Contracting a matter of taste

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Larry Harris overhauled his facility's food service program after having an epiphany. The president of the Willowbrook Christian communities in central Ohio said all it took was a night out with his wife.

"The restaurant we went to had a menu with 20 or 30 choices, the food was brought by a server, the lighting was nice, it had music and ambience," he said. "It got me thinking about what we were doing at our facilities, which was a glorified high school cafeteria, complete with green trays. Suddenly that felt very wrong and from that point on, I decided that we needed to do something better."

That was five years ago. Now the difference "is like night and day," said Harris, chairman of the Association of Ohio Philanthropic Homes, Housing and Services for the Aging. "It's spectacular – people would pay good money for what we serve."

The transition came by way of Bill Lutz, vice president of Columbus, OH-based Optimum Solutions & Strategies. A former restaurateur, Lutz now helps healthcare facilities implement restaurant-style food service programs.

"The restaurant methodology is the most efficient, fiscally responsible way to prepare and serve food," Lutz said. "It is also the most dignified."

Dignity hasn't always been a hallmark of long-term care food service. Food service is commonly a top inspection snafu for facilities. The American Health Care Association lists food service as the second-most common source of complaints among residents. That's not surprising, considering Lutz's description of the status quo: "They get very few choices, the food is either overcooked or cold, and a tray is put in front of them. This does not encourage people to eat."

While an epiphany is not necessarily required, revamping the food service system does take a firm commitment from management, Lutz said.

"It's a tough process because you have to get people to accept change," he said. "But the outcome has so much value."

Table by the window

Though still far from being the norm, more long-term care facilities are adopting restaurant-style dining. To accomplish this goal, some operators are outsourcing to professional food service contractors, while others are boosting their internal operations. While both methods have their advocates, either way can work, observes Maureen Leugers, healthcare marketing manager for Grand Rapids, MI-based Gordon Food Service.

"Both contracting and 'self-op' have their place," she said. "What an administrator really needs to look for is a dietary manager who understands the business side of food service. In long-term care, the dietary manager may not be trained in those skills. But nowadays, with the need to be fiscally responsible, it is essential that the dietary manager has that understanding."

Outsourcing and in-house methods have both produced success stories. In Willowbrook's case, the program is self-managed because Lutz is a proponent of the concept.

"I'm not 'dissing' management companies, but there is a natural disparity between an outside contractor and the nursing staff," Lutz said. "There is no orchestration and they rarely get along. Sometimes it works, but not very often."

Conversely, Ronald Dischinger, president of Elim Park Retirement Community in Cheshire, CT, says he could not have advanced his food service program without the aid of Avon, CT-based Sodexho Senior Services.

"We grew rapidly from 150 beds to 350 beds and our dining service needs quickly outstripped our capabilities," he said. "So we put out a [request for proposal] to three contractors and wound up with Sodexho. So far, we are more than pleased with them."

Dozens of entrees

Five years ago, Elim Park offered diners a choice of two entrees. Now they have a full restaurant menu with 37 distinct entrees, from hot dogs to prime rib to lobster. And Dischinger gives Sodexho full credit for implementing the program.

"They have the experience and resources – we never could have done it ourselves," he said. "The meals are better and the costs are well within our expectations."

Even before instituting changes in the food service program, Dischinger