Providence turns 10 3 Trinity mission fairs 9 Executive changes 11 PERIODICAL RATE PUBLICATION
OCTOBER 2026 VOLUME 42, NUMBER 10
SPECIAL CARE FOR MOTHERS AND BABIES
Ascension Florida program helps physicians navigate life’s hardest conversations By VALERIE SCHREMP HAHN
During rounds at CHRISTUS Children’s in San Antonio, Dr. Maria Pierce, left, assesses a baby in the neonatal intensive care unit.
Ministry facilities see fewer births, but more demand for NICU care
By JULIE MINDA
Never before in her 35 years as a nurse has Kathy Donovan seen the number of births at the hospitals within Hospital Sisters Health System go down while the number of admissions to the neonatal intensive care unit go up. Donovan, who is HSHS senior vice president and chief operations officer, says the same trend is happening nationally, as birth rates decline and the demand for NICU care increases. For one thing, Donovan says, “We’re seeing sicker moms, and that often means sicker babies.” Maternal and neonatal care experts at three other ministry systems say they’ve seen similar trendlines. Like Donovan, they Continued on 4
CATHOLIC HOSPITALS INCREASE NICUS’ SPACE, STAFFING AND SERVICES TO MEET NEED. PAGE 5
CommonSpirit expands support for mothers in need of mental health care
Continued on 6
Continued on 8
Italy pilgrimage gives ministry executives deeper understanding of their call to lead
Valerie Schremp Hahn/CHA
By JULIE MINDA
By VALERIE SCHREMP HAHN
When Dr. Natalie Bulock and other OB-GYNs see a new mother at a prenatal or postpartum appointment, they screen those patients for mental and behavioral health problems and address what they can. Despite the dedication of physicians like Bulock, the rate of undiagnosed cases suggests there is a need for specialized mental health support for these patients. Bulock “It’s a very busy life, and the onus has been on the physicians to really fill this gap in maternal mental health,” said Bulock, who works in Sacramento, California, with Dignity Health Mercy Medical Group, a member of CommonSpirit Health. “At baseline, one in five women have maternal mental health disorders, and 60 to 70% of those cases go
Delivering devastating news to a patient’s family is often part of a doctor’s job. It’s never easy, and it’s tough to know how to do so as compassionately as possible, how to get into the proper mindset beforehand and how to care for oneself afterward. “Somebody said to me one time, ‘If you help change the perspective for one doctor to help them feel better, how many families will you impact through just that one person?’” said Rev. Greg Hershberger, an Anglican priest who is the Rev. Hershberger manager of spiritual care for four Ascension Florida hospitals in the Gulf Coast area. “That’s pretty humbling to think about. If I have one doctor who enjoys
Kate Corbett of World Pediatrics plays with Hiyab and Wuhbto, 2-year-old twins from Ethiopia who were born joined at the head, on Sept. 16 at SSM Health Cardinal Glennon Children's Hospital in St. Louis. Corbett is one of the twins' main caregivers.
Rare surgery at SSM Health Cardinal Glennon separates Ethiopian twins fused at the skull By VALERIE SCHREMP HAHN
ST. LOUIS — By all accounts, Hiyab and Wuhbto are wide-eyed, twin 2-year-old girls who love to play together, kick and smile to music, and work on learning to sit up. “They’re also starting to do all the things that toddlers are known for, like refusing to take a nap, taking each other’s toys,” said
Dr. Nick Holekamp, chief health transformation officer at Ranken Jordan Pediatric Bridge Hospital in suburban St. Louis, where the twins are undergoing rehab. Such normalcy wasn’t possible just six months ago. The girls, from the Tigray Region of Ethiopia, are craniopagus twins, meaning they were born fused at the skull. Continued on 7
Setting off for Italy in April to take part in CHA’s annual pilgrimage for ministry leaders, Orest Holubec had a clear idea of what he hoped the journey would be: a time to reconnect with the Holy Spirit in a new way, listen to the spirit’s prompting on what he’s called to do as a Catholic healthcare executive and reflect deeply on that calling. Holubec says while the six-day program gave him numerous opportunities to do this, a specific experience was particularly Holubec meaningful: During a half-day in the central Italian city of Assisi, he ascended to a terrace overlooking the mountain town and spent some time in solitude, taking in the beauty of the natural world and pondering his place in the church’s healing legacy. In the late 12th century, Sts. Francis and Clare were born in Assisi. Both lived lives of service to the poor, advanced the mission of Continued on 12
CATHOLIC SYSTEMS HOST PILGRIMAGES AS FORMATIVE EXPERIENCES. PAGES 10-11
2 CATHOLIC HEALTH WORLD October 2026
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Upcoming Events Supportive housing
Remembering 9/11
New life for hospital
Pittsburgh Mercy, part of Trinity Health, and its partners complete a $22.2 million development with 34 affordable, permanent supportive housing units.
Take a look at how Catholic Health World covered the impact on Catholic hospitals of the terrorist attacks just after and at the one-year anniversary.
Ascension Via Christi acquires a hospital near Wichita, Kansas, that closed last year. The health system plans to reopen the hospital next summer.
Mercy Health hospital and partners take on diabetes in rural Kentucky
Community Benefit 101: Planning and Reporting Nonprofit Hospital Community Benefit Oct. 20-22 | 2 – 4 p.m. ET each day
By LISA EISENHAUER
Sharing responsibilities, expertise Mills and representatives from the other partners presented a session on their model this summer at the national conference of the National Association of County and City Health Officials. Their session detailed the work of their collaboration — officially the Lee County Diabetes Support Group Partnership. The partnership evolved from the Lee County Diabetes Coalition, which started in 2007. The coalition used grants to set up communitywide events to promote physical activity and healthy eating. By 2022, coalition leaders saw a need for a more individualized, patient-centered focus to address the county’s high diabetes rates. That’s when the partnership was born. Each partner brings unique expertise and resources. For its part, the hospital offers community health leadership, clinical expertise, A1C screenings to check blood sugar, and care coordination and referrals. Among the health department’s contributions is chronic disease prevention expertise and among those of the coopera-
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‘A special collaboration’ Mercy Health — Marcum and Wallace Hospital is part of a partnership that created and is sharing a successful model for responding to the high diabetes rate in a rural Kentucky county. The hospital, part of Bon Secours Mercy Health, consistently sees diabetes as an issue in its community health needs assessments. In rural Lee County, part of the hospital’s catchment area in Eastern Kentucky, about 20% of adults self-report having diabetes. In 2023, the hospital joined with the Lee County Diabetes Coalition, the Lee County Cooperative Extension and the Kentucky River District Health Department to create a sustainable collaborative model of care. The core of the model is a support group that meets monthly. The meetings are facilitated by the partners and offer diabetes education, healthcare services and peer support. Over the first three years, 16 people on average attended the group meetings. Of those, 83% reported improved confidence managing diabetes. In addition, 90% of those who shared their data showed improved blood sugar levels. Meghan L. Mills, director of community health at Mercy Health–Marcum and Wallace Hospital, credits the partnership for bringing “exactly what is needed into the community.” She says the program the four partners coordinate generates tangible data showing Mills direct impact on people’s lives that she can cite in future community health needs assessments and use to establish community health impact programs. “It’s just a special collaboration,” Mills says. “It’s something that others can replicate.”
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Meghan L. Mills, director of community health at Mercy Health — Marcum and Wallace Hospital in Irvine, Kentucky, leads members of a support group for people dealing with diabetes through some stretching exercises. The hospital is a partner in sustaining the group.
tive extension, which provides free informal public education, is nutrition education. The partners take turns leading the support group meetings. They invite speakers with special expertise to present on specific topics, such as a nurse who discussed foot care at a recent meeting. They provide resources related to the subject matter, such as a goody bag with a stress ball and back scratcher handed out during a session on relaxation techniques. Kristin Brandenburg, administrative specialist at the Kentucky River District Health Department, developed a curriculum for the support group that ensures all major topics identified by the partners are covered over the course of a year. Those topics include understanding the basics of diabetes and medication management. The curriculum is loose enough that even when topics repeat after a year, participants get a fresh take. For example, a nutrition-focused session might delve into the merits of home gardening or look at how to cook healthy meals given limited grocery options, as is the case in Lee County, population about 7,400.
Education and activities The variety in the meetings might explain why some of the support group members go to every session. But it also could be because in addition to being educational, the meetings are lively. Each one includes an activity. In August, there was a tailgate party, with a cookout and outdoor games. In July, at the session focused on relaxation techniques, members took a painting class. Each meeting ends with a diabetesfriendly meal. Afterward, participants get cards with recipes for the foods they just ate. To encourage members to follow up on the healthy practices covered at the meetings, the leaders created a game with prizes. When a group member follows through on a recommendation, such as getting a foot exam or flu shot, they get to check it off a bingo-like card. At the end of a year, participants get fake cash for each item they have checked off. They can use that cash to bid for prizes at an auction.
Claudia Burnett, a retired dietitian turned diabetes educator with the Kentucky River District Health Department, rounds up the prizes. She says turning the goals of the sessions into a game for the group members “makes it fun and it incentivizes the things that we want them to do in their lives.” Burnett is the collaborative’s go-to person for teaching how to manage the condition. She advises support group members and the group’s leaders on the medication and nutrition interventions that keep the disease in check. “She’s really that person that kind of keeps us right on track on what exactly they need,” Brandenburg says of Burnett. “Without Claudia being involved, with her expertise, we would definitely not be at the level of what we’re being able to provide.”
