How Kirk Soileau Solved Rural Healthcare's Biggest Problem: Finding Nurses

[Music] Back with another episode. Our next guest started in healthcare thinking it was just going to be for some time, but 40 years later he's building systems that serve the people most of the country forgets, which is not a job. It's truly a call-in. Kirk, what's up, man? How are you on this beautiful Friday? I am great. I'm great. Glad to be on the program with you today. So, yeah, man. Same here. I know it's been some time since we've had our last conversations, but I want to get right into it, man. You were on track to become a CRNA. And then what most what was most that uh you you really decided I don't want to do that. I want to do executive leadership. Why was you feeling that was your lane? Well, look, it really started out with the fact that, you know, I, as I I shared with you in the past, I had a neighbor that was a CRNA, and I thought that'd be a cool job. You know, you go to work early in the morning, you're all in the afternoons, live in a nice house. Well, I started school and I got about halfway through and I realized, oh my god, I could not be stationary, be sitting in one spot, you know, I got to move too much. And um so I I continued on my track on a on a professional route. um and in a clinical professional route I should say and uh from there it uh kind of turned opportunities afforded themselves. I really never thought I'd be in this position today. Never ever. I thought well you know I'm do always you know always felt like I've worked my last job as hard as my first and um you know I had great mentors, great leaders and one led to the next and that's I'm here today. As I'm looking to you I'm a little jealous. Normally I'm at home on a standup desk. Today I'm in Boston in the hotel room and I can't stand up with you, but it looks like you have all the energy. So, I'm super excited. Yeah. Um, and something about traveling, man, that I love about you is that you've been able to do this in multiple countries. Yeah, absolutely. Multiple hospitals. What does that look like for you, man? Well, you know, I went through a period of time. I was um I was running a health system uh in Louisiana, Texas, and Arkansas. And um actually, I was asked to go in and help do a turnaround. It was in bankruptcy. emerged them out of bankruptcy and um really got stood up all those facilities again and then we sold them off and I really got to the point where you know I I want to do something different. So started my own company Global Health and um you next thing we know we're in 21 countries um throughout the Middle East, Asia, uh India and uh built uh design build hospitals and um then as you and I were talking earlier that pull away from family was tough you know I was when I was you're on the road out of the country 8 to nine months a year that's tough and uh so sold the company and um really just was looking to slow down a little bit and next thing I know I get a phone call and say, "Hey, we got this opportunity. Want to take a look at it?" And I ended up here. That's 13 years ago. Where does this entrepreneurship come from, man? Building something so so large like that doesn't just come overnight. Well, I think it's from really the work ethic I got from my my mom and my dad. And my dad was a businessman and you know, u I don't know. I just think that, you know, we were all built, my siblings and I are all built with this drive and I really think it's a testament to our parents. Love that. And and now you're in a space that you mentioned a little bit more a little easier for you. H what is what is the hospital? What is your role for those that are watching and may not know? Well, I'm uh I'm chief executive officer for a the largest rural hospital in Louisiana. Um when I arrived here April the 1st of 2013 um we were in the beginning the last quarter of our fiscal year. So we're on a what we call a fiscal year. Our year ends June 30. Uh so we finished that year with about 57,000 patient encounters, meaning they came to the ER, they went to had surgery, maybe they went um had an admission, went to one of our clinics, they were in that number. This past year, June 30, we finished with a little over 225,000 encounters. In about 11 and a half years, we've grown and we're continuing to scale up. Um, you know, it's just a phenomena. It was a that was the reason why I came here. I just when I really looked at the opportunity, I realized, oh my goodness, this place was successful in spite of itself, and what if we just put some things together and really grow it? And so we've been on a track and uh I've been really fortunate been I work for a great company. Um allow me to do a lot of things. I've got an amazing board of commissioners. Um and um so it's it's just been good. You know, we have the hospital, we have a senior living center, we have 12 clinics, uh we have uh two rural health clinics, a cancer center we acquired four years ago. Really, we call that a capstone program for us because it's allowed us to really keep our community members here. Uh, it's been a good journey. It's been a good journey. We're not over not over yet. Oh, no. No. Like you're just getting started, man. Like you're just getting started all over again. But what one of the things you mentioned to me was that you guys are, you know, obviously hospital, but you like to say that we're service providers. What does that shift in mindset actually do for the culture and for the outcomes? Well, you know, at the end of the day, that's what we're here to do. We're here to serve this community. um you know, we're a public entity. Uh we do not have a millillage to operate. So, we're what we call a self- sustaining organization. We've got to be able to um you know, be able to uh run ourselves and continue to grow and build our workforce. Arrived here, we had about 450 uh associates. Today, we're a little over,00 um and continuing to grow and add services and and everything we do is always forward- facing about uh care for this community. That's kind of our core purpose. And you said there's no such thing as no. When last time I spoke to you, what is that about, man? There's never no. There is. You can always figure out a way around. I I don't think I've ever Look, I I don't do well. Um I don't do well in in a box. Um you know, so I like to be I like to be able to get out and be entrepreneurial. And it's been really good. You know, one thing I've really focused with my team and and our managers is you have an obligation outside of the four walls of the organization. You really got to be out there and meet really be a member of the community. So, our leaders really their job is 24/7. Um, and you know, most people embrace that and if you can't, that's okay. Uh, but we really need uh folks to be to always be representing health care for this community and we innovate. we come up think of ideas and ways what can we do differently. I'll give you an example. Um we had we're the uh one of the the poorest municipalities are parishes and we're we have parishes here. We don't have uh we don't have counties. Um we're one of the poor poorest in the state. I think probably the um poverty level is our median income within the city limits is under 17,000. So that just gives you an idea um of the poverty here. And even within the city limits, uh, we had a high no-show rate at our clinics, as high as 30% in certain clinics. And we had we figured we had to figure out what do we do to make sure we we get our community members here. So we just put together a logistics department. We opened it. And so we transport patients. We're now transporting about 1,400 patients around the community just to get back and forth to clinics. Now, we don't we don't do we don't take them grocery shopping. We don't take them to the stores, but we it's really about healthcare. What can we do to innovate and make a difference? You know, I'll give you another example in in um in CO we quickly stood up. You know, the governor called all the hospitals, you know, onto these conference calls. We'd have those every other day. And he says, "Look, we're starting to vaccinate the communities. Uh we need your help. Can you what can you do?" Uh, I picked up the phone and called the the mayor uh got the parish president involved and all of our city leaders and I said, "Look, can we commander the event center? We need to be able to vaccinate this community." So, we actually did. We took over the the event center. Uh, it's a big space about 25,000t space. We took over that space and began to vaccinate up to a thousand people a day. uh were able to run through um and but we quickly realized after about a month um that half of our population was not attending and and we're 50% African-American here and they weren't coming. They uh for what and we tried we couldn't get them to come. So my our chief medical officer uh Dr. Mason is an African-American female. She's amazing. And um I said, "Look, let's call a Zoom meeting." The time we're really just getting going on Zoom. That was five, six, six plus years ago. And um so we called all the ministers together. So we got about 14 showed up for a meeting here. And then we had about 12 on that were on Zoom. And we said, "Look, what can we do to get to your um to your parishioners, you know, to to get the word out?" And we quickly realized they were very fearful themselves of the vaccination and and I attribute it to things like the Tuskegee incident issue years ago and there's just this fear of healthc care you know uh and that kind and like so by the time we finished that that that meeting after about 90 minutes we then I was on a Friday we then stood up a a town hall the following Wednesday we did it at the MLK Event Center here in town and Dr. Mason really led that. We we brought all the churches together and there um you know they typically have a Wednesday evening worship service and then we you know we uh she spoke directly to um to the community members and we did that through Zoom and then within within about 3 to 4 weeks um we saw our numbers were evened out. We're about 5050 on our vaccinations and that's that's what we call just doing things to you know to make sure we take care of the entire community. Um you know it's a challenge. Um you know we do these podcast with physicians every month one of our local radio stations and um we did our our podcast last month was on prostate awareness. Um and I was in there with one of our urologists and we were speaking and um he gave some alarming statistics. You know, being an African-American uh community here, they u African-American men have a a much higher incidence of prostate cancer. So it's uh and we just got to get the word out. And so we quickly then stood back up what we used to call our pulpit conversations where we go to the churches. we go in there and we talk and we just explain things and um it really makes a difference. You know, you you just got to figure out how to get to different constituent groups. Sometimes it's in the churches, sometimes it's on the street, sometimes it's in, you know, we call town hall meetings. Um just kind of those things you just got to try to figure out how you take care of the community. I love it. You're quick to pivot. You're quick to figure out what's next. How do we make this happen? Um, and as an entrepreneur, as a leader, you have to think like that. I love that the what you mentioned a little earlier as you started speaking was my four walls. You know, I didn't want to just be within the four walls. And I remember leaving