By Renée K. Gadoua, Contributing writer
The 14th president of St. Joseph’s Health came to Syracuse with two connections to the hospital Franciscan sisters founded 148 years ago on Syracuse’s North Side. Leslie Paul Luke’s great-grandfather was a Chinese herbal physician in Hawaii in the same era Mother Marianne Cope ministered to patients with leprosy in Honolulu and Kalaupapa. “I sometimes wonder if they ever crossed paths,” Luke said.
In addition, his late father, a surgeon, spent a year as a medical resident at St. Joseph’s Hospital. “I think he really would have been pleased to see his son become CEO of a Catholic hospital,” Luke said. “He would probably say, ‘You finally got it right.’ I’m glad to be here and honoring his legacy of medicine.”
Luke was named president and CEO of St. Joseph’s Health in January. He succeeds Kathy Ruscitto, who led the system from 2010 to 2017. Luke is the first St. Joseph’s president from outside the Syracuse area. He belongs to the Church of Jesus Christ of Latter-day Saints (the Mormons), making him the first non-Catholic in the position.
Luke came to St. Joseph’s 18 months after it was acquired by Trinity Health, one of the nation’s largest Catholic health care delivery systems. Trinity Health, based in Livonia, Michigan, operates more than 93 hospitals and 121 continuing care programs in 22 states. In addition to the 451-bed St. Joseph’s Hospital, Luke oversees primary, specialty, and home care programs throughout Central New York and Pennsylvania.
A native of St. Louis, Missouri, Luke was raised in Hawaii. He earned a bachelor’s degree in sociology and a master’s degree in health administration from Brigham Young University. He previously served as interim CEO of Tennova East, a seven-hospital system in Knoxville. He has also served as CEO of a 50-bed nonprofit hospital in Kentucky and as CEO of hospitals in Las Vegas, Oregon, and Nevada and has managed physician practices.
The Sisters of St. Francis started the hospital — Syracuse’s first — in 1869 in a former dance hall and saloon they bought for $12,000. St. Joseph’s opened with 15 beds and a pledge that “in the admittance and treatment of patients, no distinction shall ever be made because of theological belief, nationality or color.”
Although the transition to Trinity Health means the Franciscans no longer sponsor the hospital, the health system’s mission honors its roots. “Inspired by our Franciscan tradition, we are passionate healers dedicated to honoring the sacred in our brothers and sisters,” reads its mission, in part.
Trinity is committed to honoring St. Joseph’s Franciscan history and the example of Mother Marianne, according to Luke. “They know that St. Marianne and her work and our mission are very much local history and legacy,” he said. “They’ve encouraged us to continue emphasizing that because it matters to people here.”
Luke recently discussed with The Catholic Sun his goals for St. Joseph’s success. Here are excerpts of that interview, edited and condensed for clarity.
How do you describe the spirit of St. Joseph’s Hospital?
The spirit of St. Marianne is alive and well. I felt it the first time I walked into the building. It had a pretty profound effect on me. I’ve been CEO of quite a number of hospitals and I can say that there has been no other hospital where I felt this. The employees and physicians all really believe in the mission and what she envisioned as what we’re supposed to be doing.
What is your sense of how St. Joseph’s fits into this neighborhood?
Our mission isn’t just talking about physical healing, it’s about healing communities and engaging communities to be the best they can be. A lot of projects that have gone on here in the last decade — the revitalization of some of the neighborhoods — I view St. Joe’s as being a very central part of that. Kathy Ruscitto did a phenomenal job integrating St. Joe’s into the community.
When Trinity Health took over, St. Joseph’s joined the majority of U.S. hospitals in becoming part of a network or health care system. What are the advantages of that? Disadvantages?
The advantage is we have access to knowledge and best practices. When you’re with a large network, you don’t have to keep reinventing the wheel in terms of how you deliver care or how you conduct business. When you’re associated with Trinity Health system, you’re able to access dollars for major projects.
Trinity has what’s called a Track 3 ACO. An accountable care organization contracts with Medicare and says, ‘We are going to take care of this population.’ If we improve care and reduce costs to Medicare, then we get some rewards. That was only possible through Trinity.
Disadvantages? I haven’t really seen any. Sometimes you have to modify or give up processes in order to get consistency across the system. But I don’t know if that’s truly a disadvantage because you’re essentially getting standardization.
What is important about Trinty’s identity that makes it Catholic?
We have to go through an audit to determine how closely we’re aligned with Catholic identity. We have to demonstrate that what we are doing is a proper reflection of what Catholic health care is supposed to look like. I’m still studying this (He picked up a small booklet, the United States Conference of Catholic Bishops’ “Ethical and Religious Directives for Catholic Health Care Services”).
So, not providing abortion services?
End of life issues?