From good intent to good example Nancy Zuech Lim, senior director of community benefit at CHA, joined Mills and Burnett for their session on the partnership at the National Association of County and City Health Officials conference. She lauds the partnership and its support group model as an exemplary example of good intentions turned into an effective intervention. “This is a real-life example, an in-action example, of our mission to care and our commitment to community,” Lim says. The Lee County partners hope to see their model adopted by others. So far, one other neighboring county has inquired and Brandenburg has shared the curriculum she developed. Mills says the curriculum is just one of the “C’s” that she thinks have made the partnership successful. The others are commitment, collaboration and consistency. Brandenburg says the overarching goal of the partnership is to simplify diabetes management for the support group members. “We’re trying to be very holistic with every part of their lives and just trying to make it easier for them,” she says, “because if your life is easier, then it makes managing diabetes easier too.” leisenhauer@chausa.org
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October 2026 CATHOLIC HEALTH WORLD 3
At 10 years, Providence St. Joseph Health continues to expand care, innovate By LISA EISENHAUER
When the leaders of Providence Health & Services and St. Joseph Health decided 10 years ago that they would be better together, they foresaw the challenges along with the promise. They could see the prospect for bringing better care to more people with more efficiency but also the hurdles. In addition to the logistics of uniting the two systems — such as combining their finances, medical records and human resources as well as those of their subsystems — decisions had to be made about where its headquarters would be based, how its mission statement would be worded and much more. Ali Santore, who was leading government affairs for Providence Health & Services at the time it joined St. Joseph Health, recalls that the unification was far from simple. “But I think, overall, we did what we set out to do, and Santore we’re not done yet,” says Santore, now the chief communication and external affairs officer for the combined system, Providence St. Joseph Health. Since its 2016 founding, Providence, as the system is commonly known, has deepened the footprint of its legacy systems in seven western states: Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. It added one hospital, bringing the total to 51, as well as dozens of new clinics, expanding a network that is now at about 1,000. It has developed a telehealth network that digitally connects 20,000 care providers. The Providence workforce numbers about 119,000. Patient visits are at 29.8 million annually. Last year, Providence provided $2.1 billion in community benefit. Santore and Sr. Katherine “Kit” Gray, CSJ, who was on the ministerial public juridic person that sponsored St. Joseph Health and on the original sponsors council for the new system, credit the commitment to discernment of both legacy systems for the success of their union. Sr. Gray says the groundSr. Gray work for that process had been laid long before talks about the systems coming together began because discernment was inherent in the culture of the legacy systems’ founders: the Sisters of Providence and the Sisters of St. Joseph of Orange. “The process of thoughtful, reflective discernment is something both communities brought to the decision to come together,” Sr. Gray says.
Blending two legacy systems Santore and Sr. Gray say what had been distinctions of the legacy systems are now part of the blended system. For example, Santore says the phrase “sacred encounter” wasn’t familiar to her until her new colleagues from St. Joseph Health introduced it. It was how they referenced interactions among caregivers and between caregivers and patients. “If you were to come to Providence St. Joseph Health now and you use the term sacred encounter, it’s just part of our shared culture,” Santore says.
HEADQUARTERS: SUBURBAN SEATTLE
51
HOSPITALS
1,002 CLINICS
119K CAREGIVERS
29K
PHYSICIANS
1.8
MILLION MEMBERS
UNIVERSITY OF PROVIDENCE IN MONTANA
The headquarters of Providence St. Joseph Health is in Renton, Washington, in suburban Seattle. The system was founded in July 2016.
Providence’s mission, values and promise statement also reflects the shared legacy. That guiding language came together after what Sr. Gray says was a year of discernment that engaged 90% of the staff through focus groups and listening sessions. “We were looking for similarities, kind of things that already fit together, and at the same time, we were looking for new language,” Sr. Gray says. Some of the values are ones to which both systems had already pledged, such as justice and integrity. But the statement includes phrases that had been associated with just one, such as the promise: “Know me, care for me, ease my way,” which came from Providence Health & Services. And part of the newer language is the vision: “Health for a better world.” That mission statement has endured. “I’ve heard no whispers of changing it, none at all,” Sr. Gray says.
Explaining the ‘why’ Like the mission statement, the governance framework set up at the time the legacy systems united has held. One board of directors oversees Providence. The system’s South division has its own oversight board and Sr. Gray is a board member. More than three dozen local boards oversee service areas within Providence. The sponsors council for Providence continues to include five members each from the legacy systems, some lay and some consecrated religious. In her role at the start of Providence, Santore helped shepherd the union through the regulatory process in California. That included hosting more than a dozen public hearings in communities where the legacy systems had hospitals to explain the “why” behind the pending partnership to the public and to staff. “It’s been really exciting for me to see
what we talked about in those hearings — the vision for what this ministry would be and how we could have a greater impact on those we serve — come to fruition,” Santore says. One of the programs that embodies the commitment Providence made at its start to improve the health of the communities it serves is the Well Being Trust. That foundation describes itself as “dedicated to advancing the mental, social, and spiritual health for all.” Providence seeded the foundation, initially called the Institute for Mental Health and Wellness, with $100 million. Santore says it was the new system’s effort to address the need for mental health care, which showed up repeatedly in community health needs assessments. Since its founding, the trust has funded programs and joined partnerships that have touched 1 million lives, Santore says. One example of its impact is the initial $1.2 million that the trust provided to establish Waterfront Recovery Services, a substance abuse treatment center in Eureka, California. “We were able to bring resources through the Well Being Trust that otherwise would not have been there,” Santore says.
Pioneering spirit endures Another highlight of Providence’s first decades is running a Medicare shared savings program that Santore says is one of the nation’s largest and most successful. For 2024, the system says the program, in which the system works with providers to coordinate care, generated more than $177 million in savings for the Center for Medicare and Medicaid Services. Another success has come from Providence’s environmental stewardship efforts. Across 1,000 facilities that encompass 44 million square feet of real estate, Santore
says, the system has decreased its carbon footprint, or its output of harmful greenhouse gas emissions, by 27%. “We have over 100 sites running on 100% renewable energy, including all of our sites in Texas,” she notes. Sr. Gray says both of Providence’s legacy systems shared a “pioneering spirit.” Well before the two combined, their sponsor councils met to support one another and discuss such topics as how to extend healthcare deeper into communities, improve access and accelerate innovation, all while remaining faithful to their charisms. Even with that history of communication and support, she admits, the actual unification wasn’t simple. For example, each system had leaders with the same job description, and the new system only needed one, so some top jobs were lost and some people lost their positions. Similarly, the systems were on different electronic records systems and to combine them meant merging them into one. “It’s just darn hard bringing two complex organizations together and two cultures together,” Sr. Gray says.
Living, expanding the mission In the end, the union has succeeded. The leadership team came together. Dr. Rod Hochman, who was president and CEO of Providence Health & Services, stepped into the same roles in the combined system. He stayed in those roles through 2024 and continues to hold the system title of CEO emeritus. His successor, Erik Wexler, has been with Providence since it was formed. Providence combined its medical records in 2018 in what was the single largest single implementation of the Epic system. As Providence marks a decade of success, Santore acknowledges that, like healthcare systems across the country, it is facing strong headwinds. Some are coming from the Medicaid funding cuts and changes that are phasing in. Providence projects a loss of $1 billion in Medicaid funding over time. The system is looking at how to sustain itself and maintain services. Santore says the revenue loss might mean the system has to adjust, as it did with its planned sale of Queen of the Valley Medical Center in Napa, California, to another nonprofit system. She says Providence discerned that the hospital would be better able to serve the community under the other system. “Our founding congregations and sisters, they had to have that same discernment and evaluation through their times in stewarding the ministry,” Santore says. “It’s taken a great deal of humility and courage to recognize that in some very rare cases our ministries might thrive in the hands of others.” Looking ahead, Sr. Gray hopes that in its next 10 years Providence continues to provide care that promotes human flourishing. “I want us to be able to say that we have lived the mission,” she says. Santore says her hope is that “we have extended our mission to more people and made a continued impact, and that the health status of the communities that we serve is better because Providence St. Joseph Health was there.” leisenhauer@chausa.org
Nike co-founder gifts $1.1 billion to Providence St. Vincent in Portland, Oregon A historic $1.1 billion gift from Nike co-founder Phil Knight and his wife will help Providence St. Vincent Medical Center in Portland build Oregon’s first women’s hospital and expand other services. The gift, announced Sept. 15, is one of the largest to a healthcare institution in American history, the hospital’s parent, Providence St. Joseph Health said in a press release. In March, the hospital announced that Phil and Penny Knight were making a
second $75 million donation to advance cardiac care at the hospital and at the Providence Heart Institute, which share a campus. That donation brought the Knights’ gifts to the heart institute to almost $200 million over the last 10 years. The most recent gift will help fund Oregon’s first women’s hospital, additional cardiovascular care, clinical research and innovation initiatives, workforce and physician development, and patient support services
that improve access and continuity of care. “Penny and I have always believed that real breakthroughs come from people willing to take on the toughest challenges,” Phil Knight said in the release. “Providence has shown that kind of ambition in cardiovascular care, and we see the same opportunity to do something truly distinctive for women’s health. We’re proud to invest in teams that will change what’s possible for communities across Oregon and beyond.”
Erik Wexler, president and CEO of Providence, said in the release that the gift marked a “significant and transformational milestone” and enables Providence to enhance access and support for patients as well as create new possibilities in women’s health and cardiovascular care. “I join everyone at Providence in extreme gratitude to Phil and Penny Knight for demonstrating their confidence in our caregivers, our leaders and our mission,” Wexler said.
4 CATHOLIC HEALTH WORLD October 2026
SPECIAL CARE FOR MOTHERS AND BABIES
After in-utero treatment, baby born at CHRISTUS shows no signs of cystic fibrosis
skin for an hour, stayed that night and went home the next day,” Nolte said. Months later, Nolte, a first-time mother, continues to take Trikafta as she nurses Warren. If needed, he eventually will be prescribed the medication on his own.
By DALE SINGER
In the spring, Kendall Nolte and her unborn son were the main characters in an unusual medical cliff-hanger. Tests showed Nolte and her husband were carriers of a gene linked to cystic fibrosis, though they don’t have the disease themselves nor does anyone in their families. A test of their son, still in the womb, showed signs of the disease — the portent of a difficult future where thick, sticky mucus is prone to build up and damage the digestive system, lungs and other organs. A possible treatment existed that could turn the negative prognosis around, but the needed insurance approval and the treatment’s success were uncertain. Fortunately for the Noltes, their medical team at CHRISTUS Children’s in San Antonio delivered, in several ways. The team helped the family win insurance coverage for the in-utero treatment, a medication taken orally by Nolte, and on May 13 the team delivered Warren Joseph — 7 pounds, 5 ounces. The infant is thriving with no signs of cystic fibrosis. Dr. Louise Giles, chief of the CHRISTUS Children’s Pediatric Pulmonary Division, said Nolte is not only one of the first women to undergo the in-utero treatment at the hospital, but also one of the few women worldwide without cystic fibrosis to Giles undergo it. She put the number at “maybe not even two dozen,” enough to give the medical team hope if not confidence in the baby’s outcome. “We had held off the worst of the disease for Warren, and I would have been cautiously optimistic that he would be doing
Kendall Nolte credits her medical team at CHRISTUS Children's in San Antonio for saving her newborn, Warren, from the complications of cystic fibrosis.
fabulous in terms of growth and everything like that,” Giles said. “I think what I was not anticipating was how well he’s actually been doing.”
