Chief Operating Officer

Chief Operating Officer – Adam Cisroe Pearson

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What is your full name, title, and company name for your current, primary role?

Adam Cisroe Pearson, OTD, OTR/L – Chief Operating Officer of Peter & Paul Community Services

What additional roles do you currently have?

Instructor at Washington University School of Medicine, Program in Occupational Therapy

Where are you located?

St. Louis, Missouri

Where did you go to OT school, and what year did you graduate?

Washington University School of Medicine, Program in Occupational Therapy; 2011

What did you do when you first finished school, and for how long?

I worked as a clinician and lecturer for Washington University School of Medicine, Program in Occupational Therapy. My job was split into three buckets: community practice, research, and teaching, with community practice taking up the bulk of my time.

For practice, I contracted out to a drop-in day shelter in downtown St. Louis where I created programming for the homeless population. The research and teaching were both centered around assessing the built environment, and its impacts on participation.

In what setting(s) did you work, and what types of patients did you treat?

I have worked in numerous settings through the years, doing more administrative work than clinical.

Outside of the work at the drop-in day shelter, I’ve done outpatient home assessments for people with neuromuscular disorders. This was particularly challenging in the early years, as I had not been exposed too much to ALS and Huntington’s Diseases.

What did you enjoy about your early roles? What didn’t you enjoy?

I enjoyed the discovery, the autonomy, and learning more about how systems affect every day participation in daily activities.

Traditional 1-1 or group modalities were interesting to me, but I enjoyed learning more about meso/macro-level factors that led to people becoming more independent.

What else have you done since then, prior to your current role?

I did travel therapy in Dalhart, Texas for four months. I did this in between my clinical role with Washington University in St. Louis, and my new role as director of the Garfield Place Apartments at Peter & Paul Community Services.

Travel brought on new challenges, as I was the only OTR in a good section of the Texas panhandle. I worked in a mix of settings: schools, outpatient, inpatient, memory care, hospice, work and industry, and home health–some days I did many of those things in the same day!

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When and why did you decide to do something non-clinical?

Clinical was always fascinating to me, but what really got me excited was learning about leadership, systems, and the process by which we create better systems to spur participation. So, my work gradually transitioned from clinical to management, to leadership, to a bit of policy interplay.

What are you doing these days?

I am the chief operating officer at a homeless services organization in St. Louis called Peter & Paul Community Services. At PPCS I oversee our six programs, including four housing and shelter programs, and two work/leisure programs.

My department includes around 50 staff, who operate several 24/7 facilities that operate year-round. I oversee strategic planning for the agency, facilities, and clinical best practices. All of this means that I have to work quite a bit at broader city-wide/regional levels to affect change, and I thoroughly enjoy it.

Are you still treating patients, or are you solely non-clinical?

I only see clients if we take on a student who would benefit from me showing them OT assessments or intervention. Outside of that, I am primarily administrative.

How long have you been in your COO role?

A little over 2 years.

Did you get any special certifications or training along the way to help you become Chief Operating Officer?

To support clinical staff in some of their day-to-day duties, I have become Level One Medication Aide Certified. I have also attended several trainings on harm reduction, mental health first aid, etc.

How did you find your job? Did you apply or find it through a connection?

My position existed at the agency before I arrived, but was modified in part to include clinical program oversight and oversight of maintenance activities. After it was posted, I applied, and the rest is history. It helped that I had previous experience with the agency.

What was your interview like?

Several layers of interviews given the broad cross-agency nature of the position.

What are some of the things you did to stand out, take initiative, and advance in your career?

Volunteer for facilitation and leadership opportunities, seek outside mentorship and training. Most of all, ASK LOTS OF QUESTIONS! Get excited about the content, the mission, and seek to understand the issues and systems inside-out.

How have people reacted to you leaving patient care?

Because I’m still doing clinical work, but in an administrative setting, I haven’t really left. It’s just slightly more nontraditional than other roles.

What’s a typical day in the life like for you as Chief Operating Officer?

Every day is different. I start work checking emails, and then block out some time to connect with our maintenance team. After that, it’s a combination of meeting prep, working on strategic planning, reviewing policies and procedures, and diving into compliance work.

Some days, I deal with a bit of crisis management related to clinical issues. On others, I might deal with personnel matters with our director of HR. There’s a lot of time spent on the computer, and on visiting our other facilities to meet and touch base with staff.

What are some of the rewards of your role? What are the biggest challenges?


  • Watching clients succeed and move into housing
  • Watching them receive some really helpful services
  • Seeing our staff grow and develop.


  • COVID is an ongoing challenge, especially because the unhoused population carries a significant comorbidities burden
  • Funding is always a challenge
  • Staff conflict

How did your clinical background prepare you for being a COO?

Learning how to evaluate an issue inside and out, and be creative with thinking through root causes and contributory factors to myriad issues. And ultimately coming up with solutions that fit the client in the context of the client’s environment.

All of that is scalable to an organizational level, where one issue may have several causes, and you have a limited amount of time and resources to investigate, solve, and evaluate.

Roughly speaking, how are the hours and pay compared to patient care?

Longer hours, comparable pay. Maybe a bit higher because of the scope of responsibility.

What type of person do you think would do well in your role?

Diplomatic, creative, compassionate, assertive, thoughtful, and mission-driven.

Do you work remotely or onsite?

On-site 90 percent of the time.

Does your organization hire PT, OT, or SLP professionals into non-clinical roles? If so, what type of roles?

Thus far, all of the roles that health professionals have taken on are clinical roles. Occasionally those roles require administrative duties, such as when someone who is an RN or OT gets promoted to program director. In this case, they would blend administrative and clinical roles as time accommodates.

Did you read any books, take any courses, or do anything special overall to get you where you are today?

There’s a leadership development organization in St. Louis called FOCUS St. Louis. They have quite a few development programs that are available for early, mid, and late-career professionals.

What is a typical career path for a Chief Operating Officer?

Typically a chief administrative position leads to a chief executive role. After that, if there’s interest and opportunity, broader engagement with local and regional leaders to address systemic issues. Outside of that, there would be opportunity to consult, and embed oneself more with lawmakers and community change agents to create legislative and system changes in funding and advocacy.

Editor’s note: Interested in reading more about careers in healthcare leadership? Check out this spotlight on Chentelle Lane, PT, DPT, who is Chief Operating Officer for Karoo Health!

What is next for you?

A dream job for me would be to consult or do homeless services advocacy at the national level, whether it’s for the federal government, or as a local change agent who scales the organization to the point where there’s a regional impact.

What would you recommend to someone who wants to become a COO?

  1. Read all that you can.
  2. Understanding your learning/development needs is just as important as playing on your strengths!
  3. At a certain point, hard skills only take you so far. One needs to be comfortable with learning about people, what makes them passionate about what they do, and how to connect with them. Budgets, spreadsheets, word docs–you’ll get plenty of practice with that. But the most important aspect of the job is the art of connecting with others, and appreciating the skillsets and gifts that people bring to the table.
  4. Recognize the humanity in others, and give yourself grace. Early on in the pandemic I realized that when I get stressed out, I engage in busy work, and I was inadvertently passing that on to my team. But not everyone copes like me, and I had to come to this realization that everyone was struggling, but managing with their own unique coping mechanisms. Learn what those are, support where you can, and be flexible when you can.

What career advice would you give yourself that you wish you had during school?

Get more practice with public speaking and networking, ASAP!

Do you have any special advice for others who want to follow in your footsteps?

Prioritize self care, take time for you, enjoy the process, celebrate the growth, and learn to be grateful for dull times and times of little growth.

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