The Food Service Manager’s Tune-up Book

By Timothy L. Bauman DHCFA, CDM, CFPP

and

Wayne Toczek BS-Dietetics, CEO- Innovations Services

Reflections and reminders for the experienced manager with course, direction and things to consider for a new person taking charge.

Copyright 2008 by Tim Bauman and Wayne Toczek All rights reserved. Published by Innovations Services, LLC. Introduction

This book was written for people who operate food services for residential healthcare organizations in the US: nursing homes, retirement communities, hospitals, group homes, and so on.

Individuals in these businesses often wake up to discover that they are embarking on a career… an exciting and important one… especially after that first promotion.

“So, what should I be doing?” is a common question when one steps into a new role and needs to get a better understanding of how all the moving parts of healthcare food service fit together.

This same question will occur to the specialist: a skilled chef, expert supervisor or efficient production person who steps into a larger job.

This book is for YOU, if you want to know more about healthcare food service or if you have people working for you who would benefit from a broader understanding of the industry.

Acknowledgements

The authors thank the following experts who generously gave permission for us to reprint their information. ~ The chart: Menu Planning for Nutritional Adequacy Nancy Giles Walters, MMSc, RD, CSG, LD, FADA Food & Nutrition Care Consultant

Dr. Nancy Collins, PhD, RD, LD/N, FAPWCA President/Executive Director, RD411.com, Inc. “Where Healthcare Professionals Go for Information” ~ The chart: Roles of the Nutrition Professional and Technician Cynthia Hilliard, Operations Specialist Consultant, Innovations Services ~ Explanation of Full-Time Equivalent (FTE) James D'Wolf, CEC, Director of Dining Services, Twin Lakes and Twin Towers at Montgomery, Loveland, Ohio ~ Explanation of the role of the consultant in kitchen design Brad Crow, President, All Things Restaurant, inc. Sandusky, Ohio Accolades

What a terrific resource and quick reference guide. It will be added to my permanent library and used as a resource for our department management and undergraduate and graduate nutrition students. Tim Bauman and Wayne Toczek have their fingers on the pulse of healthcare food service and have explained the intricate mechanics well. This guide will be useful for anyone in healthcare food service management—from the student just learning the trade to the well-seasoned manager with many years of experience. Thanks to Tim and Wayne for their hard work.

… Denisa B. Cate, MS, RD, LDN, DHCFA, ASHFSA President Elect (American Society of Healthcare Food Service Administrators), Director of Food & Nutrition Services, Henry County Medical Center ~

WOW! I can appreciate the amount of work you put into it and your expertise in so many areas, particularly food production systems. Easy to read and clearly explains and defines foodservice concepts for all levels of managers. This is a step-by-step manual that could be used as a text to train people going into foodservice of any type.

… Digna Cassens, MHA, RD, VP Nutritional Services, Country Villa Health Services ~

The Food Service Manager’s Tune Up book should be required reading in all CDM and Culinary courses throughout the US. It’s information is priceless. As a FSD for over 13 years, I thought I had seen or heard everything. After reading FSTU, I realize there is more I can learn about the industry. I thank Wayne Toczek and Tim Bauman for their vision and for having the guts to put out material that will advance our profession.

… Shannon Agee, CDM, CFPP, Executive Chef ~

… very positive… There are myriad books written about foodservice management and books written on healthcare, but I have found very few written on foodservice management in healthcare! Your chapters flow in an organized manner and encompass all aspects. This is a realistic management book!

… James D'Wolf, CEC, Director of Dining Services, Twin Lakes, Twin Towers ~

Food Service Tune-up provides great information for both new and seasoned mangers.

… Tom Weaver, Dietary Managers Association Virginia State President, 2008-2009. ~

This handy little book is a nice refresher but even more so, a great tool for developing manager orientation and training tools. The content is extremely thorough and useful.

… Janet Schuch, MBA, RD, LDN, District Manager, Cura Hospitality ~

This is the one resource that no manager should be without! It's a comprehensive collection of all the things you need to know to operate a food service department and the perfect reference tool. I could replace all of my other "dust collecting" useless manuals with this one practical tool. I wish that I had this thirty years ago.

… Chip Argenziano, Campus Dining Services Director ~

I have worked with a diverse group of dietary managers, and I highly recommend this book to help them navigate through the foodservice system.

… Jill Lightner, Vice President of Multi-Unit Sales, SYSCO Cleveland ~

This book was obviously written by people that are well versed in the healthcare food service industry. I have been in this field for 20 years and this book gave me new ideas on how to better serve my customers. Every Food Service Director, Executive Chef, and Supervisor in the healthcare industry or those aspiring to these roles should read this book to find ways to improve their operation for the betterment of their customers and residents.

…Michael Randolph, Food Service Director, Certified Dietary Manager and Executive Chef at the Brethren Retirement Community ~

Dedications

This creative piece is dedicated to my wife Marci, the best wife in the whole world. The value of her love and support to me is incalculable. To Wayne Toczek, a brilliant, tireless and motivating individual. To all the professionals I have met through the years because good, bad, or indifferent, we learn from those we have spent time with. Finally, no one should forget their family because they anchor us and make the world a better place.

… Timothy L. Bauman

This book is first dedicated to my great family, Jackie, my wife, and my little Polish princesses, Kristina Rose, Ava, Waylyn, and Victoria Plotner and Jessica Groat. Without their love and support this book would never be possible. Especially to my wife Jackie who enabled me to pursue my business dreams and goals.

And second, to my Parents Bill and Sylvia Rose, Grandmother Anna Toczek and in-laws Ann, Tom and Shirley (Nana).

And finally, to all the professionals I have had the privilege to work with and learn from over the years that have inspired me to take what I have learned and to make it useful to others.

… Wayne Toczek

Table of Contents

Enjoy the chapters. They are the Main Events, the Entrées.

Use the Accompaniments, forms and tables, to help manage your operation.

The Deserts, including articles and additional references, will round out this nourishing learning experience!

I. An Overview of Food Service...... 10 Hospitals ...... 11 Patient Food Services...... 12 Non-patient services ...... 13 Rehabilitation Centers...... 14 Nursing Homes ...... 15 Assisted Living Facilities...... 17 Food service in assisted living facilities ...... 17 Food service in Memory Care Units/Homes ...... 18 Retirement communities...... 18 Food service in CCRCs...... 19 Working in senior living food services...... 19 MRDD or group homes ...... 20 Home Delivered Meal Service (Meals on Wheels—MOW) 21 Summary...... 21 The roles of the nutrition professional and technician...... 23 More than a meal….creating a masterpiece! ...... 26 II. The menu is everything...... 30 Menu: impact and statement...... 31 The Conceptual Stage ...... 32 The Operational Stage ...... 34 Decline...... 35 Transition...... 35 Menus: a complex and powerful tool ...... 37 Different menus for different places...... 37 Menu planning basics ...... 38 Menu planning basics ...... 43 Kind of customer who will use the menu ...... 43 Helpful hints ...... 45 Menu Reality...... 45 Menu planning for nutritional adequacy...... 47 Descriptive menu words ...... 49 Request for menu change form...... 51 Analyzing Customer Demographics for Menu Planning...... 52 III. Purchasing goods and services ...... 60 Forecasting...... 61 Inventory...... 61 Purchasing objectives ...... 62 Order Guide ...... 63 How to set up your Order Guide...... 64 The bid process and organized purchasing ...... 65 WIN WIN with vendors...... 66 Group Purchasing Organizations...... 70 What the manager needs to know...... 70 IV. Production systems— Putting it all together ...... 80 Production Sheets ...... 82 Production Sheet procedure...... 84 Accurate forecasting of production...... 87 “You are only as good as your last meal.”...... 87 Portion control ...... 88 Pre-preparation/ freezer pulls...... 90 Production meetings ...... 90 Batch cooking ...... 91 Steam table diagrams ...... 91

Proper handling of leftovers ...... 93 Standardized recipes ...... 93 Final words ...... 94 V. Staffing, personnel and scheduling...... 96 The food service culture and mindset...... 97 Solid Staff – No Money Needed...... 97 Food culture: ...... 99 Participative management...... 101 Free up your time for added success...... 101 Culture and socialization ...... 102 Attraction-Selection-Attrition...... 103 Management and the work of the food service world ...... 104 Planning ...... 106 Organizing ...... 106 Directing ...... 107 Control ...... 107 Evaluation ...... 107 Managing Labor...... 108 Staffing plan grid ...... 109 Job routines...... 110 Job descriptions...... 111 Orientation program...... 112 VI. Understanding the budget— Hit or miss ...... 114 Budget components of a food service operation...... 116 What is a zero-base budget? ...... 117 Commonly used computations and benchmarks ...... 118 Meals served ...... 118 Steps to determine meal equivalents...... 119 Meal Count Summary...... 120 Meals per man-hour...... 120 Patient hours per day...... 120 Menu cost per day...... 120 Check average (retail)...... 121 Non-productive hours or dollars...... 121 Inflation and costing factors ...... 121 The menu ...... 121 Measuring and monitoring the budget...... 122 Accruals and their effect on the budget ...... 123 Other variances ...... 123 Hourly wage… weighted and unweighted...... 125 Budgeting for food cost increases...... 125 Cost and price dynamics ...... 126 The CPI market basket...... 127 How to stay on budget ...... 128 Track expenses that flow into the budget ...... 128 Track physical flows and inventory...... 129 Days-on-hand inventory (by supply item)...... 129 How often to take physical inventories...... 130 Track food industry and service trends...... 131 Track revenue that is credited to the budget ...... 131 Creating a Position Control Process to manage labor...... 131 The impact of the menu on the budget ...... 132 Determining the cost of a menu...... 132 Dealing with budget problems...... 134 Learning about FTE17 ...... 135 Twelve budget tips to consider ...... 137 New Year! New goals! New budget!...... 139 Analyzing the budget, skills and operations ...... 141 Negotiating change ...... 143 VII. Regulatory considerations...... 144 Who is the PIC? ...... 146 PIC: demonstrate knowledge or assign responsibility...... 146 Getting training on food safety ...... 149 ServSafe certification...... 149 HACCP course...... 150 In-service training...... 151 Employee orientation...... 151 Free resources ...... 151 Get to know your local health inspector ...... 152 Navigating the regulations...... 152 About State-level food codes...... 152 About FDA food code...... 153 Navigating the regulators...... 155 Department of Health...... 155

Who is the inspector?...... 156 About the Joint Commission...... 156 Joint Commission Surveys...... 157 Always be ready for a survey or audit ...... 158 Nursing home inspections...... 158 Surviving surveys in long-term care...... 160 Understanding the PIC...... 163 PIC—demonstration of knowledge...... 164 Food safety watch tip—water...... 167 Regulations: what you can do, not what you can’t do...... 167 VIII. Technology issues...... 172 Technology in the institution ...... 173 Critical technology issues ...... 173 Interfaces...... 173 Infrastructure costs...... 174 Cannibalization of processes and revenues ...... 174 Identifying fads versus trends...... 175 Diversification/brand challenges ...... 176 Lack of resources ...... 176 Budgets move SLOWER than technology ...... 177 Foodservice software overview ...... 177 Payroll...... 178 Financial management software ...... 178 Food production software ...... 178 Inventory management software...... 179 Menu planning software ...... 179 Forecasting and purchasing software...... 180 Clinical management and meal service software...... 180 Selecting software...... 181 Overall trends...... 182 IX. Kitchen design and technology...... 184 A few words about design ...... 185 Answers to guide design ...... 186 Design tips to consider...... 187 Floor design ...... 187 Dish washing machine...... 187 Power ...... 187 Mop closet...... 188 Shelving ...... 188 Flooring...... 188 Products with new technology...... 189 Use common sense about partially processed foods...... 189 Product development—convenience or smart ...... 190 What about new equipment—will it allow...... 190 The Accutemp machine ...... 190 A food processor...... 190 Pre-made items (made in YOUR kitchen)...... 191 Just what is technology……...... 191 Useful terminology and tools...... 192 Payback Period ...... 192 Return on Investment...... 193 Determining energy efficiency ...... 193 Approaching kitchen technology decisions ...... 194 Principles for kitchen technology decisions ...... 195 Think through your technology decisions ...... 196 Look for advancing technology in these areas: ...... 197 Case study: making the decision...... 198 The role of consultants in kitchen design ...... 200 Leveraging new trends and technologies...... 201 Get help in “going green” ...... 202 Going green example: exhaust hoods ...... 202 Example: Combi-oven ...... 203 Example: ice machines ...... 204 Example: convection microwave...... 205 Trade-offs: avoid spec’ing the wrong equipment ...... 205 Get advice tailored to your situation...... 205 Descriptions of new kitchen technology...... 206 Induction heating ...... 206 Induction pellet charging system ...... 206 Boilerless ...... 206 Fast cook ...... 206 Combitherm® ...... 207 Combitherm® Combination Oven/Steamer/Smoker...... 207 Cook chill...... 208

