Eat Well, Be Well, with Chef Steve Smith, episode 16

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Eat Well, Be Well, with Chef Steve Smith, episode 16

Join us for the latest episode of Health on the Plains - a Kansas Health Institute podcast focused on rural health challenges and opportunities in Kansas. Meet the leaders and doers working to make communities healthier, more vibrant places to call home.

Summary:

In this episode of Health on the Plains , Wyatt Beckman sits down with Chef Steve Smith, the innovative culinary mind behind a fresh approach to food and healing at Smith County Memorial Hospital, in Kansas.

Chef Steve shares how he's transforming hospital dining by creating customized, nutritious meals designed to support patient health - a model rooted in the belief that food is medicine. His work doesn't stop at the hospital doors. From a home meal delivery program to welcoming community members into the hospital's on-site restaurant, Chef Steve has built a culinary ecosystem that nourishes the entire county.

Discover how this small rural hospital is leading big change, and why Chef Steve hopes this model of whole-person, community-centered nutrition can be replicated across Kansas and beyond.

Tune in to learn how good food - and good care - go hand in hand.



Episode Highlights

• 0:42 - 10:58 Chef Steve Smith describes his path to being both a chef and registered dietician, and how he ended up working in Smith Center, Kansas.
• 11:11 - 14:26 Wyatt asks Chef Steve to describe how the Hometown Cafe, a restaurant in a hospital, came to be.
• 15:25 - 25:00 Chef Steve talks about how the medical staff works with him to serve patients and produce meals that are tailored to benefit each patient.
• 26:00 - 32:34 Wyatt has Chef Smith explain how he balances the need for healthy food with getting patients to eat the food, as well as trust him and other hospital staff.
• 32:39 - 39:26 Wyatt has Chef Steve describe their unique Meals on Wheels service.
• 39:46 - 40:53 Chef Steve has partnered with the local grocery store, and describes another community program that is aimed at assisting people with choosing healthier food and knowing how to prepare it.
• 41:09 - 43:49 Wyatt notes that it sounds like Chef Steve has become an educator and asks him to describe the experience of teaching others to change their lifestyle or food choices.
• 44:17 - 45:00 Chef Steve discusses how important workforce is when trying to do so many different programs.
• 45:16 - 49:45 Wyatt and Chef Steve discuss how the key ideas of partnerships, trust, collaboration and supporting the community have led to several of the programs that he now has a large role in, as well as the relationships he has with hospital leadership.
• 50:00 - 52:15 Chef Steve gives the stats on how large of an impact this food service has on the community, on average, each day.
• 52:30 - 58:17 Wyatt asks Chef Steve about any future plans, as well as advice to others who might be inspired by their model or food programs.

Transcript

Voice over 0:00
This is Health on the Plains, a podcast about rural communities, rural life, and the many factors influencing the health and well-being of rural Kansans. Health on the Plains is a podcast from the Kansas Health Institute, a nonprofit, nonpartisan educational organization committed to informing policy and improving health in Kansas through honest, nuanced conversations with leaders and doers from a variety of backgrounds. The Health on the Plains podcast offers unique insights into rural health challenges in Kansas and shines a light on the people and organizations working to make their communities healthier, more vibrant places to call home.

Wyatt Beckman 0:42
Welcome back to another episode of Health on the Plains. I'm your host, Wyatt Beckman. Today we are in Smith Center, a small rural Kansas community of about 1,500 people located in the north central part of the state. We are here to talk with Chef Steve Smith. Chef Steve is a trained chef and seasoned food service professional who is also a registered and licensed dietitian. Chef Steve was trained at the Culinary Institute of America. In our conversation, he talks about leaving the Culinary Institute, but fails to mention he went back to finish and graduate some 20 years later, earning the patch he wears on his sleeve. Now, Chef Steve has an incredible background and story, one that took him all over the world, but he found a home and a mission in rural Smith Center at the Smith County Memorial Hospital. Smith County Memorial Hospital is a small, Critical Access Hospital, one of 80 plus across the state. With the support of hospital leadership, Chef Steve and his team have created a wealth of great food programs, including a Hometown Cafe that's open to the public and a food home delivery program, and so much more. They have faced challenges that are familiar to rural communities, especially around workforce. And Chef Steve is a one of a kind individual, but he and his team show what's possible in a rural community when collaboration, hard work and a bit of creativity all come together. Everything we're going to talk about today, and I mentioned the Hometown Cafe, which is just over the wall, where we just had, had lunch, your Meals on Wheels efforts, all of it. There's, I'm not, I'm just scratching the surface. But all of it is really shaped by your really unique skill set and abilities as both a highly trained chef and a registered and licensed dietitian. So I want to, before we get into what you're doing now, let's go all the way back to that point, and the path that set you on this health and dietitian and culinary skills. Take me back to that decision. When did that start?

