it's really cool having operators that are like, "Hey, let's,find more of this stuff, in order to just, like, see what we can do with what is a big part of the healthcare system," which you all rests on you all hand-- you all's hands. So I, I really appreciate that. [00:26:31] Paul D. Pruitt: so also just to piggyback off of, you know, p- maybe families nervous to, hear about AI being involved and really just AI in general, right? As it's, it's not new, but it's newer to some organizations using it right in their day-to-day. [00:26:44] Chelsey Gheyara: And we talk about this a lot, and I know, exacare stresses this too, is, you know, it's not replacing caregivers. It's not replacing the nurses at the bedside. It's not replacing clinical judgment or, you know, empathy or compassion or whatnot. I [00:27:00] think for our listeners and especially in our organization, it's important to hear that as we introduce these new tools, of course, we're gonna leverage them, and we're gonna make better business decisions because of it. [00:27:12] And it's not gonna replace, the care that's being delivered. [00:27:15] Laird Russell: No, absolutely, like you said. And I mean, if I was running the, uh, American budget, I'd probably triple it for the healthcare system and nursing homes. But like you say, we... You all do as much, like, do an amazing job with what you have, and then you have to turn around and say, "Hey, we got to deliver exceptional care, and we're running on, like we're doing... [00:27:35] We have-- we're taking on resources we can. what are ways we can make that more efficient?" and again, that's in the... over the next 10 years, that's the operators that are gonna be where you want your family [00:27:43] members is, there isn't just a truck backing up that is, that is giving you another 30, 40, 50 staff members. [00:27:50] So if you can make the ones that you have more and more efficient, it's just gonna end up in better care. And like you said, I think that, Like everything out there when I talk to nursing home owners, [00:28:00] it's everyone is short-staffed, needs more and more staff. I think that the goal, I'm sure for you all, is to just like keep investing and like keeping, keep trying to find ways to, have a good environment for your staff. [00:28:10] And I think AI does a really good job helping with that. Hey, [00:28:12] a nurse wants to come in, deliver quality care, connect with family members. They don't want to sit there for two hours after their shift and write up notes and communicate with payors and insurance companies or like some of the things on admission. [00:28:24] They don't want to have made a mistake and accepted somebody from a hospital because they didn't read page 37. Like, these are all things that are not the exciting part of the job. The exciting part of the job is to, to be beside the patient and hope for that good outcome. [00:28:37] Chelsey Gheyara: Yeah [00:28:38] Paul D. Pruitt: you bring up a good point, Larry, because if I go back to my days clinically, I didn't want to sit in front of a computer. I didn't [00:28:44] want to chart. I didn't want to have to sit and do billing. I remember sitting one time, this was when PPS, what is it? Perspective payment system or whatever it was back in the day went into play. I remember sitting there and I'm like, "I didn't go to school to be a bean counter. went to school to [00:29:00] take care of people, to care for them, to help them walk again, whatever that is." And I just remember sitting there and charting and stuff, and it's like this... It's becoming more laborious [00:29:10] week after week, month over month, year after year, and it just compounds even more to where I felt like there were times... [00:29:17] I remember there was one point where my... And again, I understand why they did it, I just don't agree with it, but they wanted me to do point of care charting. And point of care charting is literally I'm sitting there charting as I'm taking care of Laird. [00:29:30] Well, the hard part with that is I'm a PTA, so guess what? [00:29:34] When I'm treating you, I need my hands to treat you. [00:29:37] But yet I'm supposed to chart while I'm treating you to be efficient and billable and all of this stuff, and it's just like, okay, this is... I understand why you want me to do it, but it's not working. And there's a disconnect, and I think that's where I'm very excited about AI, and I drank the Kool-Aid a long time ago with AI being it can't replace the clinical [00:30:00] judgment, but it can start taking away, and I call it the white noise, all of that extraneous stuff that we used to have to do by hand and read and fumble through, and it can just get it down to the, what I need, the bu- the nuts and bolts of what I need so I can take care of the resident. [00:30:19] And that's what I think is absolutely [00:30:21] Chelsey Gheyara: Ha [00:30:22] Laird Russell: And like you say, well, what is the... There's a lot of things in place that create, uh, well, let's work back from like, it's like, uh, there's a lot of things that you have to do in order to, get reimbursed from insurance companies or the government, and there's a lot of things that you have to do to make sure that you're, in, uh, you're not getting citations. [00:30:39] You're basically... Well, all of that is extremely important, but in order to do the combination of that plus deliver the best care, that's really just like a set of information that is flowing through that you all are hoping to just deliver the optimal care for the right and know exactly what to do, and then be reimbursed all these different [00:31:00] things stated then but, in order to do those other things that I just said that sound light, there's a lot of rules and a lot of implications, and for a lot of people that haven't been in a nursing home, there's a lot of things going