a company after 8 years for that exact reason cuz when I wanted to do more, she told me uh she I had to wait she waited 25 years for her opportunity. I had to wait for mine. And I'm like, there's no way that I can stay within these four sandwich walls, right? Cuz I was working on the subway at that time. There has to be more, right? There has to I was cha I was chasing purpose and passion, not so much paychecks. And Kirk, you've been doing that so good, you know, nowadays. And you talk about innovation, how you guys were able to innovate. Crazy that Zoom was, you know, that you said was like 5 years ago, right? Everyone's now on Zoom and look what we're doing now virtually to be able to just have these conversations and educate people as well as as Richard mentioned it. But I want to talk about innovation in the sense of AI. I I think it's a beautiful thing. So many people are using it in spaces as transcribing for doctors to be able to do less note-taking and just more engaging on the level of the patients. Where else do you see AI being a big factor in the um the space of healthcare? Well, look, we are using now we're piloting four different AI softwares in our clinics with our providers and and for the point you you made, it's the fact that it can, you know, through whether it's an ambient listening device or a a scribe and you're using AI, it really helps the provider by the time they're finished, basically they've completed their note. All they have to do is go in there, if there's any edits, they don't have to then fill in the blanks. So again, we, you know, we we were our goal was to have a integrated AI product in all of our clinic and clinical settings by the end of this calendar year uh which would be December. The issue with that is the technology is changing so rapidly. I don't think we can pigeon hole ourselves into one product. And that's just on the clinical side. The other piece we're using AI now is on our billing, our billing and claims management processing. you know, we're pushing out in the neighborhood of, you know, uh 200 225 to 275,000 claims uh are going out annually. So, with that, we had to figure out a way what can we do? We what can help our our our billing companies and help uh maximize the providers uh documentation so that we take advantage of what payments are. And again, we don't want to fabricate anything, but you know, our we bill in health care off of the severity of illness and we determine the severity of illness based on the documentation of the provider. So the more in depth the the documentation, then the higher coding you can get and then help potentially helps you with a higher reimbursement. Do do you um do you feel like you get some push backs when you were implementing some of these pilot programs on AI? I feel like so many people were kind of scared of what AI was going to do, take away jobs, but really is it's it's beneficial, right? It's it's helping us do more of the things that we love and and less of the things that we don't, which is documenting that you kind of mentioned. Do you see push back and how are people actually taking it now? You've been piloting some programs. Well, look, it's interesting. Our providers were the ones who were demanding it. Um, so it it really made it easier for us to be able to do that. Um, and look, we've got a very innovative medical staff here. I think it's because of our approach. We're very forward facing. You know, for instance, we used to have when I had I had an amazing chief nurse here uh for probably my first five or six years and um she went on to get a become a nurse practitioner and she left me. Uh but she's doing great things as a nurse practitioner. Uh nonetheless, what her and I she came to me frustrated. She was like, you know, our doctors have complaints and we it just never feels like we ever close the loop. I said, "Well, why don't we treat them like we do our patient concerns?" And I started when I got here basically 13 years ago is stand-up meetings and immediate. So, if we had a patient concern took place, we want to administer or work through a service recovery in real time while they're still here. So, I would call a stand-up meeting, a five-minute meeting. What's the issue? What's going on? uh if we can't address it and come to a resolution in about 5 minutes, we disband and then before the end of the day, we would recircle back again and close that loop. So, it really made great a great difference with our with our patients and their families. So, I said, Donna, why don't we just do the same thing with our physicians? Let's treat them the same way. Let's change it from our our patient care uh committee to a customer care. And so, we treat our physicians as our customers. And when we started doing that probably 7 years ago, our doctors felt like I'm being heard. Uh I'm getting a response and I may not like the answer, but I'm getting followup and follow through from leadership. That's totally changed our relationship with our medical staff. You know that they're all high drivers, high performance. They wouldn't be physicians that they aren't. And so everything they do is always about what's the best and best I can do for my patients. I want to make sure we we provide the highest quality of care and the safest care we can do. You're a standup guy, man. Stand up meetings, stand up desk. I talk with my hands. If somebody tied my hands behind my back, I'd be in trouble. Okay. Same. No, I wouldn't know how to do that to be quite frank. It would be very hard. But the standup desk, man, not a lot of CEOs actually get into a space where they feel comfortable. You you want to make sure you're comfortable in the position that you're doing. But also the energy feels different, right? When you're standing up and you're having these conversations like where did that come from? Is that something that you just kind of it happened this year? Did it happen over the years? Was it always a thing? You know, it's been a few years. You you didn't know me when I used to be 350 lbs. No way, Curt. Oh, yeah. Yeah. I was a big boy. And uh so I just decided one day I said look I want to be here for my kids and my grandkids and I don't want to I I just so I just started this health journey about I don't know five or six years ago. Didn't take medicine. Didn't have surgery. I said I'm just going to go to the gym. I'm going to cut out carbohydrates and I'm going to keep moving. I always I never felt bad. I just was I didn't realize how big I was. And so I got everybody in my office, every single senior leader and our executive assistants all have standup desks. So, um, about half of us use them every day. So, I stand up probably 90% of the time. Only if I'm in my conference room in a meeting do I not stand up, you know, and and I'm always about engagement, having time limits on meetings. And you don't bring a phone to a meeting. when you go to a meeting, you could leave the phone at the door. Uh, and if it's that important, they'll come get you because I think it's a distraction. Same thing with um with with laptops. I said, "Look, this isn't a meeting where you you're answering emails and we're having a meeting. I want to be cognizant of your time as well." So, those are just some of the things we do. And we have no meeting Fridays. So, we have no meetings in this organization on Friday unless we have to. and maybe if they're with a physician, we'll have those kind of meetings. But I wanted our leaders to be able to to do f wrap up your week, get everything done off your desk, all your your projects and timelines completed. And so Friday is your day. Uh and it's really made a difference. We did that probably five or seven seven plus years ago. You know, we're we're what we you call a Baldridge organization. We're all we're we're on a pursuit of a national Baldridge award. Everything we do is processoriented. Everything has a reason behind it. Our how we communicate. You know, I do quarterly uh CEO roundt meetings. Those are mandatory for our associates to attend. Uh they'll be coming up next week. I'll do 12 of those in a week. They're about 30 minutes long from early in the morning, midday till late evening. And it's to be able to catch our folks and do face toface meetings with them and say, "Hey, what's going on? What's working well?" uh and and the like. And it's all about communication. How do we push information down through the organization and how do we get and receive information from every single member of our team? So, it's that's mission critical for us. Hey, real quick, have you enjoyed the podcast? We first want to say thank you and we also just want to give you a little insight of what we're up to at Francis. Some don't even realize that we're working with organizations to help them use AI to create that real human communication experiences. Whether that's actually supporting your your families, those patients, or the entire community, we're actually creating tech that connects. Check it out. Francis.ai. That's some good stuff you just mentioned, man. First of all, the 350 pounds. Kudos to you, right? Stay consistent. Consistency wins all the time. People always want to know how get how do you get to do what you do? always stay you got to stay consistent, you know, just got to just got to do the reps and it it'll work in itself and obviously you've seen it. But also investing into your people like a lot of leaders fail because they forget to invest into their people. They lose amazing talent because they're not invested into their people and everything that you mentioned is is investing, right? Where's all that coming from? Like does somebody pour that into you? Were you learning that the hard way? Were you learning that because someone uh wasn't doing it good enough? So you said, "You know what? Let me actually implement some of these things." Like where does this all come from man? Because people need leaders that are watching need to know how to invest into their people. Well, look, we we've done a couple things and look, I've learned from every leader I've had over the year. I've had some amazing leaders and mentors. Had two or three that are absolutely phenomenal. Then I've had some really bad ones. Yeah. And you learn from both. I mean, you know, I I take it from every, you know, from everybody. Look, I treat my philosophy is you treat every single person in the organization as if they're the boss. And it doesn't matter what your role is. You, you know, you might be our groundskeeper or you might be our chief medical officer, but you still deserve the same level of respect um at at any level, whatever you are. So when we greet people, I we we have what we call uh we have uh check-ins with our team members every six months. Um and we call those high solid low conversations. They are standup conversations and we start first with our high performers. Then we start f then we go to our our um our good performers and then our low performers we do last. And we talk about we need to move you. We're trying to move you to be uh to be a good or outstanding performer. And we that's the group we coach out if they can't get there. But look, we're in a rural area. We have to figureate figure out and innovate what can we do to retain talent and workforce. I mean, we're we're in a the largest landmass parish in the state of Louisiana. Um we our closest competitors 3540 miles away and um we just have to figure out what can we do differently. So and and so we've been focusing very heavily on over the last probably eight years on successioning because every