Rethermalization...... 208 Blast chill ...... 208 Radiant heat ...... 208 Impingement technology ...... 208 Burner-baffle system microwave technology...... 208 Infrared...... 209 Induction cooking ...... 209 Self cleaning floor...... 209 Ventilated ceiling...... 210 Air curtain—cold ...... 210 Air curtain—hot...... 210 X. Catering the best impression—advanced marketing...... 212 Scheduling the event...... 213 Menu and pricing...... 213 Wait staff...... 214 China and disposable expectations ...... 214 Supporting a theme ...... 215 Cost and price summary ...... 215 Serving the food...... 215 Organizing the business ...... 216 Master binder ...... 216 Catering equipment inventory ...... 216 Catering checklist ...... 217 Important basic information...... 218 Rules of thumb...... 219 Service staff reference ...... 219 Seating capacity ...... 219 Staffing suggestions:...... 220 Other service styles—terms you may encounter ...... 220 Last minute details...... 221 Things to remember...... 221 Special events form (external clients)...... 222 Dining services request (internal clients)...... 222 Special Event planning form (external)...... 224 Marketing Dining Service Request form (internal) ...... 225 24 catering tips to add pizzazz...... 226 Bonus tip—action stations...... 229 Other ways to generate revenue...... 230 Marketing, the driver of food service innovation ...... 230 Creating value through catering...... 232 Service themes and creativity create opportunity...... 233 Creating the Customer Experience ...... 234 Breaks add value...... 234 Staff—hidden performance talent?...... 234 Add in prop fees...... 235 XI. Leading change...... 236 Factors driving change...... 238 Responding to change with initiatives...... 238 Operational excellence...... 239 Innovation ...... 239 Essential change steps...... 239 Awareness...... 241 Enrollment ...... 241 Solutions ...... 242 Commitment ...... 243 Performance...... 244 XII. Resources—references to support your program ...... 246 The FDA Food Code...... 247 Food for Fifty...... 248 Diet Manual ...... 249 Policy and Procedures Manual ...... 250 Material Safety Data Sheets...... 251 Useful Web sites ...... 253 Other industry Web resources...... 256 Various food interest links...... 256 Recipes and culinary tips ...... 259 Associations...... 263 Food guide pyramid...... 264 Additional resources ...... 265 Health departments and restaurants associations...... 266 Food safety resources...... 266 Magazines ...... 268 Joint Commission checklist ...... 270 Food Code quick reference...... 277

Glossary of terms and acronyms...... 280 Footnotes...... 287 References and sources cited ...... 289 About the Authors...... 293 Timothy L. Bauman...... 293 Wayne Toczek ...... 294 About Innovations Services ...... 295 The Cost and Price of the Customer’s Experience ...... 295 Safe Dining for the Susceptible Customer...... 296 Resident Manager software ...... 297 The Dining Experience ...... 298 Poster training...... 299 Manuals to encourage standard policies ...... 300 Diet Manual ...... 300 Clinical Quick Reference...... 300 Policy and Procedure Manual...... 300

I. An Overview of Food Service – pg. 10 CHAPTER ONE

I. An Overview of Food Service

Contains a fresh look at each of the segments in the Industry

Food Service Tune-up – pg. 11

Beyond the world of restaurants, catering and fast food there is a hidden food service culture in the healthcare industry. To some it is unimaginable that this industry also has catering, retail, restaurant and room-style services. It is more common to imagine an army of folks dressed in white, sliding trays and neatly wrapped food down an assembly line than to picture tuxedo dressed staff ready to exceed your expectations. The following is an overview of the healthcare industry and the typical food service provided by each type of facility.

» One of the distinctions of food service in healthcare is the involvement of the registered/licensed dietitian (RD) and other nutrition care professionals. For a review of the specifics of their roles across the continuum of care see The role of the clinical professional at the end of the chapter. Hospitals A hospital is an institution that provides acute and critical health care and often, but not always, has specialized units for longer-term patient stays. Today, hospitals are usually funded by the state, health organizations (for- profit or non-profit), health insurance companies or charities and direct charitable donations. Not so many years ago, they were often founded and funded by religious orders or philanthropic individuals and leaders. In these facilities the founding religious orders provided the core of the hospital staff supplemented by large volunteer organizations. Today’s hospitals are staffed by professional physicians, nurses and ancillary health professionals and skilled workers. Modern hospitals may be regulated and inspected by any or all of the following agencies: local health department, state health department, Healthcare Facilities Accreditation Program I. An Overview of Food Service – pg. 12

(HFAP) of the American Osteopathic Association (AOA) and The Joint Commission on the Accreditation of Healthcare Organizations (JCAHO).

There are many forms of food service in hospitals, some traditional and some avant-garde. Most hospitals will have both patient and non-patient service models. Some of those services are:

Patient Food Services For patients and residents, there is a range of food services: - Tray service – trays are assembled in a central location by several people working on a tray assembly line, placed in food transport carts and delivered to multiple locations. Trays may be passed to patients by a food service or universal service worker. Patient may or may not select menu. If selected, this process usually occurs 3-5 meals in advance. Time of meal service is very structured. - Pod assembly service – trays for each patient unit are assembled by a single food service worker according to menu selected by the patient 1-2 meals in advance. Trays are placed in food transport carts, delivered to the unit and passed to the patient by the person who assembled the tray. Time of meal service is structured. - Concierge service – trays are assembled from mini assembly lines at each service location or from a mobile hot/cold cart that parks outside the patient room. Tray may be delivered by food service, universal service

Food Service Tune-up – pg. 13

worker or member of nursing staff. Patient usually selects meal at time of service or not more than one meal in advance. Time of meal service is structured. - Room service – patients have an in-room menu and call a designated number to order or place order via an in-room computer terminal when they are ready to eat. Service may be available 24 hours per day or at designated times. Meal is usually delivered by food service staff on hotel-type room service carts. Often limited to specialty areas, i.e. labor and delivery. Time of meal service is flexible. - Private suite/private chef – food preparation facilities adjacent to patient suite, May be staffed by facility chef or patient’s private chef. Common to those facilities with suites available at additional charge. Patient usually determines both menu and meal time.

Non-patient services For visitors, staff and the public, food services might include: - Straight line cafeteria – may or may not include salad bar - Destination station cafeteria – may include in-house branded facilities such as grill or franchise extensions from retail outlets (i.e. McDonald’s, Subway, Starbuck’s) - Kiosk and remote location retail outlets – usually coffee, deli, etc., may or may not be franchise-branded I. An Overview of Food Service – pg. 14

- Remote site meal service – facility sponsored daycare, and meals on wheels are most typical - Vending – in-house or oversight by service provider - Catering-basic – meal service for in-house events happening at meal time - Catering-upscale – meal service for board meetings, physician meetings, etc. - Catering-major – meal service for fund raising events, conferences, etc. Rehabilitation Centers A rehabilitation center provides services that increase the ability of people to function physically, emotionally, socially or vocationally. Typical services include physical, speech and occupational therapy. These services are usually short term, 20-100 days and may be covered by Medicare. The centers may be separate operating units within a hospital or nursing home or may be free standing rehabilitation facilities. This affiliation may impact the type of food service you offer. Customers in this environment are typically healthy and plan to return to a home environment. They are looking for a menu that offers the same variety of foods available outside their current setting. Rehabilitation facilities may be regulated or inspected by any or all of the following agencies: local health department, state health department, and JCAHO.

Food service in a rehabilitation facility may be: - Waitstaff service offering selections from fixed and short-order menus in small dining room setting. Assistance is frequently a part of meal time as patients develop their self-

Food Service Tune-up – pg. 15

feeding skills. Meal times are usually fixed but scheduled around therapy needs. - Room Service with extensive variety, prepared to order and delivered by designated food service staff. Meal choices placed by phone or in-room computer terminal by member of nursing staff or patient as patient’s ability allows. Meal times are flexible within operating hours. Nursing Homes These facilities provide care to people who can no longer care for themselves and cannot get their care needs met using community services at home. Nursing homes provide a wide range of personal care and health services planned for each resident’s specific needs. For most people, this is care that assists with support services such as dressing, bathing, and using the bathroom. Medicare doesn’t pay for this type of care. Nursing homes may be inspected by any or all of the following: local and state health departments, JCAHO and the Ombudsman.

» Long-Term Care (LTC) Ombudsman Programs. In some states, there is an LTC Ombudsman Program. This program is charged with the responsibility of identifying, investigating and resolving complaints made by, or on behalf of residents of nursing homes, rest homes, and transitional care facilities in the state region. The Program seeks to protect the rights of residents of LTC facilities, advocates for positive changes to the long-term care system in the state, and provides general information about LTC issues.

I. An Overview of Food Service – pg. 16

A nursing home is often the last stop for the customer served here. The goal is to serve healthy food, modified as necessary for individual needs, served with a dignity that assures that the resident has the highest possible quality of life. Both the industry and its clientele are becoming more complex and demanding. Tray service is no longer a desired option. For more information about the possible options, refer to the book “The Dining Experience” written by Wayne Toczek. For nursing homes, food should not be merely produced and delivered. It should be tasty, presented well and served in a dignified manner. In a nursing home setting, you may be expected to: - Encourage dining room participation - Provide dining room service in multiple locations in close proximity to residents’ living quarters - Provide different levels of service compatible with resident’s abilities - Allow resident to select menu at mealtime in accordance with their ability to do so - Provide a dining room ambiance commensurate with the average resident’s way of life prior to moving to your community - Offer a menu that appears to have wide variety while the number of items available is managed by waitstaff offering the specials for the meal

In a nursing home setting you often have to alter the food’s original state to meet the residents’ needs. Here are some things you can do: - Plan your menu to include the food culture of your clientele

Food Service Tune-up – pg. 17

- Reshape mechanically altered food to shapes as close to those of the original item as possible - Keep colors separated when pureeing or blending food items. - Season according to recipes and garnish appropriately. Seniors in this setting are used to food cooked with reasonable seasonings. - Provide proper condiments to accompany the meal when the meal is served. The customer should not have to ask for these. - See article at the end of this chapter “More than a meal” Assisted Living Facilities Residents in assisted living facilities often live in their own room or apartment within a building or group of buildings and have some or all of their meals together. Social and recreational activities are usually provided. In this group living arrangement, residents are assisted with activities of daily living such as taking medicine, getting to meals and appointments on an as-needed basis. Some assisted living facilities have health services on site. Costs for assisted living facilities can vary widely depending on the size of the living areas, services provided, type of help needed, and where the building is located. Residents usually pay a monthly rent and then pay additional fees for the services that they request. Services included in monthly rent vary widely from one facility to another.

Food service in assisted living facilities Food service operations at an assisted living facility may look as though main street has been brought inside. I. An Overview of Food Service – pg. 18

They may feel and look like restaurants, bistros, coffee shops and ice cream parlors. People come to these facilities because they simply need some assistance with daily life. The living quarters often have no or little kitchen space, usually just a small refrigerator and microwave. This customer can still leave the campus and go out to eat, but will most likely dine on campus at least 90% of the time. Operations are inspected by the local and state health departments and the ombudsman

Whether special diets are offered to residents depends on the community’s philosophy. Many facilities choose not to offer special diets, but plan menus and season foods in a manner consistent with healthy eating for older Americans. The resident should be able to choose their meals from items offered with alternate options available in all menu categories.

Food service in Memory Care Units/Homes Residents in these facilities have varying degrees of dementia and require special care with meals. They can no longer make meal choices at time of service and often require finger foods. Decreased attention span makes smaller, more frequent meals very common. Retirement communities Also called a Continuing Care Retirement Community (CCRC), These housing communities have different levels of care based on the client’s needs. Housing depends on the level of care needed. In the same community, there may be individual homes or apartments for residents who still live on their own, an assisted living facility for people who need some help with daily care, and a nursing home for those who require higher levels of care. Residents move from one level of care to another based on their

Food Service Tune-up – pg. 19 needs but still stay in the CCRC. A CCRC contract usually requires the client to use the CCRC nursing home when that level of care is needed. The nursing home and assisted living facility are usually under one roof.

Food service in CCRCs Food takes on increased importance and the quality of the food services is often part of the marketing plan. Food may be an option for those in independent living and assisted living quarters but is a major factor in choosing the facility for both the potential resident and their sponsor. Most CCRCs require and charge assisted living residents for at least one meal per day. The meal service has more in common with a country club than an old folk’s home. Working in senior living food services The interesting trend in senior living food services is that many chefs and restaurant managers find that these types of operations offer all the challenges of the best restaurants while affording a better quality of life for the staff. It is common to hold major catering events and very elaborate dinners.

It is important to remember that your customer is captive to some degree and their choice of different experiences is limited so… it is really up to the Dining Services director to initiate excitement and deliver memorable culinary experiences to the customer. Wouldn’t you tire of your favorite restaurant if you had to eat there every day?

A common thread for all of the above healthcare facilities is that they all serve a highly susceptible population, defined by the Food and Drug Administration (FDA) as “persons more likely than other populations to experience I. An Overview of Food Service – pg. 20 food-borne disease because they are either immunocompromised, preschool age children, or older adults.”

In addition, the prohibitions against raw fish, unpasteurized juices, unpasteurized or undercooked eggs mean that scrupulous attention must be paid to safe food handling throughout the food storage, preparation and service processes.

Taking these standards as a given, food should be cooked just as in the finest restaurant, held and served hot or cold as appropriate, seasoned according to recipe and not over cooked.

Standardized recipes are the key to success. The customer will know what to expect and you will know that your menu, as served, meets the nutritional requirements defined in your diet manual. MRDD or group homes Group homes are small homes or cottages in which a small number of adults or children qualified under the Medicaid Mentally Retarded and Developmentally Disabled (MRDD) program reside. These programs are governed by local and state programs and are partly funded by Medicaid. The food service available in a particular group home will depend on the clientele: age, degree of disability, special needs addressed. Operations are inspected by the local and state health departments and clients and their sponsors may have access to an ombudsman program.

Food Service Tune-up – pg. 21

Home Delivered Meal Service (Meals on Wheels—MOW) Meals on Wheels is the name for programs that deliver meals from a central production site to individuals at home. These individuals usually live in their own homes but need assistance with meals to help maintain a nutritionally adequate diet. Meals on Wheels is the brand name of a home delivered meal program but the term is commonly used by the general public to describe any home delivered meal program.

Many of the recipients are the homebound elderly. Not surprisingly, most of the volunteers are the still-mobile elderly. These programs serve a basic meal that meets at least one-third of the daily nutrient requirement for older Americans. Programs may operate from any of the facilities listed above or may even be served from a central production facility whose purpose is to produce and deliver meals to people at home. Oversight of these programs is from the local health department and area Office on Aging. Summary In summary, all of these operations are monitored by outside agencies in addition to the local health department. The RD has varying levels of responsibility in each facility. The challenges for managing the budget are the same as for any other food service establishment. The food service department exists to meet the goals of the community. In all these operations the dining services operation is usually the largest or second largest department in terms of human resources and total dollars managed.