Steve Smith 3:03
Okay, alright. Well, on June 23, 2003, I waddled into Grant Medical in downtown Columbus, Ohio, holding my chest, and I had what was called the heart episode. Didn't have a heart attack, but I was in the, in the emergency room for, I don't know, eight or nine hours, something like, it was a weekend. And there were evidently no docs available. And there was a couple of med students that sounded like, there. And so I didn't get sent upstairs for a CAS, and probably would have had stents put in, maybe something more serious. So I got out of there, and I basically sound myself out AMA, and got back home, and I was, this is a long, convoluted story, so. Well, I'm gonna give you the short version. I was running an internet sales business at that time, selling rare and out of print video tapes on, on eBay and Amazon. And I got up online, which is where I was living, and did a real quick search, and, you know, heart disease, that type of thing, and a bunch of lifestyle modification stuff came up. And I got introduced to some, some people that I have over here, John McDougall and, and some other people that do lifestyle medicine. And they were talking about lifestyle modification and a plant-based whole foods diet. And I also ran into, believe it or not, on the same search, Bruce Lee. And you know, I was, well obviously I knew who Bruce Lee was, but I didn't know he was a philosopher. And I started getting into Bruce Lee and one of the things I have on the back of my business card is one of his quotes; "Knowing is not enough. We must apply. Willing is not enough. We must do." So I became acquainted with that kind of action-oriented stuff, and I picked up some some other stuff from Bruce Lee, and decided to do a lifestyle modification with heavy exercise and diet. Took off a bunch of weight, 80 pounds, and it's up on my website. I think it's three and a half months. I did a very strict vegan diet with no oil, no processed food, no dairy, very low sodium and, and coupled with exercise, the weight just fell off of me. I normalized my lipid profile without drugs and basically healed my body. And that's, that's the thing that turned me on to using food as medicine. Cooking that food, though, was really difficult. So I'm a foodie. I'm not going to eat something if it doesn't taste good. So a lot of my first attempts with that style of food, without salt, fat and sugar, which is what I was trained to use at the Culinary Institute of America. You know, in that, in the mid 80s, that's what they were doing, is salt, fat and sugar, you know. If it needs flavor, grab a handful of cheese and they're good. You know, I'm oversimplifying it, you know, and I don't want to demonize the CIA, but, you know, that was his main philosophy, you know. And I learned how to do that, but it was extremely difficult. And I got at the end of this, and I said, "What chance does a regular Joe have?" You know, here I am, a graduate of the Culinary Institute of America, been a chef in some of the best resorts, at least in the West Indies, and I had a hard time with it. I did. I had to discover things that put umami back in the food. Umami is that savory flavor profile that meat has, that really makes the food sexy and something I want to eat. And you got to figure out things that will get it in, and not, the things that don't have a lot of sodium and don't have a lot of fat, saturated fat, etc., cholesterol. I learned how to do that and decided that the average Joe has no chance of ever doing that. They can try, but if they don't have the skill level and the willingness level. So that's the other thing that, that Bruce Lee is all about is, you know, if you don't want to do it, it's not going to happen. You have to have that willingness level and the expertise. And I decided to go back to school to, to become a registered dietitian, and so I could show people in a clinical setting how to do that. Yeah, that's where it all started. That's, that's the short version.

Wyatt Beckman 8:15
That's the short version. What a powerful example, too of your, your both willingness and dedication and ability to put that into practice. And we, we were talking about some of the work you're doing here, and talking about starting your day really, really early. And I still see that, that work show up, show up in the how you're bringing food to people now. But I, you mentioned West Indies. You've also worked in Qatar, United Arab Emirates,

Steve Smith 8:53
Dubai.

Wyatt Beckman 8:54
Dubai, New York State. You have other places, 13 restaurants. I think Kansas is great, big fan of Kansas. But I can't help but wonder, how do you end up here?

Steve Smith 9:11
Believe it or not, if you look at my resume, you think that I chose locations, geographic locations. I didn't. I chose jobs. And I've never, ever looked at a geographic location. I look at a job. And one thing, one thing that I left out is that, I started at the CIA in 1984, I didn't graduate. I went into some, some personal issues, and I left off what's called restaurant row, so I could not work in the United States. We're very sheepskin conscious in the United States. Luckily, I fell into work overseas training for the Caribbean Hotel Association, where they don't care about a degree. They care about what you can produce. And I found a home, right? So not everyone can work in those environments, so I was pretty much limited to all these great locations. So I took the US and that, that was out, and now I have the rest of the world to look at. But I chose jobs, not geographic locations. So what I looked at that this, it wasn't, I looked at Smith Center, you know, and it's a quaint little town, and it has its pluses and minuses, like any place in the world. You move there and discover what's great about that community. And there's some great things about this community. But I chose it for this opportunity, which is a rare opportunity. I had no idea what it was going to be. And I didn't start out to do this great big thing at all. I just came to open a restaurant in a hospital and see what could possibly happen.

Wyatt Beckman 10:58
Yeah, so say more about what, what the job was when you started. What, what was the vision from,

Steve Smith 11:05
There was no vision.

Wyatt Beckman 11:07
-where, because we're going to talk a lot about where you've ended up, but yeah, where did it start?

Steve Smith 11:11
There was, there was no vision. I was just trying to survive. So I have, I took the crew from the old facility, and they were doing pretty basic food, that was all prefabricated, no cooking per se. And move that crew into an environment where we do as much as possible, from-scratch cooking. You know, it's not, I can't, I can't do from-scratch cooking, but I do it as much as possible. I pick a few critical points and do from-scratch cook. And I trained everybody from ground zero, working all three shifts, training people. And I just slotted people in where they showed that they had an affinity towards that type, type of work. For instance, Cheyenne is the gal that does the salad bar, and I noticed that she was being pretty meticulous, and I put her on the salad bar and it turns out that she's an artist, and works really well with, with things. She did the tomato rose that you saw out there. And I start her off, and then she runs with it. And I had some other gals that were more directed towards cooking. I had one gal that had a gift for logistics, and I just moved people around until we fit. And then we started. It was about, we opened to the public maybe a month and a half. There's 100 employees here, so that's enough to work with, and the 30 Meals on Wheels, that's enough. We didn't open to the public for a couple of months, until I have everything situated and we could produce the salad bar. And we did it gradually. I've opened 13 other restaurants, so I know about soft openings. You do it gradually, instead of all at one time. And that's what we did. And I wasn't even seeing patients at that point in time. We, they held on to the contract, contracted registered dietitian, and she did the, the charting that had to be done, and I picked up patients a few months after that. So it was a step-wise opening with no vision. All I did, had no idea what was going to happen at all. I, you know, who, who thinks of opening a restaurant in a hospital? I certainly didn't. You know, it's never on my agenda.

Wyatt Beckman 13:49
And, and, and it's in the hospital. You,

Steve Smith 13:52
Yeah,

Wyatt Beckman 13:52
-come in the main door.

Steve Smith 13:53
You have to come in.

Wyatt Beckman 13:54
-main emergency room entrance and then take a left, and all of a sudden, you're in, you're in this small restaurant.

