During her term, she established missions beyond Indiana for the first time and greatly reduced the Congregation's indebtedness, which was partly a result of the Panic of 1873.

Her parochial school in Madison was run by the Sisters of Providence, and the congregation foundress Saint Mother Theodore Guerin visited this mission in 1846.

[1]: 70–71  Schools in Michigan, Ohio and Illinois took the Sisters of Providence outside of Indiana for the first time,[3] with the permission of Bishop Jacques-Maurice De Saint Palais.

[1]: 81 Mother Mary Ephrem also proved skillful at soliciting donors and regulating spending within the congregation, greatly reducing the debt of the Sisters of Providence.

After various other ministries, Mother Mary Ephrem spent the last ten years of her life at the motherhouse, where she died on February 1, 1916.