on. [00:31:11] So anything you can do with tools and information to be able to say, "Hey, we can deliver the best care. We can then just appropriately get reimbursed for it, and we can, like, make sure that we're not doing anything that, we shouldn't," that is like, again, would be a version of citation. Again, those are all the, the rules and all the important pieces because what you all do has so many implications, and that's why I think it's, like, amazing that AI can help with all three, which is what everyone is trying to get to. But there's just, there's n- there's no one, or at least it's a very small percentage or hopefully zero, that is, like, trying to actively end up in a bad a bad write-up or scenario or missing medication or due, you know what I mean? So anything that you can do to hit a better, like, hit, like, create a better outcome for all those, I think everybody is, is on board with [00:31:57] Chelsey Gheyara: Mitigating risk, seeing that, flagging [00:32:00] everything is great. Laird, if a CNA or a nurse, um, is listening to this and they're skeptical, they've seen technology and AI come and go, and mostly, you know, sometimes they may say we have a new system that's creating more work for them. what do you want them to know? [00:32:16] Paul D. Pruitt: Yeah, I would say that like, you hear stories of like, hey, this didn't work, or this created more work, or this is like, The biggest thing for any nurses or anybody going through this, I would say on two sides, it's like you're not wrong that there's things that you will try that, they weren't designed with you in the room. Not to say that the application of them wouldn't be great, but there might be, and you hear this over and over again, they missed by 20%, so it created more work for you. so I'd basically say like, there's a number of people like myself, others that are trying to get to good outcomes with this technology. It's relatively undeniable that with us sitting in the room and listening well and understanding those workflows, you can really supercharge those, what they're [00:33:00] doing and get to really good outcomes. So on one side, the technology groups need to be patient and be sitting beside the nurses and be sitting beside the CNAs, and like, we really try and do that and try and be in as many facilities and listen to feedback and trying to get to that spot. [00:33:15] Laird Russell: And then on the other side, hopefully, like we ask for that similar grace of when something's 10% off or 15% off, it doesn't mean it's a failure. It just means that like you are working with something that is going to, if you give the feedback of like, "Hey, I'm trying. If it did this, I'd get to here." that feedback changes the system and then all of your colleagues and everybody else now gets to a really good input. So I, I, think it's both sides where like you're not wrong that you will run into some things that aren't perfect. And then, if you can work with that though, you, you'll-- I'm sure you'll see more and more applications where you say, "Wow, this is magic. [00:33:48] This really changed, saved my day." so it's really like both sides working together to say like, not everything is perfect, but if we are trying to all get to the same goal of like optimizing this, hopefully we [00:34:00] can meet in the middle and continue to get there. [00:34:02] Paul D. Pruitt: you know, Chelsea, I think that's a really good question to call out. And I think, Laird, you identified it. You know, again, as soon as people find an error, they don't wanna use it. [00:34:11] And the thing of [00:34:12] it is, is the best outcome could be that the teams come together and sit in a room and identify, because if you don't know it's not working, for example, then you don't know what to do to fix it. [00:34:25] So if no one's sitting next to you to say, "Laird, that's causing more havoc on my side. That's causing me to work more," then you don't understand, well, what do I need to change in the system? And that's what I appreciate about the relationship. Chelsea had, several people from InstaCare here a few weeks ago, and they were down in our Bluegrass Hoosier, I don't know which room, but down in one of our rooms and strategizing. [00:34:50] And again, all of it was about how to make it better, [00:34:53] how to keep making improvements, how to keep pushing the envelope to get that higher quality. 'Cause at the end of the day, I always say [00:35:00] every decision that is made, every conversation we're having has an outcome that will impact our residents. [00:35:07] And if we want to be the premier, we want to be the one that is ahead of the game, we want to be the one that is truly driving excellent care to those we serve, we have to be willing to sit at the table with our partners, with our colleagues and say, "Okay, here's where we want to go. [00:35:23] Can you help us get there?" [00:35:24] And Laird, you guys have been doing that, which we can't say thank you enough [00:35:28] Chelsey Gheyara: Well, Paul, you mentioned our, our mission, and it leads me into our very last question. Our mission here at Majestic Care is we deliver excellent healthcare to those we serve. Um, Laird, what does excellence mean to you? [00:35:41] Laird Russell: What does excellence mean to me? Uh, [00:35:44] I mean, especially in healthcare, it's really important. I think that if we were building, and I think we talked to Bailey about this, it's like, ah, I likely could have, like, s- showed up and, and built in a number of, industries, but building in healthcare and thinking about, like... And I, I [00:36:00] probably drive myself a little bit crazy because, like, excellence for us means that, like, hey, if we do things at the highest, like we, we push our technology, we push the team, we push-- what we're doing that leads to, like, better outcomes for our customers, which