Far from routine Until the Noltes of New Braunfels, Texas, were both tested at 18 weeks and the signs of cystic fibrosis were spotted, Kendall’s pregnancy had proceeded normally. After the diagnosis, a cystic fibrosis specialist discussed immediate treatment with Nolte. “And that sounded really appealing to me, that there could be possibility for treatment,” she said. “But then I also had other doctors telling me there’s nothing you can do if he has it, so why don’t you just wait until birth, to get the newborn screen, and then we’ll go from there.” The CHRISTUS Children’s team told Nolte about the three-drug therapy called Trikafta with the caution that not much was known about giving the drug directly to the unborn child through the placenta. “But the little research that there was was beneficial,” Nolte said. The Food and Drug Administration first approved Trikafta in 2019 for cystic fibrosis patients 12 and older. The agency has since approved it for patients 2 and older. Its use beyond that remains experimental. The medication has been proven to be highly effective but not without risks, such as
liver damage, cataracts and mental health complications. Nolte was nervous about whether to pursue the treatment. “I thought about it for two weeks during the night. I couldn’t sleep. I was restless about what my choices would be. And me and my husband decided that the risk of not taking it was too high,” she recalled. “So we ended up doing the treatment because it was better than to have complications at birth that would risk Warren’s life.” That big decision wasn’t the only hurdle Kendall faced. Four times, her health insurance rejected her efforts to get coverage for the medicine before finally relenting and ending what Giles called “a real struggle.” The doctor said without the coverage, the medication could cost the family $325,000 or more every year. As Nolte put it, to get the coverage, her medical team “fought like crazy.” The CHRISTUS Children’s team began Nolte’s daily Trikafta treatment at 30 weeks into her pregnancy. When it was time for the birth, Nolte recalled in late summer, more than a dozen neonatal intensive care unit staffers were in the delivery room “just ready to jump on at any moment and do lifesaving measures.” The emergency preparations proved to be unnecessary. “After Warren was born, we did skin to
NICU trends From page 1
say a complex set of factors explains the phenomenon. Dr. Maria Pierce, who is affiliated with CHRISTUS Health NICUs, cites a growing population of extremely premature infants and babies with complex medical conditions. She says many babies who would not have survived a decade ago do now, but that survival often comes with extended NICU stays. Dr. Maria Barber, an Avera Health neonatologist, says care disparities as well Barber as socioeconomic disparities can explain some of the increased need for NICU care. CommonSpirit Health neonatal care experts Mindy Foster and Dr. Mark Bergeron say the trends hospitals are seeing among moms and babies mirrors what is happening in the general population.
Opposite trendlines According to the Centers for Disease Control and Prevention, the number of annual births in the United States declined by 10% from 2010 through 2023, the latest numbers available. The National Center for Health Statistics says that the percentage of infants admitted to a NICU rose from 8.7%
Joan Bloome, speech language pathologist at HSHS St. John’s Children’s Hospital in Springfield, Illinois, holds a baby in the hospital’s neonatal intensive care unit.
in 2016 to 9.8% in 2023. The NICU rates rose for all maternal age groups, for all racial groups and for most states. At CHRISTUS, Pierce says attended deliveries are up, average length of stay has increased, patient days have grown, and average daily census is higher across NICU units. “Taken together, these trends suggest we are caring for smaller, sicker babies who require more intensive and longer-lasting interventions rather than simply caring for
more babies overall,” she says. Pierce is system director of neonatology for CHRISTUS Health in San Antonio and New Braunfels, Texas, and clinical assistant professor for Baylor College of Medicine.
Threshold of viability Bergeron, CommonSpirit physician system vice president of the women and infants service line, says a key reason for the increased NICU admissions is that the threshold of viability, or the gestational
Good news in general To Giles, Warren’s success story is welcome news for other families facing a similar situation. “I remember as a medical student, identifying cystic fibrosis in a baby,” Giles said. “There was no newborn screen at this time, and the conversation that the respirologist or the pulmonologist had with the family was just devastating in a lot of ways.” Doctors in the past would assure families they would do all they could for children born with the disease, Giles said, but still had to caution that their child might not survive to adulthood. With Warren, Giles added, “We’re learning from him as we go along. To be able to sit there and think Warren can have a totally normal life is just indescribable.” Erika Lopez, a nurse who is cystic fibrosis clinic coordinator at CHRISTUS Children’s, said getting Nolte to the treatment was challenging. “There were a lot of roadblocks with insurance and what have you, and it was imperative that we get Kendall on this medication at a certain point in her pregnancy,” Lopez said. “So jumping over all of those hurdles and getting her on it at the correct time was surreal. This is pretty phenomenal.” Nolte intends to help other families who face a decision like hers on whether to undergo in-utero cystic fibrosis treatment. She wants them to understand the stakes and the possible outcomes. “I really want to be a part of the community to support other moms and potential babies that could have it,” she said. “I would like to be a support and share my experience and my story to potentially persuade someone to do this treatment, because it really does save lives.” Lopez said of Nolte: “She’s really the hero of this story. She took the leap of faith with us. Knowing all the side effects, knowing this or that could happen, knowing that there are so many unknowns, she still took that chance to do what she could for her baby. Thankfully he’s doing amazing, she’s doing amazing, and she’s the hero for real — 100%!”
age at which a preterm baby can survive once delivered, has lowered over time. As a result of improvements in medical capabilities, knowledge and technology, highlevel NICUs now can provide intensive care for babies as young as 22 weeks’ gestation with meaningful outcomes, whereas not long ago, babies younger than 25 weeks had extremely poor outcomes. Donovan adds that improved medical technology and capabilities have increased clinicians’ ability to identify at-risk pregnancies and diagnose babies’ conditions in utero earlier. This has meant that more babies have a better chance of survival, but that Donovan they likely also will need interventions that place them in the NICU. Pierce says “in general, advances in neonatal medicine now allow us to support infants who previously would not have survived, but this comes with increased care demands, longer stays and higher specialized clinical expertise.” She expects modern medicine to continue to push the threshold of viability to earlier and earlier ages. A December 2025 JAMA Network Open article seems to lend support to this concept. The researchers studied the outcomes of 22 infants born alive at 21 weeks’ gestational age. Six of those babies survived to Continued on page 5
October 2026 CATHOLIC HEALTH WORLD 5
SPECIAL CARE FOR MOTHERS AND BABIES
Facilities increase NICUs’ physical space, staffing and services By JULIE MINDA
capabilities.
More newborns in the U.S. are requiring neonatal intensive care, and industry experts expect demand to continue to rise. Neonatal and maternal care experts from four Catholic healthcare systems say their neonatal intensive care units reflect this trend. They say those units are responding with multipronged approaches. This includes expanding the physical space of the units, increasing staffing, improving technological capabilities, and offering programming and services to help NICU families. CHRISTUS Health-affiliated neonatal expert Dr. Maria Pierce says NICU care today looks very different than it did even a decade ago. “The complexity, intensity, and level of commitment required from clinicians and families has grown dramatically,” she says. She adds, “Meeting this Pierce moment requires foresight, investment and a deep mission-driven approach.”
The family as team member CommonSpirit has 158 hospitals in 24 states, and 52 of those hospitals have NICUs of varying levels of care capabilities. Foster says there are more than 84,000 births a year across the CommonSpirit ministry. Bergeron and Foster say that many CommonSpirit NICUs have been building up their capabilities as hubs by bringing in clinicians with specialty expertise and advanced training, by expanding the facilities’ telemedicine capabilities, and through the advancement of standards of care. Bergeron and Foster say an area of particular focus is personalizing care and making it more family centered. CommonSpirit sites are maximizing NICU families’ role as part of the care team, so they’ll be well prepared when it is time for their baby’s discharge. And, with the prolonged lengths of stay in NICUs nationwide, the CommonSpirit facilities are paying close attention to those families’ well-being. This includes ensuring optimal comfort in the spaces where families gather and where they sleep while staying with a baby who is in the NICU.
No magic fix The Centers for Disease Control and Prevention’s National Center for Health Statistics says the percentage of babies admitted to NICUs has been increasing steadily nationwide. Experts from Avera Health, CHRISTUS Health, CommonSpirit Health and Hospital Sisters Health System say likely reasons for this increase include that advanced medical technology and capability are enabling babies of younger and younger gestational ages to survive, that poor maternal health is leading to more at-risk neonates, and that socioeconomic factors are worsening the well-being of moms and their babies. Ministry NICUs are among those seeking to determine how best to respond compassionately and effectively to the needs. Mindy Foster, CommonSpirit Health system vice president of the women and infants service line, says to keep up with the changes in neonatal care and the increasing demand, “We’re Foster asking, how can we ensure that women get the care they need before, during and after pregnancy?” She says they find that to meet the demand, “the care model across the U.S. is going to have to evolve. There is no magic fix.” Dr. Maria Barber, an Avera Health neonatologist, says to keep up with the demands, NICUs need more clinicians with increasingly high levels of skill, education and experience and with certifications in specialized care. Pierce says as medical knowledge has grown and the standards of care have changed, CHRISTUS Health NICUs are
NICU trends from page 4
hospital discharge. The study authors said their learnings suggest that “some infants born at 21 weeks’ gestational age can survive, some with minimal morbidities.”
