What does it take to lead a public company through financial distress, activist pressure, and ultimately into a stronger strategic position? During a fireside chat I moderated at Barnes & Thornburg’s 2025 Shareholder Engagement Summit, prominent healthcare executive Paul Kusserow offered a candid perspective: turnarounds succeed not through spreadsheets alone, but by aligning leadership, culture and shareholder trust. 

Lesson 1: Align Leadership With the Workforce 

When Kusserow became CEO of Amedisys, the company’s workforce was 90% nurses, most of them women. The leadership team and board, however, were almost entirely male. Kusserow stated this disconnect was more than cosmetic — it undermined credibility inside the organization and with stakeholders. 

By reconstituting leadership to reflect the workforce and patient base, Kusserow tapped into a deeper source of resilience. Kusserow said the board became 80% women, and management was diversified across backgrounds and experiences. He noted the move wasn’t symbolic; it built trust with employees and sharpened decision-making. 

Kusserow’s Takeaway for Boards: Skill matrices should not only measure technical expertise but also whether leadership reflects the people and markets the company serves. Alignment builds legitimacy. 

Lesson 2: Put Quality at the Center 

Most turnarounds focus first on cost. Kusserow chose quality as the non-negotiable standard. “Regardless of what we do, we are always going to be the best at quality,” he told employees. That clarity galvanized a 22,000-person workforce and repositioned Amedisys competitively with patients, payors, and investors. 

Kusserow’s Takeaway for Boards: In moments of turbulence, stakeholders look for clarity of purpose. Elevating one “North Star” priority — whether quality, safety, or innovation — helps boards and management navigate difficult trade-offs. 

Lesson 3: Engagement Begins at Home 

Shareholder engagement often focuses on proxy advisors, institutions, and activists. But Kusserow reminded the audience that credibility with investors begins internally. A workforce that believes in leadership and a board that reflects its mission send a signal the market cannot ignore. 

Kusserow’s Takeaway for Boards: Engagement strategies should not stop at the proxy statement. Culture, workforce alignment, and board composition are part of the story investors evaluate. 

A Broader View of Turnarounds 

Kusserow’s journey at Amedisys ultimately positioned the company for a strategic transaction. But the enduring lesson isn’t about the deal. It’s about how boards and CEOs can use moments of distress to reset — to realign leadership with the workforce, to define a clear purpose, and to rebuild credibility with investors. 

Turnarounds, in other words, are less about rescue than about renewal. 

If you'd like to watch Kusserow's fireside chat in its entirety, it is available below.