C-Suite Unscripted · Sep 23, 2026 · 33m 18m saved
With Matt Lynch, CTO and Co-Founder of Sage
By 2030, 77 million baby boomers will have aged past 65, and Matt Lynch said the country will be 1.8 million caregivers short of what that population needs.
Sage did not set out to make hardware. Lynch said the call bells, pendants and pull cords he found in senior-living buildings were 1970s and 1980s technology, so the company built its own devices to get the data its software needed.
"You're not going to be able to get that data with such a bad interface, right?"
Matt Lynch, CTO and co-founder of Sage, on C-Suite Unscripted, Forbes' interview show for executives. Before Sage he was a forward-deployed engineer and then an engineering manager at Palantir, on a product that became one of the core tools in its Foundry platform, and before that he worked on ship control systems as a Navy software engineer. Sage has about 150 employees, roughly a third of them in his organization.
The full interview is covered here so you can skip it. 33 minutes of audio, 15 minutes of reading.
Here are the 17 lessons that matter.
Key Takeaways
The US will be 1.8 million caregivers short as 77 million baby boomers pass 65 by 2030
Sage began because Lynch's grandfather fell twice and lay on the floor for hours each time
Much of the call-bell equipment in senior living hasn't been updated in 50 years, which is why Sage builds its own devices
Off-the-shelf pendants from a third party gave Sage 85% of what it wanted, with no factory of its own
Sage sits on top of the electronic health record rather than competing with it
The AI flags a likely fall; a caregiver or a clinician makes the call
Even the best models will get it wrong, he said
Sage at least pays for itself in net operating income, "100% of the time", in his words
A $30K–$40K hardware bill per building is the main thing slowing sales
Sage's values ask staff to disagree and commit, and he hopes every employee runs a startup one day
At Palantir he learned that people who fail usually were not set up to succeed
1. What Sage Sells
Forbes' Maggie McGrath opened by describing Sage as an AI-powered fall detection and nurse alert system for senior care facilities, and asked Lynch for the 60-second version.
A platform for residents, caregivers and owners
Sage is building a care intelligence platform for senior living and skilled nursing right now.
Matt Lynch
It combines hardware and software, he said. Residents get better care, caregivers get workflows that make their jobs more efficient, and executive teams and owners get data on how their buildings run.
2. 77M Aging, 1.8M Short
McGrath said senior living "doesn't sound all that sexy" but is a large economic need, and asked Lynch to explain the silver tsunami, the term for baby boomers reaching old age at once.
The shortage he expects by 2030
It's 77 million people by 2030 are going to be aging into this population while at the same time we're going to have a shortage of 1.8 million caregivers in order to keep up with the caregiving demand that we're going to see there.
Matt Lynch
The industry will have to do two things, he said: give people reasons to become caregivers, and give the caregivers it has technology that lets each of them look after more residents.
3. A Grandfather's Two Falls
Raj Mehra, Sage's CEO, came to Lynch during the pandemic with the idea of building a business in aging. They had no product in mind. Lynch said the conversation made him think back on his grandparents, who lived into their 90s and whose decline took 15 to 20 years each.
His grandfather's first fall went unnoticed for hours
He was in his 70s living by himself, had mobility challenges, he fell down, in his home by himself, ended up fracturing his hip, wasn't found for hours, ended up coming to live with us after he had surgery.
Matt Lynch
The family then moved him into an independent living facility nearby. He fell again there and was on the floor for hours, because he had no practical way to call for help. Lynch said nobody was at fault.
No one did a bad job, he said
It's just he's getting old and that sucks for him and this is just what it looks like to get old.
Matt Lynch
Looking at it with Mehra, he decided the company "could totally have a huge impact here with just basic modern technology applied to the space." Ellen Johnston, the third co-founder, has a similar story, he said.
4. 50-Year-Old Call Bells
McGrath said she had not expected a software founder to build hardware, and brought up the "Help, I've fallen. I can't get up." commercials for Life Alert, which she said was her most vivid picture of the category. Lynch gave two reasons for building devices.