Steve Smith 14:02
Yeah,

Wyatt Beckman 14:02
With the, with the meal for the day and a really good salad bar. It was, it was all very good. But so you start, and the task was, okay, we're starting a restaurant.

Steve Smith 14:12
Yeah.

Wyatt Beckman 14:12
In a hospital. We're gonna serve our staff. And then you slowly keep adding community, add, do the patient work?

Steve Smith 14:23
We did the patients first.

Wyatt Beckman 14:24
Patients first.

Steve Smith 14:25
Yep.

Wyatt Beckman 14:25
Okay, the, I. So something I saw on the hospital's website, and I wonder, maybe this was vision at the beginning, or maybe this was a vision that evolved. But I, the food service department is described as highly relevant to the medical team, the staff of the facility, patients in the hospital and the community at large. So you all set out for this food service department to be a resource, not just for patients and for staff, which is what I think of when I think about a hospital food service, but for the whole community. And I want to talk about the Hometown Cafe, which is over where we where we ate, and the Meals on Wheels program and Chef Steve Grab Good, which we'll, we'll talk about with, partnership with the local grocery store. But I want to start with that, that relevant to the medical team.

Steve Smith 15:25
Sure.

Wyatt Beckman 15:26
How, how do you work with the medical staff, the doctors and the nurses, other providers, and what does that look like to bring in? It's really food is medicine. You're, are you part of the team and crafting a meal plan? What does that look like?

Steve Smith 15:40
Well, you use the word vision rather loosely there. There was no vision. So this was just, you know, I've never worked as a dietitian on a floor. This is my first adventure, and I view that as an asset, not, not as something that, as a hurdle that has to be overcome. So there's, that picture, right there is a picture of my grandmother. And I didn't have this in mind when I, when I started to do dietetic services on the floor, but it was the first week that I was visiting patients. And I visit every patient, every day. And there's a bunch of reasons for that, but I wanted to see how they're doing so I can target food to exactly how they're doing that day. Because it, it changes, it changes. So it was the fourth or fifth, I forget, on the first, first or second day. I sat across from a one woman who looked exactly like my grandmother. One of the times I came up from, I think it was Jamaica, to visit my, my parents in Connecticut, my grandmother was visiting, and she had a stroke. And she was checked into Waterbury Hospital, and I went to visit her. I forget which side wasn't working and she was in bad shape, wasn't eating. And I asked the nurses, what, you know, what are you feeding her? And they showed me, you know, cream of wheat and just, you know, basically garbage hospital fruit. And my grandmother's from Chattanooga, Tennessee. She eats. She's one of the people that I learned how to cook from, or at least at her skirts, you know, eating her food and watching her do it. And, you know, she eats grits and gravy, and ran a boarding house, and she knows what she's doing around, around food. And I mentioned to the nurses that, you know, she's not going to eat that. She's definitely not going to eat that. So I went home and I made, you know, grits and gravy and some biscuits and ham, and some, you know, braised greens, very similar to the ones that I do here. And brought it in, and, you know, lo and behold, she started eating. Isn't that funny? She feeds something to someone that they're, that they, they're familiar with, and that they're, they're used to eating. They start to eat. Isn't that funny? Now, I'd completely forgotten that. I, you know, that's funny. You know, I'm sitting here saying, and you can say, well, he was thinking about. I completely forgot that, until I was standing, you know, sitting in front of this, from this woman, and she said, I talked the way that I always do table side. This is table side service, right? I didn't realize that either. So what I've been doing, you know, with celebrities and politicians and high-end customers, and, you know, the best restaurants and, and resorts in the West Indies, is, I do table side stuff, and I give them that kind of personalized service. And what you do is, you, you're standing in front of them, you have a conversation, and without them knowing, you know, you find out what they want to eat that night. And then you say, out of the blue, how about bing, bing, bing, bing. And they're going, "Yeah, I was kind of thinking about that." Okay. And that's a skill, you know, that's a skill, and that's what I do with the patients. That's exactly what I do. So I made grits and gravy for this woman. And you know that, after that, I was like, okay, now I get it. You know, that's what it's going to be. So that's, it's not always, to get back to your question, it's not always that I'm a part of the medical team, is that they let me loose on the patients. That's the relationship we have. So over half of the diet orders that come in are custom. They don't do a diet order, you know. I, I go in and it's not, it's based on what their condition is, and they may give me. They may grab me in the hallway, and say, you know, room number three really needs a heart healthy diet. See what you can do. And I go into the room and they're non-compliant, and, you know, they don't want to, and it. So it's my job to move them as close as they possibly can, and keeping in mind that word willingness. So they have to, you have to judge their level of compliance with the assigned, or what they should be doing as a diet. You know, there are a couple of very serious exceptions. You know, diabetics that take insulin, you know, you need to have, there's an education process. And I do it right there. I do it right there. If they don't, you know, my, my main question is, you know, to a diabetic, is, I see you're on a diabetic diet, is that something that's new for you? And you know, if I get the feeling that they know what they're doing, then, then we proceed like that. And if they don't, then it's an education moment. Yeah. I thought that I would be doing the direct opposite of what I do 90% of the time. 90% of the time, I'm trying to get people to eat. Not keep them from eating too much.

Wyatt Beckman 21:11
Interesting.

Steve Smith 21:12
You know, my background is in lifestyle modification, so I'm used to deal- dealing with heart disease and people that are over, obesity, and blah, blah, blah, blah. And I do that, but about 90%, are people that are in really rough condition that you need to get them to eat. And that's what I've become really good at. So that's when they just let me go, and in a day or two, you know, it comes up from just water to, you know, maybe an Ensure shake, that I have a pretty good milkshake that I make out of, of Ensure. And if I can't get you eating with that, then there's a problem. And I take and do, what, if there's a different consistency. And I teach my staff, the CDMs that I've trained how to do anything that they want. That's really what we do. We come up with a, we try to keep them on the same food that we serve the public and the staff. Same exact food. But if they can't do that, I might have 10 patients and 10 different meals going up.

