The 2025 compensation budget at Baton Rouge, La.-based FMOL Health had accounted for $11 million. However, after the system’s chief human resources officer made the case for more, President and CEO E.J. Kuiper approved nearly five times that.
The impetus behind the fivefold increase was a compensation analysis CHRO Jennifer Trahan presented to Mr. Kuiper showing far more positions needed market-rate adjustments than projected. The system would ultimately invest close to $50 million, including across-the-board minimum wage increases and market-based pay adjustments.
The results are showing up in retention. FMOL Health’s registered nurse turnover rate has since fallen below 10%, outperforming the national healthcare average of 17.6% in 2025.
“Every time a full-time RN turns over, the cost is around $50,000 to $60,000 for an organization,” Mr. Kuiper said. “So take care of people, make sure that they feel they’re taken care of, that they’re in an exceptional workplace — and then they stick around and help us take care of the patients and the communities that we serve.”
The investment is not incidental to FMOL Health’s broader growth. Since becoming CEO more than two years ago, Mr. Kuiper has overseen more than $500 million in approved capital projects across the system’s four markets in Louisiana and Mississippi, roughly $250 million of it in the Greater Baton Rouge area. The system has posted record financial results back to back, with margins above 10%.
One key way the system has kept a strong balance sheet is through being careful where dollars are spent — ensuring those investments are translated into better patient care — as well as strong leadership, careful labor control, productivity, and efforts to keep supply and pharmacy costs as low as possible.
“It’s challenging, given the inflationary dynamics that are out there right now,” he said. “But we’ve been very blessed. We’ve posted record financial years the last couple of years, and what’s so good about that is, we immediately invest those dollars that are produced back in our people, technology, and in our buildings.”
The framing Mr. Kuiper returns to most often is the distinction between leading and lagging indicators. Workforce engagement belongs in the first category. Quality scores, patient satisfaction, market share and financial performance belong in the second — and every day, he said, the question his team asks is how to create the best place to give and receive care. The metrics follow from that.
Capital allocation follows a similar discipline. Mr. Kuiper’s senior leadership team, which includes market presidents from each of FMOL Health’s four markets, meets weekly for roughly five hours to weigh incoming capital requests. The market presidents carry dual accountability: they advocate for their own region and share responsibility for systemwide decisions. Larger markets absorb more capital, Mr. Kuiper said, but the governing question is consistent across all of them: where is the biggest need, and where is the greatest growth opportunity.
Growth in the next phase may look different. FMOL Health’s five-year strategic plan, finalized about 18 months ago, prioritized organic investment in its existing footprint. As that work matures, the system will turn its attention to potential acquisitions such as hospitals, health systems or physician groups. Mr. Kuiper is deliberate about the pace.
“As we grow as a health system — we’re currently around $5 billion [in revenue] — we don’t want to stretch our dollars too thin,” he said. “We want to make sure that as we add hospitals, clinics, health systems, that we’re still going to be able to sufficiently fund our existing footprint, people, technology and buildings. There’s some headwinds coming in healthcare — reimbursement cuts contemplated in HR 1 that are going to affect all of healthcare — and we’re not going to be immune to that.”
Building the workforce FMOL Health will need is also part of the strategy. The system is the official Championship Health Partner of Louisiana State University, providing sports medicine for student athletes and care for all students through an on-campus student health center. The relationship extends into graduate medical education, interdisciplinary learning and research. In April, LSU opened the Our Lady of the Lake Health Interdisciplinary Science Building on its Baton Rouge campus, a facility with 1,150 students, faculty and researchers. FMOL Health also operates FranU — Franciscan Missionaries of Our Lady University — a Catholic university in Baton Rouge focused on health sciences and nursing.
“Investing in academics, creating pipelines so we can invest in producing the next healthcare leaders — the next nurses, medical technologists, physical therapists, occupational therapists and pharmacists — is really important,” Mr. Kuiper said. “We always have to prepare for tomorrow, and tomorrow we’re going to need more nurses and more healthcare workers.”
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