Marc Halpert has had a year under his belt as the CEO of Minnesota-based nursing home operator Monarch Healthcare Management, and is relishing his new role after having been on the operations side of the business for almost two decades.

Amid the challenges of rapidly rising interest rates, staffing shortages and a tough economic environment, Halpert spoke to Skilled Nursing News about initiatives — including a bonus program that could award workers up to $100,000 — to overcome these hurdles, hurdles that are magnified due to Monarch’s location as the largest provider in a rural state. 

“We’re building this company for my kids, for my grandkids, for all the partners’ families. We are not looking to sell, we’re not looking to divest. We’re looking to grow, but really to maintain what we have right now … we have a great portfolio that is successful,” Halpert told SNN. “Obviously, there are still staffing challenges and [other] obstacles in our way. And our job is to knock down those obstacles and grow when the time is right.”

Monarch, also one of the largest providers in the Midwest, completed the acquisition of 11 buildings – bought from Villa Healthcare – in January, and is busy transitioning them. “We are conducting the training for those buildings to bring them up to our standards,” Halpert said.

And aside from sights on growth in the future, Halpert has spent the year focusing on workforce challenges and customer service initiatives, both areas he promised to follow up on when took the reins of leading Monarch last year.

Prior to becoming CEO, Halpert, who is also founder of Monarch, served as the company’s chief operating officer for over six years.

“Focusing on our customer service program has always been a key [effort] of mine since we started Monarch,” Halpert said, adding that stepping out of COO shoes has allowed him to focus more on customer service – a task that is difficult to oversee when an organization is as large as Monarch. “When you have 10-15 buildings, it is doable as a chief operating officer, but if you have 60 buildings, it’s really impossible to do it while focusing on operations.”

Monarch has been in business since 2015, and provides skilled nursing and rehabilitation services as well as memory care, assisted living, and independent living across almost 60 communities, with 44 skilled nursing homes – half of the SNFs are based in the Minneapolis metro area – and 14 assisted living facilities.

And in shifting gears to lead Monarch, Halpert has not only focused on customer service based on the hospitality industry, but also employee engagement; previously, he told SNN, “We’re really going to try to bring the Ritz-Carlton mentality to our facilities.”

Now, Halpert said that his company has been able to address workforce challenges and alleviate staffing shortages through initiatives aimed at better hiring, training and retention – and bonuses.

The bonus program was launched last quarter and awards a bonus of up to $10,000 a year for up to $100,000 over a period of 10 years. This is different from a sign-on bonus program and is meant to short-circuit the cycle of providers trying to out-compete each other for talent by continually ratcheting up their hourly wages.

Moreover, Monarch has been able to reduce its agency use over the last four months, although this varies depending on the location of the facility and its leadership, but is certainly something that organization is trying to overcome. Monarch also maintains its own “float pool” of workers that it tends to retain for six months at a time.

The transcript below has been edited for length and clarity.

How has the year fared in your role as Monarch’s new CEO?

Halpert: It’s been phenomenal. On a personal level I’ve been in operation for the better part of 18 years. My entire career has been focused on operations. So from my standpoint, handing over the reins to a new chief operating officer has been just a whole other world to life. But from a business level, it’s allowed me to focus on our growth strategies, and really streamline a lot of processes I didn’t have time for because I was stuck in the weeds. So now, I’m more focused on the bigger picture and that has allowed Monarch to continue to shine.

How has Monarch tackled rising interest rates and new acquisitions?

Halpert: It obviously impacts us a lot. We have several loans that are variable, so those mortgages now go up every month and we have to be paying a higher amount. Looking at new acquisitions, it’s definitely something that’s scary to pay that kind of interest. But, at the end of the day, I’ve always taken the mentality that I’m here for today, and I’m looking for tomorrow. These are the cards I’m dealt. I can fold, or I can keep playing. So, I’m choosing to keep playing. And it’s working. I do truly believe that at some point those interest rates will go down. That said, the days of low interest rates and buying a facility for pretty cheap may be gone for a while.

How has customer service played a role beyond keeping your residents happy?

Halpert: I have a happy staff. So if you can keep people happy, they’re not going anywhere. So that’s been our thing. We’ve had people that left, three weeks later call back to say, ‘Please take me back.’ So, we have a good culture, a good environment, and I think that our customer service has led to that.

How has implementing the Ritz-Carlton Leadership Program worked out?

Halpert: It’s been great. Every one of our employees focuses on the daily core value every day. And really, we’ve implemented the Ritz Carlton program and they love what we’ve done with it. And hopefully, in decades from now, people will still be talking about how Monarch customer service training is a bar above everyone else.

Staffing is a problem for nursing homes based in rural states. How is Monarch challenged by labor issues?

Halpert: Actually, 65% of our buildings are not using agency labor and are considered fully staffed. That said, in the Twin Cities, I have a facility that’s running almost 90% agency. So [agency labor] really ebbs and flows depending on the location and leadership of the building. But our agency usage has been down week over week for 11 consecutive weeks. So that’s progress to me. And we’re just going to continue fighting the fight.

What are some unique strategies within your organization to retain staff?

Halpert: I’m going after the agency people. We had to figure out a way to keep staff happy and address their needs. They want to work in fewer facilities, and so [since] we’ll have more than a few facilities, we’re sort of figuring out ways to beat the system. Also, there’s no one really moving to Minnesota, and so we have to work to attract workers to our facilities. I look at it as: there’s a nursing home across the street from mine, why are they working there? Come work for me. We’re having those conversations, and slowly we’re getting there.

As a retention strategy, you offer your employees $100,000 over a period of 10 years. Tell us about it.

Halpert: We actually put together a $100,000 retention bonus for our staff. So getting that and with our wages, they’re pretty close, if not better, than the external agency. So we’ve been able to put programs together that have been beneficial and really rewarding our staff for sticking with us. This is not a sign on bonus. We have that also. This is really something to say, ‘Hey, you stay with us for [long term], and we’re really going to give you a lot of money.’

And the response has been phenomenal. Everyone’s just ecstatic about it. And it’s great and it’s a number that we were able to swallow financially, knowing that our employees are dedicating themselves to us for the next 10 years, and we’re dedicating ourselves to them.

What’s the story behind the bonus?

Our mission statement at Monarch Healthcare is that we are here to deliver a new way of health care, and a better living situation, and so we are extending that to our employees too. Increasing the hourly wage didn’t accomplish anything because if I raised the wage, my competition raised their wages. So I wanted to do something that was different from everyone. And I went ahead and gave a $10,000 signup bonus, but I really wanted the employees to commit so I went beyond that. People are always saying that in health care, companies are just looking to make a quick buck and sell. That’s not who Monarch is. Through this program, I want to show that we are here to stay.