Yes. Exactly. You can say you’re a Catholic health system, but to be a Catholic health system are two different things.
Is the Catholic Social Teaching new to you? You’re spitting it out like you know it well.
I was raised Catholic. My dad, after he retired as a surgeon, became a Catholic deacon and served in the St. Louis Archdiocese. I’m a member of the Church of Jesus Christ of Latter-day Saints, the Mormons. The way I view it is I’m CEO of a Catholic hospital, and therefore I’m going to operate under the Catholic system and values and standards. Frankly, I haven’t found any major dissonance between my personal beliefs and what I’m being asked to do. Managing a faith-based health system is so much more refreshing than managing a for-profit hospital or a community hospital.
What do you mean?
All hospitals have a positive mission, but when it’s faith-based, it’s how people feel and think about their jobs in perspective of eternal principals that translates into how they care for the patients. It’s not just a job. It’s a mission.
Often there’s a sense that a business is either profitable or it’s faith-based.
Right. It’s not either or. Three years ago, the system lost $30 million, two years ago around 15. This past year we ended up break even, which is great. This year we are continuing to improve. We’re approaching it from the quality perspective. I’m really into what’s called continuous quality improvement. The general theory is as you improve quality, your costs go down. You don’t approach it the other way where you try to drive down costs and miraculously quality is supposed to happen. It doesn’t work that way. If you take a look at our quality outcomes right now, as we’ve also exercised better financial discipline, all the indicators are pointing in the right direction. We should have a 3 percent operating margin every year, reliably, to sustain our business. That allows us to achieve our mission, it allows us to invest in this place, and it allows us to stay competitive to offer really good jobs. Every penny above that 3 percent will allow us to expand our mission to serve more of the poor and the underserved.
In August, nearly 90 employees took voluntary buyouts. Your website lists more than 100 job openings, including more than 40 nursing jobs. How do buyouts and job openings exist at the same time?
It depends on what those openings are. Trinity and St. Joseph’s Health, and pretty much every health care organization right now, are making this significant shift. It’s a shift from a hospital-centric delivery system and episodic health care to population health where we’re essentially trying to keep our community healthy. And you’re probably going to continue to see a need for bedside registered nurses. You may also see a decrease in other areas of the organization. We can’t always predict where that’s going to be.
Trinity Health’s CEO released a strong statement criticizing the latest effort to repeal and replace President Obama’s Affordable Care Act (ACA). Can you talk about that?
We’ve been very consistent. The Affordable Care Act was beneficial to St. Joseph’s because it provided coverage for people who didn’t have it before. All of the attempts to change the ACA would have resulted in a great number losing coverage. The populations that are at most risk are the ones who have the most to lose — the underserved and the poor. When people can’t access health care, we aren’t able to achieve our mission. We will remain opposed to any modification of the ACA if it does not properly address that issue.
Before the ACA was passed, a number of Catholic organizations opposed it because of the contraception mandate and abortion [coverage]. What is Trinity’s position on that?
We will remain consistent to our beliefs and we will use every legal means to ensure we do so.
Mother Marianne and her Franciscan sisters were committed to providing access to health care, dignity, and equal treatment to people on society’s margins. How does St. Joseph’s, as part of Trinity Health, do that in this neighborhood?
We see a lot of patients with chronic conditions and mental conditions from right around here. We’ve been making a much better effort at addressing their other needs, which are root causes of why they are here. We’re doing a much better job at things like making sure they have their medications immediately. We’re doing a better job connecting them to resources for the rest of their care, like connecting them to a primary care physician or more resources for mental health care. We’re also getting better communication within our organization to make sure handoffs are taking place. This is a fragile population. That’s why we’re here.
Anything you’d like to add?
For a long time I kept feeling like my life was split in two. My service life was here and professional life was here and I couldn’t get the twain to meet. Here, for the first time in my life, they’re tied together and I feel so much like a whole person. I can take all of my talents and what I believe in and roll it all into one. It’s very fulfilling.
Renée K. Gadoua is a freelance writer and editor. Follow her on Twitter @ReneeKGadoua.
Leaders of St. Joseph’s Hospital
Sister M. Dominica Cummings: 1869-1870
Mother Marianne Cope: 1870-1877
Mother M. Bernardine Dorn: 1877-1888
Sister M. Genevieve McCormick: 1888-1899
Sister M. Gertrude McCarthy: 1899-1914
Sister M. Veronica Powers: 1914-1919, 1929-1935
Sister M. Antonia Fleck: 1919-1929, 1935-1951
Sister. M. Wilhelmina Fitzgerald: 1951-1969
Sister Patricia Ann Mulherin: 1969-1987
James Abbott: 1987-1989
William Watt: 1989-1994
Ted Pasinski: 1994-2010
Kathryn H. Ruscitto: 2010-2017
Leslie Paul Luke: 2017-