I. An Overview of Food Service – pg. 22

Any of these organizations can also be for-profit or not- for-profit. A nonprofit organization exists to provide a particular service to the community and is required to invest any surplus back into the business. For-profit operations invest a portion of the profits back into the business and distribute the rest among shareholders. A not-for-profit business exists for the purpose of providing a service; a for-profit business provides a service for the purpose of generating a profit. For-profit or not-for-profit status should not make a difference to the dining services department as you should run your piece of the business in a fiscally responsible manner, regardless.

Food Service Tune-up – pg. 23

The roles of the nutrition professional and technician

Food service professionals have varying roles in the different health services organizations. The following pages summarize the roles for the different types of operations.

Prepared by Cynthia Hilliard, Operations Specialist Consultant, Innovations Services. Used with permission.

I. An Overview of Food Service – pg. 24

Food Service Tune-up – pg. 25

Prepared by Cynthia Hilliard, Operations Specialist Consultant, Innovations Services. Used with permission. I. An Overview of Food Service – pg. 26

More than a meal….creating a masterpiece!

» Adapted from: More than a meal….creating a masterpiece! by Wayne Toczek and Chip Argenziano, Nursing Home Digest, Vol. 2, Issue 4.

All things with bricks and mortar being equal, food can really make a Community stand out. The dining services department takes this to heart. The campus dining services team and executive Chef works together daily to make the food look as good as it tastes. According to Chef Steve, “We buy the highest quality foods we can find to begin with. Our meals are mostly made from scratch, such as home-made soups and sauces.”

Residents enjoy the opportunity daily to choose either a continental breakfast or a hot breakfast in one of several dining rooms. With our dining program, we are working on ways to make food more “homelike” and appealing. For example, pancakes made-to-order on the griddle

Food Service Tune-up – pg. 27 reminds our residents of home and entices them to come down to the dining room. This is our version of aroma therapy. If a resident chooses not to join in, then room service is also available.

As our dining services team met to discuss the success of our breakfast, one staff member commented, “The residents are coming down for the continental breakfast and sometimes stay for the hot breakfast, and getting double orders.” This breakfast program results in positive outcomes – weight gains instead of weight loss and more satisfied residents.

The Chef and his staff work on plate appeal with all types of food, from regular diets to mechanically altered foods. Mechanically altered diets such as purees are no longer just blended; they are reshaped and molded to look like the original item in its natural form.

The residents of the skilled nursing unit who require a pureed diet are enjoying a new look at foods that once were unappetizing foods and lacked eye appeal. The Director of Health Services has said, “I was amazed at how the pear halves looked like they came right out of the can. You would never know they were pureed.” In response, Chef Steve has said “I enjoy watching the nurse aides trying to figure out whether or not the food is pureed.”

Hot and cold items are appealing because they look familiar instead of piles of simple puree blend. The staff, including our food specialists, take great pride in making even a Sloppy Joe or a chicken breast look like the real thing. Henry leads the team in preparing these artistic treats. The cook enthusiastically works on these creations at every opportunity. There is experimenting and some I. An Overview of Food Service – pg. 28 trial and error but this is all part of the fun as the excitement continues to build. Watching the cook make pureed corn look like it is still on the cob or a sandwich layering with each of the bread slices and the filling to capture the same texture and color as the original is amazing. We like to make sure it both looks good and tastes good.

Recipes were developed that are scaled to the correct amount to ensure the correct flavor and texture. Bread is not incorporated into the recipe; we prefer serving it separately and our customers and families appreciate the effort we take to make sure the food is nicely presented. We finish the items with the full complements of gravy, sauce or butter as this will make a difference at the table.

Another area that’s been addressed is the variety of diabetic desserts. Our Chef researched and developed some nice recipes made with sugar substitute. We are able to create a lot of the same items with less sugar that are just as tasty but are even better for our customer. The real success in making these items is the accomplishment and satisfaction on the resident’s or customer’s face and the added intrigue in the production area.

Food Service Tune-up – pg. 29

II. The menu is everything – pg. 30 CHAPTER TWO

II. The menu is everything

The steadfast favorite that everyone will remember

Food Service Tune-up – pg. 31

Menu: impact and statement Saying the menu is everything is a bold and all-inclusive statement, but it is very close to the mark. The menu is the center of foodservice operations. It is the principal driver of revenue and largely determines the customer’s decision to return, and so, is a key customer attractor. The menu presents the food service theme, organizes purchasing and workflow and fundamentally impacts food service profitability. Menus control (and can limit) how you use space, equipment and the people required to run the operation. It is essential to understand the menu’s critical role in all phases of an operation.

The menu is where decisions on many aspects of the food service are made. It is a tool for planning, marketing and operations. Perfecting an operation’s menu is an ongoing process and should never stop. Menus dictate the foods served and the customers the operation wishes to attract or take care of. No one can have a menu large enough to be all things to all people, so when a menu properly reflects your operation and its place within the larger institution, it will focus the food service operation.

Whether your facility is in the conceptual stage, in planning or in physical operation, the menu is the centerpiece. The menu concept must fit the location, image and type of operation. It must provide a clear statement to the people involved, including employees, patients or residents and visitors, and gently declare that your operation provides the best dining alternative around.

Understanding the population served is important for every phase of the menu planning process. For further II. The menu is everything – pg. 32 reading on analyzing target population of a menu, read the article at the end of this chapter “Analyzing Customer Demographics for Menu Planning.”

Many menu ideas and delivery systems are not new, although they may be marketed as such. Mostly, they are a refinement or improvement on something that already exists. For example, adding ethnic concepts to a menu may be marketed as new, yet what is new about a cuisine that is steeped in a thousand years of history? However, properly applying an ethnic concept for your customer (especially in healthcare food service and when the customers are affiliated with the ethnicity involved) is creative and respectful of the customer as well as an exercise in practicing good nutrition science.

Because the menu determines profit, controls food service theme and impacts patient care, it is essential to consider its critical role in four phases: Conceptual, Operational, Decline and Transition.1

The Conceptual Stage If your operation is in the conceptual stage you may be working on a cycle menu of what to provide each day of the week to support the diets needed by your patient residents. You may be thinking about a cafeteria or food kiosk to serve employees and visitors. You may be considering a vending concept to be operated in-house or through a vending company. The image and type of service will be defined by that menu and the menu is an important means for conveying the concept effectively to patients, residents, staff, visitors and the public.

The menu reveals something about the intended clientele because it is written to attract and serve this specific

Food Service Tune-up – pg. 33 group. A cycle menu is used for an acute care or long term care facility, whereas the menu for a cafeteria operation may be written differently on a daily or weekly basis. The purchase of equipment is heavily related to the menu. A long-term care facility may have equipment to place lids on drinks, whereas cafeterias usually make lids available for customers to place on their own drinks. An upscale service demands refined china and tableware (increasingly common in long term care and assisted living), while feeding people with certain disabilities requires special utensils. If a lot of scratch cooking will occur, a larger kitchen is needed. If ready-made or speed scratch cooking is planned, more refrigeration and freezer space is needed.

Staffing is closely related to the menu and type of service. The skill level requirement for food preparation and service staff increases as the complexity of the operation increases. In acute care, employees often face over 500 variations on medically prescribed diets and a high degree of emphasis is placed on skill and training. In running a fast-food kiosk, employees can be trained in a short time to meet performance expectations. For example; many fast-food chains employ push button timers for such equipment as fryers and preprogrammed ovens. If you can teach a person to push a button, you have trained your French fry person.

The menu affects the décor of the eating facility. A cafeteria may be decorated to relax healthcare providers and visitors from the stresses that occur in the organization. Many long term care and assisted living places try to match the look and feel of the home environment. As the menu evolves, you (and your design team) can visualize the production and service areas. All of the above factors shape the operation. II. The menu is everything – pg. 34

The Operational Stage Keeping up with trends, meeting the eating habits of your demographic and performing good patient care are common success factors. If you open an operation and sales don’t meet expectations, ask if you have kept abreast of the foods your customers want? Monitoring sales and patient meal satisfaction are critical. Track what sells and what doesn’t.

Imagine the residents in a long term care facility forming a food committee and taking complaints continually to administration? That’s a sure sign of problems with the menu or training of the staff. What if a cafeteria becomes too heavily subsidized because there is not enough volume to support the staffing? That’s a recipe for new food service management.

Benchmarking, comparing what you do in relation to similar facilities is a valuable tool. Catch and remove your declining items before they detract from your bottom line or impact customer satisfaction. Offering popular items or serving a medically prescribed diet is useless if quality and accuracy decline and the foods are not prepared well.

Food trends and the media influence customer preferences. Adding newly fashionable items to the menu positively affect sales and profit. Eliminating the slow moving and unprofitable items protects the bottom line. Many of the industry magazines publish statistics on trends and tell what other operators are doing to generate customer interest. Look at the menus of successful restaurants in your area to see what works in your community. After all, these folks need to make a profit and pleasing their customers keeps them in business.

Food Service Tune-up – pg. 35

Decline As profits diminish, look at what is going wrong. This may be a clear reflection of customers’ opinion of the operation, or of rising costs. Few businesses are willing or able to subsidize a troubled operation. In the food business, customers vote with their feet meaning they can stop patronizing your operation and go elsewhere. Patient populations differ in that they are captive in a sense, but as complaints increase, the manager’s job security decreases.

Reevaluate the menu pricing structure and consider raising prices. If the food offered is still right for the market served, then an increase could be all that is needed to restore profits.

If the group you expect to attract is changing then you need to change with them or seek new markets. Running daily specials is a great way to test customer preferences without revamping an entire menu. Redesigning the physical menu can help. Use of good graphics and a look reflective of the operation is key. Signage and merchandizing in the serving and dining area affects sales. To boost sales, use companies who specialize in merchandizing to give an effective twist to product presentation.

Transition Change is ongoing and a constant in the food industry. Changes in eating habits, demographics and patient populations served can drive a facility to transform from one type of operation or service to another. The views and opinions of the people running the organization can also have an effect, although the customers and patients are the ultimate boss. In a transitional market or in II. The menu is everything – pg. 36 response to a change in the larger organization, a food service is there to serve. Quickly repositioning the operation and making needed changes is good business.

A transitional period is the opportunity to grow the operation again, increase profits and change objectives. This can be a time of renewal and the focus should be on the menu once again. Reducing costs is commonly done in a transition phase. A mistake many managers succumb to is while cutting costs; they lessen the perceived value of their menu and food in the customer’s eyes. If an item with an established perceived value is made a lesser value, customers can be disheartened with the dining experience and not return. A strategy to avoid this is to create new items. This encourages customers to attribute a new perceived value to the item without the comparison of experience with an old product.

Over-expansion of a menu can cause problems in the transitional phase. Adding items without subtracting under-performers can cause menu bloat. Too many items may mean the storerooms and freezer/refrigerators are too full and the slowed turnover of product can cause waste and invite pilferage. A dollar thrown out in the trash is a dollar that did not make it to the bottom line. Let the menu define the operation and set guidelines and limit it to what the customers want to purchase or to what is made well and fills the patient need.

You can survive a transitional period and improve profit while continuing to serve customers and patients. To control your destiny, you can market your way through, merchandize, rewrite the menu, reprice the offerings and more. The menu belongs to the customer not the manager or owner. The menu is a reflection of the people the operation serves. Looking at your menu through the

Food Service Tune-up – pg. 37 eyes of the customer and patient is the way to envision a successful operation. Menus: a complex and powerful tool The menu is a complex and powerful tool on one hand and on the other it is merely a list of the choices offered to the customer. "Menu" can also be used in a more general sense, as synonymous with diet, the selection of foods available generally to a particular location or culture. The word menu, like much of the terminology of cuisine, is French in origin. It ultimately derives from Latin minutus, something made small. In French it came to be applied to a detailed list or résumé of any kind.2 As a planning tool, it is the starting point and also the place around which everything will revolve.

Different menus for different places A menu needs to relate to the people it serves and the places where it is used. Some menus serve customers who eat at the same location over a long period of time. Customers of long term care, assisted living, schools, colleges, prisons and employee eating places demand variety because they come there almost every day. Planned variety is the byproduct of the cycle menu and the days can be matched to dates on the calendar. Cycle menus repeat themselves and change daily. The length of the cycle depends on the operation, but a single cycle is usually a seven-day set of meals.

A hospital has an average length of stay of 3 to 4 days so a one-week cycle will do. A nursing home has permanent residents so a four- to six-week cycle is common. The shorter length of a hospital menu cycle can mean there is less inventory to store per patient meal but, at the same II. The menu is everything – pg. 38 time, the size and volume of a hospital is usually larger with the addition of the commercial side represented by a cafeteria, vending and catering. Both hospitals and nursing homes have cycle menus but the items inventoried in the store rooms will be somewhat different.

The traditional method and still one of the most common menu systems is the conventional method where a paper menu is placed before the patient for decision. Variations include Room Service menus, Restaurant Style and Spoken Menus. With Room Service, the resident calls food service and orders what he wants from a static menu. With Restaurant Style, a cycle paper menu for lunch and/or dinner is left with the patient when breakfast is delivered for the patient to fill out. It is picked up with the breakfast things for later delivery of the meals. For a Spoken Menu, a foodservice employee or volunteer visits the patient, offers a limited select menu orally and asks what the patient would like.

