Marquis is in the ‘hood!

Last week, we had the very real pleasure of meeting the faces of Marquis Health Services: CEO Norman Rokeach, LNHA (Licensed Nursing Home Administrator), and Regional Director of Operations Stacey Rebelo, RN.

Since the sale of the North End Nursing Home was finalized in January, Marquis has been busy doing their homework while Partners/Spaulding continues to run operations in the leased-back facility. Marquis expects to take over operations in November of this year when Spaulding’s Brighton facility renovation is completed. So, what are they up to now and what can we expect?

First a little background on Marquis Health Services. They are the healthcare subsidiary of Tryko Partners, and have been around for about seven years. One of three partners in Marquis, Yonah Cohn, is the third generation of his family to run nursing homes. His grandmother began as a cook in a facility in Chicago in the ‘50s, going on to get her degree, move into the business office, and eventually buy the home. The family continued to acquire and manage nursing homes, and Marquis started by managing one of the family-owned facilities in Rockland, MA, buying it two years later in 2013. Now, with the acquisition of the North End home, Marquis owns 17 facilities in the northeast corridor, ten of which are in MA (mhslp.com/locations/).

Mr. Rokeach is one of the other two partners at Marquis and its CEO. He has been a Licensed Nursing Home Administrator for close to 18 years. Rokeach learned about caring for the elderly at an early age, helping his parents take care of his mother’s aging parents, Holocaust survivors, who in their late 80s moved into the first floor of the Rokeach family home in Brooklyn. With older brothers off at school and younger sister a baby, Rokeach was tasked to sit with his grandparents nightly for four years. While this chore may have turned some kids off, Rokeach found his calling (“When I grow up, I want to take care of people!”) and has dedicated himself since to providing not only healthcare, but also comfortable, caring homes for seniors in need. He says, “Understand that this is an industry [where] we are dealing with people’s lives, understand that we are in it for the residents who live here; this is their home, and our job is to make their home and life as comfortable as possible.”

Ms. Rebelo, who is a registered nurse with a degree in health care management, has spent her career working in long-term care management. She brings the same commitment to providing patients and residents not only health care services, but also emotional and psychological support, as Rokeach. On the financial aspects of running a nursing home, she says, “It’s pointless to chase numbers, you’ve got to get good care, good customer service, [and] good relation-ships with people, then all that stuff comes.” Her priority is people, and that includes clients, their families, and staff. She and Rokeach make a good team.

Marquis plans to invest about $4M in renovating the existing facility, which they will do with as little impact as possible to the current residents. This is great news as it was very important to the community that residents would not have to be relocated, even temporarily. The Home is their home, and many of the residents would not understand what was happening and be frightened, not to mention the possible adverse effects on their frail health. Marquis gets this. They use a contractor that specializes in doing renovations with as little impact on residents as possible.

But before renovations can begin, informed planning must take place. Both Rokeach and Rebelo have been meeting with a variety of stakeholders to determine what the needs and the desires of the community are before swinging the sledgehammers. What? They haven’t talked to you yet? Be patient. Sometime later this summer, Rokeach and Rebelo will attend community meetings, including the monthly NEWNC and NEWRA meetings. They will be better able to answer many of the questions we have by then, and may also be able to show some conceptual sketches. Meanwhile, Rokeach, Rebelo and several other Marquis staff will be at the Home every week overseeing the renovations and transition. They look forward to meeting more of the community and all are welcome to drop by to see what’s going on or call with any questions.

One question that we hope will be answered soon is the status of the LDA (Land Disposition Agreement) extension to 2032 (it currently expires in 2022). If you recall, it is this LDA, requiring a nursing home and rehab facility be operated on this site, that forced Partners to either continue operations or sell to another operator. When pressed by community liaison Francine Gannon about Marquis’ long-term intentions, Rokeach assured us that they have “every intention of being around for many, many years to come.” Good to know, but we still want to see that new LDA signed…

Here is what we do know now.

