New CEO of Majestic Care On Setting Lofty Goals, High Turnover, Punitive Regulation for SNFs

At a meeting with five other Indiana-based CEOs, newly appointed CEO of Majestic Care Dr. Paul Pruitt promised his organization would surpass theirs in terms of quality and metrics.

“We all laughed,” he said. “But that is the goal. And I think you need to set lofty goals and strive for them to get to success. And we need to keep pushing in this industry because at the end of the day, all of us get to go home to our families but our residents stay in our facilities and they need the highest quality of care.”

In late May, Majestic Care announced the resignation of its CEO Bernie McGuinness.


Pruitt joins Majestic Care with more than 15 years of senior management experience, including 12 years as a licensed physical therapy assistant. He formerly served as COO for Mission Point Healthcare Services in Michigan.

Pruitt spoke to Skilled Nursing News about his top priorities as he begins his tenure to lead Majestic Care. As a tech savvy, data-driven leader, Pruitt said one of his goals is to draw efficiencies from advancing technology. He also shared his thoughts on the proposed minimum staffing mandate, the high turnover at his company and the “punitive” nature of regulation for nursing homes as being counterproductive.

The following transcript has been edited for length and clarity.


Could you tell me a little bit about the CEO role at Majestic Care, and why it appealed to you as an opportunity?

When I was tapped on the shoulder about the position and asked to look at it, I considered a couple of things. This is only my fourth job in my life. So, I don’t jump jobs quickly. I went out and did a lot of research on the company. I had to do a lot of research through the internet, because I’m a Michigan-based guy and there weren’t a lot of people that knew a lot about Majestic Care. I went out and did a lot of research on social media, Facebook, LinkedIn, looked at some videos and the mission statement. And everything that I could find really fit my core values as a leader and really resonated with what I believe we should be doing and long-term care to take care of our residents. So, that really is what intrigued me to pursue the further interviewing and then to be selected to be the CEO. I believe that the core values and the mission are what taps into my beliefs and then also I believe that I can help continue to move us forward with the goals and divisions that the company has had.

What are your first priorities for your tenure as CEO?

I think a lot of it is continuing to understand the culture of the company. That’s one of my biggest goals and to continue to understand the leaders in the company and who they are and their roles. The second piece that I’ve started to develop is looking at technology systems. We utilize a lot of technology, but the systems are not integrated and they’re not interfacing with each other. So we have a tremendous amount of people having to work in separate systems, which costs a lot of time. I’m a very data driven leader. So, [inefficiencies] minimize my ability to move quickly and pull the right data so we can make strategic decisions. I think continuing to reorganize the company, and we’re doing a little bit of reorganizing where roles or responsibilities, who owns what pieces and really setting this up for the future so that in the future, whoever is in the role, truly has a solid foundation to continue to grow the company to be the best. And the goal shall be to be the best in the state and the nation.

Do you have any concerns about the pending staffing mandate? 

I’ve worked in healthcare my whole career. One of the companies I worked with was a hospital based organization. There is no mandate in hospitals on staffing. It’s interesting that now all of a sudden nursing homes are going to be getting a staffing mandate. And it really isn’t about the amount of numbers of people in the building. It’s about the leadership and it’s about the training. And education that we do with our staff. 

I could put six nurse aides on the floor. And if all six nurse aides do not work well together, or have good strategies or good training, they don’t have anything. It’s going to be a mess. I could put four CNA’s on the floor. If they all are trained well, they’re all engaged. They all buy into the vision of the presidents. And then you can have the best day.

It’s not about the number of people that need to be on the floor. It’s about training and education and about leadership and what we’re doing to drive for excellence and accountability. I’m very concerned that they’re coming down with this mandate, and who’s going to pay for it at the end of the day.

What is the workforce situation at Majestic right now? 

We do have a high turnover. So, we do need to work on that. It all goes back to the culture of our company and about our leadership. As an administrator myself, it really starts at the facility level with your leadership and the engagement of your leaders with your staff. Do you know your staff, do you know your staff enough to say you know what, “It looks like you’re having a rough day, what’s going on?”

I’ve been in leadership for long enough to know that there is a high percentage, 80 to 90 percent of people, that leave organizations because of their boss. What we need to do is continue to work as leaders to grow our staff and develop that relationship, so they feel trusted, valued, and like their voices are heard.

That’s what we need to work on and really drive to bring stability. The government can mandate the numbers, but let’s be honest, there’s only so many people in the workforce. So you can’t mandate whatever you want. But if nobody’s out there, wanting to work, we have to drive the culture and the change and have our leaders really engaged with the employees.

If you could change one CMS policy, what would it be and why?

One of the things that we struggle with is the regulatory environment that we work with. Our environment is more top down. It’s more of looking for the failures and citing the failures versus identifying where the system is broken, and then educating, training, and helping us be better than what we are. Sometimes, it feels more punitive. It’s not because of the surveyors themselves. It’s the process that has been developed. They’re not allowed to educate. It’s around the policy and the education that they’re trained on. So, it’s not a people issue, it’s a process issue.

If I could have my wish, it would be to develop a culture where our best interest is the residents, and the system is built around that to educate, train and really help us drive success to our residents.

If I could change that policy, that would be one of the ones I would love to see changed and handled differently because I’ve been in this realm long enough to see it can become punitive and adversarial but it really doesn’t need to be.

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