When CEOs walk into a struggling organization, they often look first at the numbers. They study margins, overhead, contracts, utilization, and cash flow. That makes sense. If the business is bleeding, the instinct is to stop the bleeding fast.
Mark Mullahy sees it differently.
Yes, you have to examine expenses. Yes, you need to understand the contracts. Yes, you need to know where the financial leaks are. But in his experience, the first real lever is not found in the budget. It is found in the culture.
As president and CEO of Montgomery Place Chicago, Mark has built his career around turnarounds in healthcare and senior living. He knows what it means to step into an operation that is underperforming and rebuild both the economics and the experience. At Holly Hall Retirement Community, he helped reverse a $2 million annual loss and turn it into sustained profitability. At the same time, he raised the quality of care from a two-star rating to a five-star rating and improved employee retention from 68 percent to 92 percent.
That combination matters. It is one thing to repair the balance sheet. It is another to do it while raising quality, stabilizing the team, and creating an environment where people want to stay.
Mark’s message is simple and powerful. If you want lasting performance, start with culture.
Why Culture Comes Before The Financial Fix
When I asked Mark what the first operational lever should be in a financial turnaround, he gave an answer that many leaders do not expect. He said it starts with “the culture of the organization and the culture of the business.”
That is not soft thinking. It is practical.
If people do not know the mission, if they do not understand the values, and if they are operating in silos with unclear leadership, then performance begins to erode everywhere. Service suffers. Accountability weakens. Waste grows. Employees disengage. The business may still be functioning, but it is no longer aligned.
Mark described the difference clearly. “When everybody’s just there to collect the paycheck, you have issues. But when people are there because they truly want to make a positive difference in the life of someone else, it’s a completely different culture and a completely different mindset.”
That is especially true in senior living and healthcare, where the quality of work is inseparable from the quality of care. But the lesson applies far beyond healthcare. In any business, people either see themselves as stewards of something meaningful or as workers passing through. That difference shows up in the numbers faster than most CEOs realize.
How Leaders Change Culture
The obvious follow-up is this: if the culture is broken, what does a CEO actually do?
Mark’s answer was not a grand slogan or a corporate rebranding exercise. It was much more grounded. He starts by asking people to reconnect with the human being behind the work.
He said, in effect, if this were your mother, would this be acceptable? If your mother lived here, would it be okay to be distracted, to cut corners, to show up late, to treat the job casually? That question changes the lens. It pulls people out of routine and back into purpose.
What I liked most about his approach is that he does not lead with accusation. He leads with perspective. He shifts the frame from tasks to people, from process to responsibility, from “what” to “who.”
That is a more powerful form of accountability because it does not rely only on rules. It relies on conscience.
A lot of leaders want better performance, but they try to get there by tightening controls before they have rebuilt commitment. Mark’s approach reminds us that people rarely give their best to a system they do not emotionally connect with.
The Power Of Mentorship And Repetition
Mark’s leadership style did not appear by accident. Early in his career, he joined a nursing home as a director of dining services and ended up working for a mentor for 14 years. That mentor taught him not just how to run a business, but how to lead people, communicate clearly, and build teams.
That kind of long apprenticeship matters.
Too many leaders are thrown into management before they have seen it modeled well. Mark had the opposite experience. He had time to absorb not only the mechanics of leadership, but also its tone and discipline. You can hear that in the way he talks about coaching, partnership, and trust.
It also explains why he is so focused on helping others grow.
When I asked how he scales across multiple locations, he did not talk first about tighter control. He talked about adapting his style to the leaders he supports. He understands that different leaders need different forms of communication and support. At the same time, he stays clear on the destination. Accountability still matters. The outcome still matters. But the path there should reflect the strengths of the person leading it.
That is mature leadership. It is not rigid. It is responsive.
Scaling Means Letting Others Lead
One of the strongest parts of the conversation came when Mark reflected on what he wishes he had learned earlier. His answer was direct: “You can’t do it by yourself.”
He described his early management years with real humility. He tried to do too much on his own. He did not ask for enough help. Like many first-time leaders, he believed effort would solve what only team design could solve.
That lesson is universal.
Every scaling CEO eventually runs into the same wall. The company begins to outgrow the founder’s habits. What once looked like dedication starts to become a bottleneck. Decisions pile up. Delegation stalls. Good people wait too long for approval. The business starts leaning on one person in ways that are no longer sustainable.
Mark’s answer is not to disappear from the work. It is to build the right team around you and trust them enough to lead. He talked about strategic planning, stretch goals, and working together as a team to get there. He also emphasized something many leaders miss: you do not need to know everything. Sometimes the right move is to bring in the person who does.
That is not weakness. That is scale.
Process Matters, But So Does Flexibility
Because Mark has led turnarounds, he has seen what happens when organizations drift. Costs expand, standards slip, and people start tolerating things that would have felt unacceptable earlier.
He responded to that not with bureaucracy, but with clarity.
He looks closely at expenses and contracts. He asks when things were last negotiated. He questions duplication. He examines what is actually necessary. That operational discipline supports the cultural work rather than replacing it.
This is an important point for CEOs. Culture and process are not opposites. In a strong organization, they reinforce each other.
A healthy culture creates the will to do good work. Good process makes that work repeatable.
AI In A Human-Centered Business
When we turned to AI, Mark’s answer was thoughtful and appropriately restrained.
He is not chasing AI for its own sake. He is looking at it through a human lens. Where can it strengthen resident engagement? Where can it support employee engagement? Where can it help people stay independent longer? Those are the questions he is asking.
That is the right posture.
Healthcare and senior living are full of administrative friction, and AI will absolutely change parts of the operating model. But Mark is also clear that some aspects of care still require a human presence. Empathy, reassurance, judgment, and emotional connection are not line items you automate away.
In his world, AI may become a powerful support layer. It may help with communication, organization, engagement, and access. But the culture of care still depends on people who understand what it means to serve another human being with dignity.
That is not old-fashioned. That is reality.
What CEOs Should Take Away
Mark Mullahy’s story is a reminder that growth and turnaround do not begin with spreadsheets alone. They begin with people. They begin with values. They begin with whether the organization remembers why it exists.
If you are leading a turnaround, or trying to scale an operation without losing quality, ask yourself a few hard questions.
Do your people know the mission well enough to say it in their own words?
Do they understand the standards well enough to protect them when you are not in the room?
Do your leaders have both autonomy and accountability?
And have you built a culture where people care about the work because it matters, not just because they are being watched?
Mark put it plainly: “When you don’t know what the mission statement is and you don’t know what those core values are and you’re working in silos and there’s not real clear guidance or leadership, everything just begins to fall apart.”
That is true in senior living. It is true in healthcare. It is true in your company too.
I am Glenn Gow. I coach CEOs.
If your organization is under strain, do not just ask where the money is leaking. Ask where the meaning is leaking. In many cases, that is where the turnaround really starts.
