St. John’s new VP a lifelong innovator

Much of Nate Sweeney’s career in elder care has been focused on a culture change movement, in reimagining the way in which seniors are cared for and how that care is provided. So when he was approached by St. John’s vice president of skilled services to take on her role when she vacated it, it was a no-brainer.

“Rochester is such an epicenter for so much of that work, and St. John’s in particular has really been a catalyst for a lot of that innovation,” Sweeney said of his work’s focus. “The opportunity to be part of this team really is something that was a fantastic opportunity that I did not want to pass up.”

Sweeney recently replaced Rebecca Priest in the vice president role, a position that has him overseeing 475 seniors at St. John’s Home and two St. John’s Green House homes in Penfield. He walked into the role midstream; St. John’s has been on a path toward reinventing itself and the industry it resides in.

“The person who was in that position, Rebecca Priest, really was a fantastic employee who really understood and was driving our culture change here,” St. John’s President and CEO Charles Runyon said. “She had known Nate for probably five or six years and knew he could come in and kind of continue the path that she had set us on. We were thrilled he was a candidate and he was thrilled that we were in a position where we were able to offer him the position.”

St. John’s Senior Services Inc., as the organization is formally known, was founded nearly 130 years ago by a group of German-speaking Lutheran and Congregational churches to help ensure that their aging and vulnerable mothers and fathers would receive good care.

Out of that beginning grew an organization that employs more than 1,000 people across four facilities. The agency serves 1,010 people in areas such as senior independent living, rehabilitation, enhanced assisted living, adult day services and Alzheimer’s care, among other things.

In 2003, the mission of St. John’s Home was renewed based on the Eden Alternative Principles of eldercare, which promotes quality of life for elders and their care partners, wherever they may live. The new mission brought a radical new approach to St. John’s skilled nursing care, with a philosophy, organizational structure and architecture that was crafted to remove institutionalization from long-term care.

In 2012, St. John’s made history as the first long-term care facility nationwide to embed Green House homes into the community. It was a new concept in nursing homes: home-like facilities with skilled nursing care, integrated into an existing community. This launch also led to St. John’s fully embracing the concept of “small homes” at its main nursing home campus.

After extensive renovations and staff retraining, dining and many other daily activities now take place in smaller, home-like settings, enhancing care by facilitating closer relationships between caregivers and residents.

“As we’ve moved and changed our culture to try to change this large institution into small neighborhoods, what we’ve found is that trying to do that in a large, institutional building is much more difficult and different than doing it in a brand new, freestanding building that you start from scratch,” Runyon acknowledged. “So Nate’s really continuing where Rebecca was and taking all those great things we learned when we opened the Green Houses in Penfield, figuring out what works and translates. And then figuring out what doesn’t translate and making those things happen, in spite of the fact that they don’t translate well from one setting to the other.”

Hailing from the Baltimore area, Sweeney brings 17 years’ experience to St. John’s. He began his career with Jesuit Volunteer Corp., where he worked at a hospice for homeless people with AIDS and served as a direct caregiver helping residents bathe and dress.

After earning his master’s degree, Sweeney led the effort for the licensing and opening of the Harry & Jeanette Weinberg Green House Residences at Stadium Place in Baltimore. Most recently, Sweeney served as executive director of the LGBT Health Resource Center for Chase Brexton Health Care in Baltimore.

While there, Sweeney took part in establishing Baltimore’s first programming for lesbian, gay, transgender and bisexual and queer adults, as well as the region’s first interdisciplinary care program for transgender youth and a new behavioral health clinic focused on health disparities in the LGBTQ community.

Sweeney said one of the problems he sees in long-term care is a true labor challenge that does and will exist around providing enough competent caregivers to address the needs of the population of elders.

“There’s going to be periods of rapid growth and shrinking, disruption in our market, as the (baby) boomers continue to age, and we have to be positioned to be agile to new innovations,” Sweeney said. “But part of why I came to St. John’s is this is not an organization that’s interested in just being agile in responding. This is an organization that’s interested in being an innovator, in being one of the disruptors, as opposed to waiting for things to be disrupted.”

Sweeney was fortunate to have inherited some of his father’s creativity, he said, which allows him to ask the questions, “Why are we doing it this way? Is there an opportunity to completely rethink?”

“As we continue to shrink down the experience for those who are living in small homes, you have to ask the question, do all of those homes have to be exactly the same, or can we start to offer up some real targeted opportunities for community living in those small homes,” Sweeney mused. “What opportunities are there for intentionality?”

For example, he suggests that there may be an opportunity to create small communities of elders with similar interests.

“Are there groups of people who might really want to come together in a house that is solely dedicated to celebrating the performing arts. Or having a section completely devoted to sports,” he explained. “Let’s talk about how we can provide options to really celebrate people’s interests and celebrate people’s lives and identities.”

What Sweeney brings to the table, Runyon said, is his compassion and understanding for seniors.

“He has worked and started out as an aide, so that brings a huge perspective to being able to communicate with the staff, understanding the issues that the staff are having and being able to solve those issues,” Runyon said. “Nate’s just a really good person and that’s who we need in our business—great people who understand how to help with the needs of the people we’re taking care of.”

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