one of us in healthcare and our roles will go away and so are you going to leave that organization better than you had before and you cannot do it unless you have a sustainable workforce that's behind you to take over. So we put in place uh what we call uh we do um a leader index and and our expectation is every leader needs to have at least one to two people behind them that can fill in for them take over if something will happen. And so we call that um our survivability index and I'm actually writing an article on this. We're doing a white paper I came up with one of our um one of our leadership uh coaches we use. And so this is the deal. What's your survivability if the bus went off the cliff tomorrow? So, if the every senior leader was on this bus and the bus went off the cliff, could this organization survive? And we base that survivability index on what percentage of our leadership team has a replacement that could fill in tomorrow for them. And we did the same thing with our with our leadership throughout the organization. You know, we have 65 leaders and what would happen if they were all on a charter plane together and the plane went down? You got to we got at the end of the day, we got to be here to take care of this community. And so we work very heavily and focus uh very hard on successioning um and succession planning. The other thing we've done is we started our own leadership academy. It's a year-long program. We offer it about every 18 months. It's a rigorous selection process. It's we it's a we don't we take no more than 14 into the class and we'll we'll reserve about five or six spots for leaders, new leaders. The rest are for um you know potential emerging leaders. So it's an application. You have to write an application. You have to be in good standing with the organization. You have to get letters of reference, go through an interview process, and then commit to three years upon afterwards uh after graduation to remain with the organization. Uh so we've just completed our third leadership cohort group um phenomenal group. Um we lo out of that uh you know this again that's our third group of 14 was from the time we began until today we've only lost two of those folks. Everyone has been promoted within the organization at some point. And look, it's a rigorous uh uh training program. You it's mandatory. You attend all the sessions there. They they're typically two-day sessions throughout for about nine months and then we have a formalized graduation and you we we develop as senior leaderships two capstone projects. The capstone projects are around uh areas of opportunity in the organization. The last two for example were one of them we didn't do a good job we from our through our associate um associate engagement surveys we got feedback that says we need to do a better job recognizing and thanking them for a job well done. So one of the teams came up with how do we do that? So now my uh roundts that that will take place next week we uh we use what we call poll surveys. We ask people what do you want to hear about? uh what questions do you have specifically for me to be able to answer so that and then what do what are you looking for from a rewards and recognition perspective and what are the big things it's it's not always about the money it's about recognizing them for doing a great job from that we've emerged our what we call our quarterly award uh award and recognition lunchons where we uh we celebrate associates and leaders that have been recognized by patients, family, physicians or the community. It's a It's a great great pro uh process. We started that one about 3 years ago. Um and folks love it. They get to bring a family member in with them and uh we celebrate them. And those then the throughout the year, the quarterly award recipients then go on to become an annual award winner at our annual banquet and hospital Christmas party in December. So, it's a great way we recognize and celebrate. Good, man. They're not going to let you leave. You keep doing all these amazing things, man. Well, at some point I'm going away, too. You know, look, I I'm not slowing down anytime soon. I, you know, I I love what I'm doing. I wake up every morning. You know, I've got a crazy day. I start at 4:15 in the morning. I'm up out of the bed. I'm at the gym. I come back uh have a little coffee, then I go to uh I go to morning mass. And then after that, I'm home. 7 7:30. Uh I've showered. I'm at uh on the way to the office. So, uh, put you on a spot here. What are you benching nowadays? Um, if I bench press 190, I can do, um, good. I can do I can do 14 is my best. And I work with a trainer cuz I need to be pushed. So, I got a personal trainer I work with three days a week and then a couple days I'm on my own. Uh, but and I'm a gym rat. I love getting on the treadmill. I could I could get on a treadmill for hours. But then what I do is I listen to um American Top 40. So I know all the top 40 songs and so I'm like on the phone and my my kids and grandkids, how do you know that song? I said I listen to Ryan Serrass top, you know, American Top 40 and and I love it. I love that. I even have classical on my truck. R I love rap music. The only thing I'm not crazy about, I'm not a country guy, but I like to go to country concerts. Huh. I'm get into the country music. I was actually with my brother here in Boston. He's like, "Don't judge me." He starts to put on some country music and I'm like, I listen to it from time to time, but I'm like, "Yeah, this is good." I feel like country music is getting better actually nowadays. It It really is. It's not like the old I call Il Twang country. Look, we saw I've seen Bonnie Ra. She's amazing. We saw her um in Shrefport about two months ago. She was amazing. I'd seen her in Jackson uh about three years ago. Um and I said, "We got to see her again." She's 72 years old. She performs nonstop for two and a half hours. Absolutely phenomenal. Uh, and I really didn't I didn't think I knew her music until I listened to it and I'm like, I know every one of her songs. That's crazy. Um, I love this. I love that. You know, so many times people think of CEO and they just think like very high-end. Uh, don't talk to this person you but you're very laidback. I could tell that anyone and everyone can come and speak to you, man. and just everything that you told me in the leadership aspect of it, it's it's because of what you've been able to implement. I'm guessing low low turnover as well because of all the things that you're implementing. Is that correct? Look, we we what's absolutely phenomenal. You know, you hear about the national nursing shortage and it's real. It's a real deal and it cycles usually about every 20 years. You'll see it, but it really honors uh some high performers. They wanted to travel, really make crazy money, and they did. Some have come back. Uh, but a lot of them didn't. And then we had those folks, I call the baby boomers that were probably within five to seven years of retiring said, "I'm out." You know, the work was crazy. We, you know, it was, you know, I hope we never go through another experience like that. Um, but it left these voids. So, you know, we did some things like we partnered with the local university here in town. Northwestern State has probably the strongest nursing program around and probably three or four state region. They they do phenomenal work. And so we have funded in order to and let me step back. We talking specifically about an RN um didactical training component. You know, you can put them in a classroom of 500. No big deal. But clinically, they can it's a 1:10 ratio. That's basically nursing regulation. So every faculty member can only have 10 students. So if you do the math, if you don't have enough faculty, then you can't process enough nurses through the system. So we funded, our foundation funded one and then the hospital itself funded uh two full-time uh faculty professorships. So and then we opened up clinical site here as well. So now we're you know we we we're now in our fourth or fifth year of funding two faculty members. that's helped turn out 20 more nurses every six months so they can do their clinical trainings here. Um, and it's made a difference. We have today zero registered nurse openings in this organization. It's absolutely crazy. Um, look, and but I I have a and I I got to give kudos. My chief nurse is absolutely phenomenal. She's grounded. She's young. Um, she is the strongest nursing leader I've ever worked with in my career. and but and that has a lot to do with it. And so she's really engaged her leaders to really be connected and it's made a difference. So to have no RN openings, I cannot tell you. Kirk, man, a lot of CEOs are going to be jealous of this conversation they were having because you're just making it seem like it's so easy and some are still struggling in the same space of trying to get people in the doors, but you're doing phenomenal clearly. Um I I I want to talk about was Louisiana home for you? like how did you end up in Louisiana in such a a a um community that that really needed needed your help, needed your guidance? Is that coming back home or is this you just knew you needed to be here? No, you know, I'm a south I was born and raised here. Um South Louisiana guy. I've spent um probably four or five years of my career outside of the state. Um let me No, probably about seven years outside of the state. Um you know, I've never looked for a job. I've always had somebody come knocking. Um, and you know, after I had done my international work, I just needed to defog. The bankruptcy work was just you deal with lawyers and everything else. And I'm like, "Oh my god, I got to do something else. I I want to just do my own thing for a while." And that's what I did. I did international healthcare for about 5 years. And then after that, um, I was, you know, kind of settling down. And, you know, you I guess you get a reputation, people know about you and hear about you. And um so they called and said, "Hey, look, we got this opportunity. I I'm with a uh I am with a large uh faith-based health system and um their only managed hospital in the entire state is here in Nacadesh and um and uh again, I'm from South Louisiana and then Nacades is in the kind of in the northwest portion of the state. Uh we're about 60 miles south of Shreport and about 50 miles uh north of Alexandria. and we're about 26 miles from the Texas state line due west. Um so it's kind of a just a little a little area with nothing around it. Population comm community the the parish here is about 38,000 total. Uh but we pull from about 200,000 people now uh into our system and um so no it just kind of it afforded itself. Um and you know I've never taken a job that was going to be okay. I'm going to be here three years. I'm going to do something else or I'm going to be here 5 years. And look, I've had opportunities within our system to go to other places in the country. And I I backed off and I look, I could have gone and made I could have double my income, but at the end of the day, I felt like we had unfinished business here. And I still continue to see that um today. And so I'm like, I'm not ready yet. I'm not ready to go anywhere. Even my board said, you know, Kirk, you you can do anything. and you could be anywhere you want to be. And I and my comment back to them is I choose to be here as long as you want to have me. I'm going to be here. And so my you know, and it's that philosophy of you work your last day as hard as you work your first day. Um and at the point when