Institutional menus, regardless of type of service in healthcare, filter the therapeutic diets to patients with specific diagnoses by distributing a menu for the patient reflecting the diet spreadsheet. The menu distribution includes menus written for such diets as calorie- controlled, fat-controlled, fiber-controlled, cholesterol- controlled, sodium-controlled, renal, regular, etc. For our purposes, we will leave out tube feed patients since this method of feeding is more in the realm of nursing in the majority of facilities.

Menu planning basics Planning a menu is complex and affects all food service activities. The Food Service Director (FSD) hopes to promote good nutrition, have happy customers and stay

Food Service Tune-up – pg. 39 in line with budget and cost goals (at least in a perfect world). All menus are ultimately subject to the universal boss—the customer. Even the legal system and regulations support the notion of menu rejection with “Individual rights.” If the end consumer does not want what you serve, his choice rules.

Health and nutrition are great places to start designing a menu but as the process moves forward, they will get tweaked a bit to make things fit. The regulations stipulate that the menus be nutritionally adequate. Often times the FSD or a designated staff member writes the regular diet menu and the dietitian writes the special diets in line with the regular diet offerings. Dietitians use a set of standards outlined in the diet manual used by the organization or the consulting company to aid the menu creation process.

Availability is a factor—whether your broadline distributor stocks the items you need or whether you need to buy from specialty distributors. Availability often affects the menu because if you can not get the ingredients for an item, you will not be able to serve it. Availability has held back the trends toward sustainable and organic foods. Seasonal availability is a factor although today we are increasingly spoiled by a food distribution system that finds places on the planet to grow whatever we want and ship it for availability almost year-round. Canning and other food preservation methods are now so good that we can take them for granted. Seasonal effects move prices up and down. A great credit should be paid to the food service folks who find ways to please the pallet year round.

Production, type of service and food delivery methods needs to be in sync with the menu. If you do not have a broiler you will not be able to make broiled items, at least II. The menu is everything – pg. 40 in the way they are meant to be produced and served. An accommodation may be buying pre-marked (broiler marks done at the manufacturer) chicken breasts and finishing them in the convection oven. Items that are supposed to be fried may be bake-able and that is the route if you do not have a fryer. The customer may not notice the difference but you are pushing the limits of authenticity. Cook chill and cook freeze methods of production need what is called a “smart menu.” To retherm frozen food can be a quality issue in that some menu items do better than others. Other arguments for properly serving food via the in-house delivery method include serving the item soon after preparation. For example, some managers prefer to serve muffins as opposed to toast since it is almost impossible to serve warm toast over a distance. The key concept here is that food looses in quality in relation to the distance it travels to the point of service.

Authenticity, Taste, Appearance and Presentation contributes to the satisfaction and aesthetic enjoyment of the menu. Consider authenticity. Customers are getting torn in many culinary directions. They seek an antidote wish to 'reconnect with the real,' with authentic foods. These are products with a compelling brand narrative and are based on traditions, heritage and passion. Companies are recognizing this and for ethnic foods are researching land native to the food. Food also needs to look good, smell good and have variety in color, texture, and taste. It needs to be plated in interesting three-dimensional shapes. In the meantime, don’t forget to use matching tableware, plates, plate covers, trays, etc. Customer needs play roles not only in regional and ethnic influences but also in their ability to feed themselves and their general health. Inspire your customers to want to eat your food and make the process simple and easy.

Food Service Tune-up – pg. 41

Variety and a balanced diet mean good nutrition that does not cause boredom to set in with the population served. Many a good manager has been under pressure to cook her way out of an angry customer mob by placing new things on the menu. Healthcare, prison food service, schools and the many places that require a balanced diet via regulation do so for good reason. The science supports the practice. Many dietitians these days espouse the concept of “everything in moderation.” This supports a balanced diet. Consider placing items from different entrée and meat groups side by side. In other words don’t place fried chicken next to baked chicken unless your customers are demanding a perceived health difference between baked and fried foods. If one item is beef, then the side-by-side item should not be beef; instead use ham or pasta. Variety is the spice of life.

Time, labor and staff expertise matches who does the work, how long it takes and whether they are skilled enough to make it all happen. This author thinks skill comes first because no matter how much labor you throw at a production cycle, the folks need to know how to get the job done. Cooks are laborers but they are skilled laborers. The cook at the level of the executive chef starts to become a knowledge worker and the chef is a legitimate professional. Once your staff has the skills, the production schedule dictated by the menu must be realistic. Time- and labor- intensive items may crowd your labor resources and require adding menu entries that for production purposes are convenience items. Convenience is anything that is intended to save time, energy or frustration. Convenience items such as premade cook- and-serve lasagna, pizza, pot pie, casseroles, desserts, frozen soups, etc. are often a bargain when the total cost to point of service is figured. Use of automated production lines in the food industry has made great II. The menu is everything – pg. 42 strides in the last several years. Often manufacturers can make a finished product and sell it to a food service operation at a lower price than what it costs the operation to make the item. Raw food cost is only part of the picture and the labor, overhead and profit margin are factors when deciding to make an item in-house or not. Consider adding additional freezer space in the next kitchen redesign of your facility to better take advantage of the quality prepared products that are coming to market.

Integrating menus and streamlining production are ways to optimize production, purchasing, inventory management. There are many ways to gain efficiencies by overlapping other menus in your facility with your cycle menu. As an example; the meatloaf served to patients may also be great to serve in the cafeteria or in vending meals. It is usually and in theory easier to make more of one item than make a similar amount of two different items. Food served to patient populations should be good enough to stand the test of the commercial cafeteria purchase decision or you have quality issues to work on.

Food safety needs to be mentioned no matter how basic it seems. Many operations send food to populations that are at risk such as the sick and elderly. Follow ServSafe and the suggestions of your local health department. The principles of good sanitation are in every way congruent to the principles of good cooking.

Meeting budget is essential and we all get hit with the tracked figures of per patient day or per inmate day. Selecting items with the right cost structures for your menu is key to accomplishing this. Yes, operations need to buy good food at the best price, but the costs that are

Food Service Tune-up – pg. 43 added within the facility are most critical. There are no profit centers within a business, only costs. The ability to measure the value produced can only be done when the internal costs are looked at in relation to the revenue received for sale of an item or weighing it against the portion of the room charge devoted to food. Profit is external to the organization because the revenue comes from outside.

Menus have a limited time or life cycle and need periodic updating and revision. Matching the menu to the facility and the population served while staying in tune with the customer is good business, good patient care and good food service. Take care of the customers whoever they may be and enjoy the great career that food service can offer. Menu planning basics Ask these questions or gather this information prior to beginning to design your menu.

Kind of customer who will use the menu - Longterm care - Independent - Assisted living - Acute care - Retail or Café

What does this matter? The customer kind will influence the type and length of your menu: - Restaurant style - Family style - Café/ bistro - Room service II. The menu is everything – pg. 44

- Based on Cycles (spring, summer, fall, winter)

What pattern will you follow? Will it be based on calories or cost?

Once you determine your customer base and style then you can begin to build your menu.

Start with breakfast. A good investment of time is to develop a one- to two-week cycle menu. If you can provide good variety for two weeks, your customer may enjoy the result even more if you incorporate some consistent weekly specials, such as: - Egg burritos - Breakfast sandwiches - Fresh baked goods - Topping for waffles, pancakes and French toast - Creative skillet meal or casseroles

Once you complete a breakfast cycle menu, focus on Lunch and Dinner

Things to consider: - Will one meal be heavier than the other? - Will it be mixed - What courses will you offer? - Will an alternate be available? - Will it be a selective menu? - How will it be served: restaurant, family style or room service? - Will one of the meals be “made to order”? - with there be specials daily or weekly?

Food Service Tune-up – pg. 45

- Do you have the equipment to support the menu?

Once you have answered these questions, you can begin to develop the building blocks to create a menu, the pattern set becomes the road map of the items needed.

Helpful hints Any one who has written a menu understands that you simply cannot accommodate wide variety and meet all the possible needs and run an efficient operation.

Try colorizing parts of the menu to emphasize the variety that is there. For example, for the entrée, use colored highlighters or inks: red for meat, blue for chicken, yellow for pork and so on. Take a look at the menu after highlighting it. Doesn’t it look as if there is variety? You can apply this technique to vegetables also. Try to be consistent with your color scheme because the residents will learn it over time and use it in making their selections. If you use a Excel spreadsheet to lay out the menu, you can color the cells and print the menu in color.

And the colors will also help you and the staff to get a global view of the menu and avoid apparent oversights.

Menu Reality The menu is a work-in-process. After you get started, the first menu you produce will inevitably need to be adjusted based on resident feedback and what you learn in the kitchen from preparing it. Further changes will need to be made as you run through a few cycles and the seasons change. The only bad menu is one that continues to repeat over and over.

II. The menu is everything – pg. 46

Your cash register and the foods not eaten capture the judgments of your residents. Track what sells and what doesn’t sell, and what is returned on the plate. Take those findings into consideration in revising your menus. This principle used in retail settings applies just as well to health care food services.

Food Service Tune-up – pg. 47

Menu planning for nutritional adequacy

» Nancy Giles Walters, MMSc, RD, CSG, LD, FADA Food & Nutrition Care Consultant, and Dr. Nancy Collins, PhD, RD, LD/N, FAPWCA President/Executive Director, RD411.com, Inc. “Where Healthcare Professionals Go for Information”

II. The menu is everything – pg. 48

This important chart is available in living color at www.rd411.com/policies/menu_planning_for_nutritional_adequacy.pdf

Food Service Tune-up – pg. 49

Descriptive menu words

Depending on your clientele, it may help to describe the foods you have on your menu. Consider providing an explanation of the ingredients and cooking method for uncommon or unfamiliar foods, such as ethnic specialties.

Some of your foods may have been prepared for certain medical conditions. Work with the dietitian to properly identify the food characteristic, such as: low calorie, low fat, low fiber, low cholesterol, low sodium, gluten/wheat free, egg-free, peanut-free, dairy-free and so-on, or the condition it was formulated for: heart-healthy, weight reduction, renal, vegan, celiac diet, etc.

Here are some words to liven up the descriptions of foods on your menu.

100% Designed Irresistible Sensational All Natural Enjoy Juicy Simmered Aroma Exotic Large Simmering Assorted Extra Layers Sizzling Baked Famous Legendary Smothered Best Fancy Light Soft Big Favorite Lightly Breaded Special Blend Filled Lightly Seasoned Specialty Broiled Finest Loaded Spicy Carefully Flavor Lovingly Stacked Char -broiled Flavorful Meaty Stimulating Chefs Choice Fluffy Moist Stuffed II. The menu is everything – pg. 50

Chefs Special Fresh Mouth-Watering Succulent Chilled Freshly Natural Succulently Choice Full New Super Chunky Garden Fresh Old Fashioned Tangy Classical Garnished Original Tender Colorful Generous Perfect Tenderly Cool Generously Perfection Thick Crisp Giant Piled High Thickly Crunchy Golden-brown Piping -hot Thinly Crusty Great Refreshing Topped Customized Grilled Refreshingly Treat Delectable Heaped Rich Tropical Delicate Heaping Richly Wrapped Delicately Hearty Sautéed Yummy Delicacies Hot Seasoned Zesty Deliciously Huge Secret Delightful Iced Secretly Delightfully In season Selected Deluxe Inch-Thick Selection

Food Service Tune-up – pg. 51

Request for menu change form Request for menu change

Cycle

Day

Meal BRK LUNCH DINNER

Item that needs changed

Replace with ? Justification

Process Please verify that all support systems have been changed Recipe Menu

Production sheet Extensions

Order Guide Pre-prep

Comments:

II. The menu is everything – pg. 52

Analyzing Customer Demographics for Menu Planning

» Adapted from: Analyzing Customer Demographics for Menu Planning by Timothy L. Bauman, DHCFA, CDM, CFPP, Healthcare Foodservice Trends (The quarterly magazine of the American Society for Healthcare Food Service Administrators), Vol. 5, Issue 2.

Serving food in healthcare institutions is the most complex type of food service. Complexities in this industry include the “medically prescribed diet” which can involve about as many variations as the science of our dietitians and medical staff can develop, tempered only by the capabilities of the kitchen. Beyond the patient food, healthcare institutions usually serve in cafeteria settings,

Food Service Tune-up – pg. 53 catering and vending. In this article we will explore all the customer constituencies served by healthcare institutions and how we can create menus to serve those often very different customers. Success in meeting these demands is success for the food service administrator.

Successful cafeterias often need to follow the trends of the larger restaurant and business and industry segments. Hospital cafeterias typically serve anywhere from seventy percent to ninety percent of their meals to employees of the institution. These are repeat customers who potentially eat in the same place more than two hundred times per year. Think of the full time employee who has two days off per week, subtract their vacation time and see what is left in a three hundred and sixty five day year. Capturing that potential business and fostering their satisfaction is success plain and simple. When looking at the differences between foods sent to patients and to other parts of the total food-serving picture we see a difference, yet melding the two optimally is another key success factor. When a part of the patient food production can go to the cafeteria or catering, the efficiency of the operation is increased. Too much patient food in the non-patient serving areas meets resistance and of course, a lot of the cafeteria food is not going to cover the requirements of the medically prescribed diet. How does the food service administrator know where that fine line of optimal food service runs?

Studying the patient and customer demographics of a healthcare institution sheds light on the paths the manager should take when developing menus. Demographics defined means; “the characteristics of human populations and population segments, especially when used to identify consumer markets” 3 Since healthcare managers have such distinct differences in the II. The menu is everything – pg. 54 populations they serve, we will divide the problem in two parts to serve up answers. Patient/resident and non- patient food areas seem to be a good simplification, so that is how we will cut the pie for the rest of the article. Your resources for demographic intelligence information as food service administrator can vary in what your institution is willing to pay for and what intelligence information they can gather on their own. Pay a visit to the marketing people in your facility and don’t forget to bring them a complementary box of goodies from the kitchen so they will work hard for you. These people give you the patient related information, whereas it is up to you to get the cafeteria, catering and vending information. Marketing people can show you what has been discovered from the patient surveys that most people get during or immediately after their stay. Outside sources include hospital associations and private companies that specialize in demographics.