Wyatt Beckman 22:21
Wow.

Steve Smith 22:22
So it's highly individualized, and the staff knows that that's what I do.

Wyatt Beckman 22:29
What a, what a great story, and the prompt,

Steve Smith 22:32
Yeah.

Wyatt Beckman 22:33
-the picture. Even if it, yeah, even if you weren't thinking about it. What, what a, almost a full circle moment. Something I'm hearing in, in that, that I am interested to hear you talk a little bit about. Because you have a, you have a unique set of skills. I think it's, it's fair to say. And I heard you framed it as, they let you loose. And what I, what I think I hear underneath that is, there's some trust, and there's this really productive collaboration between you, medical staff and hospital leadership. Tell me about that relationship and how important that's been to what you all have built.

Steve Smith 23:12
The reason why I stayed here after working for a couple of months and sussing out the situation is that the doctors here are not jerks. That's real important. And they listen, not only to me, but to all the staff. And there's really a team, a team concept.

Wyatt Beckman 23:35
And you're part of the team.

Steve Smith 23:36
Absolutely. I don't, you know, I've drawn a few lines here. I, I'm a chef RD, and I need to do the kitchen stuff. So you're not going to see me at meetings. I'm not going to do rounds. They know when they need to grab me, to corner me in the hall. They know when I'm going to be up there, and they corner me and give me, you know, specific directives on people. And that's it. It's very informal. And the reason why they turn me loose is that, number one, I don't do stupid things. I feed people, you know. And once they see that a couple times, then they're, okay, listen, I don't know what he's doing, but just get him to, get, get him to get patient in two to eat, please. And that's what and people gain weight or that, they come in on, you know, the blood sugars are unstable. They, they stabilize. And after seeing that a couple of dozen times, then they're, they're more apt to trust you. They're not, they're not stupid people, you know. And they, and they act on what they see. It's the same thing that I got used to working overseas, you know. Produce results, and people will trust you. They'll give you more work, right? They're not interested in what's on your piece of paper. And no one is.

Wyatt Beckman 25:02
I, I, let's, let's talk about another area where I think it's fair to say you've had results. Let's talk about the Hometown Cafe. So,

Steve Smith 25:13
Sure.

Wyatt Beckman 25:13
This, I got the menu here from, from this week.

Steve Smith 25:19
Yes.

Wyatt Beckman 25:20
This is what you served today. Let me find, so steamed salmon or baked cod.

Steve Smith 25:26
Yep.

Wyatt Beckman 25:27
Steamed gold potatoes, fresh asparagus. There's also a steak soup.

Steve Smith 25:32
Right.

Wyatt Beckman 25:33
A full salad bar. On, on Tuesday you did,

Steve Smith 25:38
Might be next week's.

Wyatt Beckman 25:39
Oh, this is next week.

Steve Smith 25:40
Yep, that's next week.

Wyatt Beckman 25:41
So next-

Steve Smith 25:42
That's just as good!

Wyatt Beckman 25:43
Next week on Wednesday, you're doing a fajita rice bowl with seared skirt steak.

Steve Smith 25:47
Yeah.

Wyatt Beckman 25:47
-Spanish rice and pinto beans and corn. Earlier this week,

Steve Smith 25:53
Brown rice, brown rice.

Wyatt Beckman 25:54
Brown rice.

Steve Smith 25:54
Yeah.

Wyatt Beckman 25:55
-earlier this week, you had baked steak, onion gravy, mashed potatoes, fried okra and homestyle green beans. What I'm getting at, is that all sounds like genuinely tasty food. And it was tasty food today, but it's also all the things you've been talking about is, it's needs to fit into people's dietary needs. You're really thoughtful about sodium level, about cholesterol and fat, and you accompany the menu online with notes about the food. So how do you, how do you approach this, this balance, because it seems to be a successful balance you've struck, of making food that people enjoy eating, and on their own volition, from the community come in to get your food, but also supports health and well-being?

Steve Smith 26:44
Well, so I'm feeding all of those people. And the way to look at this is, the way that I explain when I do a dietetic consultation. I obviously come from a background of a whole foods, plant-based diet, but that doesn't translate into Smith Center really well. In fact, I don't talk about that. We don't use the V word. We don't use vegan word here. So I describe what I call a healthy diet spectrum. And on one side, I've got the whole foods, plant-based diet that's extremely well studied. It'll heal your body right now, but you got to have a high level of willingness and some skill to be able to do it. It's not easy. I know, because I did it. And I'm a trained chef. On the other end is something called the DASH diet. And in between, there's plenty of other diets that would, that I could describe as healthy diets. This is an entry level diet, the DASH diet, Dietary Approaches to Stop Hypertension, and it's also very well studied. It's easy to follow, but the results are limited somewhat. You're going to, you're going to stabilize your blood sugars a little bit. You're going to reduce your blood pressure, you're going to reduce your cholesterol, your lipid profile, a little bit. You're going to lose some weight. It's a great entry-level diet, and the idea is to move down, closer and closer to a more, more effective diet, and pick a diet that's right for your willingness level. So even though I started way up here, my willingness level has changed over the years. It goes back and forth. I'm not going to kid you. No one, no one, you know, that does a plant-based whole foods diet does that for the rest of their life. I'm sorry. There may be a few, you know. Dean Ortiz might do that, though he probably slips off every once in a while, has some ice cream or something. But the point is, your willingness level changes, and you need to correspond your diet with your willingness level and your ability. So I, I, I make food for all those levels of people. So you described the chicken-baked steak that I did this last Tuesday. So that is a chicken-baked steak that's got a lot of sodium in it. And I tell you, if you're on the DASH diet, and that's the only person that should really be eating this. If you're on the DASH diet, you can fit it into your diet, but you better be decent with sodium at breakfast and supper. And that's how you do it, their daily me- daily parameters, and the rest of the meal actually fits into a plant-based whole f- a whole foods diet.

