Queens Boulevard Extended Care Facility, Inc.: Dr. Jonathan Mawere, Administrator and Chief Operating Officer

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Jonathan-Mawere-thumbDr. Jonathan Mawere started his career at Queens Boulevard Extended Care Facility in 1999 as the head of the Rehabilitation Department. Then, in 2008, he was appointed Administrator and Chief Operating Officer.

He brings to the C-suite an extensive educational background, including doctorates in both physical therapy and medicine, as well as a license in administration, all of which equips him to serve a complex patient population.

Located about 15 minutes from Manhattan, Queens Boulevard’s patient population is both ethnically and generationally diverse.

This 280-bed skilled-nursing facility treats patients of all backgrounds, including Hispanic, Irish, Asian, Italian, Greek, Indian, Russian, and Polish. Almost 50 percent of the patients are sent to the facility for sub-acute rehabilitation services, meaning they’re only at Queens Boulevard for a short period of time, anywhere from one to four weeks, usually following strokes or joint-replacement surgeries.

Because of the short-term nature of these services, one of Queens Boulevard’s greatest challenges has been lowering rehospitalization rates.

“The subacute population has become extremely complicated,” Mawere said. “Due to the medical complexities of some sub-acute patients, reducing rehospitalizations has become a hurdle and a challenge we are meeting head-on.”

Rehospitalizations lead to penalties and reduction in reimbursements for hospitals, and care facilities like Queens Boulevard have had to find ways to avoid sending patients to another stage in the continuum of care, keeping them at the facility when medically possible, and stabilizing their condition in-house.

Thankfully, Mawere said, Queens Boulevard has been successful in reducing rehospitalization rates, thanks in no small part to its affiliation with the North Shore-Long Island Jewish Health System.

This demand, however, is merely representative of how extended-care facilities have been affected by healthcare reform and of how they, too, have had to adjust their care-delivery models in order to accommodate a changing marketplace.

Upgrading services to enhance the quality of care

There is a second group of patients to whom Queens Boulevard delivers care: long-term residents who reside in the facility for as long as their life expectancy allows. This group comprises the other 50 percent of its patient population.

Keeping patients out of the hospital also means keeping the long-term residents out of the hospital, too, Mawere said. As a result, Queens Boulevard has upgraded its services, improving its ability to treat chronic conditions, pneumonia, and other ailments at the facility. Queens Boulevard also does most of its testing in-house and has radiology and laboratory services available on-site.

Recently, Queens Boulevard unveiled an outpatient rehabilitation program for patients within the community who may need treatment without an inpatient stay or after their sub-acute rehabilitation has been completed.

“This program, we think, is a huge complement to what we already provide in the sub-acute rehab program,” Mawere said.

In addition to the new outpatient services, Queens Boulevard has established an Adult Day Health Care Program over the last decade, providing specialized medical monitoring for patients who are well enough to live at home, but have chronic medical conditions such as diabetes, heart failure, or Alzheimer’s Disease, to name a few.

The ADHC Program participants come into Queens Boulevard for a five-hour period of time during which they have the opportunity to socialize, participate in recreational activities, and receive medical monitoring from doctors and nurses who see them on-site.

Since CMS began rating nursing homes, Queens Boulevard has been five-star rated and is on the U.S. News and World Report’s Honor Roll for America’s Best Nursing Homes.

“The accolades we receive are accomplished through doing things correctly,” Mawere said. “We are able to showcase these achievements through a demonstrated proficiency in delivering care in the best way that it can be provided.”

Adapting to change by embracing it

Like most healthcare facilities, Mawere said, Queens Boulevard has “had to endure a barrage of regulatory changes” and a rapidly evolving reimbursement environment.

“Adapting to those changes is challenging for any organization,” he said. “We’ve been able to embrace changes and look at them as opportunities. To capitalize on these opportunities and be able to innovate and adapt is a true measure of success in the healthcare arena.”

He added, “That’s why we have remained one of the most sought-after facilities in the New York metropolitan area.”

Mawere said Queens Boulevard would not be where it is today without the partnerships that have been developed and without the willingness to invest in technology. Realizing that no organization can survive in isolation anymore, Queens Boulevard has branched out, forming relationships with Patient Care Associates for radiology and working with North Shore-LIJ Labs to reduce turnaround times for test results. Furthermore, Queens Boulevard has adopted evidence-based practices in delivering care.

Without real alignment of best services and without implementing proven methods of providing best care, Mawere doesn’t think Queens Boulevard would be able to survive.

“I am pleased to say that, as an organization, the entire team here has embraced what works and we have learned to work with fewer resources and be successful,” he said. “Queens Boulevard remains an organization that is dedicated and committed to providing the best care. We are a smart organization and a great organization that is on its way to becoming greater and smarter. The community can count on us to be there in the future because we are looking forward.”

-by Pete Fernbaugh

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