Poor maternal health Barber says a reason that more babies are born needing NICU care is that expectant moms aren’t as healthy as in the past, and this puts their babies at risk. Just as Americans generally experience high rates of hypertension, diabetes, obesity and other chronic illnesses, so too do moms. These conditions present a public health problem, Bergeron says. Some chronic illnesses of pregnant women can have a long-term impact on their children’s health
Nurse Kelsey McCarty, left, delivers a patient update during rounding with the care team in the neonatal intensive care unit of Avera McKennan Hospital & University Health Center in Sioux Falls, South Dakota.
continually evolving their care protocols and assembling teams that can carry out those directives. Pierce is system director of neonatology at CHRISTUS Health in San Antonio and New Braunfels, Texas, and a clinical assistant professor at Baylor College of Medicine. Kathy Donovan, HSHS senior vice president and chief operations officer, notes that preserving top-quality care in NICUs throughout the ministry is particularly important since the closure of rural facilities makes central NICU hubs ever more essential. Her colleague Dr. Beau Batton, neonatology chief at HSHS St. John’s Children’s Hospital in Springfield, Illinois, notes that the dynamics of rural medicine today also are impacting NICU admission rates. He explains that at St. John’s, about 40% of NICU admissions are from rural counties. With recent obstetrical ward closures in Illinois, about two-thirds of the state is more than 30 minutes from a delivering hospital. “Many communities also have limited access to high-quality prenatal care,” Batton said. “These factors — combined with a rising incidence of pregnancy-related conditions such as hypertensive diseases and gestational diabetes — means that pregnant women residing in rural communities often present to an obstetrical hospital in an advance state of disease in which there are few options other than to deliver the baby preterm.” Dr. Mark Bergeron, CommonSpirit Health physician system vice president of the women and infants service line, says that it remains key in these efforts to ensure the best interests of the NICU families are at the heart of all Bergeron decisions. Each system has its own way of doing so.
Feed and grow near home Aside from St. John’s, HSHS St. Vincent Children’s Hospital in Green Bay, Wisconsin, has the only other NICU within the
outcomes. Donovan adds that women have babies at older ages now, and this also can increase the health risks for both them and their babies.
Social drivers Foster, CommonSpirit system vice president for the women and infants service line, says social drivers of health, including difficulty in accessing pre-conception care, can lead to additional challenges during pregnancy. Some women delay or forego prenatal care because of these barriers, increasing the chance of poor outcomes, she says. Bergeron notes that increasing numbers of babies are born to women who have been affected by substance use during their
13-hospital system. Both hospitals’ units are Level III. (There are four levels of NICU care, with Level IV being the most advanced.) The HSHS NICUs have responded to growing demand for their services with expansions. St. John’s completed an $11 million expansion in 2021 that doubled its capacity; and St. Vincent is in the midst of a $17.2 million renovation that will be complete in about a year. The expansions allow for more private rooms and more amenities for families. Donovan notes that in addition to the physical space expansions, these NICUs have bolstered their capabilities to serve as hubs for rural healthcare facilities in their regions. A goal is that once babies from rural areas are stabilized in the HSHS units, they can transfer back to their home communities to “feed and grow,” Donovan says. The HSHS team provides support to those rural communities’ clinicians to help with the process.
Telemedicine backbone Avera Health, which has 38 hospitals in South Dakota, Minnesota, Iowa and Nebraska, also operates as a hub with rural facilities as spokes. The Level III NICU at Avera Children’s Hospital in Sioux Falls, South Dakota, provides extensive telemedicine services to rural communities in its region. A construction project slated to end next year will expand the NICU from 42 to 60 beds and add shelled space for future growth, while also expanding women’s and children’s services. Barber says in undertaking this expansion and other improvements since her 2019 arrival, the NICU team has worked to give families privacy and space. She says Avera’s NICU has been bringing on increasingly specialized clinicians, improving the electronic medical record, adding advanced technology such as bedside ultrasounds, and making other changes to improve that NICU’s
pregnancy, and this can lead to neonatal complications that can require NICU care. Barber says the increased use of marijuana among moms could contribute to neonatal health issues. Donovan adds that women who are low income, who lack access to nutritious foods, who have poor housing quality, who have transportation barriers or who have other significant socioeconomic challenges are at risk for negative maternal health outcomes. Likewise for those who lack insurance. “These social determinants of health absolutely affect the well-being of these patients and their families,” Donovan says. Pierce agrees, noting, “Social determinants can significantly influence length of stay, caregiver engagement and post-discharge outcomes.”
Demand multiplier CHRISTUS Health operates about five dozen hospitals across four southern states and in South and Central America. Pierce works in CHRISTUS’ south Texas region, which has three NICUs. CHRISTUS Children’s in San Antonio is a Level IV NICU, CHRISTUS Santa Rosa Hospital — Westover Hills opened in 2012 and is transitioning its NICU from Level II to Level III status; and CHRISTUS Santa Rosa Hospital — New Braunfels opened in 2012 and has a Level II NICU. Pierce says the addition of the two suburban facilities and their NICUs 14 years ago was in response to rapid population growth in the San Antonio metropolitan area, and that continued population growth has multiplied demand for NICU care. The facilities have been working to boost their capabilities in response and now offer therapies that in the past would have required babies to be transferred to a higher-level NICU. The three south Texas NICUs have concentrated on early engagement of expectant moms, coordinated perinatal care planning, and aligned maternal care with social support and early intervention to improve outcomes. Pierce acknowledges that being a NICU family can be tough, but says, “our emphasis on specialized integrated care and dedicated clinical teams stands out. By intentionally designing care around the most vulnerable infants, we deliver highly individualized treatment while supporting families through one of the most difficult experiences they will ever face.” jminda@chausa.org
Protecting humanity While a constellation of factors drives the increased NICU admission rates, the ministry experts say their response for all the patients is to provide mission-based care. Avera’s Barber says, “While the challenges in the NICU can be traumatic, we’re helping families to have hope.” HSHS’s Donovan says the system’s NICUs “reflect our mission. We’re caring for the most vulnerable, and this is one of our most important service areas.” Pierce of CHRISTUS says: “Caring for extremely premature infants, often at the margins of viability, reflects a deep commitment to the sanctity of life and to accompanying families during some of the most vulnerable moments.” jminda@chausa.org
6 CATHOLIC HEALTH WORLD October 2026
SPECIAL CARE FOR MOTHERS AND BABIES
Maternal mental health From page 1
undiagnosed. Suicide and overdose are leading causes of death in the first postpartum year, and 100% of those are preventable.” Through a two-year pilot project, supported by the nonprofit Policy Center for Maternal Mental Health, CommonSpirit Health is taking maternal mental health care a step further. The program pairs community health workers with pregnant and postpartum mothers to help connect them with resources and additional care to address mental well-being.
MATERNAL MENTAL HEALTH Maternal mental health disorders, such as postpartum depression, are the leading complication of childbirth, impacting 20% of women in the United States. Over the last decade, the mental health of mothers in the country has worsened.
WHY IT MATTERS Untreated maternal mental health disorders are associated with increased risk for preeclampsia, preterm birth and babies with low birth weight. Untreated disorders can lead to negative early childhood development outcomes. Untreated disorders are estimated to have an annual economic cost of $14.2 billion.
“I always ask if there are any spiritual beliefs they have, and we support that,” she said. Meda, who is fluent in Spanish, speaks to the women in the clinic or by phone and can take as much time as needed to help them. She has helped women with histories of behavioral health and substance abuse issues to manage their medication, and access better care for their mental health. When needed, Meda will refer her patients to high-risk maternity programs and connect them with a social worker. “It’s rewarding to see patients’ lives completely changed,” she said. “My favorite part of my job is when time passes and I get to see happy and healthy moms and their babies.”
Source: Policy Center for Maternal Mental Health
Piloting a new approach CommonSpirit Health’s women and infants service line has championed anxiety and depression screening systemwide, with this pilot program serving as the next evolution in its commitment to improving mental health outcomes for patients. The program integrates reimbursable community health worker services, which may provide financial sustainability to future programs. In 2022, California made community health worker services a Medi-Cal benefit, and CommonSpirit Health is using the workers to help pregnant and postpartum patients navigate the complexity of mental health referrals. The pilot launched in October. Results collected through June are promising: Of the nearly 1,500 maternal mental health screenings conducted, 28% identified patients as at risk, and 3% as at risk for self-harm, which enabled early crisis intervention. The program increased screening frequency from once during pregnancy and once postpartum to at least three screenings during pregnancy and up to two times postpartum. Of those screened, clinicians referred 374 mothers to community health workers for follow-up support, such as education, community resources and behavioral health referrals. All referred patients received interventions. Treatment plan rates were 32%, more than double the national average for comparable programs. CommonSpirit Health, one of the largest Catholic healthcare systems in the country, has 71 birth centers in 16 states, with 24 of those centers in California. More than 84,000 babies are born annually in CommonSpirit Health facilities, one in every 42 babies born in the United States. Bulock serves on the system’s women and infants service line executive council, which has a representative from each CommonSpirit Health region. Six birth centers are in the Sacramento area, including a rural location in Woodland and an urban location in Midtown Sacramento. The pilot program is underway in this market, with a community health worker based at each location. Alison Kemps, who manages the market’s continuKemps ing care department, said the system picked the Sacramento area because of the population diversity. “We can really do some cross studies regarding the two different populations,” she explained. Expanded screenings Before the pilot, patients were screened for depression and anxiety. Now the women also are screened for bipolar disorder, intrusive thoughts, suicide risk and safety planning. Community health workers also address the social determinants of health, which can complicate pregnancy or access to prenatal and postnatal care. The expanded screenings help identify patients with more serious issues like postpartum psychosis and bipolar disor-
ders, so they can be prescribed medication and connected to mental health resources. Often, the women stop taking medication when they are pregnant or they have not seen a doctor before pregnancy. “That’s been a really nice, good catch that we’ve been able to identify some of those patients and prescribe appropriately,” Kemps said. The clinicians and community health workers use the Edinburgh Postnatal Depression Scale, a set of 10 questions that can show if someone is at risk for depression and anxiety. The screenings are done in the hospital, during checkups and by text. The pilot is showing that more women than caregivers realized need help. “So these are moms that sometimes are just sitting at home and we didn’t even know,” Bulock said, adding that now a team of caregivers is poised to respond quickly.