Wyatt Beckman 29:43
Lots of fruits and vegetables.

Steve Smith 29:44
No, that, that meal.

Wyatt Beckman 29:46
This, this was

Steve Smith 29:47
The onion gravy is something I did on cooking demonstrations at Whole Foods Market 25 years ago.

Wyatt Beckman 29:53
Oh, wow.

Steve Smith 29:54
The, the, the braised, I mean, the homestyle beans are also something I did in that same cooking demonstration.

Wyatt Beckman 30:04
Woah.

Steve Smith 30:05
The soup that day is a direct opposite. So the soup that I make on, on, on, like today. The steak soup is something that I tell people, if I see them and I know that they're doing a more healthy meal, they'll, they'll ask me, they'll come in, ask me about, is the soup for me? And I will tell them, "No, that's not your soup." And I don't eat that soup. It's a great soup, but it's not something that fit, that, that's, that's for my diet. However, if you're on a DASH diet and you want something that tastes good, that's wholesome, that, that soup is for you. And if it means that you'll come back to me and eat something else, maybe you pick up a vegetable, that 25 or 30 types of vegetables that are on the salad bar. Or maybe you try something because I built rapport with you. That's, that's what the goal is.

Wyatt Beckman 31:04
Yeah, talk about, talk about that rapport. Because it, it seems like, we were in there. You pretty much knew everyone, everyone in there.

Steve Smith 31:12
Yeah.

Wyatt Beckman 31:12
You have a lot of people that come in once, have a good experience, you create that, that entry point into eating good food and healthy food, and then they keep coming back.

Steve Smith 31:22
Right. Yep.

Wyatt Beckman 31:23
Is that, is that an intentional relationship, you, you're thoughtful about building?

Steve Smith 31:28
Well, that's, that's actually what you do as a chef. Coming in, a new chef, coming into a town, is, the first thing you want to do. First thing you do not want to do is come in with your style, unless you're a really well known chef, then people know you ahead of time. If you're just a Joe Schmo like me, you come into town and you build rapport with your clientele. And you build up their trust and get them to return, become regular clientele, and then you can start doing things that you want to do, and they'll trust you with it. The same way that patients up on the floor, trust me when I say, you know, I think you're going to like this, you know. And if it works one time, it's going to work again, you know. And I have, that's how you move people, noncompliant heart patients, into a more heart healthy diet slowly, you know. So it's, it's building rapport. It's building rapport on the floor of patients, it's building rapport here. No one knows me from Adam. They know my food.

Wyatt Beckman 32:35
Well, let's, let's talk about another thing you, you all do. And it's the same food that you're just describing, and it's your Meals on Wheels program. On, on the website where people can sign up to volunteer, delivery driver or sign up to receive meals, you, you say, we have many people who need to get food into their house. Food insecurity is present in every city in the United States, including our town. It seems like you all at the hospital, and you personally, have recognized that need. But instead of saying, "We have this great Hometown Cafe, come, why don't you just come get the food? It's here." You're, you're taking it directly to them. You're walking in, in the door. Tell me about, tell me about that.

Steve Smith 33:27
So we're not, we're not govern- government funded. Our program is not funded, so we're free to do what we want to do. So we have, you know, you need to qualify, but there's no hard edges on that qualification. One way that you can get started on Meals on Wheels, and it's probably about a third of people, is that you come in for rehabilitation here, after hip surgery, foot surgery, whatever. You're immobile. You can't, or you're a little shaky or whatever, and you can't, you can't cook. And we start you on Meals on Wheels, and sometimes it lasts, you know, a day or two, a couple of weeks, months, whatever it is. And I always get a phone call from somebody that says, "You know what, I'm good to go. Thanks a lot. Appreciate it." And they're off Meals on Wheels. So that, that is one way, it's like a continuation of rehabilitation.

Wyatt Beckman 34:29
Part of their care.

Steve Smith 34:30
Right, exactly, it is. And doctors are now doing that and say, "Can you, can you get Ethel on, on Meals on Wheels?" Another way is if you just can't afford food, and we have, we have people that are homeless, you know. You don't, you see a town like Smith Center, and you don't, you don't think that there's homeless people. We get a lot of people coming through that police will pick up, bring over here, because they are in bad shape. I feed them for a couple of days. They get a hotel room or whatever, and we do Meals on Wheels for them. We have people that are in low income areas, that, low income housing that we have here. And not always because they're low income, it's because they need to be close to services. Older folks that need to be, heck, you might find me there one day. Close to services, and need some company, and it's a better location for them, and they need some help with food. A lot of them, a lot of our clients, are that. And then people that are just too old to get out, you know. And we have, I mean, this is an old, older community, and probably about another third is people that, you know, just can't get out.

Wyatt Beckman 35:58
And I, on the video, on the website, there's a promotional video and the person that's stopping, talking to the people receiving the meals. There's a clip of one of them calling you and saying, "Hey, today I could really use some chicken noodle soup. That sounds really good." Tell me about is that a real, is that a phone call to you?

Steve Smith 36:22
I'm not going to use her name. Yeah, yeah. So, yeah, we, we do that. We do that. Because we're small. We have 30 clients. We can do that. That's, that's a lot of work. I'm not going to kid you, to change on the fly, but it's an outgrowth of what I do with patients. So any given lunch, you may see me come down 10 minutes before service and say, okay, okay, stop room, room three is this, room four is this. And we just shipped. And, you know, that's something that you'll see in a, in a well-oiled restaurant, you know, right, right at service. And that's what we do. And I just do the same thing with, for Meals on Wheels. We had a gentleman this week. He's probably watching, hi. That had some stitches in his tongue this week. So for a week, we switched him to, he didn't want pureed soup, but pulsed soup that he's going to take through a straw. So we send him a quart of pulsed soup in a food processor that he can suck up through a straw. And that's something we didn't even think twice about. Yeah. We have a vegan on Meals on Wheels that we have fun coming up with different things for. We have one gentleman that has a real problem chewing, and he doesn't eat anything but meat and potatoes. So when we do something like meatloaf, we keep it in and he'll eat the same thing every, every meal. He doesn't care. Give me mashed potatoes and you got meatloaf three, three days in a row. That's great. And that's what, that's what we give them. We don't give him any of the fancy stuff or anything else. It's meat, potatoes every day.