you feel like you cannot you can no longer contribute to the job or the community you're working for, it's probably time to do something else. You know, and you know, healthc care is changing so quickly now. We used to do strategic planning. it'd be 3 to 5 years you plan out. Now we're planning six months out. Um we don't even plan I mean we have long-term goals, don't get me wrong. We have a huge We've got a $50 million building campaign we're working on right now for this rural community that we're going to launch hopefully within the next 18 months uh to really transform what I call generational healthcare. Now that'll be my swan song and I'll step away in about you know seven seven years or so whatever that looks like. Um or heck, I'll I'll hang around as long as they want me. Um but you know, you've got to just be able to look out the confines of the walls and and I go back to, you know, how do we innovate? When I went to my board and I said, "Look, we're going to we're going to pay for some we're going to fund faculty positions." and they first kind of scratched their head and I said the end result we're paying it forward by by investing in the education so that we can then develop our own workforce and why we spend you know every time I put a leadership development group through 14 people that's a $100,000 investment but I'm bringing in coaches leadership coaches where you we're taking away from the work site and from their jobs but we're investing in them for a future. And so my my challenge to every to my colleagues and peers you uh is to always be thinking how do you innovate? What can you do differently today that you weren't doing? Look, healthc care is changing so quickly. You got to figure out how you change. And when you see the the changes that are taking place in health care as an as a threat and not as an opportunity, you probably need to do something else. Uh because you can't I mean look look the you know we got we administrations in DC change every four years and really play a big part in what we're doing. Um you know we're uh you know with most hospitals the vast majority of your income comes from one of the federal programs whether it's Medicare, Medicaid or government funding. You got to roll with the administrations. And you know, we've got a new one, got a new leadership in there, group in there now, and they're really, really pushing back on Medicaid, our most vulnerable population. So, we're working on strategies. What do we do to shore that up and not count on federal dollars? You just got to, you got to continue to to kind of think through the strategy and uh strategies and how you manage. And, you know, I don't do most I I do very little work now. my team. I got amazing teams and they do great work. I I come up, you know, I I walk look, I I'll tell you, I walk in the office and and I I'll walk in in the morning and we have a first thing in the morning is a standup safety meeting. We bring all the leaders together 15 minutes. Okay, what's going on? What happened last night? What's not working? Do we have supply, you know, shortage of supplies or medications? What do we need to do about that? So, it's a standup huddle. We do it on one of our floors and everybody comes in. We have about 45 people there and it's done in about 15 minutes. Then I come down and I do a senior huddle the same way. Okay, what are we doing today? What are we focusing on? And but I come back to the group and I'm like, you guys, you're not going to believe what I thought of last night or this morning. And I and they know how long did you stay in the shower? Cuz I have shower conversations with myself. And so I'm in there and I'm like, okay, look. So like take our cancer center for instance. I'll give you an example of this. Um, we acquired the cancer center here in town four years ago. Totally renovated it, totally modernized it, state-of-the-art equipment, recruited some amazing physicians there. And, you know, when you finish treatment, you ring the bell, you know, you you probably seen that you you get to ring the bell. And I thought, you know, let's do something different. Let's put a bell tower outside. So, I went started looking around for some donors. And I just met with some folks, some um philanthropy people around town and I I went to a family. I said, "Hey, we got this idea. We'd like to build a threetory bell tower outside the cancer center." So when a survivor finishes treatment, they ring the bell. Well, it's it took off. We raised somebody wrote us a check for that bell tower and it's three stories tall. And when they ring it, you hear it throughout the community throughout the neighborhoods and we've tied it into our um into our uh emergency communication systems and you hear the bell ringing and people are like, "What's that?" I said, "Somebody just like they might be in a clinic. They might be in the hospital and they'll say, "What's that bell ringing?" I said, "Somebody just finished their cancer treatment." It's like when we play the lullabi after when a baby's delivered, you hear the lullabi and you know, oh, that's some of the good things we do in healthcare where we bring a new birth into the world. You know, it's amazing. So, you know, those are kind of things we do, you know, just kind of uh uh just to kind of tie into folks. So, Kirk, we need a lot of you throughout the healthcare. Okay. I feel like your your energy, man, that you bring, I can imagine why people are so excited to even come to work and that is so important to you, man. like the energy that you're bringing here and this is the energy you bring to your staff is the reason people want to come back. They want to continue to grow because I it all starts from the top and if this is the energy you're bringing for all the leaders if this is the energy that you're bringing believe me it trickles down this way. So, I love that you come with so much energy that you've cared enough for for your own health to make sure that other people can see about their health, right? Like you truly are a leader. You come back to the same community you grew up in, man, to make impacts, right? You didn't have to. It It wasn't to you, we mentioned a little bit earlier, it wasn't about the paycheck. It was about the purpose and the passion of of leaving something back home where I it all started for me. And and just kudos, Kirk, man. I love that you shared the message because that was really my last question is that message for those leaders and you shared that. So, I kind of go right into that blind question, man, as we start to wrap up. You spent your life building for others, but what's one decision you waited too long to make, and what did it teach you about leadership that no book could ever teach? Let me think through that. Um, you know, I've always been I I think the biggest thing I learned from a leader a number of years ago, and I thought I was doing a great job. I thought I was I mean, I thought I was a cat's meow. I'm like, "Oh, it's my first true leadership position." And so my boss calls, she calls me in. She goes, "Hey, how do you think you're doing?" I said, "I think I'm doing great." And she goes, "Well, let me tell you where you have some opportunities." And she says, "You're you're disared, a little disorganized, you're kind of scattered out there." And so this is what I want you to do. Every morning, we're going to do a we're going to do a fivem minute check-in. So why my where my standup meetings kind of come from? came from a leader. And so she said, "Okay, I want you to write I want I want you to come into your list and talk about what are the things you're going to be working on today and then end of the day, let's meet and talk about the things that you accomplished." We we did that for only maybe two weeks and after that totally changed my thinking on prioritization um and the and the ability to make change uh and how to be organized. And so I am meticulously organized today. I walk around with a calendar in my hand and I'll show you. It's my it's just my my calendars like this and you see writing on there. I write notes as I'm rounding and you see some are scratched off and they're stack up on my desk and and and if I ran if I ran into you in the hall and you said, "Hey, this is what's going on. We're having a problem with it." I'd write it down and then I'm going to follow back up and when we close the loop, we fix it. I take it off the list. And I've done that with our leaders and we set times on everything. But when you when I really look at when I talk about leadership, probably the biggest thing for me was if I had to do every anything over again earlier in my career, I would have exhibited greater leadership courage. You've got to be willing to be okay to walk out, stand out there in front by yourself. And you need your you're always about a team. It always is about a team. But I believe it takes that leader to have that courage um upfront to be able to do things. When COVID hit, look, I will tell you uh I can remember we had just invested heavily. I recruited a number of subsp specialists and to the tune of like $4 million in additional salaries alone for eight like five, six, seven doctors. And I'm like then everything came to an end. No more elective surgeries, no more elective cases. I'm like that's 80% of business in healthcare is elective is you know outpatient. So we quickly had to turn around and stand up stand up zoom meetings zoom you know visits. But I I I was in my I would go home in the evenings and I was working probably 18our days. in I'd go home and I'm thinking, I've got 800 families. How are we going to feed them? What are we going to do about them? And so I said, we're just going to lead this change and we got to get out front and we got to figure out get in front of the communities and get in front of uh legislators, you know, figure out ways what what we need to do. Don't wait to be told. Lead, be upfront. And that totally what I learned handful of years earlier earlier in my career I've taken with me and it's about having that courage to get in front and being comfortable enough to be able to say this is why we're doing it. You may not agree with it but just come along with us and hopefully you'll see um you know cuz change often is insidious when you look back on things you can look back and say ah now I understand it. So come along with us. So again, I think the you always having always having purpose in everything you do and using leadership using cou and having cou leadership courage to be able to get out there and get in front. Well, Kirk, man, I really appreciate the time here. We we could do this for a long time. I can imagine there's so much more gems that uh you could really share with us, but I really appreciate the conversation. very transparent, very real, but also just showcasing why you are in the the space you're in today and hope that a lot of leaders can kind of take from this as well and continue to implement those things in their organizations because you're doing phenomenal. Can imagine what's happening in the next 5 10 years with everything that you're mentioning. New building is happening because of you. So, we definitely thank you for those that are watching. Continue to share, like, subscribe. These how we get this is how we get those messages out. For those that want to be in the healthcare, we need real conversations with real leaders talking about what's really happening. And Kirk, you did that for us today. So, we appreciate you. I'm Ephrain. This is Kirk. We'll see you on the next one. Great. Thank