Help with connections Lidia Meda is a community health worker in Woodland, a large agricultural community. Some residents are low income and do not speak English, and health literacy is a concern. “They are dealing with a lot of social determinants of health, and not only mom, but within the family,” she said. “Sometimes they also need education on Meda medication or behavioral health connections. Some of them don’t know how to make appointments or to contact transportation to even get to the OB appointments.” She helped connect one mother to a church community because the mother said she wanted to volunteer to help others and she did not have family around for help herself.
Providing human kindness Kemps said the service line hopes to expand the pilot program systemwide and is standardizing the program so it can be replicated and services can be reimbursed by health plans. The core brand and philosophy tagline for CommonSpirit Health is “Hello Humankindness.” “We’re providing that patient-centered, holistic care and meeting all of their concerns,” Kemps said. “If anything, human kindness really speaks to this project. We’re very proud of the work that we do.” Bulock added that the program helps empower her and other OB-GYNs to provide holistic patient care. Instead of sending a struggling mother out the door with a list of resources, Bulock can refer her to a community health worker like Meda, who can meet with her to make sure she has everything she needs. “That’s huge for us,” Bulock said. vhahn@chausa.org
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October 2026 CATHOLIC HEALTH WORLD 7
SPECIAL CARE FOR MOTHERS AND BABIES
Twins From page 1
Surgeons at SSM Health Cardinal Glennon Children’s Hospital in St. Louis successfully separated them at 2:31 a.m. Feb. 25 in a 25-hour surgery. More than 60 caregivers — surgeons, pediatric hospitalists, intensivists, nurses, imaging specialists, therapists, anesthesiologists, and more — were involved in the operation. “This achievement reflects SSM Health Cardinal Glennon Hospital’s commitment to providing highly specialized pediatric care for those facing the most complex medical conditions,” Dr. Hossain Marandi, president of the hospital, said at a press conference Sept. 16. “It is also a testament to the expertise, compassion and dedication of countless caregivers who came together with one goal in mind, creating the best possible future for these two beautiful girls.” He credited the partnership of World Pediatrics, Lola Children’s Home in Ethiopia, Ronald McDonald House Charities, Ranken Jordan and other organizations and individuals for their part in helping the girls.
An ‘exceedingly rare’ operation Craniopagus twins are found once in every 2.5 million live births and represent just 2-6% of all conjoined twins. Separation is risky and complex. “Even though this has been done before, it’s exceedingly rare,” said Dr. Kevin Chen, plastic surgeon and director of the 3D lab at Cardinal Glennon, which was used extensively to plan the numerous surgeries needed to separate the girls and rebuild their skulls. Only 32 craniopagus separations have been performed in the last 30 years, and only 62 in the last century, Chen said. In most surgeries in the first 50 years, one or both of the twins died. “So we’ve been advancing the way that the surgery has been done significantly over the last couple decades,” he said, “and even with that, with a couple trailblazers before us, a lot of the things were unknown, and a lot of things were being discovered and fig-
Hiyab and Wuhbto, twins from Ethiopia who were joined at the head, underwent a delicate separation surgery at SSM Health Cardinal Glennon Children’s Hospital in St. Louis in February. The 2-year-olds are now working on building strength to sit up with the hope of standing and walking.
ured out for how it was going to work for us.” The hospital separated craniopagus twins in 1984. Devon and Jevon Wilson, of Washington Park, Illinois, were separated in a 10-hour operation. A leader of that effort, neurologist Dr. Richard Bucholz, advised the present-day team. The medical team is working on several articles about the separation that they hope to publish in journals so that others may learn.
A phone call and an X-ray Dr. Andrew White, chief medical officer of the hospital, first got a phone call about the twins about two years ago, when the girls were several months old. He had worked in Ethiopia before and he coordinated with the nonprofit World Pediatrics to fly the twins to St. Louis in March 2025, when they were almost a year old. World Pediatrics has connected more than 29,000 children to advanced pediatric care that they would otherwise not have had access to. Ethiopian Airlines removed six rows of seats from a plane to safely accommodate the girls and those traveling with them. The Cardinal Glennon doctors had only an X-ray of the twins’ skulls to study before seeing the girls in person.
The conjoined twins came to St. Louis in March 2025 when they were about a year old.
“At its heart, this is a story of local and global collaboration coming together on behalf of two children,” White said. All the organizations and others pitched in to pay for the effort. Because of social and visa issues, the twins’ parents could not join them. The Lola Children’s Home in Ethiopia has been working with the family to care for the girls and sent representatives to stay with them. Planning the medical care for the girls took months, requiring extensive imaging, simulations and multidisciplinary reviews, said Dr. Joanna Kemp, a neurosurgeon at Cardinal Glennon. “This case demonstrates what can happen when experts from multiple disciplines come together around a shared goal,” she said. Besides the actual separation, the girls’ care involved at least six other operations. Four surgeries involved separating blood vessels, Kemp said. The twins’ brains were largely unconnected, save for a couple small fused areas. Surgeons placed balloon expanders under their skin to allow it to stretch and provide enough coverage for their skulls once they were separated. The twins were conjoined at the widest part of their skull and facing opposite directions, Chen said as he held up one of several plastic 3D models used to help plan the surgeries. “So they’re missing the most bone, the most skin possible, and we scraped and scrounged just to maximally get as much skin as we could, so that the separation can be successful,” he said. The surgical team tried to be consistent with their models: using the color blue for Hiyab and red for Wuhbto. A tiny screw doctors inserted on the side of Hiyab’s skull helped doctors distinguish the girls on imaging and X-rays. Since the successful separation, Wuhbto has undergone cranial reconstruction surgery, and Hiyab faces a similar cranial reconstruction later this fall. “While there’s still more work ahead, each step is focused on supporting their continued growth, development and qual-
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ity of life,” Chen said.
Distinct personalities The girls spend much of their time at Ranken Jordan, working on individual therapies and skills such as sitting upright, eating, speaking, socializing and playing with other children, said Holekamp. They visit Cardinal Glennon for healthcare needs. “They’ve gone from being conjoined at the head in such a way that they were always fully reclined and couldn’t even see each other, much less interact functionally with each other,” he said. “Now they are beginning to be able to sit and move on with their lives independently.” Kate Corbett, a senior program director with World Pediatrics, is one of the girls’ main caregivers. She said that while the girls love a lot of the same things — playing, singing, being outside — they are also very different. Wuhbto, affectionately known as Woobs by her caregivers, “is outgoing, feisty and rambunctious in the best way,” Corbett said. She is “always moving,” and seems “about to hop out of her wheelchair” when she hears her favorite song, “Dance, Dance, Dance.” Hiyab is a “sweet, social young lady who welcomes you in immediately,” Corbett said. “She is so smart, and understands all of our silly, funny jokes, and just smiles. And our best days are when she gets the giggles and just can’t stop laughing. “So they’re just both so smart and so joyful.” Corbett said she was honored to be in the room the day the twins first saw one another, a few weeks after the surgery. Caregivers finally were able to put the sisters in bed together. “Never before had they been able to snuggle up to each other and reach for each other, and be together in that special, sisterly way,” she said. Looking to the future When the girls return to their family in Ethiopia — in the not-too-distant future, doctors hope, and perhaps in their own airplane seats — they will join their parents and two brothers, who stay in close touch with caregivers. Caregivers frequently hold up their phones to the girls to play videos made by the family or connect them over FaceTime. They will also reunite with the family they have made at Lola Children’s Home, which has also provided and coordinated care for the girls. Abebe Fantahum, founder of the home and guardian of the twins, smiled broadly as he spoke for a video that was played at the press conference. “When I think about Hiyab and Wuhbto’s future, I see two joyful girls continue to grow, learn and discover who they are as individuals,” he said. “My hope is that they will return home knowing how deeply they are loved, both in Ethiopia and St. Louis. Dear, beloved community in St. Louis, these girls are here because you chose to care.” vhahn@chausa.org
8 CATHOLIC HEALTH WORLD October 2026
Difficult conversations From page 1
their career better because they have more support, even better.” Rev. Hershberger and members of his team, including spiritual care specialist in clinical education Cristy Sutton, have developed an in-person training program called Compassionate Conversations to teach physician residents how to deliver a devastating diagnosis and how to integrate spiritual care into a family’s worst moment. The program started in November 2025 after a trauma Sutton surgeon requested that the spiritual care team talk to trauma residents about how to have difficult conversations with families and how to care for themselves before, during and after those conversations, Sutton said. The program is spreading to other parts of Ascension Florida and has the potential to be replicated and used in other parts of the Ascension market. It started as an hourlong session every quarter with trauma and general surgery residents and is now a yearly conversation with OB-GYN, emergency medicine, internal medicine, and pediatric resident groups. The program runs for two hours, with Sutton and Rev. Hershberger as instructors, and has expanded over time with discussions about case studies and issues physicians struggle with. As of mid-September, they have held seven seminars with a total of 68 residents.
Building on a framework Compassionate Conversations grew out of another effort called Breaking Bad News, which was an interdisciplinary approach that focused on the SPIKES protocol, a sixstep framework used by healthcare workers to deliver difficult or bad news to patients and their families. SPIKES stands for Setting up the interview, assessing the patient’s Perception, obtaining the patient’s Invitation, giving Knowledge and information, addressing Emotions with empathy, and Strategy and Summary. Compassionate Conversations builds on that framework, focusing on integrating the spiritual part of difficult encounters. Participants discuss how to use mindfulness prior to entering the room, while in the room, and after leaving. Rev. Hershberger said a colleague mentioned that dealing with an encounter and talking about it can be awkward. “That’s a really honest way to approach it,” he said. “That’s what we’re trying to do, is give people a safe place to say out loud some of the things that are challenging about it and just reflect for a moment on why it is challenging. And if we do it several times in a day, how do we maintain our own health?” Careful language One component of the training involves the language best used in difficult conversations. For example, Sutton said, the training encourages doctors to use the word “died” rather than “passed” or “expired” because families may not understand what those words mean. It helps the families understand that their loved one has died, she said. “But it’s not just death situations that we talk about,” Sutton said. “It’s also those situations where a patient comes in as a trauma and they have a non-survivable brain injury, a patient comes into the hospital and is diagnosed with a terminal condition, or a patient comes in and is diagnosed with a chronic illness. It’s about helping them to understand the gravity of the situation. What does non-survivable, terminal, or chronic mean?” The training includes a resource that offers alternative ways of saying certain things when speaking to patients and families. For example, instead of saying, “Unfortunately, this is just a part of life,” a clinician could say, “I know this is difficult news to hear. I wish we weren’t meeting this way.”