Wyatt Beckman 38:23
Wow. It really is. You're, you're really building the rapport with,

Steve Smith 38:29
Right.

Wyatt Beckman 38:30
-everyone, building the trust, and really tailoring it to what, to their needs and their desires and what is realistic, will work for them. And you, you're doing that here in the hospital,

Steve Smith 38:42
Right.

Wyatt Beckman 38:42
-it extends to the the Meals on Wheels program. That's sounds like a lot of work, but also an amazing resource for the community.

Steve Smith 38:50
It's not a lot of work, and I can tell you exactly where it comes from, if you don't mind.

Wyatt Beckman 38:54
Yeah!

Steve Smith 38:54
It comes from working in high-end resorts. It's called the spirit of hospitality. When you have guests come into your, your hotel, you take that personally. You're welcoming them into your house, and you're going to provide everything that you possibly can. That's what these people pay for. That's what you learn how to do in a high-end resort. And that's all I did, was take that experience and graft it onto the hospital, bringing hospitality into the hospital. That's what I do.

Wyatt Beckman 39:26
Another example of how you're like blending and, in a very complimentary way, your, your backgrounds and your unique skills and expertise. Let's talk about another, yet another place where your skills and expertise are showing up. And we, we drove by it on the way in, into town. You've partnered with the local grocery store, Gene's Heartland Foods,

Steve Smith 39:50
Sure.

Wyatt Beckman 39:51
-and you. The goal is to make it easier to select healthier foods shopping at the grocery store.

Steve Smith 39:57
One of the goals.

Wyatt Beckman 39:57
One of the goals. So there's a, it's called Chef Steve's Grab Good,

Steve Smith 40:02
Yep.

Wyatt Beckman 40:03
-and you've got information. There's QR codes. It takes you to recipes and tips.

Steve Smith 40:08
This sits right on the side of the aisle. There's a little clip so you can see it from the end of the aisle. And I have, this is one of the items that we have down there. I asked him to bring this in, and it's a, it's a ham base that we use and right on the aisle, boom, there it is. You can see it, go right to it, bang.

Wyatt Beckman 40:27
And this is to, so the idea is to help, if I'm shopping and I want to pick something that will taste, still taste good, work with my, what I'm cooking, but also can fit into my dietary needs. This supports all that. And then I hop on website, and I've got videos and some recipes and some tips.

Steve Smith 40:48
I show, I show them how to use this, and then mention that you can get it right down the road.

Wyatt Beckman 40:54
Something I see is a through line, and I want to, I'm sure we'll s- we might even stop by on our way out, and I'd love to see it in person. But something I keep hearing, and I think this is a good example. But I also hear it in how you talk about supporting the staff that work with you, is this, this sense of teaching people.

Steve Smith 41:18
Right.

Wyatt Beckman 41:19
You're, you, not only are you wanting to make good food for people that they enjoy eating, that contributes to their health and well-being, but you're also wanting to help them learn how to do that and implement that in their own lives. So tell me about that. Do you see yourself as a teacher? Is that, is that something that you would, you would identify with? And if so, is this an extension of that?

Steve Smith 41:43
Yeah, so it's, I, it comes from working overseas. My first job overseas was as a trainer for the Caribbean Hotel Association, and that's how I came into it. After you do that, it's kind of ingrained. And when you work overseas, you're a trainer as well. You may work with a couple key expatriates that are brought in that don't need to be trained. You just tell them what your signature is, and that's the way we're going to do it. Everyone else needs to be, needs to be trained, the same way that I did here. You know, when I, I, I have precepted five CDMs here, Culinary Certified Dietary Managers, five of them.

Wyatt Beckman 42:33
Wow.

Steve Smith 42:34
And that's also what I have learned overseas, is that you need to enrich the lives of people that work for you. Give them a way, it's like not giving them fish, it's teaching them how to fish, right? That's, that's what it is. And that's what I've done here. So any one of these CDMs can go anywhere, after the experience they have here, anywhere in the country, and get a job and shine, you know. If they can find a place that will allow them to do, what, what we do. You know, allow them to cook. But so it's, it's a, it's just ingrained into, it has to get ingrained into your being, that you're both a teacher and facilitator. And that's, that's what you have to, that's what you have to be doing. That is why I got into this, is to show people how to do what I did with food. So, you know, from the very start, that's, that's what it was.

Wyatt Beckman 43:39
Yeah, you saw that, saw the power of food in your own life, and extension of that.

Steve Smith 43:44
Right.

Wyatt Beckman 43:45
And helping people see it in their, in their own lives. It something we talk about a lot, when we talk about health and health care and hospitals, and remind everyone as much as we're talking about all these amazing programs, we're, we're in a hospital, doing this from a hospital, is workforce. Do we have enough workforce? How do we recruit and retain trained professionals or train them up? And we talk about that when it comes to doctors and nurses and physician assistants. Is, it sounds like you're certainly thinking about the training piece. Is workforce something that's on on your mind?

Steve Smith 44:22
Absolutely, all the time. And I'll just be blatant with you, one of the reasons why we always seek exposure, is to get the news out about what we're doing, to hopefully get to some trained people that might be frustrated in positions that they're in, that want to give me a phone call and say, "Do you need somebody?" That's really what we're trying to do.

Wyatt Beckman 44:47
And then you're, you're working really hard to make sure that whoever is here and whoever does join, gets a good experience.

Steve Smith 44:53
Yes.

Wyatt Beckman 44:53
And if they want to learn new skills, get new certifications. You're, they're supported in that. And that's good for your team. It's also can be really good for them.