you. [Music] Back with another episode. Our next guest started in healthcare thinking it was just going to be for some time, but 40 years later he's building systems that serve the people most of the country forgets, which is not a job. It's truly a call-in. Kirk, what's up, man? How are you on this beautiful Friday? I am great. I'm great. Glad to be on the program with you today. So, yeah, man. Same here. I know it's been some time since we've had our last conversations, but I want to get right into it, man. You were on track to become a CRNA. And then what most what was most that uh you you really decided I don't want to do that. I want to do executive leadership. Why was you feeling that was your lane? Well, look, it really started out with the fact that, you know, I, as I I shared with you in the past, I had a neighbor that was a CRNA, and I thought that'd be a cool job. You know, you go to work early in the morning, you're all in the afternoons, live in a nice house. Well, I started school and I got about halfway through and I realized, oh my god, I could not be stationary, be sitting in one spot, you know, I got to move too much. And um so I I continued on my track on a on a professional route. um and in a clinical professional route I should say and uh from there it uh kind of turned opportunities afforded themselves. I really never thought I'd be in this position today. Never ever. I thought well you know I'm do always you know always felt like I've worked my last job as hard as my first and um you know I had great mentors, great leaders and one led to the next and that's I'm here today. As I'm looking to you I'm a little jealous. Normally I'm at home on a standup desk. Today I'm in Boston in the hotel room and I can't stand up with you, but it looks like you have all the energy. So, I'm super excited. Yeah. Um, and something about traveling, man, that I love about you is that you've been able to do this in multiple countries. Yeah, absolutely. Multiple hospitals. What does that look like for you, man? Well, you know, I went through a period of time. I was um I was running a health system uh in Louisiana, Texas, and Arkansas. And um actually, I was asked to go in and help do a turnaround. It was in bankruptcy. emerged them out of bankruptcy and um really got stood up all those facilities again and then we sold them off and I really got to the point where you know I I want to do something different. So started my own company Global Health and um you next thing we know we're in 21 countries um throughout the Middle East, Asia, uh India and uh built uh design build hospitals and um then as you and I were talking earlier that pull away from family was tough you know I was when I was you're on the road out of the country 8 to nine months a year that's tough and uh so sold the company and um really just was looking to slow down a little bit and next thing I know I get a phone call and say, "Hey, we got this opportunity. Want to take a look at it?" And I ended up here. That's 13 years ago. Where does this entrepreneurship come from, man? Building something so so large like that doesn't just come overnight. Well, I think it's from really the work ethic I got from my my mom and my dad. And my dad was a businessman and you know, u I don't know. I just think that, you know, we were all built, my siblings and I are all built with this drive and I really think it's a testament to our parents. Love that. And and now you're in a space that you mentioned a little bit more a little easier for you. H what is what is the hospital? What is your role for those that are watching and may not know? Well, I'm uh I'm chief executive officer for a the largest rural hospital in Louisiana. Um when I arrived here April the 1st of 2013 um we were in the beginning the last quarter of our fiscal year. So we're on a what we call a fiscal year. Our year ends June 30. Uh so we finished that year with about 57,000 patient encounters, meaning they came to the ER, they went to had surgery, maybe they went um had an admission, went to one of our clinics, they were in that number. This past year, June 30, we finished with a little over 225,000 encounters. In about 11 and a half years, we've grown and we're continuing to scale up. Um, you know, it's just a phenomena. It was a that was the reason why I came here. I just when I really looked at the opportunity, I realized, oh my goodness, this place was successful in spite of itself, and what if we just put some things together and really grow it? And so we've been on a track and uh I've been really fortunate been I work for a great company. Um allow me to do a lot of things. I've got an amazing board of commissioners. Um and um so it's it's just been good. You know, we have the hospital, we have a senior living center, we have 12 clinics, uh we have uh two rural health clinics, a cancer center we acquired four years ago. Really, we call that a capstone program for us because it's allowed us to really keep our community members here. Uh, it's been a good journey. It's been a good journey. We're not over not over yet. Oh, no. No. Like you're just getting started, man. Like you're just getting started all over again. But what one of the things you mentioned to me was that you guys are, you know, obviously hospital, but you like to say that we're service providers. What does that shift in mindset actually do for the culture and for the outcomes? Well, you know, at the end of the day, that's what we're here to do. We're here to serve this community. um you know, we're a public entity. Uh we do not have a millillage to operate. So, we're what we call a self- sustaining organization. We've got to be able to um you know, be able to uh run ourselves and continue to grow and build our workforce. Arrived here, we had about 450 uh associates. Today, we're a little over,00 um and continuing to grow and add services and and everything we do is always forward- facing about uh care for this community. That's kind of our core purpose. And you said there's no such thing as no. When last time I spoke to you, what is that about, man? There's never no. There is. You can always figure out a way around. I I don't think I've ever Look, I I don't do well. Um I don't do well in in a box. Um you know, so I like to be I like to be able to get out and be entrepreneurial. And it's been really good. You know, one thing I've really focused with my team and and our managers is you have an obligation outside of the four walls of the organization. You really got to be out there and meet really be a member of the community. So, our leaders really their job is 24/7. Um, and you know, most people embrace that and if you can't, that's okay. Uh, but we really need uh folks to be to always be representing health care for this community and we innovate. we come up think of ideas and ways what can we do differently. I'll give you an example. Um we had we're the uh one of the the poorest municipalities are parishes and we're we have parishes here. We don't have uh we don't have counties. Um we're one of the poor poorest in the state. I think probably the um poverty level is our median income within the city limits is under 17,000. So that just gives you an idea um of the poverty here. And even within the city limits, uh, we had a high no-show rate at our clinics, as high as 30% in certain clinics. And we had we figured we had to figure out what do we do to make sure we we get our community members here. So we just put together a logistics department. We opened it. And so we transport patients. We're now transporting about 1,400 patients around the community just to get back and forth to clinics. Now, we don't we don't do we don't take them grocery shopping. We don't take them to the stores, but we it's really about healthcare. What can we do to innovate and make a difference? You know, I'll give you another example in in um in CO we quickly stood up. You know, the governor called all the hospitals, you know, onto these conference calls. We'd have those every other day. And he says, "Look, we're starting to vaccinate the communities. Uh we need your help. Can you what can you do?" Uh, I picked up the phone and called the the mayor uh got the parish president involved and all of our city leaders and I said, "Look, can we commander the event center? We need to be able to vaccinate this community." So, we actually did. We took over the the event center. Uh, it's a big space about 25,000t space. We took over that space and began to vaccinate up to a thousand people a day. uh were able to run through um and but we quickly realized after about a month um that half of our population was not attending and and we're 50% African-American here and they weren't coming. They uh for what and we tried we couldn't get them to come. So my our chief medical officer uh Dr. Mason is an African-American female. She's amazing. And um I said, "Look, let's call a Zoom meeting." The time we're really just getting going on Zoom. That was five, six, six plus years ago. And um so we called all the ministers together. So we got about 14 showed up for a meeting here. And then we had about 12 on that were on Zoom. And we said, "Look, what can we do to get to your um to your parishioners, you know, to to get the word out?" And we quickly realized they were very fearful themselves of the vaccination and and I attribute it to things like the Tuskegee incident issue years ago and there's just this fear of healthc care you know uh and that kind and like so by the time we finished that that that meeting after about 90 minutes we then I was on a Friday we then stood up a a town hall the following Wednesday we did it at the MLK Event Center here in town and Dr. Mason really led that. We we brought all the churches together and there um you know they typically have a Wednesday evening worship service and then we you know we uh she spoke directly to um to the community members and we did that through Zoom and then within within about 3 to 4 weeks um we saw our numbers were evened out. We're about 5050 on our vaccinations and that's that's what we call just doing things to you know to make sure we take care of the entire community. Um you know it's a challenge. Um you know we do these podcast with physicians every month one of our local radio stations and um we did our our podcast last month was on prostate awareness. Um and I was in there with one of our urologists and we were speaking and um he gave some alarming statistics. You know, being an African-American uh community here, they u African-American men have a a much higher incidence of prostate cancer. So it's uh and we just got to get the word out. And so we quickly then stood back up what we used to call our pulpit conversations where we go to the churches. we go in there and we talk and we just explain things and um it really makes a difference. You know, you you just got to figure out how to get to different constituent groups. Sometimes it's in the churches, sometimes it's on the street, sometimes it's in, you know, we call town hall meetings. Um just kind of those things you just got to try to figure out how you take care of the community. I love it. You're quick to pivot. You're quick to figure out what's next. How do we make this happen? Um, and as an entrepreneur, as a leader, you have to think like that. I love that the what you mentioned a little earlier as you started speaking was my four walls. You know, I didn't want to just be within the four walls. And I remember leaving a company after 8 years for that exact reason cuz when I wanted