Rev. Greg Hershberger, left, the manager of spiritual care for four Ascension Florida hospitals, helps lead a discussion with pediatric residents at Ascension Sacred Heart Pensacola on how to have difficult conversations with patients and families and how to care for themselves before and afterward.
COMPASSIONATE CONVERSATIONS As part of its guidance for doctors on how break difficult news, the Ascension program includes some examples. The second sentences here are suggested language. “I’m sorry, we did everything we could.” "I want you to know that your loved one is important to us and we made every effort to save her life.” “Despite our best efforts we weren’t able to save her.” “We made every effort to save her life but I’m sorry to tell you that she died.” “We have done all of the testing and your loved one is consistent with brain death.” “Your loved one shows no signs of brain activity, and that means he has died.” “I’m sorry for your loss.” “I join you in your sorrow.” “Unfortunately, this is just part of life.” “I know this is difficult news to hear. I wish we weren’t meeting this way.” Source: Ascension
Using phrases like, “at least they didn’t suffer” or “at least they lived a long life,” minimizes the family’s grief and can make it seem invalid, the handout says.
Chaplain accompaniment The spiritual care team encourages doctors to ask for a chaplain to accompany them for difficult conversations. Before the doctor arrives to share news, a chaplain often can spend time with the family to get an idea of what the family understands at that point, and a chaplain can brief the doctor. “So, if a family thinks the person’s getting better and you (as a physician) know they’ve died, that’s a huge gulf to jump,” Rev. Hershberger said. Having a chaplain in the room can help the doctor pick up a family’s reaction as the doctor speaks, and the chaplain can provide extra support. Also, the chaplain often can spend more time with a family afterward when the doctor cannot. “It’s challenging to be the person who gives the news, and then also the comforter, and then the explainer,” Rev. Hershberger said. “I always tell physicians it’s not that we’re doing it wrong. It’s just that one person was never able to do all those things at the same time.” Now that this program is in place, the chaplains see more moments of connection with doctors after they meet with families and patients, even if it’s just a 30-second interaction in a hallway. Doctors and residents are asking the spiritual care team to come back for quarterly debriefings, so they can talk through those encounters further. What grounds this work, Ascension spiritual care leaders say, is helping physicians know they are not alone in dealing with the most difficult conversations they have to deliver. Also, the work goes beyond
supporting patients and their families to include the well-being of Ascension physicians and clinical teams. “We’re just acknowledging the physician and saying, ‘That was tough. You know, I’m with you,’” Rev. Hershberger said. “They often remark that’s a very meaningful exchange because it’s private. It’s not formal. But we’re just acknowledging the moment.”
Expanding the program The Compassionate Conversations program launched in Pensacola, expanded to other Ascension sites on Florida’s panhandle, and more sites have requested it. It now extends past the health system: the Eglin Air Force Base chaplain corps in the western Florida panhandle is training alongside the Pensacola team for trauma response. Sutton and Rev. Hershberger developed a presentation that they hope to deliver next year for the Association of Professional Chaplains. They hope to support physicians everywhere during difficult moments. “It’s the part that nobody wants to do,” Rev. Hershberger said. “So we try to be sympathetic to that. And I think I could go to any hospital in America, and they would all say that.” Sutton and Rev. Hershberger used a boat analogy to explain the concept behind the training. Medical professionals and people in spiritual care can join patients and their families in their boat if invited, or they can push the patients and their families away. “The boat experience isn’t always fun,” Sutton said. The boat can have holes, take on water, and be buffeted by strong winds, but people don’t want to take that ride alone, she said. Rev. Hershberger said climbing into a boat has to be done carefully. “Jumping in, you’re going to tip the whole thing over. So somebody stabilizes it while the other person gets in, but everybody has to work together, right? That’s kind of how I see it,” he said. “We’re always aware of our own needs, but also making space for someone else.” vhahn@chausa.org
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October 2026 CATHOLIC HEALTH WORLD 9
Through new ‘fairs,’ Trinity Health Senior Communities increases mission engagement By JULIE MINDA
ESSENTIALS FOR LEADING MISSION EIGHT MONTHLY SESSIONS FROM NOVEMBER 2026 TO JUNE 2027 11:30 A.M. TO 1 P.M. ET Designed for new, emerging and discerning mission leaders, this multi-month cohort experience combines learning, reflection, mentorship and peer engagement to help participants grow in mission leadership and build meaningful connections across Catholic healthcare. Space is limited. Register today at chausa.org/events and strengthen the competencies needed to lead mission effectively.
Photos by Chris Stranad
Partway through the lively mission fair at Fraser Villa in southeast Michigan, administrator Claire Collier paused, looked around and absorbed the scene. She says, “What I saw was laughter, meaningful conversations; I saw colleagues bouncing ideas off Collier of one another … I saw leaders really taking the feedback from the colleagues on different topics.” Collier, who is administrator of the Trinity Health Senior Communities senior community in Fraser, says the mission fair on Aug. 13 “was such a wonderful sight to see. And as a leader, what more could we want?” Fraser Villa is among many senior healthcare and senior living campuses within Trinity Health Senior Communities hosting fairs this year to familiarize staff with the organization’s mission and values. Michael Prince, Prince Trinity Health Senior Communities mission leader, came up with the mission fair idea. He says the events are “a unique opportunity for us all to come together, celebrate who we are and share deeply about the sacred work we are called to do and the wonderful way in which we are called to do it.” “It is a chance for us to have fun while integrating our culture in the heroic service we provide,” he says.
president-level executives, each create their particular station at the fair, with information about the value they’re focusing on, activities, takeaway trinkets and other items. All employees are welcome to attend — the fairs often are held at multiple times to allow different shifts to participate. As of mid-August, seven campuses had held mission fairs.
Above: Chaplain Jonathan Balun blesses the hands of Shatara Tennon, a certified nurse’s assistant, at the mission fair at Fraser Villa in Fraser, Michigan. Trinity Health Senior Communities is holding similar fairs at all of its senior care campuses to engage staff in learning about the organization’s mission, vision and values. Left: The mission fair featured six stations, each sharing information on a Trinity Health Senior Communities value. At the station on stewardship, each Fraser Villa colleague received a prayer card and cross.
Reinforcing culture Trinity Health Senior Communities has 24 owned campuses as well as multiple affiliated campuses in Connecticut, Georgia, Illinois, Indiana, Iowa, Massachusetts, Michigan and North Carolina. Prince says the organization long has had programming to engage staff in building a mission-based culture at its campuses, but the COVID pandemic put a damper on that programming. A couple of years ago, Prince began brainstorming new and different ways to engage the 3,000-plus employees across the organization in learning about and being formed in the system’s mission. Some challenges he considered were that budgets are tight in senior healthcare and senior living generally, and he has a limited staff of mission leaders to assist him. So he built off a concept that long has undergirded the mission integration work at Trinity Health Senior Communities: Every leader is responsible for mission. Prince came up with the idea of hosting events at each site where local leadership could use fun activities and interactive learning approaches to talk with staff about mission topics. “One of the ideas behind the mission fair is to empower, form and support members of leadership teams in local THSC communities in becoming the leaders in mission and culture work themselves,” Prince explains. Tailored to the site Prince worked with system-level and local colleagues to build out the mission fairs concept, developed materials, piloted the idea, refined it, and then began working with the local communities to roll it out. The current framework is for every campus to host an annual mission fair for a three-year cycle, with year one focusing on the organization’s core values, year two on the mission statement and year three on the commitment statement. This year, each fair is made up of six stations, with each focused on one of Trinity Health’s core values: reverence, commitment to those experiencing poverty, safety, justice, stewardship and integrity. Prince supplies materials such as informational poster boards, and he builds up leaders’ understanding of the mission and values before the leaders plan the fairs. Each site has leeway in carrying out the local iteration. They can choose the themes, the décor, the room setup and many other details. Leadership, including C-suite and vice
Fraser Villa Fraser Villa is a 111-bed skilled nursing and rehabilitative facility. Collier says its mission fair had 12 leaders staffing six tables. Leaders shared their perspectives on living out Trinity Health’s values and discussed how the employees perceive those values. Collier says the fair had a “phenomenal” turnout. At one station, employees received a blessing of hands. At another, they learned different ways to convey reverence in conversation. At another they received a stress ball shaped like a heart. Collier herself painted a tree poster this summer, with a little help from her kids. Employees could write their perspectives on the values onto paper leaves and affix them to the tree. Wanda Barber is a certified nursing assistant who has worked at Fraser Villa for nine years. She now Barber works in the skilled nursing unit. She says she enjoyed the mission fair and gained more knowledge about the facility’s values. She says she liked that leaders were participating so fully. She says she could immediately apply what she’d learned to her daily work. Purpose and meaning Stacey Johnson, chief operating officer of Trinity Health Senior Communities, has helped Prince coordinate the fairs and has attended them at multiple sites. She says the events bring the mission to life for Johnson attendees. She notes that many young people are seeking purpose and meaning, and they can find that in a career in senior care. She says the fairs help crystallize why and how employees can provide the type of missionbased care senior adults need, and how providing that care can be very fulfilling. Collier says working in senior care can be very “heavy” but also very rewarding. She says ensuring mission and culture align is key, and the fairs help do that. Prince too concedes that working in senior care facilities can be very demanding, but he says it can offer deep relationships with residents and their families and that is a real benefit for staff. He says the mission fairs help form employees into a culture that supports, bolsters and celebrates the important work they are doing. The fairs are meant to reaffirm a sense of belonging that is key in senior care. He says many Trinity Health Senior Communities sites have low turnover rates compared to industry averages, in large part because of the strong culture. Barber agrees, saying, “I am really blessed to be working here at Fraser Villa. It has been nothing but open doors and opportunities for me, and I’m grateful for that.” Prince says the fairs are meant to elevate staff like Barber and each one is a celebration. “Everybody is just smiling, and they just feel great about themselves,” he says. “They feel great about the community that they’re serving in.” He adds, “Somebody who feels this deep sense of belonging, and purpose, and meaningfulness — this deep sense of reward — they’re not going to leave.” jminda@chausa.org
10 CATHOLIC HEALTH WORLD October 2026
PRESERVING THEIR ROOTS THROUGH PILGRIMAGES By JULIE MINDA
Ministry systems have a formidable challenge when it comes to preserving their legacy: How can they ensure their leaders have a full understanding of the systems’ mission, vision and values? And how can the systems nurture the leaders’ call to serve in a mission-based way? Multiple Catholic health systems have found that a particularly effective way to accomplish these goals is to connect their leaders to their systems’ origin stories through pilgrimages. By immersing these pilgrims in places of historical and spiritual significance, and enabling them to experience the roots of the ministry in a highly experiential way, the systems can help them see their place in that legacy. Executives from five Catholic healthcare systems explain: CHRISTUS Health CHRISTUS Health, which has nearly four dozen hospitals and hundreds of outpatient facilities across three states and three other countries, traces its origins to the Sisters of Charity of the Incarnate Word of Houston and of San Antonio and the Sisters of the Holy Family of Nazareth. At the urging of Galveston Bishop Claude Marie Dubuis, the Incarnate Word sisters journeyed from France to Texas in the late 1860s to found South and Central Texas ministries. The Holy Family sisters, who hailed from Italy and after initially serving in Chicago, traveled to Tyler in east Texas to establish ministries. About every other spring, CHRISTUS hosts several dozen leaders of its ministries and sponsoring congregations to visit places within France and Italy with historical significance for the Catholic Church and for the founding sisters. It’s a packed agenda, with stops at the birthplace of Bishop Dubuis in Coutouvre, France; the Lyon, France, site where three Sisters of the Incarnate Word and Blessed Sacrament received the call to serve in Texas; ancient sites of martyrdom in Lyon; and a onetime public hospital in Lyon that is now a hotel. In Rome, the group visits the church of St. Mary Major, where Frances Siedliska often would pray. Once she became a sister, she was known as Mary of Jesus the Good Shepherd. She is now in the final process of canonization, and is Blessed Mary of Jesus. She was the founder of the Sisters of the Holy Family of Nazareth. The pilgrims also usually participate in a papal audience in Rome. Gabriela Saenz, CHRISTUS executive vice president, chief of staff, says a highlight of the journey is that sisters with CHRISTUS’ sponsoring congregations serve as storytellers. Participants process the experiences through prayer, reflections, circle time and moments of solitude. Saenz says the pilgrimage solidifies leaders’ calling to Catholic healthcare. She explains that for the pilgrims, there is growth that comes from “opening yourself up and walking in those footsteps. And so, I feel like they come back with a deeper sense of pride and also a deeper sense of accountability and responsibility.”