Planning input is being collected from stakeholders that include current staff, patients/clients, their families and attending physicians, concerned community members, Partners/Spaulding, North End Waterfront Health, other area medical professionals, architects, and construction experts to determine:

• What is needed/desired by the residents, staff, and the community
• What needs are not being met in this geographical area (e.g., subspecialties not adequately addressed)
• What can be done given the existing superstructure
• When and how it can be done

Some welcome changes already planned are a new and much larger gym/rehab facility (over 3000 sq. ft.) to be located on the first floor with offices and other common areas; more single private rooms (from six now up to about 40); piped-in oxygen instead of concentrators or tanks (rare in skilled nursing facilities, and much safer); and more common areas in general. As Rebelo noted, “If you walk upstairs to the second floor, [you see] everybody is in the hallway.” Residents should not have to be left in hallways! Partners has transferred the license for 100 beds (keeping 40 that they were not using anyway) to Marquis, and Rebelo envisions three floors with 30-35 clients residing on each: one for residents, one for short term rehab patients, and one with a mix including longer term rehab patients. There should be some flexibility depending on whatever the current needs are.

Work on the renovation will likely not begin for two to three months, after planning is completed and the required permits are obtained; the work is expected to take about a year to complete. One change beginning earlier, though, is the introduction of electronic health records, which should happen soon. And, of course, staffing efforts have been ongoing for several weeks. It is a complicated transition, as some people will elect to stay with Partners/Spaulding, moving to the new Brighton facility. Staff are going to have to decide in the next week or so whether to stay or go. But happily for us, many staff members are indeed electing to stay. Marquis worked hard to put together compensation packages that maintain salaries, seniority, and tenure, making the decision to stay easy for those who want to. So residents can look forward to seeing many of the familiar faces they love after the transition.

Senior level positions that will be filled by new applicants, though, include Director of Nursing, Medical Director, Sub Acute Program Director and Specialty Program Director. And, as Marquis is not restricted to any specific health network, they will work with all the top-notch medical organizations in the Boston area, not just Partners. Rebelo noted, “We do business with a lot of folks … we’ll have patients from everywhere.” Presumably, that includes medical staff also. Relationships with current attending medical staff are expected to be maintained as much as possible, but new medical staff will be recruited as well. Part of Marquis’ modus operandi is to introduce new medical specialty programs as needed. As these require only specialized staff and equipment, they can begin as soon as two to three months after Marquis takes over operations. Examples of specialty programs include pulmonary, cardiac, and stroke recovery. Rokeach noted, “One of the things we focus on is having an interdisciplinary team of the physicians, therapists, clinicians, and — believe it or not — our activities staff, because the quality of life and stimulation and the recreational input from the staff is a big, big part of the reorganization.”

Marquis has a very specific vision of care. They have even trademarked it—Rehabbing Care^TM—but it very much includes long-term care as well. From their website:

Our all-encompassing continuum of care includes a dedicated focus on every patient’s physical, social, and emotional well-being…We build on each facility’s unique identity, intent on meeting the specific needs of the community, and positively impacting the surrounding area. (mhslp.com/approach/)

And from Uri Kahanow, Director of Acquisitions at Tryko Partners:

We recognized the opportunity to grow our regional presence while at the same time preserving this valuable asset for local residents. Spaulding Nursing and Therapy Center is a great fit for us, offering proximity to quality healthcare institutions and a dense population. We look forward to working closely with Partners HealthCare and the City of Boston to uphold and enhance this North End gem.” (tryko.com/portfolio/healthcare/)

My emphasis there. Hopefully they mean it. After meeting Mr. Rokeach and Ms. Rebelo, I certainly believe they do. But as Rokeach himself says, “The proof will be in the pudding.”

His message to our community: “The one thing I can definitely say is we will give 150% dedication to mak[ing] the facility a warm, open, embracing facility for the North End community, and I think it’s important that we understand that we need to earn the community’s respect and trust. We are going to work very hard to do that.”

This article is republished with permission, courtesy of Boston’s Post Gazette.