to do more, she told me uh she I had to wait she waited 25 years for her opportunity. I had to wait for mine. And I'm like, there's no way that I can stay within these four sandwich walls, right? Cuz I was working on the subway at that time. There has to be more, right? There has to I was cha I was chasing purpose and passion, not so much paychecks. And Kirk, you've been doing that so good, you know, nowadays. And you talk about innovation, how you guys were able to innovate. Crazy that Zoom was, you know, that you said was like 5 years ago, right? Everyone's now on Zoom and look what we're doing now virtually to be able to just have these conversations and educate people as well as as Richard mentioned it. But I want to talk about innovation in the sense of AI. I I think it's a beautiful thing. So many people are using it in spaces as transcribing for doctors to be able to do less note-taking and just more engaging on the level of the patients. Where else do you see AI being a big factor in the um the space of healthcare? Well, look, we are using now we're piloting four different AI softwares in our clinics with our providers and and for the point you you made, it's the fact that it can, you know, through whether it's an ambient listening device or a a scribe and you're using AI, it really helps the provider by the time they're finished, basically they've completed their note. All they have to do is go in there, if there's any edits, they don't have to then fill in the blanks. So again, we, you know, we we were our goal was to have a integrated AI product in all of our clinic and clinical settings by the end of this calendar year uh which would be December. The issue with that is the technology is changing so rapidly. I don't think we can pigeon hole ourselves into one product. And that's just on the clinical side. The other piece we're using AI now is on our billing, our billing and claims management processing. you know, we're pushing out in the neighborhood of, you know, uh 200 225 to 275,000 claims uh are going out annually. So, with that, we had to figure out a way what can we do? We what can help our our our billing companies and help uh maximize the providers uh documentation so that we take advantage of what payments are. And again, we don't want to fabricate anything, but you know, our we bill in health care off of the severity of illness and we determine the severity of illness based on the documentation of the provider. So the more in depth the the documentation, then the higher coding you can get and then help potentially helps you with a higher reimbursement. Do do you um do you feel like you get some push backs when you were implementing some of these pilot programs on AI? I feel like so many people were kind of scared of what AI was going to do, take away jobs, but really is it's it's beneficial, right? It's it's helping us do more of the things that we love and and less of the things that we don't, which is documenting that you kind of mentioned. Do you see push back and how are people actually taking it now? You've been piloting some programs. Well, look, it's interesting. Our providers were the ones who were demanding it. Um, so it it really made it easier for us to be able to do that. Um, and look, we've got a very innovative medical staff here. I think it's because of our approach. We're very forward facing. You know, for instance, we used to have when I had I had an amazing chief nurse here uh for probably my first five or six years and um she went on to get a become a nurse practitioner and she left me. Uh but she's doing great things as a nurse practitioner. Uh nonetheless, what her and I she came to me frustrated. She was like, you know, our doctors have complaints and we it just never feels like we ever close the loop. I said, "Well, why don't we treat them like we do our patient concerns?" And I started when I got here basically 13 years ago is stand-up meetings and immediate. So, if we had a patient concern took place, we want to administer or work through a service recovery in real time while they're still here. So, I would call a stand-up meeting, a five-minute meeting. What's the issue? What's going on? uh if we can't address it and come to a resolution in about 5 minutes, we disband and then before the end of the day, we would recircle back again and close that loop. So, it really made great a great difference with our with our patients and their families. So, I said, Donna, why don't we just do the same thing with our physicians? Let's treat them the same way. Let's change it from our our patient care uh committee to a customer care. And so, we treat our physicians as our customers. And when we started doing that probably 7 years ago, our doctors felt like I'm being heard. Uh I'm getting a response and I may not like the answer, but I'm getting followup and follow through from leadership. That's totally changed our relationship with our medical staff. You know that they're all high drivers, high performance. They wouldn't be physicians that they aren't. And so everything they do is always about what's the best and best I can do for my patients. I want to make sure we we provide the highest quality of care and the safest care we can do. You're a standup guy, man. Stand up meetings, stand up desk. I talk with my hands. If somebody tied my hands behind my back, I'd be in trouble. Okay. Same. No, I wouldn't know how to do that to be quite frank. It would be very hard. But the standup desk, man, not a lot of CEOs actually get into a space where they feel comfortable. You you want to make sure you're comfortable in the position that you're doing. But also the energy feels different, right? When you're standing up and you're having these conversations like where did that come from? Is that something that you just kind of it happened this year? Did it happen over the years? Was it always a thing? You know, it's been a few years. You you didn't know me when I used to be 350 lbs. No way, Curt. Oh, yeah. Yeah. I was a big boy. And uh so I just decided one day I said look I want to be here for my kids and my grandkids and I don't want to I I just so I just started this health journey about I don't know five or six years ago. Didn't take medicine. Didn't have surgery. I said I'm just going to go to the gym. I'm going to cut out carbohydrates and I'm going to keep moving. I always I never felt bad. I just was I didn't realize how big I was. And so I got everybody in my office, every single senior leader and our executive assistants all have standup desks. So, um, about half of us use them every day. So, I stand up probably 90% of the time. Only if I'm in my conference room in a meeting do I not stand up, you know, and and I'm always about engagement, having time limits on meetings. And you don't bring a phone to a meeting. when you go to a meeting, you could leave the phone at the door. Uh, and if it's that important, they'll come get you because I think it's a distraction. Same thing with um with with laptops. I said, "Look, this isn't a meeting where you you're answering emails and we're having a meeting. I want to be cognizant of your time as well." So, those are just some of the things we do. And we have no meeting Fridays. So, we have no meetings in this organization on Friday unless we have to. and maybe if they're with a physician, we'll have those kind of meetings. But I wanted our leaders to be able to to do f wrap up your week, get everything done off your desk, all your your projects and timelines completed. And so Friday is your day. Uh and it's really made a difference. We did that probably five or seven seven plus years ago. You know, we're we're what we you call a Baldridge organization. We're all we're we're on a pursuit of a national Baldridge award. Everything we do is processoriented. Everything has a reason behind it. Our how we communicate. You know, I do quarterly uh CEO roundt meetings. Those are mandatory for our associates to attend. Uh they'll be coming up next week. I'll do 12 of those in a week. They're about 30 minutes long from early in the morning, midday till late evening. And it's to be able to catch our folks and do face toface meetings with them and say, "Hey, what's going on? What's working well?" uh and and the like. And it's all about communication. How do we push information down through the organization and how do we get and receive information from every single member of our team? So, it's that's mission critical for us. Hey, real quick, have you enjoyed the podcast? We first want to say thank you and we also just want to give you a little insight of what we're up to at Francis. Some don't even realize that we're working with organizations to help them use AI to create that real human communication experiences. Whether that's actually supporting your your families, those patients, or the entire community, we're actually creating tech that connects. Check it out. Francis.ai. That's some good stuff you just mentioned, man. First of all, the 350 pounds. Kudos to you, right? Stay consistent. Consistency wins all the time. People always want to know how get how do you get to do what you do? always stay you got to stay consistent, you know, just got to just got to do the reps and it it'll work in itself and obviously you've seen it. But also investing into your people like a lot of leaders fail because they forget to invest into their people. They lose amazing talent because they're not invested into their people and everything that you mentioned is is investing, right? Where's all that coming from? Like does somebody pour that into you? Were you learning that the hard way? Were you learning that because someone uh wasn't doing it good enough? So you said, "You know what? Let me actually implement some of these things." Like where does this all come from man? Because people need leaders that are watching need to know how to invest into their people. Well, look, we we've done a couple things and look, I've learned from every leader I've had over the year. I've had some amazing leaders and mentors. Had two or three that are absolutely phenomenal. Then I've had some really bad ones. Yeah. And you learn from both. I mean, you know, I I take it from every, you know, from everybody. Look, I treat my philosophy is you treat every single person in the organization as if they're the boss. And it doesn't matter what your role is. You, you know, you might be our groundskeeper or you might be our chief medical officer, but you still deserve the same level of respect um at at any level, whatever you are. So when we greet people, I we we have what we call uh we have uh check-ins with our team members every six months. Um and we call those high solid low conversations. They are standup conversations and we start first with our high performers. Then we start f then we go to our our um our good performers and then our low performers we do last. And we talk about we need to move you. We're trying to move you to be uh to be a good or outstanding performer. And we that's the group we coach out if they can't get there. But look, we're in a rural area. We have to figureate figure out and innovate what can we do to retain talent and workforce. I mean, we're we're in a the largest landmass parish in the state of Louisiana. Um we our closest competitors 3540 miles away and um we just have to figure out what can we do differently. So and and so we've been focusing very heavily on over the last probably eight years on successioning because every one of us in healthcare and our roles will go away and so are you