Steve Smith 45:03
Exactly. I want to go back to the, to the Grab Good.

Wyatt Beckman 45:07
Yeah, let's talk. Let's go back to that.

Steve Smith 45:08
I didn't answer that question. So that's one reason that, that we wanted to do this. That wasn't the initial reason.

Wyatt Beckman 45:18
Yeah, tell me more.

Steve Smith 45:19
The initial reason was, to keep that place open. We're in what's called a food desert. So if that place is closed, closes down. I got to go, you know, 20 miles either direction to get to, to get to grocery store. Even with poor, well, you know that direction, the fruits and vegetables might be better. Not in that direction. And I don't want to live in a town like that. Plus there are 20 or 30 people that live in Smith Center, working in that place. So I want to support those people. So I spend as much money as I possibly can there, and with a smile on my face. That, the hospital spends that money. We want to support them, you know, not in a stupid way, but we want to support them. And I need a second purveyor. I only have one purveyor, and I need a second purveyor. That's, you know, that's one of the reasons that we, that I started this, and there's always a second reason, because we have three people on this team. It's not just me. It's all through the CEO, Sarah Ragsdale and Shannon Rogers, the marketing person. And they always throw things on top of what my idea is. And this idea is something that Shannon came up with, and came up with a great, some great graphics for it, and facilitated. So that, that's actually something that she did. You know, I got it immediately, and we were then doing it together. But it's always multifaceted, you know. Sarah will put something on, and Shannon will put something on, and I will be doing something, and then Shannon will come up with, I mean, this is, this is Shannon's idea. These, the menu, you know. So it's a much more. I mean, I started out typing the menu myself, because I needed a menu. You know, that's all in. She came up with a much better, I mean, I seriously came, it was just typed. I just want to show people what we're having for lunch.

Wyatt Beckman 47:34
It's got nice pictures-

Steve Smith 47:36
Right? Exactly.

Wyatt Beckman 47:37
People can pick one up when they're in this week, and then they know next week.

Steve Smith 47:41
Meals on Wheels people, and now it becomes bigger. So it's a collaboration. And it's not, it's not, it's not just me, you know, it's not just me doing this. Also, I never intended to do any of this. I really didn't. Every, everything, only an idiot would say that they want to change the way that a hospital does food service, you know. I really, if you'd come to me seven years ago and said, you know, why don't you do this? And you mentioned the vision at the start, there wasn't, you know, it was simply, we went down the road, the path of least resistance, whatever was easy to do and we could do. We had the resources. On the end, we did that. And it takes no money at all to extend the spirit of hospitality. Zero goose egg, none. So that's what we did. And then the other things just, just came on board, you know.

Wyatt Beckman 48:42
And it, it makes me think back to the, our earlier conversation about the trust you have with the medical team. It sounds like the, the trust and collaboration you have with the leadership of the hospital has played a huge role in, in this as well.

Steve Smith 48:57
Well, Sarah was the Director of Nursing, and I created what I do with patients right in front of her. I mean, right in front of her. She was standing at the door, while I was doing this stuff, and saw exactly what happened. So, yeah, she's, she's a supporter. There's definitely, there's definitely that. I, I couldn't do what I'm doing without that level of support. I could not, you know, there's a lot of things that I do really poorly in here. And some of that falls into the categories of what a Food and Beverage Director usually does in a hospital, that because I'm doing other things, I let go a little bit. If I didn't have that support, I couldn't be doing this.

Wyatt Beckman 49:47
You've talked about the, we've talked about the Hometown Cafe, and you shared with me, before we started, some numbers. Just thinking about, you know, the how many, and we walked through the kitchen area. It's not, it's not huge, but you all are putting out a lot of meals and feeding a lot of people. Give me that, that, those numbers in that context for just. Put how many people you're feeding relative to the size of this, this community.

Steve Smith 50:16
Sure. We do. Let me find exactly what they are, because they're pretty astounding. So last week, we did an average of 67.6 covers at lunch.

Wyatt Beckman 50:30
Covers being a meal or?

Steve Smith 50:32
That's how many people came in from the public.

Wyatt Beckman 50:34
Gotcha.

Steve Smith 50:35
That's aside from the 100, or 80 to 100 staff members and the 30 Meals on Wheels and the patients.

Wyatt Beckman 50:41
That's just,

Steve Smith 50:42
And, yes-

Wyatt Beckman 50:42
That's just public.

Steve Smith 50:43
Right.

Wyatt Beckman 50:44
Coming in on their own-

Steve Smith 50:45
That's just, that's just the public. That's all we're, that's all we're concerned about with these numbers. We have 1,585 people in Smith Center, so that represents 4.265% of the population. If you equate that to a town like Hays, Kansas, that has 21,000 people in it, 4.265 is almost 900 lunches on a daily basis. So it doesn't sound like a lot. You know, 60, just under 70 people. That's not a lot of people. There's 70 people. But percentage wise,

Wyatt Beckman 51:25
For how big the town is-

Steve Smith 51:26
Massive. If you go on to Salina, that has 40, 45,800 people, that 4.265 is almost 2,000. 1,953 meals a day as an average, not on Mother's Day, as an average, right? And I'm trying to get it up to 5%, we'll, we'll see. I mean, that's a crazy number. That's a crazy number. What is the exposure that that, that's a number you can just spread around. I mean, I'll call CNN. I'm calling CNN. If we do 5% for a month, I'm calling the CNN in December.

Wyatt Beckman 52:02
And a lot of the, a lot of those people are. If you, if you do get that, that magical 5% number, it seems like it's gonna be fairly steady, because your, your people are coming back every week to-

Steve Smith 52:15
Yeah.

Wyatt Beckman 52:15
-have have the food you're, you're fixing. I, I grew up with a parent who worked in a hospital, and so I spent a lot of time vis- visiting her, and I'd walk right by the hospital food service area. And if I'm being pretty honest, I couldn't really tell you what the food was like, because I didn't really pay it any attention. I just sort of thought of it as well, the hospital food is, you know, just for the, the patients that have to have it, and the staff and it's it, it was kind of an afterthought for me.