Some examples are the American Hospital Association (http://www.aha.org), the Ohio Hospital Association (http://www.ohanet.org/ , and Claritas http://cluster1.claritas.com. How these organizations, or whoever your institution uses, divide patients into groups for study is a revealing tool for managing healthcare food service.

Writing patient menus can be a lot of work and the manager who completely kicks out an entire menu on a regular basis is a glutton for punishment. This task ages your dietitian, staff and production managers quickly. Slow evolution of a patient menu to keep current is best by replacing only a couple items in various sections at a time. If you are in long-term care or in a hospital with such a facility attached, complete menu changeover at specified times during the year cannot be avoided.

Food Service Tune-up – pg. 55

Tackling the mountainous menu writing task should involve studying the target market because with all the work involved, implementing food in your service that is not well accepted can be an additional headache no one needs. Demographic data produced by different organizations for hospitals is commonly divided into four categories for males and four categories for females.

Sex Group 1 Male - Low Utilizers, age 20-44 - Peds, age 0-19 - Beginning Utilizers, age 45-64 - Medicare population, age 65 and over

Sex Group 2 Female - Low Utilizers, age 20-44 - Peds, age 0-19 - Beginning Utilizers, age 45-64 - Medicare population, age 65 and over

Good data is derived from your local area as opposed to generic information which includes national or other geographic regions. County health department information is available upon request and can help in seeing trends in your area and gaining even greater insight into any statistics you review. With information from outside sources in hand, you can get the survey and admission information for your institution. Marketing people, admissions departments in hospitals or social workers in long term care settings compile statistics for review by administrators who use it in the decision making and planning process. Compile the information from the sources inside and outside your institution and study it until you get a true picture of the different customers you serve and where you serve them. II. The menu is everything – pg. 56

Let’s put together a few revealing statistics and thoughts to consider for menu writing. The average length of stay in community hospitals in the year 2000 was 5.8 patient days.4 The Medicare age population of a hospital ranges from 45 to 65 percent range depending on the types of services the institution offers. If you run a long term care food service, the Medicare age population can reach 95 percent. In this case, the length of stay can average much longer than any typical cycle menu. A point we can draw from these facts about patient/resident populations is that in acute care you may only need a one week cycle menu whereas in long term care the patients/residents may need a multi week cycle menu to keep interested in the food. A commonality for healthcare in general is that our populations are older than the average age of the general population.

As new technology has allowed for more care to shift to outpatient departments, outpatient visits have increased by 150 percent since 1980 and outpatient utilization rates have continued to increase. Outpatient surgeries now represent 63 percent of all surgeries up from 18 percent in 1980.4 Considering that fewer patients are laying in beds in hospitals makes for a different dining setting. We may be lucky to catch these people in a cafeteria or vending area if at all. Despite decreases in the number of hospitals with emergency departments, the number of ED (emergency department) visits has increased by about 19 percent since 1990. In a recent AHA survey, 62 percent of hospitals reported their EDs were at or over capacity and 33 percent reported having to divert ambulances.4 The proliferation of kiosks and other compact and mobile methods of delivering food in healthcare will increasingly be driven by such factors. Taking a few queues from other industries, such as theme parks, shows us that

Food Service Tune-up – pg. 57 while people wait in line for a company’s core service, their satisfaction is either preserved or increased with food and beverages. This presents a chance to maintain lost revenues or increase them. The decision for managers is how far we need to go to chase our customer base depending on our mission and profitability.

There are distinct differences in the type of foods to serve patient/resident and non-patient diners. Sixty four percent of registered nurses in the year 2000 were between the ages of thirty and fifty.5 The vast majority of patient/resident customers are past sixty five years of age and are on medically prescribed diets. The conclusion here is that healthcare institutions need to run two different menus targeting two distinctly different populations.

What are the differences in the patient/resident and non- patient menus we need to produce? Eastern, Midwestern, Southern and western United States areas will vary a little with some regional twists to their food offerings however, the emphasis for patients/residents will be on tastes and preferences that were developed while growing up in the 1920s through the 1940s. These children of the Great Depression and World War 2 experienced rationing and scarcity that has been a rarity since. When you don’t have much food, you clean up your plate and less expensive items are commonplace. Chipped beef, meatloaf, mashed potatoes and all the things we currently call comfort or home style food were the foods of the times. Remember that the fast food era did not start until after World War 2 with the baby boom, the proliferation of cars and the improved highway system. Most entertainment was done at home and no one had computers or television. The non-patient population we serve began eating in different times. With two working parents and single parent II. The menu is everything – pg. 58 families more prevalent today, people are used to eating value added foods. Value added foods are items where part of the preparation and/or cooking process is done prior to receiving the item. As institutional food services, we more frequently pass by our recipe collections to offer an entrée made on a production line in a food factory (we just heat and serve) and we do “Speed Scratch” (putting two or more value added items together to produce a dish which requires less prep time) - one of my favorites. This takes away from the house recipe or secret recipe that distinguishes our items from other similar operations and in addition, regional and national branding is on the rise. This crowd represents anywhere from sixty to ninety percent of the cafeteria, catering and vending business in hospitals. Keeping them happy is how we keep our jobs.

While Americans remain fixed on comfort, classic, retro and American regional foods, they are also doling out dollars for those with a more gourmet edge. Artisan foods, high end desserts, and chef created concepts are adding a little luxury to life.6 The big three ethnic foods of Asian, Italian and Mexican are now considered mainstream. Shoppers are eating more foods they enjoy. Statistics show seven in ten (72%) agree and 30% strongly agree with the statement, “I eat foods I enjoy, even if they are not good for me.”6 What we are seeing here for our non-patient populations is a diverse variety of foods of increasing quality and greater convenience. The patients/residents are comfort food people with an occasional step into more modern menus. As food service administrators we can meet the challenge and profit. We have two distinct populations to create different menus for and all told we run some pretty complex organizations. Try to meld the two as best you can to keep costs in line and still play to both audiences. As with any great onstage performance, keep them clapping.

Food Service Tune-up – pg. 59

III. Purchasing goods and services – pg. 60 CHAPTER THREE

III. Purchasing goods and services

The best value and when done right, always a winner!

Food Service Tune-up – pg. 61

What do you need to run your food service operation? Forecasting Being a good fortuneteller directly affects the fortune you are able to reap in your operation. This process of estimating future needs and how much to order ties in your existing inventory with what your cooking efforts remove from the shelves. As routine as is seems and needs to be, developing a timetable or schedule for forecasting, doing it approximately a week ahead while keeping food fresh and honoring your menu makes things run smoothly. Base forecasting on the menu, customer counts and historical data. Inventory Taking stock of what you have on the shelf and transforming the information into a usable format is the gist of the inventory process. Inventory can be considered the ongoing maintenance of your facility’s list of actual goods and materials held on hand. Keeping raw ingredients and partly-finished foods on hand is necessary because the delay in producing food is longer than the delay in delivery and serving. Also, inventory eases the effect of inefficiencies in the production process if production capacity stands idle for lack of food stocks.

Organize your inventory items by unit or by number whether or not you’re automated. Be sure to categorize items in your records and on your storage shelves with common industry-wide name subcategories, such as Frozen, Canned and Dry, Produce, Meat, Seafood, Poultry, Dairy, Tabletop, Disposables and Chemicals. Define your purchase units and issue units and decide what sizes fit your needs. Changing unit sizes can create the need to III. Purchasing goods and services – pg. 62 change your order guide, recipes etc. Combining the above items to create an inventory list/order guide creates a key planning tool. Use this list to order, count and place a dollar value on everything. These dollar figures, called an inventory valuation, is needed for weekly or monthly operating reports. These reports provide useful management information, financial performance and can uncover problems such as pilferage. Many of your most pressing questions (and upper management concerns) are answered by trending what you track with your inventory valuations. As an ordering tool/order guide, “sheet to shelf” or par levels set a minimum purchase amount to store until needed. The above-mentioned subcategories allow you to drill down your analysis of how the operation is doing. The vigilant and proper use of these tools is one of the food service manager’s most powerful weapons. Purchasing objectives Purchasing is more than just placing an order. The process must be managed from all aspects to achieve desired results. The purchasing focus is on buying needed products economically with fulfillment and delivery to the location of need. Food service purchasing has many complexities as a result of quality, quantity, price, supplier and delivery schedule. Quality control begins with purchasing specifications. Specifications (food specs) are a detailed list of requirements or particulars in specific terms. There are a few government and private publications available that define these. Efficient purchasing buys food that is no better or worse than the needs call for. As an example, U.S. number 1 tomatoes (perfect color and firmness) may not be needed under the bun of a sandwich, but are quite visible on top of a salad. Specifications are the real life comparison of “apples to

Food Service Tune-up – pg. 63 apples”. Examine your recipes and menu requirements because in purchasing, price and quality cannot be separated.

In the know………. - Can cutting: Sampling products for purchase and to check that you are getting a product that meets your specifications. Literally it is to open a can and check for overall quality, taste, texture and appearance followed by your evaluation. - Weight: Net weight (weight without packaging) and drain weight (weight without the packing liquid) affects your yield and price value. - Edible yield factor: This is how much remains after preparation. Terms in this include AP (as purchased), which is the amount at purchase, and EP (edible portion), which is the amount left after preparation. Your edible yield factor is expressed by the following calculation: EP ÷ AP. Order Guide An order guide can ensure ordering efficiency, stabilize inventory, limit substitutions due to run outs or over stocks, track and document product costs, help keep food cost on target and allow a substitute to place an accurate order in the absence of your usual person. In addition to all of this, Order guides contribute to food quality and safety by ensuring the you order known products whose characteristics are suited to your recipes and production methods.

III. Purchasing goods and services – pg. 64

In the know………..

How to set up your Order Guide - Complete a comprehensive inventory list of items required to produce the menu. Organize the list by storage area. This list should flow from inventory sheet to storage shelves (“sheet to shelf”) and should not include dead stock. For example, as you walk in the store room, the inventory list should start with the first item on the shelf and work its way to the other end. This process needs to be completed for the freezer, cooler and reach in coolers and all other storage areas. - Set up (or have your vendor rep do so) the order guide on the computer so it flows in the same manner as your inventory list throughout all storage areas. - Print off a master copy; this will be the base for your order guide. - Establish par levels for all par stock items - sugar, creamers, butter, flour, cereal, rice etc., and enter them on the master order guide - Take the menu and group the days together that equal an order. For example, if you have a five-week cycle menu (Monday- Sunday) and you order twice a week (e.g. Wednesday and Saturday), then you will have ten groupings of orders. The order you place on a Wednesday would normally come in on Thursday, but you wouldn’t start using it until Friday… in case there is a delivery problem. The order you place Wednesday

Food Service Tune-up – pg. 65

would cover food needed for Week 1 cycle— Friday, Saturday, Sunday and Week 2 cycle—Monday. The order you place on Saturday would normally come in on Monday, and would cover food needed Week 2 cycle—Tuesday, Wednesday and Thursday. - Order the specific non-par stock items: entrees, vegetable, starch, breads dessert, etc., and all par stock items needed for service, pre-prep and freezer pulls through the next order date. Amount ordered should be: Amount needed for the order cycle Minus amount on hand Plus amount to be used prior to and including delivery date Equals amount to be ordered - Use inventory list to complete a monthly inventory at the designated day each month.

Tip… Keep a separate order guide for your china, flatware and serving utensils. Include: par level, reference the type, pattern, vendor and any other specifications that will help you order the same thing. This will save you from many problems when you want to reorder later on. The bid process and organized purchasing As specifications are worked out, obtaining bids and organizing your suppliers is the way to obtain optimal value at the best price while constraining expenditures. Competitive bidding gives several vendors a chance to fill your needs. You set the specs and terms and the ground III. Purchasing goods and services – pg. 66 rules for bidding. Dietary operations usually find it advantageous to select a “prime vendor.” Prime vendors are the folks you purchase the majority of your products from (usually under contract) and do so at guaranteed pricing set for a specified period of time. This all takes time and constant monitoring. In today’s world, purchasing groups have evolved to take on some of these complexities and save the food service manager time and money. For an introduction to group purchasing, read on.

WIN WIN with vendors A vendor relationship operates at peak efficiency when all parties operate as partners to ensure each party’s interests are met. It must be “WIN WIN” or both will lose.

An understanding of what a vendor can and can not do is critical. Remember once the order is received it is up to you to manage the preparation and serving processes and control the end cost.

Food Service Tune-up – pg. 67

Never ask the delivery driver to check an order or drop it off and sign for it in your stead. You must be able to verify that the product is correct and the correct label is on the box. Miss-picks and missing items happen every day, so make it a priority to make sure the products you receive are correct.

Here is a list of ten things that you should ask for and expect in your partnership with your vendor:

1) Computerized ordering ability. This will give you instant knowledge of out-of-stocks, cost and product options. On line ordering is the only way to go. When you find an item is out-of-stock, you have the ability to make an educated substitution.

2) Categorized invoices and in duplicate form. Invoices can be set up by your food categories, such as frozen, meat, produce, etc. Perseverance on this will save you weekly searching to break out a case of cups within your dry goods. Always keep invoice copies in your office file and refer to them when you have to.

3) Available delivery window options. When staffing resources depend on assisting with stock and inventory management it is important to have reasonable delivery times that mesh with your operation and staff availability.

4) Monthly velocity reports. A velocity report is best explained as the sum total of the food items you order over a certain period of time. Instead of having ground beef on five separate invoices, the total of the orders of ground beef for the month can be shown on one report. And the same for other items. These reports can easily generated by any of your vendors and can be produced several ways—ascending or descending by dollar amount III. Purchasing goods and services – pg. 68 and by quantity of units purchased. The typical report shows items by total dollars from highest to lowest.