The Mercy system, based in suburban St. Louis, hosts pilgrimages in Ireland to immerse its leadership in places of historical and spiritual significance. These Mercy pilgrims are exploring the area around St. Patrick’s Well, an ancient holy site close to the village of Marlfield in County Tipperary.
Mercy Dan Ensell, senior vice president of mission integration for suburban St. Louisbased Mercy, says that as the last large Catholic health system with a single founding congregation, it is important to Mercy to ensure its leaders and sponsors understand Ensell the system’s foundations. Catherine McAuley established the Sisters of Mercy in 1827 in Dublin. A contingent of Mercy sisters traveled to the U.S. in 1843 and went on to found healthcare and social service ministries. Many of those now make up the Mercy system that includes 55 hospitals and thousands of other sites across five midwestern states. Mercy hosts two pilgrimages to Ireland annually, one for executive leadership
and the other for frontline caregivers recognized for exemplary, mission-based service. While the two pilgrimages vary and each differ with each iteration, both are heavily focused on Dublin and surrounding areas. This includes homes where Mother McAuley lived, the House of Mercy that she founded to serve the vulnerable, and a church where she and other sisters often attended Mass. The longer iteration of the pilgrimage visits other Irish cities exploring the roots of the Catholic Church on the Emerald Isle. Sr. Claudia Ward, RSM, program manager of Mercy Neighborhood Ministries, says both pilgrimages offer particiSr. Ward pants an opportunity to walk where Mother McAuley carried out her ministry. Present-day Sisters of Mercy
CommonSpirit Health Kyle Klosterman is system senior vice president of mission and formation for CommonSpirit Health, which has 141 hospitals and more than 2,000 additional sites across 24 states. The system is the result of multiple mergers and has 17 founding congregations, each of which has multiple orders that shaped CommonSpirit facilities’ evolution. The challenge, Klosterman says, is to find a way to immerse leadership in the legacy of so many founders. Currently, the system is rotating among key sites of significance, and its regions have their own local pilgrimages. The most recent CommonSpirithosted pilgrimage for system-level sponsors and other top leaders was in March to Emmitsburg, Maryland, where St. Elizabeth Ann Seton moved in 1809. Her passion for serving vulnerable people motivated the widowed mother of five to establish a girls’ school and multiple
During a CommonSpirit Health pilgrimage in the spring, attendees gather at the National Shrine of St. Elizabeth Ann Seton in Emmitsburg, Maryland. St. Elizabeth Ann Seton established the Sisters of Charity in the 1800s. The sisters would go on to found Catholic healthcare ministries across the U.S.
charities as well as a religious community that would become the Sisters of Charity congregation. During several days in the Emmitsburg
area, the CommonSpirit sponsors and executives visited the saint’s home, which was once used as a school and now houses a museum. The pilgrims also visited her
including Sr. Ward provide insights, historical perspectives and spiritual experiences. Prayer time, Masses, reflections, and time for solitude are all woven into both pilgrimages. Sr. Ward says that during each, serendipitous “God moments” arise. One year, a Mercy sister decided to type Mother McAuley quotes onto slips of paper for attendees to keep for personal reflection and integration. Ensell notes, “Healthcare is sacred work but unfortunately sometimes in our busy-ness … we forget why we said yes to this work in the first place. We’ve made a commitment to serve and to do something meaningful with our talents. We get into this work but can lose the why….” He adds that on the pilgrimages, Mercy reminds the leaders that what they are doing really matters. “We need leaders who get this,” he says.
nearby grave site. They spent time at a center, a shrine and a basilica dedicated to her memory. The CommonSpirit group’s journey included tours, presentations, reflections, religious services and social gatherings. Klosterman says for all its formation activities, including its pilgrimages, CommonSpirit seeks to engage participants’ heads with factual learning, their hearts with spiritual learning and reflection, and their hands with lived experiences such as the tours. He notes that participants come to the pilgrimage with a range of backgrounds. For those new to Catholic healthcare, it is about “just getting them exposed to a broader sense of the church and the church’s ministry.” For seasoned Catholic healthcare sponsors and leaders, he says, “it was really about strengthening and sustaining their own spirituality and worldview to this call to the healing ministry within the Catholic tradition.”
October 2026 CATHOLIC HEALTH WORLD 11
Providence St. Joseph Health With 51 hospitals and more than 1,000 outpatient sites across seven western states, Providence St. Joseph Health hosts multiple pilgrimages to honor the legacies of the system’s two main founding congregations — the Sisters of Providence and the Sisters of St. Joseph of Orange. Justin Hurtubise, chief mission officer for Providence Sacred Heart Medical Center & Children’s Hospital and Providence St. Luke’s Rehabilitation Medical Center in Spokane, Washington, says that two particularly developed pilgrimages are in the Spokane region. The Sisters of Providence Pilgrimage and the Dominican Pilgrimage are each full-day immersive bus tours. The Providence sisters tour travels between Spokane and Cataldo, Idaho; and the Dominican tour between Spokane and Colville, Washington. Providence hosts about 40 leaders on each trip. The participants each take part in the role of a particular sister — at multiple stops along each journey, they receive journal entries and historical information about “their” sister as well as about others in the congregation. They have time to disembark to visit places of historical significance to the congregation and time to talk about what they are experiencing and learning. The pilgrims stop at homes where the sisters once resided, healthcare ministries they founded and at the resting places of some of the sisters. It is usual for current-day members of the congregations to join the bus tour to
KEEPING UP
Gnann
Lucio
McDonald
Combs
Vasdev
Oswald
PRESIDENTS/CEOS
Providence St. Joseph Health hosts multiple pilgrimages in its catchment area. This was a stop on one of the two pilgrimages that originate in Spokane, Washington.
share in the storytelling. Hurtubise says the experience helps bring the congregations’ historical and spiritual legacies to life for leaders. He says the Spokane region has invested much time and effort into developing these pilgrimages because of the essentiality of grounding the leaders in the sisters’ heritage. Colleen Fox, chief philanthropy officer
of the Providence Inland Northwest Foundation, says an anonymous donor has committed about $10,000 annually to support the Spokane region’s pilgrimages. She says the person has a passion for the sisters’ work. This donor wants to ensure the pilgrimages are preserved for leaders even amid rough financial times, when they might otherwise be deprioritized for lack of funds.
Andrew Gnann to president and CEO of Ascension St. Vincent’s Riverside in Jacksonville, Florida. He was president of Ascension Seton Williamson in Central Texas. Dr. John Lucio to president and chief medical officer for SSM Health St. Mary’s Hospital in Jefferson City, Missouri. He previously was regional chief medical officer for SSM Health’s Mid-Missouri Region. He succeeds interim President Justin Morely. Tauana McDonald plans to retire as president and CEO of Mount Carmel Health System of Columbus, Ohio, at the end of this year. She has worked in various roles at Trinity Health for over 23 years. Trinity Health leadership is working with Mount Carmel’s board of trustees to begin the search for McDonald’s successor.
ADMINISTRATIVE CHANGES Emily Combs to vice president of specialty care, supporting women’s and children’s care, at Mercy health system of Chesterfield, Missouri. Sonia Vasdev to system director of accountable care services for Hospital Sisters Health System of Springfield, Illinois. Jessica Oswald to chief administrative officer of Providence Alaska Medical Center in Anchorage, Alaska, effective Oct. 5. Dr. Joseph Teel to president of Trinity Health Mid-Atlantic Medical Group of Newtown Square, Pennsylvania.