going to leave that organization better than you had before and you cannot do it unless you have a sustainable workforce that's behind you to take over. So we put in place uh what we call uh we do um a leader index and and our expectation is every leader needs to have at least one to two people behind them that can fill in for them take over if something will happen. And so we call that um our survivability index and I'm actually writing an article on this. We're doing a white paper I came up with one of our um one of our leadership uh coaches we use. And so this is the deal. What's your survivability if the bus went off the cliff tomorrow? So, if the every senior leader was on this bus and the bus went off the cliff, could this organization survive? And we base that survivability index on what percentage of our leadership team has a replacement that could fill in tomorrow for them. And we did the same thing with our with our leadership throughout the organization. You know, we have 65 leaders and what would happen if they were all on a charter plane together and the plane went down? You got to we got at the end of the day, we got to be here to take care of this community. And so we work very heavily and focus uh very hard on successioning um and succession planning. The other thing we've done is we started our own leadership academy. It's a year-long program. We offer it about every 18 months. It's a rigorous selection process. It's we it's a we don't we take no more than 14 into the class and we'll we'll reserve about five or six spots for leaders, new leaders. The rest are for um you know potential emerging leaders. So it's an application. You have to write an application. You have to be in good standing with the organization. You have to get letters of reference, go through an interview process, and then commit to three years upon afterwards uh after graduation to remain with the organization. Uh so we've just completed our third leadership cohort group um phenomenal group. Um we lo out of that uh you know this again that's our third group of 14 was from the time we began until today we've only lost two of those folks. Everyone has been promoted within the organization at some point. And look, it's a rigorous uh uh training program. You it's mandatory. You attend all the sessions there. They they're typically two-day sessions throughout for about nine months and then we have a formalized graduation and you we we develop as senior leaderships two capstone projects. The capstone projects are around uh areas of opportunity in the organization. The last two for example were one of them we didn't do a good job we from our through our associate um associate engagement surveys we got feedback that says we need to do a better job recognizing and thanking them for a job well done. So one of the teams came up with how do we do that? So now my uh roundts that that will take place next week we uh we use what we call poll surveys. We ask people what do you want to hear about? uh what questions do you have specifically for me to be able to answer so that and then what do what are you looking for from a rewards and recognition perspective and what are the big things it's it's not always about the money it's about recognizing them for doing a great job from that we've emerged our what we call our quarterly award uh award and recognition lunchons where we uh we celebrate associates and leaders that have been recognized by patients, family, physicians or the community. It's a It's a great great pro uh process. We started that one about 3 years ago. Um and folks love it. They get to bring a family member in with them and uh we celebrate them. And those then the throughout the year, the quarterly award recipients then go on to become an annual award winner at our annual banquet and hospital Christmas party in December. So, it's a great way we recognize and celebrate. Good, man. They're not going to let you leave. You keep doing all these amazing things, man. Well, at some point I'm going away, too. You know, look, I I'm not slowing down anytime soon. I, you know, I I love what I'm doing. I wake up every morning. You know, I've got a crazy day. I start at 4:15 in the morning. I'm up out of the bed. I'm at the gym. I come back uh have a little coffee, then I go to uh I go to morning mass. And then after that, I'm home. 7 7:30. Uh I've showered. I'm at uh on the way to the office. So, uh, put you on a spot here. What are you benching nowadays? Um, if I bench press 190, I can do, um, good. I can do I can do 14 is my best. And I work with a trainer cuz I need to be pushed. So, I got a personal trainer I work with three days a week and then a couple days I'm on my own. Uh, but and I'm a gym rat. I love getting on the treadmill. I could I could get on a treadmill for hours. But then what I do is I listen to um American Top 40. So I know all the top 40 songs and so I'm like on the phone and my my kids and grandkids, how do you know that song? I said I listen to Ryan Serrass top, you know, American Top 40 and and I love it. I love that. I even have classical on my truck. R I love rap music. The only thing I'm not crazy about, I'm not a country guy, but I like to go to country concerts. Huh. I'm get into the country music. I was actually with my brother here in Boston. He's like, "Don't judge me." He starts to put on some country music and I'm like, I listen to it from time to time, but I'm like, "Yeah, this is good." I feel like country music is getting better actually nowadays. It It really is. It's not like the old I call Il Twang country. Look, we saw I've seen Bonnie Ra. She's amazing. We saw her um in Shrefport about two months ago. She was amazing. I'd seen her in Jackson uh about three years ago. Um and I said, "We got to see her again." She's 72 years old. She performs nonstop for two and a half hours. Absolutely phenomenal. Uh, and I really didn't I didn't think I knew her music until I listened to it and I'm like, I know every one of her songs. That's crazy. Um, I love this. I love that. You know, so many times people think of CEO and they just think like very high-end. Uh, don't talk to this person you but you're very laidback. I could tell that anyone and everyone can come and speak to you, man. and just everything that you told me in the leadership aspect of it, it's it's because of what you've been able to implement. I'm guessing low low turnover as well because of all the things that you're implementing. Is that correct? Look, we we what's absolutely phenomenal. You know, you hear about the national nursing shortage and it's real. It's a real deal and it cycles usually about every 20 years. You'll see it, but it really honors uh some high performers. They wanted to travel, really make crazy money, and they did. Some have come back. Uh, but a lot of them didn't. And then we had those folks, I call the baby boomers that were probably within five to seven years of retiring said, "I'm out." You know, the work was crazy. We, you know, it was, you know, I hope we never go through another experience like that. Um, but it left these voids. So, you know, we did some things like we partnered with the local university here in town. Northwestern State has probably the strongest nursing program around and probably three or four state region. They they do phenomenal work. And so we have funded in order to and let me step back. We talking specifically about an RN um didactical training component. You know, you can put them in a classroom of 500. No big deal. But clinically, they can it's a 1:10 ratio. That's basically nursing regulation. So every faculty member can only have 10 students. So if you do the math, if you don't have enough faculty, then you can't process enough nurses through the system. So we funded, our foundation funded one and then the hospital itself funded uh two full-time uh faculty professorships. So and then we opened up clinical site here as well. So now we're you know we we we're now in our fourth or fifth year of funding two faculty members. that's helped turn out 20 more nurses every six months so they can do their clinical trainings here. Um, and it's made a difference. We have today zero registered nurse openings in this organization. It's absolutely crazy. Um, look, and but I I have a and I I got to give kudos. My chief nurse is absolutely phenomenal. She's grounded. She's young. Um, she is the strongest nursing leader I've ever worked with in my career. and but and that has a lot to do with it. And so she's really engaged her leaders to really be connected and it's made a difference. So to have no RN openings, I cannot tell you. Kirk, man, a lot of CEOs are going to be jealous of this conversation they were having because you're just making it seem like it's so easy and some are still struggling in the same space of trying to get people in the doors, but you're doing phenomenal clearly. Um I I I want to talk about was Louisiana home for you? like how did you end up in Louisiana in such a a a um community that that really needed needed your help, needed your guidance? Is that coming back home or is this you just knew you needed to be here? No, you know, I'm a south I was born and raised here. Um South Louisiana guy. I've spent um probably four or five years of my career outside of the state. Um let me No, probably about seven years outside of the state. Um you know, I've never looked for a job. I've always had somebody come knocking. Um, and you know, after I had done my international work, I just needed to defog. The bankruptcy work was just you deal with lawyers and everything else. And I'm like, "Oh my god, I got to do something else. I I want to just do my own thing for a while." And that's what I did. I did international healthcare for about 5 years. And then after that, um, I was, you know, kind of settling down. And, you know, you I guess you get a reputation, people know about you and hear about you. And um so they called and said, "Hey, look, we got this opportunity. I I'm with a uh I am with a large uh faith-based health system and um their only managed hospital in the entire state is here in Nacadesh and um and uh again, I'm from South Louisiana and then Nacades is in the kind of in the northwest portion of the state. Uh we're about 60 miles south of Shreport and about 50 miles uh north of Alexandria. and we're about 26 miles from the Texas state line due west. Um so it's kind of a just a little a little area with nothing around it. Population comm community the the parish here is about 38,000 total. Uh but we pull from about 200,000 people now uh into our system and um so no it just kind of it afforded itself. Um and you know I've never taken a job that was going to be okay. I'm going to be here three years. I'm going to do something else or I'm going to be here 5 years. And look, I've had opportunities within our system to go to other places in the country. And I I backed off and I look, I could have gone and made I could have double my income, but at the end of the day, I felt like we had unfinished business here. And I still continue to see that um today. And so I'm like, I'm not ready yet. I'm not ready to go anywhere. Even my board said, you know, Kirk, you you can do anything. and you could be anywhere you want to be. And I and my comment back to them is I choose to be here as long as you want to have me. I'm going to be here. And so my you know, and it's that philosophy of you work your last day as hard as you work your first day. Um and at the point when you feel like you cannot you can no longer contribute to the