leads to better outcomes for, patients. [00:36:17] So I think, like, excellence for us is twofold of like, doing everything we can to move as fast as possible to deliver as many, whether that's tools, options, workflows for you all. and then that's also, like, doing it from the lens of sitting with you, understanding the outcome, the patient, what this means. because ultimately, the goal for me and what we're trying to do here is deliver a better experience and a better outcome for patients. I think that I talk a lot internally about, like, we can't-- W- we need to deliver a, 10 times or 20 times better experience before we charge for something. because it's really like I [00:37:00] genuinely, and, yeah, we have investors, we have all this, but like, I'm genuinely here with the, "Hey, we wanna build, grow, move the industry forward." so this isn't like a, "Hey, let's just deliver software that kind of creates something." It's like, hey, excellence is again, we're pushing things really forward. making Not to squeeze game-changing, uh, new workflows, modules, and at the end of the day, that's then going to really 10x you all, you all's experience or the, patient at the end of that. and I think that that's ultimately, like, what's made us successful so far with customers in the industry growing so fast. It's been like, I think people genuinely do believe that we're trying to build and evolve and grow something. One, with, like, really good people, and we push that really hard, but we're doing to, at the end of the day, have a really big impact. not to squeeze a version of margin out of the, the industry, but really to say, like, "Hey, how much have we given in order to find..." Obviously, we have to keep the lights on and find what we, we can do, if any of my investors are listening. But like, hey, how much can we push [00:38:00] the envelope here to give to this? And that what in return in order to then turn around and take that investment and do more and more is really, I think, what excellence means to us and what I think we're really, like, proud of feeling like. Even having our customer summit and having you all come together, I think people genuinely feel from our team that We're there to have like, an outsized impact, not like a [00:38:24] moderate impact. [00:38:25] We're really like, "Hey, how do we... If we're doing something great and you guys are saying, you guys have already said probably from the beginning when we were doing, 'Oh, the, the product is great,' and then working with us, it's like every day it's like, 'Well, how do we make it 10 times better? How do we release this new thing that would completely change this workflow?' so I, I, I think like continuing to drive to deliver value and, and not taking any of this for granted of who we're doing it for is, excellence for, for exacare [00:38:51] Chelsey Gheyara: just piggyback, I think, 'cause you used, um, a w- a statement or a phrase that, um, I just started working through is [00:39:00] 10X. So our 10X object- objective this, for the next three years, and I don't think we've said it on a podcast yet, [00:39:08] Paul D. Pruitt: have [00:39:09] Chelsey Gheyara: I don't think we, I don't think we have yet either [00:39:12] Paul D. Pruitt: So it is we wanna be nationally recognized as the premier senior living provider. [00:39:18] Chelsey Gheyara: Yeah [00:39:18] Paul D. Pruitt: again, I use the word in there is the premier, not a premier. We wanna be the premier. So again, that 10x, that big goal to say that's where we wanna be, and our mission is going to be to continue to, you know, through the hearts of our care team members, we provide excellent healthcare to those we serve. So those are the things that we're striving for, and we wanna be in relationships with people that will help us get there and continue to help us meet those expectations. Because again, at the end of the day, it's somebody's loved one, it's somebody's healthcare journey, it's somebody that wants to provide us exceptional care that we continue to fight this fight with so that they can [00:40:00] continue to deliver that care, which is excellent. [00:40:02] Laird Russell: No, that's awesome. And Like you say, I mean, it's... I always say, like if you can understand why a group or someone or anyone does something, everything else follows from there. So as, as yourself leading the company and like you said, Chelsea you being in leadership and you all having that goal vision of doing this because from what I've learned from you all is to just deliver the best version of care. and I think everything ideally in healthcare and all this flows from that. I know people talk about, hey, having a census or a number of buildings of like, hey, for you all it's, hey, how do we premiere version of this healthcare? that's just a, a cool lens. [00:40:34] And then, I mean, the, like I usually... I mean, I wish on those people that are part of that, that are coming from the right place to have the best outcome 'cause you're just gonna, more heart, more lives are gonna end up in your care and it's gonna be for the right reasons and you're gonna have a whole culture of people that are banded behind that, which just is, yeah, which is awesome for, for healthcare in itself. [00:40:56] Chelsey Gheyara: thank you for tuning in to Hearts of Excellence. Laird's [00:41:00] journey is a reminder that the most powerful innovations in care don't come from technology. They come from people who have needed care themselves and never forgot what it felt like. If you're interested in learning more about the culture at Majestic Care or want to find out more about our career opportunities, visit majesticcare.com/contactus. [00:41:22] If you or a loved one needs long-term care, reach out to us. We're here to support your next chapter. Thank you for tuning in today, and we'll talk to you soon