What to do with a velocity report?

A velocity report is best way to determine where your dollars are being spent and where you should focus to save or control cost. Since these reports show the impact of the dollars spent, you can often use these reports to make informed decisions on purchases and items in question.

You can make decisions and understand their impact if you can determine the weekly or monthly volume use of, for example, apple juice—frozen, canned or boxed.

5) Special order items. Vendors can often supply special order items, things you ask them to locate for you and that are not on their order sheet or catalog. You may need special order items to prepare for special events, such as an ethnic food dinner.

6) Skip day ordering and the ability to reduce miss-picks. A skip day eliminates the panic ordering or last minute mistakes. It allows you time to add to the order if needed and to react to shortages or out-of-stock items to make intelligent decisions on substitutions.

7) Instant invoice adjustment on damaged goods during check in. This capability allows you to make the adjustment on the invoice instantly and avoid having to wait or track down credits. This is another critical reason for managers/ supervisors to check in each order

8) Delivery check-in assistance. It is not unreasonable for vendors (typically bread and milk vendors) to have the

Food Service Tune-up – pg. 69 driver identify stock for confirmation, rotate stock so that older, (first-in) stock is placed in front of new stock so it is sold first (first out), or FIFO.

9) Product sampling and introduction/ market updates. Your vendor should have knowledge of trends and market impacts. Make sure your vendor keeps you informed. Ask the vendor to run a mini food show for customers and staff so you all can learn about what’s new.

10) “Opportunity lost” meetings with your vendor. Request a meeting to analyze what items you should be getting or could use instead of some you may now be purchasing. Maybe there is a “deal” item that would fit your purchasing program that you are not aware of!

III. Purchasing goods and services – pg. 70

Group Purchasing Organizations

What the manager needs to know

» Adapted from: Group Purchasing Organizations, What the Manager Needs to Know by Timothy L. Bauman, DHCFA, CDM, CFPP, Healthcare Foodservice Trends (The quarterly magazine of the American Society for Healthcare Food Service Administrators), Vol. 5, Issue 1.

Keeping costs low and making budget are critical success factors for all food service administrators. Monitoring an

Food Service Tune-up – pg. 71 operation’s costs is a yearly, monthly and yes even daily function that keeps the organization on track.

Group purchasing organizations (GPOs) negotiate for the purchase of food, supplies, services and capital equipment on behalf of their members, which include hospitals, nursing homes and other healthcare provider organizations. Group purchasing is a way to assure that consistency, ease of implementation and sanity in pricing is maintained for all the materials that come in the door, from food and supplies to capital equipment. Group purchasing can be several organizations that ban together under multiple owners, the one owner or entities such as food contractors who often negotiate their own pricing.

GPOs provide three essential functions that the manager can take advantage of. - GPOs aggregate buying power in order to obtain discounts from manufacturers and distributors. - GPOs facilitate and enhance comprehensive product comparison analysis, using clinician and management input, thereby allowing providers to purchase products that best fit their individual needs. - GPOs streamline and standardize the purchasing process, thereby reducing the inefficiencies inherent in today’s healthcare system and offer valuable cost-avoidance savings to providers.7

In group purchasing, several businesses and/or institutions with similar interests come together by combining their purchasing activities in order to achieve III. Purchasing goods and services – pg. 72 savings through volume buying. The group’s purchasing power is increased only when the volume of purchases for the group is significantly larger than it would be for individual facilities.

GPOs are helpful in overcoming several challenges in the purchasing process. Buyers, especially for smaller to mid- sized organizations, are often fragmented and can suffer from inefficient availability or discovery of seller’s prices thus creating the need and incentive to organize.

Healthcare organizations’ budgets for food, supplies, services and other goods are substantial and if they buy these items through GPOs they can get better prices. Food service contractors operate within an organization but usually use their own company’s negotiated purchasing contracts. In exchange for administrative services and the ability to sell through a GPO to its members, vendors pay administrative fees to the GPO based on the members’ purchases made using their contracts. These fees cover the GPOs costs and many of them distribute surplus fees to their owners. GPOs must comply with government regulations that limit their administrative fees to 3% or less of the sales volume. Who gets the best pricing - a facility buying through a GPO or the food service contractor - is a function of their respective purchase volumes that leverage the overall contracts they negotiate with manufacturers and vendors.

GPOs have been very successful in obtaining lower prices than members can obtain by purchasing individually, with savings from 10 to 15 percent.8

GPOs give members a great deal of choice in purchasing by:

Food Service Tune-up – pg. 73

- Getting input from member’s medical staffs, clinicians and managers before deciding what to buy. - Individual members are free to a great extent to purchase outside of the GPO, at any price they can obtain. When doing this, the member may lose volume discounts. Many contracts have clauses allowing purchases of unique items not offered by the GPO-selected vendors. - Most healthcare organizations belong to more than one GPO so they can organize their own optimal product mix from the offerings of several GPOs. - In most cases if a healthcare organization is unhappy with the offerings or services of a specific GPO, the organization is free to join a different one that meets its needs better. Be sure you know what GPOs your facility has in-house and how you can take advantage of their unique offerings.

While GPOs do not impose products on members, they provide incentives to purchase a predetermined percentage of their products through their contracts. This contractual agreement typically involves extra percentages off the base contract price and increases as the volume of purchases increase (volume discounts).

Most ask members to buy from 80 to 90 (some 100%) percent of their purchases through the GPO contracts. The incentives involving the extra percentages off with volume are usually set up in increments. As an example, you get .25% rebate (one – quarter percent rebate) for weekly purchases of $0 - $6,999.99 followed by a .50% III. Purchasing goods and services – pg. 74 rebate (one – half percent rebate) for weekly purchases of $7,000.00 to $10,999.99 and so on as your purchase volume increases.

Other incentives exist for private label products that many distributors sell and the more of those products you buy, the larger the rebate on those items.

Consider your drop size (total purchase at one time) because most vendors give rebates based on size. A large drop of say $10,000.00 or more can put as much as a half percent to your bottom line as a rebate. It is better and more cost effective for distributors to make fewer and larger drops due to their own shipping costs.

Quick pay agreements and online billing can add more to savings, so ask what can be done if your facility pays according to vendor and GPO arrangements for this. The quick pay systems are made easier if your facility is willing to pay online.

Finally, check to see if you can get lower pricing for using services and products such as the chemicals for your dish room, pot and pan and floor care area and the distributors’ beverage systems. Sometimes giving everything to them is in your interest. Food service contractors have guidelines set at the corporate level so staying abreast of available programs allows you to purchase well. The mechanics of their programs often work similarly to that of the GPO and knowing these details let you take full advantage of what is available.

According to an American Hospital Association survey, roughly 4,900 nonfederal community hospitals spent an estimated $173 billion on non-labor supplies, services and

Food Service Tune-up – pg. 75 capital in 2000. These expenditures have increased consistently ever since going beyond $330 billion in 2006.

Healthcare organizations buy a significant share of non- labor goods and services through their own purchasing departments contracting on their own while also using GPO contracts or the contracts of food contractors for an increasing larger portion of their purchases.

Manufacturers market food and medical devices in journals and at trade shows but also place great value on having access to managers and clinicians in healthcare organizations, as well as their purchasing departments, which make the final decisions. The Health Industry Group Purchasing Association (HIGPA) estimates that upwards of $151 billion of hospital purchases were funneled through GPOs in 2000 and $76 billion for the nursing home industry. More recently in 2006, they estimated that $33 billion is saved annually accounting for a 10 to 15% off purchases.

GPOs and foodservice contractors differ in their corporate structures, their relationships and services offered to members however; there are some basic facts of importance to the food service administrator regardless of whom they report to.

- Contracts: By definition a contract is an agreement between two or more parties, especially one that is written and enforceable by law. With that in mind, GPOs and food service contractors contract with major manufacturers, distributors and sub vendors to define the business relationship and spell out what is expected of both III. Purchasing goods and services – pg. 76

parties in the agreement including audit privileges to assure compliance. Just reading your contracts is a way to become aware of services you can get from your GPO and purchasing contract and how to take full advantage of them. Many times these contracts can be acquired online with a member password. Important parts of the contract include the duration of the agreement, supplier and ordering instructions, pricing, terms, minimum order amounts, shipping and volume commitment programs. - Services: GPOs offer a number of services such as help if a problem occurs with a vendor. The GPO has a great deal of clout in getting businesses that are under contract to honor the terms of the agreement. They often also offer wide ranging equipment programs and can help with the acquisition of one equipment item or an entire renovation including interior design work. When doing your capital budgets, many GPOs will let you submit your wish list and then go to the vendors for pricing and specification information on your behalf. This saves you a lot of time and can keep a food service manager from dreading the time of year when capital budgets are put together. - Value-Added Extras: This is a category that is expanding in scope as GPOs are trying to differentiate themselves from one another. Examples of value-added extras include professional organization

Food Service Tune-up – pg. 77

memberships, assistance with product standardization, customized reports and seminars. GPOs work with distributors who also provide their own set of value-added extras to members with such resources as customer reference libraries, menu and nutrition assistance, food shows, specialized healthcare sales staff, web sites and online resources. The most innovative and successful GPOs utilize professionals in the food service industry by sponsoring boards where member employees give feedback on products, services and companies to keep the GPOs offerings state of the art and of greatest relevance to the membership. Ask your GPO about the activities of their food service advisory board and consider contacting one of the members to lobby them to represent any requests or concerns you may have.

Pricing is an important part of the GPO contract to be aware of. There are two primary ways it is defined. Cost- plus pricing, the first method, takes into account cost as defined in the contract (most contracts have specific clauses that define “cost”) plus a percent over the cost to arrive at the final price. List-minus pricing uses the distributors’ established price list minus a contractually defined percent. Typically chemicals and beverage systems are offered at list minus pricing while most other items are cost plus pricing. Below is an example of a complete pricing formula.

III. Purchasing goods and services – pg. 78

1 Item Description Bran Flakes Beef Base 2 Distributor Code 0 0 3 Pack 72 12 4 Distributor Cost $18.34 $28.20 5 Additions (label, cash freight) --- 0.49 6 Promo discount from Cost --- 0.60 7 Distributor Net cost 18.34 28.09 8 Cost Plus/List minus 10.50% 10.50% 9 Promo disc from Price $2.00 $2.70 10 GPO Net Price $20.27 $31.04 11 Member Price $18.27 $28.34 12 Date 11/22/2002 11/22/2002

Take a look at the table above and note that the (1) item description is linked to the (2) distributors’ product coding system, the (3) manufacturers pack size and then the (4) distributor cost is revealed.

This is also the pricing formula that is followed in an audit where a distributor must provide proof to the GPO in the form of invoices as to what they paid the manufacturer for a given item. It is always a good idea to participate when your GPO is doing an audit to assure that distributors are living up to their agreements. Typically all you do is submit invoices and the GPO takes it from there.

Also note above the parts of the pricing formula that also include (5) additions which include distributor labeling costs and freight charges and (6) promotional discounts from cost which manufacturers give to distributors.

This all leads us to the (7) distributor net cost and allow the GPOs to do the calculations to figure (11) member price. To get member price take (7) distributor net cost and multiply it times (8) cost

Food Service Tune-up – pg. 79 plus/list minus to get the (10) GPO net price. Now subtract the (9) promotional discount from price and you develop the (11) member price.

Follow the above two examples taken from an actual audit and notice an interesting situation with the bran flakes where the (4) distributor cost and (7) distributor net cost is greater than the (11) member price. In the audit process, if discrepancies are found then the distributor must refund the difference to the GPO members and of course food service contractors often use much of the same methodology. Isn’t capitalism great?

If group purchasing organizations and various volume purchasing methods did not exist, it would cost hospitals an average of $353,000 per facility to perform the same cost comparison and product standardization function as GPOs. This figure does not even include the volume discounts GPOs provide.9 GPOs are of tremendous benefit to the healthcare industry and using one can mean a lot in how your organization compares in a competitive business environment. Work with them, read their materials and increase your success.

IV. Production systems – pg. 80 CHAPTER FOUR

IV. Production systems— Putting it all together

It starts with the recipe.

Food Service Tune-up – pg. 81

A Production System is the single most important investment of your time in an operation. The key factor is good planning. A well-planned and well-managed production system is the secret to your success. Though keeping things simple is an important consideration, having a production staff work directly from the posted menu is not recommended no matter how small the operation.

The components of a production system are shown below:

Menu

Scaled Recipes Extensions

Order Guides

Production Sheets

A production system is defined as a set of written instructions to produce all of the food items needed for the day. These instructions include: - Production sheets - Steam table diagrams - Standardized recipes - Order guides (See Chapter III) IV. Production systems – pg. 82

Surrounding the production system is a set of skills that keep the operation running smoothly and help to manage cost and maintain quality. These skills include: - Forecasting - Consistency - Portion control - Pre-preparation - Production meetings - Batch cooking - Proper handling of leftovers

A properly set up production system will enable an operator to produce a consistent, high quality product and manage cost. It is critical to constantly monitor and evaluate the results achieved from following the production sheet and answer these questions: - Was the forecast for number of meals correct? - Were portions sizes as served correct? - Were the recipes followed? Production Sheets Production sheets are basically the job routine for the production staff. The production sheet should contain all the information needed for the staff to prepare the meals for today and to organize supplies and make preparations for the next day or two. Depending on the size of the facility, it may guide the work of the day at that work station, for several workstations or the kitchen as a whole. It is also the place to record deviations from the plan for the day, if they come up.