The first was how residents feel about the incumbents. Those products are sold on safety and fear, he said, and the people wearing them feel old and weighed down. "You want people to want to use it," he said, and to treat the device as "a safety blanket" rather than a burden.
The equipment Sage found was decades old
And a lot of these technologies just hadn't been updated in 50 years.
Matt Lynch
The second was data. Buildings had a mix of disconnected devices, including call bells, pendants and pull cords on the wall. Sage wanted to move care from reacting to incidents to getting ahead of them, and that required information the old equipment could not produce. He said building hardware "is not for the faint of heart."
Why Sage had to own the whole system
So, we needed to be able to control the entire stack in order to craft this in a way that we were going to be able to get the output we wanted.
Matt Lynch
5. Pendants, Doors And Cameras
Lynch described three kinds of device. The first is a pendant, worn on a lanyard or the wrist, or mounted on the wall next to the toilet or on the headboard of the bed.
The basic call for help
So they push a button when they need help and then a caregiver is dispatched.
Matt Lynch
When the caregiver arrives, Sage's workflow software lets them record what happened for later analysis. The second is door sensors, which record when someone enters or leaves. They matter most in memory care wards, where residents with cognitive decline could wander out of the building. The third is Sage Detect, which he described as "a camera-based monitoring solution that's backed by AI." It starts with fall management, moves into fall prevention and also detects activities of daily living such as dressing, which McGrath noted can show how a disease is progressing.
6. 85% Of The Value, No Factory
McGrath had heard Lynch say a startup cannot spend a year building before it reaches the market. He said Sage started with what it called the least common denominator on hardware: a third party's buttons, which Sage used as a starting point to validate the software workflows it built for caregivers.
Off-the-shelf pendants did most of the job
There were some issues with them, but those pendants were buttons that we were working with this third party to provide got us 85% of the value that we wanted without us having to do any sort of manufacturing ourselves.
Matt Lynch
Sage still had supply chain problems and a physical product to support, he said, but it avoided manufacturing and put most of its engineers on software. It built its data products the same way. Instead of a complete insights product at launch, it asked customers for the three questions they most wanted answered and built from there.
Today the approach is mixed, and Sage prefers to buy when it can. It uses third-party networking equipment in buildings, including the receivers that relay signals to its cloud software.
He buys the network gear
It doesn't make sense for us to build our own receivers.
Matt Lynch
Almost everything a resident touches is custom, he said, either white-labeled by a third-party manufacturer or built by a contract manufacturer on a supply chain Sage owns.
7. Working With The EHR
McGrath asked how Sage fits alongside electronic health records, the clinical systems she compared to MyChart. Lynch said they are big and established and remain the clinical record for every building.
Sage and the health record help each other
But what we've recognized and what we've been able to work with our partners on is identifying that we can coexist and we should coexist because we mutually benefit one another.
Matt Lynch
Sage reads the care plans managed in the record and shows them to caregivers while they respond to calls. A caregiver answering a call bell can be told which three other tasks that resident needs that morning. Sage then sends what the caregiver records back into the health record.
A loop that improves the care plan
So there's this feedback cycle that allows us to not only operationalize what exists but improve the care plan as they use it.
Matt Lynch
McGrath asked whether the wall sensor drives this. Partly, he said, but it depends more on caregivers. Sage has spent a long time embedded with caregivers, clinicians and operators to learn where their workflows hurt, work he credited to Johnston. The aim, he said, is to make it "easier to do the right thing" and easier to document accurately than to skip the documentation.
8. AI Flags, Humans Decide
McGrath asked how the cameras tell a fall from a stumble that someone recovers from, since both start the same way.
Two kinds of AI
And the way that we treat AI, there's a big distinction between completely autonomous AI systems and AI augmented systems.