Steve Smith 52:55
Right.

Wyatt Beckman 52:56
And it is very much not an afterthought here. You've talked about how it's a value-add, and it's relevant to the community. It's absolutely relevant to the patients, to former patients that are now Meals on Wheels recipients, or just community members, relevant to the people you have working for you, relevant to everyone. It feels like the opposite of my perception of what a food service program can be. And I think about all the other small rural hospitals that have their own food service. And maybe listening to this, whether they're the hospital CEO or they're a doctor or they're someone that works in the food service, and thinking, man, that sounds pretty awesome, but I'm not a trained chef, an RD, but I'd love to do some of that. What advice you would you give to people that hear what you're doing and say, I want to try to do some of that. I think our food service can, can serve the community in a bigger way. What would you say to them?

Steve Smith 53:58
So that's a really loaded question, and probably warrants, you guys coming up here again just to talk about that. That has not escaped Sarah and Shannon and myself. So, what my idea is, and this actually came out of, just to fill you in on where this came from. We sat down, the departing CEO, Sarah the incoming CEO, and myself, sat down about three years ago just to talk about what are we going to do with this mess that we created? You know, we have this thing, you know. I just, so we let Chef Steve loose, and now we have this, this thing, and what is it that we want to keep, what is, what are we going to do with this? And, one of the things that came out of that is that this may be a template, a template, that we could give to other facilities to help them do this thing. And that's what I'm in the process of trying to do now, is nail this down with policies and a recipe book and a much more narrow, defined cycle menu, that other places can handle. Right now, I'm just playing around writing fun stuff. That's, that's really what I'm, that's what Michelin star chefs, they will, that's what I'm doing. You know, whatever tickles my fancy, that's what I put, but you can't do that, you know, if you don't have that that background. So narrow it down into something that can be transferred, right? A recipe book. And I've trained five CDMs. There's no reason we can't do one from a facility that wants to take this template, and you send me somebody, and I'll show them how to do that cycle menu that I'm going to help you put in. That's an idea. I'm not going to say it can't be done, because I had no idea this could, stuff could be done. So I'm not going to say it. I'm just not going to say that. But that, that's what we have in mind. And what we need to do to get to that point, is we need to attract some people, that are professionals that can help us do that. You know, I need an expert in writing policies. I need, you know someone that can, I can't do all this stuff. There's some, we need some, a professional team. It's time for us to get that kind of assistance. A dietitian, another dietitian that wants to learn lifestyle medicine stuff the way I do it. A chef that wants to learn something about nutrition, you know. To take the two parts of me and get some other people. We're also thinking about how, how do we make this sustainable, you know? I've heard of other chefs that had similar things going, maybe not as elaborate as we have here, that fell apart when they left. And that's what we're trying, I mean, this has that written all over it. That could easily happen here, but we're really trying to set up something that's sustainable, not just in this facility, but in other facilities. And I'm hoping that through some exposure, we can get people that have those skills, that see what we're doing, that want to come and be relevant.

Wyatt Beckman 57:49
And that, that that challenge of, of how do you keep sustainability going, comes up often, in the conversations I have around rural health and with rural communities. Because oftentimes, there's just fewer people, and the people that are doing this great work wear multiple hats and do amazing things. And, but no one can can do anything forever.

Steve Smith 58:17
Right.

Wyatt Beckman 58:17
But I, it's awesome to hear that you all are being really thoughtful about how, how you can sustain it. And I mean, the, the results have been really promising. Everything you're sharing, the how you're supporting the, the patients and the staff, and the community members. And so I, I'm optimistic we'll be back in the future to talk more about all the other things, things you've done. I want to end with something that you have in your, your email bio. We were emailing before this and to set up this conversation. And I don't, it seems like a perfect four word summary of everything that, that you have going here. You sign your emails with, eat well, be well. Tell, tell me what, what led you to sign that? When, when was that your mantra that you landed on, and tell me a little bit about that.

Steve Smith 59:23
I used to sign, my signature used to be this quote from Bruce Lee. And it's just too long and it's too intimidating, you know. This is crazy, where this came from, I know exactly where it came from. The video business that we were running. I, I sold the video tapes, and I did all the communications. You know, I'm opening up my email in the morning with two or 300 emails, and I'm, and I signed off every time with be well. And that's, that's what my, that's what my signature was. And when I got, when I got into the lifestyle modification, it just morphed into eat well, be well. And I just started doing that. Once I get halfway through, through my lifestyle modification, I took off a bunch of weight. I'm living that every day. And it just seemed natural to put eat well, be well, because that's the beginning of what makes you be well. End of story. It, I wish it was something you know-

Wyatt Beckman 1:00:31
That's a full, philosophically- great, it's a great way to to circle back to some of your, how this all started for you.

Steve Smith 1:00:40
Exactly, right.

Wyatt Beckman 1:00:41
And, and I think it's a good summary of everything you're doing here, is helping people eat well and be well.

Steve Smith 1:00:47
Yeah.

Wyatt Beckman 1:00:47
And it's a great, great way to wrap up all of your emails and also wrap up this conversation. Chef Steve, thank you so much again, for, for not only hosting us, telling us about all this great work, also feeding us.

Steve Smith 1:01:00
Absolutely. We feed everybody. We feed the people. That's what we do.

Wyatt Beckman 1:01:03
Well, thanks again for having us. I really appreciate it.

Steve Smith 1:01:05
Absolutely.

Transcribed by https://otter.ai

Health on the Plains Production Team

Wyatt J. Beckman, M.P.H., Host

Cathy McNorton, Social Media and Website Lead

Stewart Cole, Editor, Graphic Designer

Karsen DeWeese, M.P.H., Accessibility and Evaluation Lead

Theresa Freed, M.A., Producer, Editor

Emma Uridge, M.P.H., Field Producer, Coordinator