The functions of a production sheet are shown below:

Food Service Tune-up – pg. 83

Completed Weekly for use based off of Menu Complete with counts , pre- prep and Scaled Recipes Freezer pulls Attached Available for each postion

Over and under production is recorded Left overs are processed as needed

A production sheet should include the following common factors: - Name of the item to be produced–the recipe should have the same name - Total amount to be produced for each item - Distribution areas for each item (dining rooms, café, room service, etc.) - Portion size - A space to record amounts over- and under- produced for the day or the distribution - Recipe reference, if needed

Additional optional information that can be on the production sheet includes: - Garnish or garnishing instructions IV. Production systems – pg. 84

- Serving utensil - Pre-preparation for next meal or day - Freezer pulls - Special notes - Plating instructions - Batch cooking timing and amounts - Other comments to help organize the work flow for production staff Production Sheet procedure A sample production sheet is shown on a following page. The instructions below refer to the numbered blocks on the sheet.

1. Day: Enter the day of the week as day or number: Sun, Mon, Tue, etc. or 1, 2, 3, etc. 2. Cycle: this will be the week number of the cycle you are preparing the sheet for 3. Temperature: Record the temperature of the food items prior to service – making sure to follow ServSafe minimum temperature requirements for cooking, reheating and holding for service 4. Item: List the menu items to be produced for the day (or work area when separate sheets are used for each position) 5. Portion size: Copy the portion size listed on the extended menu – verify that this is the same as the portion size shown on the recipe 6. RES: The number of servings to be produced for each distribution/service point (e.g. REStaurant, tray line, main dining room, 4th floor) is written in these columns. 7. Total: This total number is the sum of the numbers for the service points listed across for #6 (item is being sent to tray line and main dining room (TL=14, MDR =10,

Food Service Tune-up – pg. 85 then the total is 24). This total is the number of servings the recipe should be scaled to. 8. Over/Under: Record the left over amount. If amount was short, then mark it as a negative number. Use this information when forecasting the menu item in the next cycle. 9. Next day prep: List food items to be prepared for use the next day… (bread or deserts baked one day before, vegetables chopped for next day’s soup, meat marinated for next day’s cooking, etc.) 10. Dish machine Rinse/Wash: Area to record your dish machine temperature settings (If not recorded on a separate document) 11. Sanitizer bucket PPM: Record your sanitizer bucket PPM 12. Freezer pulls: List food items to be pulled from the freezer two days ahead, (i.e. roast pork pull Monday to roast Tuesday for Wednesday service) 13. Refrigeration Temperature: Record refrigerator and freezer temperatures (If not recorded on a separate document) 14. Write in and document menu substitutions (also record on substitution log) 15. Write in special cleaning assignments or other duties

IV. Production systems – pg. 86

Production Sheet Breakfast Dining Services DAY1 Cycle 2 Area Temper-ature Item Portion Size RES Total Over/Under Dinner

4

5 6 7

3 8

Next day prep

9

10 Dishmachine11 Pot pan RinseWash PPM

Freezer Pulls Sanitizer bucket PPM

12 Refrigration Temperature Walk in Cooler Freezer Note: Write in any menu substitutions below:14 Reach in 1# under counter 13 Special cleaning assignment 2# under counter 15

Food Service Tune-up – pg. 87

Accurate forecasting of production Forecasting is not just for meteorologists. Accurate forecasting of production will keep you out of trouble with your customers, your staff and your boss. Many factors affect the amount of food you should prepare for any given day but with common sense and an understanding of the factors, the “over or under” production can be controlled.

Forecasting means estimating how much food you will need without having all of the information you would like to have about the situation. Nevertheless, it may be better to gamble in Vegas than with producing food. A good operator will forecast the amount of food based on information, past and present, that may influence the needs for the day. To determine your estimate, take prior cycle usage, today’s census, weather, payday, events inside or outside your operation, day of the week, holiday, and other factors you think relevant, compared with the same factors for past cycles. In other words, to do a good forecast you must be aware of happenings in the world around you. All of these factors affect the amount of food that will be consumed. For example if it is a very hot day in your area, perhaps cold items will be more in demand and should be available. “You are only as good as your last meal.” An old food service saying is “You are only as good as your last meal.” The key ingredient to any food service establishment is consistency. Will the meat loaf today taste the same as it did last time and will next time? Your customers expect to know whether or not they like an item that is on the menu – not that they like IV. Production systems – pg. 88 or don’t like it when a certain cook makes it. Is there a problem with the item? Is a recipe available and followed? Is the recipe extended or scaled to the correct amount for all ingredients and in correct measurement sizes? Are all recipe ingredients available? Once you have answered these questions, make sure that you follow-up with action needed to prevent the same problem in the next cycle. How? - by making a note on the production sheet and/or recipe for that day/item. Portion control Portion control is another critical step to ensure that you have enough food. Portion control requires some specific equipment: - Scales, pound and ounce sizes - Measuring pitchers, quart and gallon - Measuring cups, dry and liquid - Measuring spoons - Scoops, spoodles and ladles in sizes needed to serve your menu

In the know………. - Scoop numbers indicate the number of portions per quart using that scoop. A #8 scoop will give you eight portions from a quart. - Spoodle and ladle numbers indicate the number of ounces volume that the utensil holds - All utensils yield the number/size portion indicated with level measurements - Reference cut is simply a cut of an item that is to be used as a reference for cutting the remainder of the item. For example, if you

Food Service Tune-up – pg. 89

are slicing meat or cutting pie, an example of the exact way you want it done should be made. This is not only useful when beginning the cuts, but also after cutting several pounds (or pies) when for some reason the slices or pieces are usually either getting smaller or bigger.

The following chart gives number of portions per pan for various scoop, pan and portion sizes

PAN CAPACITY - PORTION CHART SIZE PAN NO.PORTIONS DEPTH (INCHES) CAPACITY SIZE PORTION YIELDED* QUARTS CUPS CUP SCOOP # 1/4 18 120 FULL SIZE 1/3 12 90 7 1/2 30 12 X 20 2 1/4" 3/8 10 80 1/2 8 60 1/4 16 206 FULL SIZE 1/3 12 156 13 52 12 X 20 4" 3/8 10 138 1/2 8 104 1/4 16 312 1/3 12 234 FULL SIZE 19 1/2 78 3/8 10 208 12 X 20 6" 1/2 8 156 1 6 oz ladle 78 1/4 16 60 HALF SIZE 1/3 12 45 3 3/4 15 12 X 10 2 1/2" 3/8 10 40 1/2 8 30 1/4 16 104 HALF SIZE 1/3 12 78 6 1/2 26 12 X 10 4" 3/8 10 69 1/2 8 52 1/4 16 156 1/3 12 117 HALF SIZE 9 3/4 39 3/8 10 104 12 X 10 6" 1/2 8 78 1 8 oz ladel 39 1/8 2 TBSP 76 THIRD SIZE 1/4 16 38 2 2/5 9 3/5 12 X 6 7/8 2 1/2" 1/3 12 28 3/8 10 25 1/8 2 TBSP 124 THIRD SIZE 1/4 16 62 3 7/8 15 1/2 12 X 6 7/8 4" 1/3 12 46 3/8 10 41 IV. Production systems – pg. 90

Pre-preparation/ freezer pulls Fail to plan and you plan to fail. Do you ever remember trying to desperately thaw a huge mass of product so it can be prepped for a meal? It happens all too often and results in short cuts being taken that put food safety at risk.

Make a list of items to be pulled from the freezer 2 days prior to preparation day. Transfer this information to your production sheet…..and don’t forget, orders for those items must be in house the day before the day they need to be pulled.

In the know…… - If you receive an item, such as a roast, that is frozen and will be used within a week, place it in the walk-in refrigerator. This will ensure that it will be thawed in time and save a step in the production area. If it is in a box, remember to take it out of the box to ensure a good thaw. - Lag/Slack is the process of panning frozen items such as vegetables in advance to allow for thawing. The benefit is better control of cooking time, reducing over/under cooking. Production meetings Production meetings should be either held daily or weekly, depending upon the skills of your production staff and the complexity of your operation. Meetings provide opportunities to discuss all the components of the production sheet, any upcoming events, recipes, substituted products, changes in the meals for the week

Food Service Tune-up – pg. 91 and any equipment concerns effecting production. A culinary tip can also be shared with or by your production team during this meeting. Batch cooking Batch cooking is preparing the same menu item several times during the meal service to ensure that the last customer gets the same quality product received by the first customer. This is most commonly used with menu items that have short cooking times, such as vegetables.

Timing is everything in giving your customer the best possible product and in reducing waste. A good example of batch cooking is McDonalds French fries: an average store may go through 1000 pounds a day but they do not cook them all at once, they cook in batches and time it correctly to always have fresh hot fries. Steam table diagrams Steam table diagrams are a great way to ensure that steam table wells are used to the greatest advantage. Presentation should be considered if in a retail area; speed, ease and accuracy of service should be the primary factors in situations where the customer does not see the steam table. All wells should be filled or covered if there is an empty segment. The configuration should factor in separation of hot and cold wells.

The following is an example of a steam table setup diagram.

IV. Production systems – pg. 92

Steam table set up Updated

Standard set up

Item Pan size Item Pan size Item Pan size Heated plates For room trays

Casserole set up

Item Pan size Item Pan size Item Pan size Heated plates For room trays

It is important to serve the room trays will pre-heated plates , please set up steam table and allow for plate section

Food Service Tune-up – pg. 93

Proper handling of leftovers Management of leftovers should follow the Servsafe guidelines: proper storage, labeling, dating and reheating procedures. Here are a few tricks:

Portion soup in muffin tins and freeze. Once the soup is frozen, place the tins in Ziploc bag, label and date, and use for individual portions as needed.

Freeze items in Ziploc bags and in workable sizes. This will allow quick freezing and thawing. Label and date.

It is important to keep track of refrigerator and freezer temperatures. Use a chart to record temperatures daily and include the initials of the person doing the test.

Don’t forget to discard items not used by discard date. Standardized recipes Use standardized recipes. A recipe is a list of ingredients and cooking instructions for a menu item. A standardized recipe has been adjusted to produce a volume of product that matches typical food service needs in your operation and the cooking equipment you use.

Use of standardized recipes is critical to producing quality food. When recipes are followed, the menu item will taste the same, regardless who is cooking.

Recipes help in the management of food cost – the cook knows how much to make, the buyer knows how much to purchase, leftovers are reduced, excess food is minimized and the menu item has the expected nutrient content. IV. Production systems – pg. 94

Final words A production system, including production sheets, forecasting, consistency, portion control, pre-preparation, production meetings, order guides, batch cooking, steamtable diagrams, proper handling of leftovers and standardized recipes will help you effectively manage your food production. A production system will directly impact the - Food Cost - Food quality - Productivity - Sales - Budget - Your job security - Your department’s reputation - Customer perception - Worker satisfaction

Food Service Tune-up – pg. 95 V. Staffing, personnel and scheduling – pg. 96 CHAPTER FIVE

V. Staffing, personnel and scheduling

Maximizing the team with motivation and training

Food Service Tune-up – pg. 97

The food service culture and mindset

Solid Staff – No Money Needed

» Adapted from: Solid Staff – No Money Needed by Timothy L. Bauman, DHCFA, CDM, CFPP, Dietary Manager magazine (a publication of the Dietary Managers Association), May 2007.

How do you keep, and even create in the first place, a solid staff and do it in a business where raises and money are hard to come by?

Let’s each rewind to our first day taking over our current operation and who were the players you were bequeathed? Was luck in your favor and you got a well- trained, talented group moving the organization into the future, or did you meet the eyebrow raiser group?

We rarely get a well-honed staff of quality players. Yeah, you may get a couple of local stars, but what happens when you throw them a few new things to accomplish and they balk or even trip?

Here’s a tip: throw them a few new things to accomplish early on and that will show you who can perform, what people’s attitudes are and how deep the skill base is that you have to work with.

Solid Staff – No Money Needed is based around a few central management concepts, first of which is “Hiring, retaining and developing great people is the biggest challenge and single greatest key to the success of any business.” 10 Few food service leaders would disagree. V. Staffing, personnel and scheduling – pg. 98

However; consciously or unconsciously, they create roadblocks that prevent them from reaching this goal. Many are unable or unwilling to focus their efforts on a common vision. They create policies and procedures that make it hard to get and retain the employees they want.

Okay, you are (or were) the new manager and walked into a conglomeration of employees tied together by a previous department culture. Is this group capable of doing what they need to do to succeed? Healthcare is ever changing and regulated to the hilt. You can’t crank out medically prescribed diets just to make people healthy—we also want them to be happy.

Corporate Culture is the shared values, traditions, customs, philosophy and policies of a corporation.11 Also, it is the professional atmosphere that grows from this and affects behavior and performance.

The food service field has its own unique subculture and if you understand it and operate effectively within it, you have power! Organizational management developed in organized quantity food service production units long ago. As a piece of history, we owe our brethren in the chef profession a debt of gratitude for working out a lot of the bugs. Remember the executive chef with the sous chefs working the stations in the early kitchens? They trained like journeymen through the various jobs gaining skill and competence. Isn’t that still one of the best ways to do things several centuries later? A successful apprenticeship program includes modeling, practice, feedback and evaluation. Napoleon Bonaparte started job evaluations and the little man who walked around with his hand in his jacket pocket was on to something. Job rotation through the training process and even regular daily scheduling builds training depth, fights boredom and gives

Food Service Tune-up – pg. 99 employees a bigger picture of the operation. The experienced employees pass on skills, along with the food culture to the up and comers.

Food culture: Organizations by definition are social entities. They represent a collection of individuals who work for a common purpose. As such, they exhibit the characteristics of any social group, including climate, a culture and role expectations. These characteristics can work either to support the goals of the organization, or thwart them.12 Those of us who have been in the industry a while know what it is to have the business in our veins and recognize the ones around us who are part of the food culture (and the ones just sliding through). Therein lays the backbone of your organization and where the tweaking begins. As the leader, find an effective mindset that shapes employees’ concept of the organization and how they fit in and should perform. Make them feel part of something bigger. The rich tradition of the chef with attention to technique, procedure and the control of outcomes can set a high standard that motivates people. Many professions have elite groups that people enter for reasons other than pay. Your best troops want to learn, be part of the organization and perform at a high level, when it has meaning. When they gain mastery and a sense of meaning, they take the extra step of excellence and you have the key to success.