Matt Lynch
Sage is in the second group. When a camera's model thinks it has seen a fall, it alerts a caregiver with context, which could be de-identified video or a written summary from the model, and the caregiver goes to check. The same applies to the other alerts Sage sends before anything has gone wrong.
No model is always right
Being able to provide something that can give you all of this lift without completely depending on it being 100% correct is the problem that we tried to solve with it.
Matt Lynch
McGrath asked whether Sage would move into diagnosis, since patients with cognitive decline have good and bad days and a doctor may only see a good one. Lynch said the cameras capture events: someone getting out of bed without their mobility aid nearby, someone trying to leave through a door they should not use, or agitation in a resident with advanced dementia. Sage can analyze trends across those events.
Where Sage stops
We can start to couple these things together and try and draw correlations between behaviors and different physical characteristics, but then leave that up to a clinician to actually go in and make the diagnosis.
Matt Lynch
9. "Pays For Itself"
Asked what customers buy on, Lynch said Sage's model differs from the traditional one. Older systems are a purchase of equipment that checks a compliance box. Newer vendors such as Sage sell software by subscription, charge for hardware at cost and sometimes waive the fee.
The industry is not used to paying this way
It's a new concept for this industry and because of that we've had to make sure that we're actually able to justify the value that we're able to provide.
Matt Lynch
He listed the sources of that value: labor efficiency, lower liability from response times that meet targets, and care plans sized correctly to what residents use.
His claim on return
At the end of the day, the owners are going to care a lot about their net operating income and being able to demonstrate that Sage at least pays for itself, which 100% of the time it will in net operating income opportunities, whether through labor efficiency or care income, things like that.
Matt Lynch
Other buyers are running what he called "dinosaur solutions" and need a replacement. They are looking for what he called a "dance partner" for the next 10 or 20 years, and often come to Sage saying their nurse call system is failing.
10. Series C, Then Expansion
McGrath cited the company's recent fundraising.
The host's figures
You raised a $65 million series C and a round led by growth equity at Goldman Sachs alternatives earlier this year.
Maggie McGrath
She added that there was $35 million in debt as well. Asked about the total addressable market, Lynch declined to give a number.
He would not put a figure on it
I'm going to talk in terms of markets that we can work in and not specific numbers because I'm sure I'm going to butcher it.
Matt Lynch
He said the market is worth billions in US private-pay senior living, where Sage is "just scratching the surface." Its skilled nursing business is smaller but addresses a market about the same size, and Sage is working to expand there. Over the next few years he expects expansion into Western Europe, the UK and Canada, and eventually a global presence.
11. The Hardware Bill
McGrath asked what keeps him up at night in summer 2026. Lynch said installing hardware in a building is expensive.
Cost slows the sale
And if nothing else, it slows down the buy cycle when you have to figure out how to digest the 30 or $40,000 hardware bill going into these buildings.
Matt Lynch
Sage has focused on offering other ways to finance the equipment so systems go live sooner. He called it "effectively a supply problem."
12. 150 Staff, No Micromanaging
The size of his team
We have about 150 people at Sage now and I think my org is roughly a third of that.
Matt Lynch
His first leadership rule is to hire creative people who think for themselves and own problems. Managers provide context and resources. "We're not there to micromanage them," he said, and added that he did not think Sage would have succeeded without that approach. The second rule is keeping those people motivated after the first rush of a big vision fades, by showing each of them where they fit in the company's growth and what they will get out of it personally.
13. Disagree And Commit
McGrath said another founder had told her she likes to hire founders, and McGrath had asked whether that leaves too many people "playing God." She asked Lynch how he handles an engineer who wants to be CEO.
He said he hopes everyone at Sage runs a startup someday, but the company's values have to work together. The first is teamwork.
Entrepreneurs on his team work for the team
It's not just you're an entrepreneur and you're here for yourself.