Avera Health opens residential recovery center for women Fr. Thomas Nairn celebrates Mass at the Portiuncula Chapel, which is in the Basilica of St. Mary of the Angels in Assisi. The Mass was part of SSM Health’s spring 2026 pilgrimage.
SSM Health With its 24 hospitals and hundreds of additional sites across Illinois, Missouri, Oklahoma, and Wisconsin, SSM Health traces its founding legacy to the Sisters of St. Mary, who later became known as the Franciscan Sisters of Mary. Other congregations that later joined SSM Health include the Felician Sisters and the Congregation of Sisters of St. Agnes. Both the Franciscan and Felician sisters have a legacy that honors St. Francis and St. Clare of Assisi. So, forming leaders in the spiritual tradition of St. Francis and St. Clare is a priority for SSM Health, says Vice President of Formation and Spirituality Joshua Allee. The preeminent pilgrimage for executive leadership and sponsors is an annual 10-day journey to Rome and Assisi in Italy. The focus of the experience is Assisi, which Allee lovingly calls the “mothership” of SSM Health’s Francis-
can roots and the Franciscan order. St. Francis was born to a wealthy family in the late 1100s in Assisi during turbulent political times. He turned away from that privilege to serve the poor and vulnerable. Eventually, he amassed a group of followers who became the Franciscan Orders. St. Clare left her life of privilege to form a congregation of women following St. Francis’ way, called the Poor Clares. In Assisi, the SSM Health leaders visit the places where St. Francis had a vision of Jesus in the chapel of San Damiano, another where he confronted his father to renounce his wealth and another where he encountered a leper colony that would serve as his home for an early part of his ministry. Allee says guides provide historical and spiritual context for each stop. Many of the stops include experiential learning. For instance, pilgrims reenact St. Francis’ renunciation of his wealth.
Allee says the pilgrim experience is immersed in prayer, daily Masses and ongoing discussion and integration. When board members return from the pilgrimage, they report back to the fiduciary board and sponsor. “You can tell that those (reports) are not taken lightly,” Allee says. “There’s a lot of reflection that goes into them, connecting the dots.” Allee mentions that SSM Health also hosts the St. Louis Heritage Pilgrimage, where SSM Health leaders can walk in the footsteps of the early sisters amid sites of importance. SSM Health offers pilgrimage experience in each of its regions. He adds that being a leader in the ministry is “an enormous responsibility, and if you don’t really grasp who we are and why we are the way we are, it’s hard to lead in that tradition and spirit. And so that’s why I think the outcomes — or the (return on investment) — it’s really hard to measure, but we experience it.”
A new residential treatment program for women with substance use disorders opened Aug. 24 in Yankton, South Dakota. Avera Sacred Heart Hospital built and owns the facility, located across from the hospital and called Park Haven Learning and Recovery Center. The hospital is partnering with Lewis & Clark Behavioral Health Services to provide programs and services. The South Dakota Department of Social Services awarded a $3.8 million grant to the hospital. Donors to the Avera Foundation also helped pay for the project. The 18-bed center serves women, including those who are pregnant and mothers with dependent children. “This amazing and much-needed resource resulted from a vision, three years in the making, for a safe and supportive place for women to experience recovery and healing,” Victoria Hanson, Avera Sacred Heart Hospital’s regional president and CEO, said in a press release. According to the Centers for Disease Control and Prevention, 13% of women report using alcohol during pregnancy and of those, 40% report binge drinking. Women also make up around 41% of overdose deaths in the state, according to State Unintentional Drug Overdose Reporting System statistics.
12 CATHOLIC HEALTH WORLD October 2026
CHA pilgrimage
and deepen important relationships. “We could see we’re not doing this alone, and we could see the collective impact Catholic healthcare can have,” he says. “You get a much greater understanding — you see the potential for high impact.” Kashman says he’s brought some of his learnings back to his colleagues, sharing insights during meetings and roundings and while hosting a podcast that his market started early Kashman this year. The podcast, “The Art of Healthcare: Inspired Stories,” showcases the positive impact that people can have on their community.
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the Catholic Church in the region and have been remembered since for their profound impact. Holubec, who is chief mission experience officer for Providence St. Joseph Health, says connecting with that spiritual history of the church — both in Assisi and during the remaining program days in Rome — was inspiring. He says healthcare is moving very fast, and it is important for ministry executives to take time away from that pace to learn about the roots of the ministry and to understand more deeply what makes Catholic healthcare different from secular care. Through pilgrimage, he says, “We can place ourselves in that story.”
Spiritual grounding CHA has offered the program, “Ecclesiology and Spiritual Renewal Program for Health Care Leaders,” nearly annually for more than two decades. A top reason CHA established and has continued to prioritize the program is because with every new generation of executives, the ministry’s leadership gets further removed from the founders. Today’s executives do not often have the same personal relationships with members of the founding congregations that their predecessors enjoyed and miss the formative benefit of those experiences, says Lori AshmoreRuppel, CHA senior director of mission services management. “We established this pilgrimage as a formaAshmore-Ruppel tion experience, and to give that experience of rootedness to Catholic healthcare’s executive leaders,” AshmoreRuppel explains. Sr. Teresa “Tere” Maya, CCVI, CHA senior director of theology and sponsorship, notes that as a part of a ministry of the Catholic Church, it’s important for these leaders to connect with the church and its mission. She says that is especially true given that most Sr. Maya U.S. Catholic health systems now have a ministerial juridic person sponsorship model that makes both lay and religious sponsors directly accountable to the Holy See. She says it’s critical that sponsors and executive leaders alike understand that the church is grounded not just in a spiritual legacy but also in tradition and history, and that offices administer its work. “It’s a living church,” says Sr. Maya, adding that pilgrimage is a way for ministry executives to experience that. Empowerment Each fall, ministry systems determine which leaders to invite for the following spring’s program — usually executive, operational and mission executives and/ or board members. Each invitee can choose a traveling companion to join them. This year, nearly three dozen ministry leaders attended, most accompanied by a spouse. While the program elements and particulars vary each year, they usually follow a similar pattern: one day in Assisi and the remainder in Rome, with programming delivered by several CHA staff as well as presenters from the Vatican, from ministries affiliated with the Catholic Church, and from clergy who serve as spiritual leaders and guides. Attendees take part in group sessions to learn about the foundations of the ministry, the call to Catholic healthcare leadership, the ministry’s shared commitments, some church history and many other topics. They also journey to historic basilicas and other sites that are important to the Catholic Church and to congregations that laid the groundwork for the Catholic health ministry. They visit the Vatican’s museum and meet with top officials in dicaster-
Participants of CHA’s “Ecclesiology and Spiritual Renewal Program for Health Care Leaders” visit the Vatican Museums. From left are Jessica Agarwal, Eduardo Conrado and Naveen Agarwal. Conrado is Ascension president and CEO. Naveen Agarwal is an Ascension board member and Jessica Agarwal is his wife.
ies that interact with the Catholic health ministry. They also take part in spiritual experiences, including Masses and prayer services, and enjoy receptions and other gatherings. “This pilgrimage is personal and reflective, and that dimension is important,” Sr. Maya says. When the healthcare leaders immerse themselves in the ministry’s foundations as they do during the Italy pilgrimage, Sr. Maya says, they “come back empowered. They have a better sense of how the ministry has evolved over time. The pilgrimage is laserfocused on what it means to be a ministry of the church, and (being part of this) builds a network of people who are intimately connected to our strategic priorities, including our strategy of being united for bold change.”
‘Collective impact’ Holubec attended the CHA pilgrimage about 14 years ago after moving into an executive role with Providence and then again this year in his capacity as CHA board chair. He says that today’s Catholic healthcare systems are facing what Providence President and CEO Erik Wexler calls the “polycrisis,” with numerous grave threats on an ongoing basis. Holubec says he knows that budgets are tight in the ministry, but he says systems are making an important investment when they enable their leaders to attend the Italy program. He says the pilgrimage can give them a renewed sense of calling and renewed energy to carry out that calling. The April journey was the first pilgrim-
Fr. Greg Friedman, OFM, leads program attendees on a walking tour of Assisi in central Italy. St. Francis and St. Clare lived in Assisi in the late 1100s into the 1200s. They founded religious orders that in time went on to establish healthcare ministries in the U.S. Fr. Friedman is a guide with a Franciscan pilgrimage organization.
age for Scott Kashman, CEO of Ascension St. Vincent’s Health System in Northeast Florida. Kashman says the experience helped him more completely comprehend the “dual identity” of all Catholic healthcare leaders in serving both a healthcare organization and a faith-based ministry. He notes that joining other ministry executives gave all of them a chance to form
“
I reconnected with my ‘why’ and my purpose and to ensure I continue to keep the person we’re serving at the center of what I do.” — Michelle James
‘Incredible gift’ Michelle James is PeaceHealth senior vice president of quality, safety, and clinical risk as well as the system’s chief nursing executive. She concedes she had been navigating some challenges before heading to the Eternal City in the spring. She saw the pilgrimage as a time to reflect and use the resources and colleagues around her to reconnect to PeaceHealth’s mission. She says the pilgrimage gave her an opportunity to learn, listen, take in information and reflect. She says it was an invigorating reminder that there is a greater purpose to the work. “I reconnected with my ‘why’ and my purpose and to ensure I continue to keep the person we’re serving at the center of what I do,” she says. A highlight of the week in Italy for James was the opportunity to meet fellow ministry leaders, and she now feels like she has a large network of friends across ministry systems she can reach out to at any time. “This was truly a special way to connect with them,” she says. She calls the pilgrimage an “incredible gift” that has challenged her to draw closer to the spirit of the men and women who founded Catholic healthcare. “What I find so important is: How do we look back to our foundresses and understand there is work to be done in transforming the care we provide?” James says. “How do we stay true to serving the most vulnerable in our communities? And how do we continue to work to stay rooted in our mission?” jminda@chausa.org
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Average No. Copies Each Issue During Preceding 12 Months
No. Copies of Single Issue Published Nearest to Filing Date
12,988
13,025
11,614
11,655
402 23
430 20
— 12,039
— 12,105
714 20 — —
697 21 — —
734 12,773 214 12,987 94.25%
718 12,823 202 13,025 94.40%
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