In 1886, the Sisters agreed to work with the Lakota Sioux Native Americans in South Dakota. Later missions were established in Nebraska, North Dakota, and Denver, Colorado. 

Ministry among the Lakota Native American people of South Dakota was the first invitation to the Midwest offered to the Sisters of St. Francis of Penance and Christian Charity in 1886, only 12 years after they arrived in the United States from Germany. It was prophetic of the historic diversity, both in ministries and, increasingly, in membership of the future Sacred Heart province. Sisters of varied races minister in institutions and services as varied as a Catholic hospital. an innovative high school for minority students, or outreach for economic and health needs of orphaned AIDS children in Vietnam. 

When the U.S. branch of the Franciscan congregation, already with headquarters in Stella, Niagara, New York, sought to serve the nation better by establishing two provinces in the West in 1939, Denver was chosen as the site for the Midwest province. In the shadow of the Colorado Rockies, and yet embracing the Plains states of Nebraska and North and South Dakota, ministries and membership grew. From the original two Native American missions in St. Francis and Pine Ridge, South Dakota, work expanded to include hospitals, boarding and parochial schools and a motherhouse and provincial center. Vatican II happened, inspiring new ministries and expanded outreach. Now Sisters also engaged in adult education, ministries to delinquent and abandoned youth, emergency housing, a mission to Mexico, adult Biblical study, a house of prayer, and still more. 

With changing times and priorities, with new participation of the laity in the life of the Church, smaller families, and more advanced educational opportunities, religious life, too, has experienced change. Sisters, though generally more highly educated, are fewer in number and the median age has risen. Sisters in Sacred Heart province have turned over their institutions to others, but their richly diverse membership continues to minister to equally diverse people as teachers or hospital ministers in institutions they do not own, and as parish pastoral ministers, directors of care centers, adult formators, peace and justice promoters, volunteer Eucharistic ministers, immigration advocates, in international mission and connection, as jail visitors, caretakers of elderly, and in ministries of province leadership and services. 

In their diversity, Sisters of Sacred Heart province experience their oneness in contemplative prayer in the tradition of Francis, Clare and Magdalen. They are committed to sharing their story and inviting others to collaboration and to membership, as associate or vowed members. They value the continuance of their Franciscan life and mission in the belief that the world, even with its brokenness and divisions, is cherished by God.