Matt Lynch
The second is a value Sage calls disagree and commit: debate, know whose decision it is, and if there is an impasse, defer and offer to help if the decision fails. The third is kindness and respect, so that challenging an idea feels like diligence rather than constant jousting. McGrath said she might steal "disagree and commit."
14. Rules Versus The Floor
McGrath traced his career back to 2007, when he was a resident assistant, or RA, in a Drexel dormitory.
What he learned as an RA
And I guess one of the big ones was figuring out how to balance the dogma of the rules with the reality of the floor.
Matt Lynch
He knew the rules, he said, but the job was making sure "nobody dies," that nothing substantially illegal happened and that residents had a good time safely. Balancing the two was sometimes "a bit of a stretch," he said, and learning it early helped.
15. Nobody Gives The Answer
Lynch's undergraduate degree is in electrical engineering. At the Navy he worked in a role that mixed hardware and software, designing physical control systems, and found he liked the software more. He switched early and later became a senior software engineer.
The project he learned most from was a new framework for ship control systems. The idea, which he said was not his, was a single framework to replace custom builds for each ship.
The Navy project
But the general idea being rather than designing a custom control system for every ship that gets delivered to the Navy, can we build a framework that makes it so that you don't need a fleet of software engineers to actually deploy a new control system on top of these?
Matt Lynch
There were no blueprints and little oversight. He said the lesson has run through his whole career.
Solve it yourself
You don't have to wait for somebody else to give you the answer.
Matt Lynch
16. Six Layers Of Managers
At Palantir, where he met Mehra, Lynch spent two years as a forward-deployed engineer on commercial projects, one in investment banking and one in healthcare. At the Navy, he said, "you have six layers of project managers between you and the customer." At Palantir he built the product sitting next to the people who used it.
He said he "maybe overcorrected a little bit" and felt too far from hard engineering, so he moved to the product group. There he was an engineering manager for a couple of years, his first management job, on a product that became one of the core tools in Foundry. He saw good and bad management.
The lesson he took from bad management
I think ultimately the biggest lesson I took away from that was a lot of times when people are failing to get the job done that they need to be getting done, it's not their fault.
Matt Lynch
They had not been set up to succeed, he said, and he included himself among the managers who could have done "a much much better job."
17. Make Your Own Luck
McGrath said his path from hardware to software to healthcare work at Palantir looked, in hindsight, like preparation for Sage.
His rule for a career
One of the things that I've kind of held to is you make your own luck and you just always say yes.
Matt Lynch
Some opportunities did not go well and he moved on, he said. He did not see Sage in his future 10 years ago, but he was curious about being an entrepreneur and took the chances that built toward it.
Bonus Insights
What he wants to tell Forbes in five years
I would love to say that we've won the US senior living market and that we are the canonical operating system for senior care in the US.
Matt Lynch
He also wants an international footprint, solid clinical traction in skilled nursing, and a start on bringing Sage's product into homes, so people can age in place. McGrath said she would have him back for that update.
Lynch's bottom line is that the caregiver shortage can only be met with better tools for the caregivers who remain, and that Sage has to own its hardware, keep a person in every decision the AI informs, and prove it pays for itself in net operating income.
Products, Companies & Tools Mentioned
Sage (Lynch's company: pendants, door sensors, AI cameras and workflow software for senior living and skilled nursing)
Sage Detect (Sage's AI camera system for fall management, fall prevention and detecting activities of daily living)
Life Alert (McGrath's example of the fall alert products residents know from TV commercials)
MyChart (McGrath's shorthand for electronic health records, which Sage works alongside)
Goldman Sachs Alternatives (Its growth equity arm led Sage's $65 million Series C, according to McGrath)
Palantir and Foundry (Where Lynch was a forward-deployed engineer and engineering manager, and met Sage's CEO)
Drexel University (Where Lynch was an RA in 2007)
US Navy (Where he built ship control systems as a software engineer)
Watch the full interview
If this was worth your time, send it to someone closer to the industry than you are.
Get the latest market chatter as it happens: