NIC Notes

Insights in Seniors Housing & Care

By: Ryan Brooks  |  November 21, 2023

PEO Solutions for Senior Care: An Interview with Paychex's Melissa Bollinger

Senior Housing  |  Workforce

Looking for ways to reduce time loss, and increase profitability and efficiency? It all starts with an effective HR strategy. NIC Senior Principal Ryan Brooks recently talked with Melissa Bollinger, Senior Enterprise Business Consultant at Paychex about the tangible benefits organizations can realize through strategic HR partnerships with Professional Employer Organizations (PEO). Here is a recap of their conversation with key insights on fostering growth, improving retention plans, and keeping employees happy and healthy in the senior care industry. 

Brooks: A lot of people see the name Paychex and might think your offerings are limited to payroll, but there’s a lot more to the organization than just payroll processing. So, to kick us off, can you tell me a little bit more about Paychex and the resources that are offered?  

2Bollinger: Paychex offers a wide variety of solutions and services for all sizes of organizations. Whether your business is looking for basic payroll services, or your organization is growing and has more comprehensive HR needs like employee benefits or PEO, Paychex has a suite of services for you. I serve as a Strategic Business Consultant in our PEO division.  

Brooks: You mentioned PEO – Professional Employer Organization – as a resource that Paychex offers. Seeing as that might be a new term for our audience, could you tell me what a PEO is and what they do to support owners and operators in this space? 

Bollinger: Absolutely. A Professional Employer Organization allows business owners to engage in a co-employment relationship, to mitigate the liability and risk of employment to the experts in Human Resources (that’s us). 

Brooks: What separates Paychex’s Senior Living PEO from other PEOs? 

Bollinger: Experience. Over the last 10 years, Paychex has made a number of strategic acquisitions in the PEO space. Those acquisitions came with talent that is exclusively focused on respective industry verticals, such as senior living. When a business decides to join the Paychex Senior Living PEO, they can be assured that all of their designated resources have senior living experience. Our specialists are experienced with senior living payrolls, shift differentials, and comprehensively understand applicable laws and policies impacting senior living staff. Our human resource business partners are experienced with senior living operations and procedures. The suite of designated services is tailored to the senior living experience.  

Brooks: What are some of the common problems that organizations approach you with? 

Bollinger: I call them “the big three.” Staffing Issues. Growing Pains. Administrative Burdens. As a former operator and early adopter of PEO in the post-acute care space, these three issues are the hat trick of time loss, profitability, and efficiency.   

Brooks: What kind of savings can organizations realize when partnering with a PEO? 

Bollinger: Every organization is different, but one of the most valuable functions of a PEO is the ability to pool resources and stabilize long-term costs such as Worker’s Compensation, EPLI, and Major Medical. Organizations often save both money and time with some of our included services such as end-of-year WOTC, or ERTC programs, not to mention the endless discounts and special programs offered to all employees of the PEO.  

Brooks: The senior housing and care sector is comprised of both property companies (PropCos), which own the real estate, and operating companies (OpCos), which manage the operations that take place on-site. How does that divide impact the attention that human resources receives? 

Bollinger: Great question! Operating companies often have very lean management strategies, and property companies are very rarely involved in the day-to-day operations. As you can imagine, HR has a ton of administrative burdens associated with it such as onboarding, unemployment claims, benefits, and taxes. Those duties and responsibilities often fall on an executive director or business office manager in each community. Neither of those folks are likely to have extensive formal training or experience in human resources or employment. It raises the question: Who’s managing the management? Outsourcing HR to a PEO allows the rapid deployment of resources and trained professionals to not only develop systems and policies and procedures that assist, but also allow for extra hands on deck when there is a crisis or employment issue.  

Brooks: Staffing has always been a hot topic for the senior housing and care industry, but even more so in recent years given how the COVID-19 pandemic exacerbated labor shortages. In what ways does Paychex help address these challenges? Employee recruitment? Retention? 

Bollinger: I don’t know of an organization that hasn’t been permanently impacted by the changes we have seen inside of the workforce since COVID. The most proactive and beneficial thing any community can do is to develop and deploy a recruiting plan. Our Senior Living HR Business Professionals at Paychex, work side-by-side with our clients to help develop those plans, make market adjustments in a timely manner, and deploy recruiting techniques to help our clients make better hires. According to the National Association of Professional Employer Organizations, employers working with a PEO see a 20% average decrease in turnover and an immediate increase in existing retention rates.  

Brooks: How has the performance management changed in a post-pandemic operating environment? 

Bollinger: I think organizations have begun to value the contributions of their employees differently. We are seeing a lot of proactive policy changes, increased flexibility, permanent remote work environments, and the use of software and automated processes to help manage overall performance.  

Brooks: What about when it comes time to have a difficult conversation with an employee, whether that be for a job performance issue, employee disengagement, or time and attendance? These conversations can often make people uncomfortable, but not addressing these issues can lead to greater problems. What are the most important considerations when planning a difficult conversation? 

Bollinger: The biggest mistake any organization can make is to avoid difficult or uncomfortable conversations. This is my favorite question because it allows me to talk about one of my favorite books. A long time ago I read the book Fierce Conversations by Susan Scott. In it, Susan illustrates a concept of C=R. Plainly, The Conversation = The Relationship. Relationships are at the heart of everything, especially in senior living. Communities have relationships with their markets. Staff have relationships with residents. Leadership has a relationship with the front line. Property companies and management companies have relationships, and all of those relationships are made up of conversations. Not unlike recruiting, you need a plan.   

Brooks: What is the role of HR in these conversations? How can the approach be structured in a way that these conversations will be productive and achieve the desired goals? 

Bollinger: Evaluating your human resources strategy is the first step to deciding which conversations might be missing in your organization. Having access to a designated and experienced human resource business professional allows you to plan these conversations, examine the intent behind them, and focus on language and messaging in advance. Often, simply discussing and deciding upon a desired outcome in advance, can steer the conversation in a mutually beneficial direction.  

Brooks: How do you gauge the long-term success/effectiveness of difficult conversations when they occur? 

Bollinger: You can judge your conversations by your relationships, and vice versa. Are your relationships stronger and more meaningful because of the conversation? Has there been a change in behavior after the conversation? Are all parties more mindful of the desired goal? A successful conversation should lead you to an enriched relationship. An effective conversation should result in meaningful change.  

Brooks: Is there anything else you’d like our audience to know? 

Bollinger: There is always an extraordinary amount of room for growth and improvement. Taking a look at human resource strategy, the relationships your employees have, and the additional steps we can take to keep employees happy and healthy will be the differentiator in every single market in 2024.   

About Ryan Brooks

Senior Principal Ryan Brooks works with the research team in providing research, analysis, and contributions in the areas of healthcare collaboration and partnerships, telemedicine implementation, EHR optimization, and value-based care transition. Prior to joining NIC, he served as Clinical Administrator for multiple service lines within the Johns Hopkins Health System, where he focused on patient throughput strategies, regulatory compliance, and lean deployment throughout the organization. Brooks received his Bachelor’s in Health Services Administration from James Madison University and his Master’s in Business Administration from the University of Maryland.

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