Every morning, Mike Baumgartner sits below the wall of windows in the St. Mary's Hospital cafeteria and reads the newspaper.
It's a chance to catch up on what's happening in the community, but it also gives hundreds of employees a chance to stop in and say "hello" or chat about a concern.
"People can come and tell me what's going on," Baumgartner said.
And he'll listen.
The quiet time allows the new president of the hospital to make connections with the people who work for him.
SSM Health Care, the Catholic nonprofit St. Louis-based owner of St. Mary's Hospital in Jefferson City, announced in January that Baumgartner would take the reins from interim President Phil Gustafson.
Baumgartner arrived as the hospital faced a chasm of uncertainty. Recent financial reports showed it was hemorrhaging money, losing more than $20 million annually. And, in August last year, SSM Health Care announced it was in exclusive discussions to sell the hospital and other Central Missouri health care facilities to MU Health Care.
The St. Mary's Hospital sale process is in a due-diligence phase, in which both parties are looking at the proposal to see how it fits their missions.
Baumgartner said Wednesday he knows no more about the status of the proposed sale than the general public.
Gustafson came out of retirement in early 2018 to lead the hospital, which had experienced severe financial shortages.
St. Mary's Hospital has operated in the Capital City for about 115 years. In 2014, SSM Health opened a new multi-million-dollar facility in western Jefferson City. By 2016, in tax filings, the health care provider reported annual losses of more than $20 million.
SSM Health has credited Gustafson with steering the hospital toward financial stability.
The years of losses are concerning, Baumgartner said. Without giving details, he said the hospital is "making nice progress on the financial health of the organization."
He said he's pleased about the financial health of the hospital, but it has some distance to go.
"The biggest (indicator)," he said, "is the bottom line, or the operating margin. It has definitely improved."
Baumgartner arrived in Jefferson City after having run SSM Health St. Francis Hospital in Maryville.
As part of the August announcement, SSM Health Care also disclosed it intended to transfer St. Mary's Hospital-Audrain, along with outpatient, home care, hospice and medical group locations throughout the region, to MU Health Care, as well as transfer St. Francis Hospital and its affiliated outpatient home care, hospice and medical group locations to St. Joseph-based Mosaic Life Care. The Mosaic transfers have been completed.
Baumgartner had been the president at St. Francis Hospital twice before arriving in Jefferson City.
The North Dakota native said he's been operating hospitals for more than 40 years.
"The one thing that's somewhat different for the career path — I actually was in a classroom on a Friday. The next Monday, I was the president of a small hospital in North Dakota," Baumgartner said. "That doesn't happen too often."
At 23, he became the chief operating officer of a hospital in Bowman, North Dakota. The hospital had only two doctors, and it served a community of fewer than 2,500 people. (The U.S. Census Bureau now estimates the town's population at 1,650.)
"That's where it all started. I'm blessed to have been given that opportunity," Baumgartner said. "So the first part of my career, I was definitely working in rural America."
He worked for three different hospitals in North Dakota, including one associated with Catholic Health Initiatives — a nationwide nonprofit Catholic system that was based in Colorado. CHI was already one of the largest Catholic health care systems in the country before it completed a merger in February with Dignity Health, based in California.
The company is now called CommonSpirit Health and has 142 hospitals, more than 700 care sites across 21 states, and 150,000 employees.
Baumgartner first arrived in Missouri, at the Maryville hospital, in 1997.
He returned north after a stint there.
A lure was the metropolitan Minneapolis/St. Paul health care market, Baumgartner said. He took the lead at St. Francis Regional Medical Center in Shakopee, Minnesota, a suburb of the Twin Cities.
There are few markets that offer the dynamism and interest of the Minnesota market, he said. And the seven years of urban work was good experience for him.
From there, he went to Baptist Health Hospital, in Madisonville, Kentucky — Baptist Health's largest hospital.
"It was a very dynamic hospital. It had residency programs," Baumgartner said. "It had an affiliation with the University of Louisville Medical School."
The hospital was considered a "rural referral hospital" because it conducted a high volume of acute care, treating a large number of complicated cases that other health providers could not.
From there, he returned to Maryville and now is in Jefferson City.
"The challenges are the same everywhere — improve quality, provide a better experience and lower costs," he said. "That's the mission of health care."
Although the challenges are equal, states' health outcomes vary greatly.
The Commonwealth Fund — a private foundation that aims to promote a high-performing health care system that achieves better access, improved quality and greater efficiency — recently released the 2019 Scorecard on State Health System Performance, which ranks each state using a number of categories.
The fund produces the scorecard every year to give a snapshot of how states are doing in terms of improving the health of their citizens.
The health outcomes for the states where Baumgartner has helmed hospitals vary greatly.
Missouri ranked 43rd of 51, including the District of Columbia. Kentucky ranked 40th. Minnesota ranked third.
Individuals have their own responsibility for their health, he said.
"What's on the inside is the part that matters. Everybody should know their own key numbers," he said. "You need to know your body mass index. You need to know what your blood pressure is. You need to know your blood sugar. You need to know your total cholesterol levels."
Blood sugar was a "wake-up call" for Baumgartner. His father went into a hospital for "a small amputation because of his diabetes." He developed sepsis — when the immune system releases chemicals into the bloodstream to fight infection, causing inflammation — and died.
Patients need access not only to information, but to care, he said.
That's a key thing in health care.
St. Mary's Hospital offers free screenings that will allow people to gather that information.
Health rankings also look at societal issues, Baumgartner pointed out.
Life expectancies are dropping because of suicide rates, addictions and gun violence, he added.
States that have expanded Medicaid have seen health improvements. The ones that haven't expanded Medicaid haven't seen improvements, he said.
"It's not one thing; all these things together make a difference," Baumgartner said.
Mental health issues pose challenges for all communities. Those communities need to develop collaborative services for behavioral health.
St. Mary's Hospital contains a Behavioral Health wing. The wing averages about 18 patients per day and has a capacity of 20. So it is basically full.
"We participate with a lot of different organizations," he said.
The hospital is working with a collaboration of agencies to provide behavioral health services for victims of the May 22 tornado that ripped through Jefferson City, and ongoing flooding.
"How do you do it?" he asked. "We're not in it by ourselves. The whole community is going to rally and come up with that answer."
The hospital is just trying to serve the patients. They are trying to serve patients based on their needs — whether that is behavioral health, medical or surgical.
"We have that expertise. We're here to help," Baumgartner said.
And he "rounds" on patients — to assure patients they are getting the best care possible.
He visits them in their rooms, where their primary physicians and nurses are listed on a board on the wall.
Again, focused on patient experience, he can walk into patients' rooms, introduce himself and look at the board and tell the patient how confident he is in the health workers who are serving them.
"I come in and say 'I'm Mike, president of the hospital, and I want to see how we're doing,'" Baumgartner said. "Then I just listen. So far, I haven't had a single complaint."