job or the community you're working for, it's probably time to do something else. You know, and you know, healthc care is changing so quickly now. We used to do strategic planning. it'd be 3 to 5 years you plan out. Now we're planning six months out. Um we don't even plan I mean we have long-term goals, don't get me wrong. We have a huge We've got a $50 million building campaign we're working on right now for this rural community that we're going to launch hopefully within the next 18 months uh to really transform what I call generational healthcare. Now that'll be my swan song and I'll step away in about you know seven seven years or so whatever that looks like. Um or heck, I'll I'll hang around as long as they want me. Um but you know, you've got to just be able to look out the confines of the walls and and I go back to, you know, how do we innovate? When I went to my board and I said, "Look, we're going to we're going to pay for some we're going to fund faculty positions." and they first kind of scratched their head and I said the end result we're paying it forward by by investing in the education so that we can then develop our own workforce and why we spend you know every time I put a leadership development group through 14 people that's a $100,000 investment but I'm bringing in coaches leadership coaches where you we're taking away from the work site and from their jobs but we're investing in them for a future. And so my my challenge to every to my colleagues and peers you uh is to always be thinking how do you innovate? What can you do differently today that you weren't doing? Look, healthc care is changing so quickly. You got to figure out how you change. And when you see the the changes that are taking place in health care as an as a threat and not as an opportunity, you probably need to do something else. Uh because you can't I mean look look the you know we got we administrations in DC change every four years and really play a big part in what we're doing. Um you know we're uh you know with most hospitals the vast majority of your income comes from one of the federal programs whether it's Medicare, Medicaid or government funding. You got to roll with the administrations. And you know, we've got a new one, got a new leadership in there, group in there now, and they're really, really pushing back on Medicaid, our most vulnerable population. So, we're working on strategies. What do we do to shore that up and not count on federal dollars? You just got to, you got to continue to to kind of think through the strategy and uh strategies and how you manage. And, you know, I don't do most I I do very little work now. my team. I got amazing teams and they do great work. I I come up, you know, I I walk look, I I'll tell you, I walk in the office and and I I'll walk in in the morning and we have a first thing in the morning is a standup safety meeting. We bring all the leaders together 15 minutes. Okay, what's going on? What happened last night? What's not working? Do we have supply, you know, shortage of supplies or medications? What do we need to do about that? So, it's a standup huddle. We do it on one of our floors and everybody comes in. We have about 45 people there and it's done in about 15 minutes. Then I come down and I do a senior huddle the same way. Okay, what are we doing today? What are we focusing on? And but I come back to the group and I'm like, you guys, you're not going to believe what I thought of last night or this morning. And I and they know how long did you stay in the shower? Cuz I have shower conversations with myself. And so I'm in there and I'm like, okay, look. So like take our cancer center for instance. I'll give you an example of this. Um, we acquired the cancer center here in town four years ago. Totally renovated it, totally modernized it, state-of-the-art equipment, recruited some amazing physicians there. And, you know, when you finish treatment, you ring the bell, you know, you you probably seen that you you get to ring the bell. And I thought, you know, let's do something different. Let's put a bell tower outside. So, I went started looking around for some donors. And I just met with some folks, some um philanthropy people around town and I I went to a family. I said, "Hey, we got this idea. We'd like to build a threetory bell tower outside the cancer center." So when a survivor finishes treatment, they ring the bell. Well, it's it took off. We raised somebody wrote us a check for that bell tower and it's three stories tall. And when they ring it, you hear it throughout the community throughout the neighborhoods and we've tied it into our um into our uh emergency communication systems and you hear the bell ringing and people are like, "What's that?" I said, "Somebody just like they might be in a clinic. They might be in the hospital and they'll say, "What's that bell ringing?" I said, "Somebody just finished their cancer treatment." It's like when we play the lullabi after when a baby's delivered, you hear the lullabi and you know, oh, that's some of the good things we do in healthcare where we bring a new birth into the world. You know, it's amazing. So, you know, those are kind of things we do, you know, just kind of uh uh just to kind of tie into folks. So, Kirk, we need a lot of you throughout the healthcare. Okay. I feel like your your energy, man, that you bring, I can imagine why people are so excited to even come to work and that is so important to you, man. like the energy that you're bringing here and this is the energy you bring to your staff is the reason people want to come back. They want to continue to grow because I it all starts from the top and if this is the energy you're bringing for all the leaders if this is the energy that you're bringing believe me it trickles down this way. So, I love that you come with so much energy that you've cared enough for for your own health to make sure that other people can see about their health, right? Like you truly are a leader. You come back to the same community you grew up in, man, to make impacts, right? You didn't have to. It It wasn't to you, we mentioned a little bit earlier, it wasn't about the paycheck. It was about the purpose and the passion of of leaving something back home where I it all started for me. And and just kudos, Kirk, man. I love that you shared the message because that was really my last question is that message for those leaders and you shared that. So, I kind of go right into that blind question, man, as we start to wrap up. You spent your life building for others, but what's one decision you waited too long to make, and what did it teach you about leadership that no book could ever teach? Let me think through that. Um, you know, I've always been I I think the biggest thing I learned from a leader a number of years ago, and I thought I was doing a great job. I thought I was I mean, I thought I was a cat's meow. I'm like, "Oh, it's my first true leadership position." And so my boss calls, she calls me in. She goes, "Hey, how do you think you're doing?" I said, "I think I'm doing great." And she goes, "Well, let me tell you where you have some opportunities." And she says, "You're you're disared, a little disorganized, you're kind of scattered out there." And so this is what I want you to do. Every morning, we're going to do a we're going to do a fivem minute check-in. So why my where my standup meetings kind of come from? came from a leader. And so she said, "Okay, I want you to write I want I want you to come into your list and talk about what are the things you're going to be working on today and then end of the day, let's meet and talk about the things that you accomplished." We we did that for only maybe two weeks and after that totally changed my thinking on prioritization um and the and the ability to make change uh and how to be organized. And so I am meticulously organized today. I walk around with a calendar in my hand and I'll show you. It's my it's just my my calendars like this and you see writing on there. I write notes as I'm rounding and you see some are scratched off and they're stack up on my desk and and and if I ran if I ran into you in the hall and you said, "Hey, this is what's going on. We're having a problem with it." I'd write it down and then I'm going to follow back up and when we close the loop, we fix it. I take it off the list. And I've done that with our leaders and we set times on everything. But when you when I really look at when I talk about leadership, probably the biggest thing for me was if I had to do every anything over again earlier in my career, I would have exhibited greater leadership courage. You've got to be willing to be okay to walk out, stand out there in front by yourself. And you need your you're always about a team. It always is about a team. But I believe it takes that leader to have that courage um upfront to be able to do things. When COVID hit, look, I will tell you uh I can remember we had just invested heavily. I recruited a number of subsp specialists and to the tune of like $4 million in additional salaries alone for eight like five, six, seven doctors. And I'm like then everything came to an end. No more elective surgeries, no more elective cases. I'm like that's 80% of business in healthcare is elective is you know outpatient. So we quickly had to turn around and stand up stand up zoom meetings zoom you know visits. But I I I was in my I would go home in the evenings and I was working probably 18our days. in I'd go home and I'm thinking, I've got 800 families. How are we going to feed them? What are we going to do about them? And so I said, we're just going to lead this change and we got to get out front and we got to figure out get in front of the communities and get in front of uh legislators, you know, figure out ways what what we need to do. Don't wait to be told. Lead, be upfront. And that totally what I learned handful of years earlier earlier in my career I've taken with me and it's about having that courage to get in front and being comfortable enough to be able to say this is why we're doing it. You may not agree with it but just come along with us and hopefully you'll see um you know cuz change often is insidious when you look back on things you can look back and say ah now I understand it. So come along with us. So again, I think the you always having always having purpose in everything you do and using leadership using cou and having cou leadership courage to be able to get out there and get in front. Well, Kirk, man, I really appreciate the time here. We we could do this for a long time. I can imagine there's so much more gems that uh you could really share with us, but I really appreciate the conversation. very transparent, very real, but also just showcasing why you are in the the space you're in today and hope that a lot of leaders can kind of take from this as well and continue to implement those things in their organizations because you're doing phenomenal. Can imagine what's happening in the next 5 10 years with everything that you're mentioning. New building is happening because of you. So, we definitely thank you for those that are watching. Continue to share, like, subscribe. These how we get this is how we get those messages out. For those that want to be in the healthcare, we need real conversations with real leaders talking about what's really happening. And Kirk, you did that for us today. So, we appreciate you. I'm Ephrain. This is Kirk. We'll see you on the next one. Great. Thank you.

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