BUFFALO, N.Y. (WIVB) — Joyce Markiewicz took the helm of Catholic Health at the beginning of the month after former CEO Mark Sullivan stepped down. It’s a high-profile job that puts her every decision under the microscope of patients, employees and the public.

“It wasn’t something that at nighttime I said, ‘Oh gee, I wish I could be the CEO,’ but when I was asked to do it, I didn’t hesitate to say yes,” Markiewicz told News 4.

Markiewicz said she’s a leader who says what she means and means what she says.

She began this month as the fifth CEO in Catholic Health’s 25-year history.

The Western New York native is also the first woman to hold the top spot.

“I will sit, I will listen, if something doesn’t make sense to me I will say that it doesn’t make sense — I’m quite transparent,” added Markiewicz.

It’s that transparency and clinical background Markiewicz believes sets her apart as a leader.

Markiewicz began her career working in health care as a nurse. She would later join Catholic Health in 2005, turning around its homecare operations. Most recently she served as chief business development officer.

News 4 asked what she believes the biggest problem facing the billion-dollar organization is.

“Workforce — we continue to struggle with workforce. And even though we’re doing better as it relates to hiring and retention, we have a crisis in this country,” added Markiewicz. “Back in 2000, the caregiver ratio was five to one. For every person over the age of 65, there were potentially five people to care for them. That number’s gone down to 2.8.”

She said the COVID-19 pandemic forced providers like Catholic Health to move away from the idea of singular hospitals being all things to all people.

“There’s other ways to deliver care than to show up at an emergency room when you have a cold,” said Markiewicz. “You know, you should be going to primary care, you should be accessing services from other places that are less expensive and make more sense and really where you have a better experience.”

After taking a financial beating during the pandemic, a nursing strike and a downgraded credit rating — Markiewicz is focused on making sure Catholic Health has a financially viable future.

Mount Saint Mary’s Hospital reduced services to become a neighborhood hospital.

Meanwhile, in Lockport, Catholic Health is gearing up to open a new $62-million hospital.

“We have to build what makes sense going forward and this is what makes sense going forward,” added Markiewicz.