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When E.J. Kuiper arrived from the Netherlands in 1991 for his one-year stint to practice physical therapy at a Florida hospital, he had no way of knowing that he would make the U.S. his permanent home and build a career in health care leadership spanning more than three decades and counting.

After working as a physical therapist in multiple settings at that HCA Healthcare hospital in Fort Myers — including acute, ambulatory and home health — Kuiper earned his master of health administration and doctorate degrees. He became an administrator. In 2006 — after 15 years at HCA — he joined the executive ranks of Catholic health care, and has since worked at Saint Anthony's Health system, Hospital Sisters Health System and CommonSpirit Health.

In the spring, he assumed the top executive role at Baton Rouge, Louisiana-based Franciscan Missionaries of Our Lady Health System, succeeding Richard Vath, who retired. FMOLHS has 10 hospital campuses in Louisiana and Mississippi.

FMOLHS has come out of the pandemic poised for growth, and Kuiper is eager to lead that expansion.

He spoke to Catholic Health World about his passion for Catholic health care and his hopes for his start at FMOLHS. His responses have been edited for length and clarity:

What drew you to FMOLHS?

The mission is what attracted me. All health care organizations have a mission statement, but I wanted to make sure it wasn't just a nicely framed-and-put-on-a-wall mission statement. I want it to be lived out, and that's very much the case here. As I talked with more and more people during the interview process, and as I also did "back door" referrals with people I know, everybody was consistently very positive about how FMOLHS' team members, and executives and board members are really living out the mission.

Now that you are in the CEO role, what are you focusing on?

I'm very much a people person, and we're in a "people business." We have 18,000-plus team members directly caring for people or supporting those clinicians. For me, it's important to create a great place to work and practice medicine for them. All of us in leadership have an obligation to remove barriers so all of them can take great care of our patients.

As soon as I got here, I started talking of the need to invert the organizational charts. I'm at the very bottom of that and our 18,000 team members are at the top. They actually are the ones who make the difference for our patients day in and day out. Our leadership team is making sure the people at the front line can develop an environment that is great to work in and a great place to practice medicine. We need to ensure that everyone's decisions are anchored in the mission.

A big part of our strategic plan has to do with providing access for patients to high-quality health care, and access drives high quality in health outcomes everywhere. So we're helping ensure patients have access to great doctors and clinics and hospitals.

We will be resourcing our leadership development program more. We have great leadership teams — we have 900-plus leaders in our organization, and we need to invest in them. Without these great leaders and team members we can't provide high-quality care. So I will visit all our markets at least four times a year and meet with these leadership teams, and will make it in person to market and board meetings at least four times a year. So, I won't be in my office much!

The more I'm out there in the markets, the more I'll learn about the needs of our communities, and the more we'll be able to address the needs.

What are some of the main challenges FMOLHS has identified?

Staffing has been a challenge for quite some time. And in 2020 and 2021 it was almost a crisis – there was significant need, and it was difficult to resource it. At our system we developed an internal staffing agency to be in a better position going forward to respond to challenges. The labor force has changed permanently since the pandemic. For example, I don't think that working from home will go away any time soon or perhaps ever. So we adapt as a health system and have various staffing arrangements in place – some people are in person, some are at home, some alternate where they work. Our internal agency will help us ramp up in our markets as things change. This includes, for example, when storms are coming up the Gulf – we must be ready to deploy. Now we're in a good position to respond to wherever the greatest need is.

Second, from a political perspective, there is always worry about reimbursement including around the 340B program. So we meet with legislators about reimbursement concerns and we educate about the issues.

And, third, there are leadership development challenges when it comes to not just the current but also the next generation of leaders. We're using our academic partnerships to help, including Franciscan University, which is part of FMOLHS and which has a great training program; Louisiana State University; Southern University; and Baton Rouge Community College; as well as several others. We partner and create pipelines to train the next generation of nurses, doctors, medical technicians, physical therapists.

You had noted that you are spending time in FMOLHS' markets talking with staff. What are you hearing?

I'm hearing that mission is very important to all of our team members, that comes up in many conversations. We will continue to be mission-centric.

And people are interested in the size of our organization. We are in growth mode, though there are no particular acquisitions pending right now. People are asking about the size of FMOLHS. And there is an opportunity for organic growth. We have a healthy balance sheet, and our recent fiscal years have been strong. We're in a position to grow, but we need to do it for the right reasons, which are to improve access to high-quality care for patients.

People also ask about our staffing agency — whether it will grow. They ask what health care will look like tomorrow and how can we grow here? We at FMOLHS have career ladders for both clinical and nonclinical staff. I'm always excited when I hear about someone who started out as a housekeeper or CNA and takes advantage of a program, and I see that they've grown to a licensed practical nurse or registered nurse. It's neat to see that for an individual who is loyal to our system.

You have emphasized in your career the importance of advocacy. What will that look like for you at FMOLHS?

It's a big part of my job to meet with our legislators on the state and federal level to ensure they understand the pressures we're under when it comes to reimbursement. While we understand that budgets have to be hit at the federal and state level, we also need to ensure the legislators understand the importance of mission-centric work. They need to understand that taking care of the poor and vulnerable is costly. And cuts put the pressure on our community benefit programs. And those community benefit programs are at the core of what we stand for, and discussing this with legislators is very important.

What has convinced you to stay in Catholic health care?

It has to do with being part of an organization that is so much bigger than you as an individual. It's being part of that legacy and heritage — like here the Franciscan Missionaries of Our Lady's heritage goes back more than 100 years. They traveled here from Europe not speaking any English and setting up the beginnings of this ministry. I look at what these incredible women have done and am in awe. We stand on the shoulders of giants.