I was the CEO. I was hired to fix the company. It was struggling and facing bankruptcy since the government had converted from paying for many home health services based on a fixed price not cost plus.

Cost plus almost encourages inefficiency and that gets embedded in how organizations operate, since the more you spend, the more you make. So, my role was to reengineer the company to fit within the new paradigm both operationally and financially. Worth noting is one third of all companies in this business went broke during the time period, I was fixing this company because they could not adapt.

So, working with my operations people at all levels and the head of IT, a brilliant guy, who now heads a venture capital backed tech company, we looked at every activity over a two-year period to visualize how it could be done better. Some of the most cutting-edge things were the product of my "vision" and my IT's brilliance in making ideas happen with software connectivity.

Long before people called the "cloud", the "cloud", i latched on to the vision of an office in your "briefcase". Since we had 300 locations that our 42,000 people worked at, I saw wireless technology linking each person to our system no matter where they were as essential to cutting costs and improving efficiency. Today, it is no big deal. But I think the same kind of thinking will be used to adapt AI to the workplace.

In summary, my role was both that of a visionary and decision maker, but the ability to turn my vision into reality depended on the diverse skills of my managers and workers. Meanwhile, my vision was aided at the more operational level with bonuses paid to employees for being "heroes". "Heroes" were people who went beyond doing their jobs and made our company a better place to work including through innovation. Having a vision is something CEOs and top executives largely "imagine", since they have access to the "big picture"... but all of that is useless unless people, who really understand the nuances buy into the vision and figure out how to apply it to their environments. To further encourage this sense of ownership in the company, I set aside around 10% of the company to go to employees over five years.

Eventually, when the company got sold a few years after I left, I got emails from some of the employees who received $10k to $75K for their stock. It was a good way to tie personal success to company success and reduce turnover.

I had a saying, that even if I were the best "decision maker" in the world, I could not compete with over 40,000 decision makers. So the key was how to get those 40,000 decision makers working for the same vision. That involves making the vision clear and rewarding participation.