Now let’s say you have been in the organization and are far enough beyond your first day that you have had a chance to do some staffing. You need a competent group who do not call you at all hours of the day and night making you do all their thinking for them. We need critical thinkers and require active involvement in applying the V. Staffing, personnel and scheduling – pg. 100 principals, policies, procedures and general mode of operation we discuss with them. As management in many organizations has been flattened, we ask employees to do more of the thinking. Whenever workers grapple with complex issues, difficult decisions and ill-defined problems, they will benefit from using critical thinking skills.13 Allow your employees to talk through problems with you that they encounter on the job. Help them think it through and devise how they should respond. Accept defeat as long as a learning situation occurred.

Characteristics of a positive Transfer of Training Culture (TTC) include: - Early socialization indicating that training is important - Continuous learning culture - Adequate peer and supervisor support - Opportunities to use learned capabilities - Access to equipment or resources that are essential for transfer of training - Adequate working conditions - Regular feedback and positive reinforcement for improved performance12

Positive TTC is worth discussion because it has significant impact on the extent to which material is applied to the job. Roullier and Goldstein14 studied management trainees in fast food companies who were trained on such topics as employee relations, food preparation and handling, shift management and customer service. They did much better in a positive TTC. Don’t better, more professional managers lower the turnover rate and keep employees happier?!

Food Service Tune-up – pg. 101

Give your employees input and empowerment. Listen to your employees, then turn their ideas into goals and action. Bill Gates called it “Learning how to harvest your companies’ intellectual resources.” 15 In a later part of the paragraph, he said how much money he made doing just that. The notion of goals as a motivational force is well known. The notion of purposefulness and intentionality is key to goal setting. Getting all this brainpower from your employees means you need to be a participative leader. This is not to say you do their actual work, but that you are doing your work when you reason their challenges and days through with them.

Participative management The University of Michigan studied participative management and came up with the following conclusions. Participative behavior on the part of the leader was a key to group effectiveness. The study suggested that leadership was not exclusively, or even predominately, about individual leader-follower interactions. Instead, effective leaders expended considerable energy in interacting with the work group as a whole.16 Get in there and reason out the tasks with your employees. The big tough boss who barks orders, demeans self-esteem and prevents critical thinking is doomed to failure and being disliked by an underperforming staff. If you have to yell at employees, you are not in a position of power. Success is when the manager can go home at night and reasonably believe that the tasks of the organization will be preformed to a high level without him being present.

Free up your time for added success Pushing more thinking duties to employees can pay dividends. Consider various areas of your operation: doing the ordering and completing paperwork. Salad people V. Staffing, personnel and scheduling – pg. 102 know much more about what will use than the manager. Toss them your pen and order guide and you may be able to cut waste, free up more of your time and make them happier because they are more intellectually challenged. Cooks can order bread and kitchen staff can help gather data for reports and quality measurement. Your life gets easier but as always, follow-up is important. Be sure they do not lose sight of creativity or do things that drive up cost unnecessarily. If you send them to a food show, give them assignments at the show and hold a meeting upon return to gather the information from them. Are both you and your employees smiling more yet?

Culture and socialization The process by which a new employee becomes aware of the values and procedures of the organization is called socialization. It starts at the recruiting stage and continues with evaluations that instill characteristics of the organization through the assessment procedures used.12 The leader of the food service department is the key shaper of all of this. Start with the interview process. Here is your best tool to screen for talent and select people with buy-in to the food service culture/mindset. Look for roots in the food business and to the geographic area. If they have been in food service for a while and live in the area, you have two valuable retention issues working in your favor. Are you hiring part-time? If so, it takes money to live and where else is the rent and food bill being paid? Let them know they can stay around long enough to make it to full time. Again, avoid improper interviewing but, casual conversation nets a lot of information offered without ever asking. Being a gentleman or lady and escorting them to the door also lets you see what condition their car is in and who brought them to the interview. You can’t ask in an interview if they have a car

Food Service Tune-up – pg. 103 but you sure can look. Ultimately you need to decide if they will fit in.

Attraction-Selection-Attrition Mistakes can be made when people do not fit into the culture and the attrition phase kicks in. As a poor fit becomes obvious, the new employee, the organization, or both engage in actions that result in the employee leaving. It can take years to clean up a department and some thorns in the organization’s side never leave. A key success factor in finding and retaining great employees is to align staffing and retention activities to the food service culture and to the overall corporate culture. “The relationship we have with our people and the culture of our company is our most sustainable competitive advantage” - Howard Schultz, the founder of Starbucks. Countless surveys conclude that money is seldom ranked as the main reason for joining, leaving or contributing one’s best to a company. A big mistake is to throw money at a talented but disconnected employee to get them to stay. All you usually get is a higher cost disconnected employee.

Long Term: Give them respect and allow for growth such as professional group participation or training your department can use. Give them input and stay off their backs as long as their work supports the organization. The better experienced and able your staff, the lower your turnover rate is and the more you can enjoy leading and not babysitting. V. Staffing, personnel and scheduling – pg. 104

Management and the work of the food service world What is a manager and what do they do? A classic explanation of management used in many published works is that it is the process of using resources to accomplish what needs to be done. Peter Drucker, the person often credited as the father of modern management said, “The fundamental risk of management remains the same: to make people capable of joint performance by giving them common goals, common values, the right structure and the ongoing training and development they need to perform and respond to change.”

Food Service Tune-up – pg. 105

Managers are the harbingers of organizational change and increasingly are knowledge workers transforming organizations dictating the speed and progress of the information age. Because of managers we can employ large numbers of knowledgeable, skilled people in productive work. There has been an explosion of knowledge and information over the past hundred or so years but it is management that has made it effective. Many managers’ responsibilities are the same between not for profit and for profit companies such as defining the right strategy, setting goals, developing people, measuring performance and marketing the organization’s services. There are seven basic resources the manager manages including employees, money, time, work procedure/methods, energy, materials and equipment and tools. Again, management is the process of using resources to accomplish what needs to be done and how good the manager is at pulling all the pieces together defines his or her performance.

Managers have basic tasks including planning, organizing, directing, controlling and evaluation. Managers determine objectives and define standard operating procedures. Reoccurring situations such as ordering, inventory and restocking require exact procedures so managers develop standard operating plans to frame how employees do the required work. The ongoing use of policies and procedures (P & P) standardizes the way a work force tackles situations. Keeping P & P up to date and available to employees “keeps everyone on the same page.” P & P paper-based manuals are giving way to Intranets where employees get daily information and a place to view and download this material. Other than face-to-face conversation, some companies have named email and the company Intranet as the primary means of communication. V. Staffing, personnel and scheduling – pg. 106

Planning Planning includes making schedules for equipment maintenance, special events, orientation and even the time to do the planning. Planning is a success activity and the managers who go awry often do not plan to fail - they just may have failed to plan. Planning is both the organizational process of creating and maintaining a plan; and the psychological process of thinking about the activities required to create a desired future on some scale. As such, it is a fundamental property of intelligent behavior. This thought process is essential to the creation and refinement of a plan, or integration of it with other plans, that is, it combines forecasting of developments with the preparation of scenarios of how to react to them.

The term is also used to describe the formal procedures used in such an endeavor, such as the creation of documents, diagrams, or meetings to discuss the important issues to be addressed, the objectives to be met, and the strategy to be followed. Beyond this, planning has a different meaning depending on the political or economic context in which it is.2

Organizing Organizing defines relationships both up and down the chain of authority in the organization. An organization chart (org chart) defines relationships, roles and the chain of command. The org chart defines the limits of everyone’s authority. Organization takes into account what goes on in the food service but also relates activities to the rest of the organization. Organizing, in a company’s point of view, is the management function that usually follows after planning. And it involves the assignment of tasks, the grouping of tasks into departments and the

Food Service Tune-up – pg. 107 assignment of authority and allocation of resources across the organization.

Directing Directing involves the actual supervising of the work. The manager coaches, motivates and gives general direction to employees.

Control Control is the set of activities that ensure objectives are met and policies and procedures are followed. Managers control performance standards, quality, productivity and service. They establish these standards, communicate them and monitor success. Overseeing employees as to the cooking process, sanitation and the overall operation of the food service to assure the standards are communicated, practiced and monitored successfully is control. The way money is spent through budgets is control. It is an important function because it helps to spot the errors and take corrective action so that deviations from standards are minimized and stated goals of the organization are achieved in a desired manner.

According to modern concepts, control is a foreseeing action whereas the earlier concept of control was used only when errors were detected. Control in management means setting standards, measuring trends in actual performance and taking corrective action before errors occur. Thus, control comprises these three main activities.2

Evaluation Evaluation is the systematic determination of merit, worth, and significance of something or someone.2 V. Staffing, personnel and scheduling – pg. 108

Evaluations are age old. Formal job evaluation was started by Napoleon Bonaparte as a tool to perfect his officer corps. People and departments should not be totally self-contained and need feedback from qualified outside sources. Managers provide and receive all sorts of reports and these provide evaluation tools. In a broader level, both the food service manager and other higher level managers and professionals in the organization need to evaluate the objectives themselves. The evaluation process in food service here is to assure the objectives are working and to ask if the master plan should be revised.

About management, as about any other area of human work, much more could be said. Following this brief overview are some key writings about the world of the food service manager. Managers who truly understand the principles of managing themselves and those within their scope of authority will build successful, productive and achieving enterprises throughout the food service industry. Managers who establish standards, set examples and leave as a legacy a greater capacity to produce wealth and greater human vision advance the industry and make the world a better place. Managing Labor One of the largest resources you will manage in food service is labor. Managing labor correctly will yield great results and benefits. To realize these benefits, several key elements must be in place

To staff correctly you must understand your needs, budget and the service you are providing. Once you understand your budget allowance you can then build a staffing plan up from the ground to cover all key areas:

Food Service Tune-up – pg. 109

- Production - Service - Clean up - Retail - Supervisory - Clerical

Building up a staffing plan can be very eye-opening and it will give you a detailed understanding of the inter working of your department such as: - Peak times of productivity - Breaks - Meal breaks - Time sensitive duties

Staffing plan grid One technique is to create a grid of the staff plan. You can make it by every 15 minutes or by every hour depending on your needs, but more detail is better. The grid will allow you to understand exactly how long any task should take, which labor resource should be doing what. V. Staffing, personnel and scheduling – pg. 110

Autumn Hills Breakfast Lunch HRS Shift Premeal During Main After meal Premeal During Main dining After meal activity meal dining service activity meal room service room

Set up steam table Serve TL and Continue Meal in DR return to Back up DR Review left over and preparation and 8 5:30 -1:30 Prepare BRK, Serve Brk kitchen ,Break Clean up area, AM Cook direct what to save following production down TL steam Serve staff sheet table start lunch meals

Return all clean items and ready assist in set Collect cups,bowls Collect cups,bowls Set up starter part of tray up of carts except for Begin DR beverage and silverware into Begin DR beverage and silverware into 8 6:00-2:30 line ,fill dish machine Start tray line non refrigerate cart. Set Start tray line Am Dining Service Aid Service RACKS ,Report to Service RACKS ,Report to SET UP DR up beverage cart for Alz clean side on DM clean side on DM unit and deliver prior to TL

Deliver tray Fill pot and pan sink Set Break down steam Deliver tray carts, Break down steam carts, Set up up coffee and Begin DR beverage Empty all garbage, Begin DR beverage table and report to 8 6:00-2:30 Set up beverage cart table and report to beverage cart Am Dining Service Aid condiments on carts SET Service clean carts Service Pot and Pan while backing up TL Pot and Pan washing while backing UP DR washing up TL

Return tray- cart and Set up cereal cart Collect Entrée plates Collect Entrée plates Gather cold items for plug in. Place all cold Set up cold Serve Bread basket, 8 6:00-2:30 Set up cold items for DR and pass and Garbage Report and Garbage Report Am Dining Service Aid trayline, Make toast items on trays in carts, items dessertpass cereal assortment to Wash side on DM to Wash side on DM take lunch break

Pass 8 1O:00 -7:00 Set up dining room Hostess beverages

Begin plating up dinner Prepare next desserts and prepare 8 11:00-7:00 day lunch follow prod sheets Prep/Plater dessert cart for Dining items room

Follow production sheet and set up DR Follow prod Continue to follow 8 11:00-7:00 Serve DR PM Cook steam table for lunch sheets prod sheets service

4 Pm Dining Service Aid 4:00-8:00

4 Pm Dining Service Aid 4:00-8:00

5 Pm Dining Service Aid 4:00-8:00

69 483 12.075 DAY week FTE

Job routines Next, you should create specific job routines. These should not be confused with job descriptions.

A job routine is the tasks for that position on that shift for the schedule. Once you set up your job grid or flow sheet, routines can easily be developed and adjusted as the details are worked through.

Food Service Tune-up – pg. 111

Job descriptions A job description describes the measurable competencies of the job, the equipment used and the expected results or deliverables. For example the job description for a cook will list the types of foods he or she must be able to prepare, what equipment skills he/she should have and explain the associated duties depending on the shift requirements, such as keeping track of the amounts of ingredients available for the foods prepared and possibly drafting order sheets for the buyer.

Job descriptions are developed for the various categories on the grid.

They detail the skills and knowledge required to fill a particular position. They should be kept as part of the Policy and Procedure manual for the operation, and should also be given to the employee and a copy kept in the employee’s personnel file. The job description is also useful when preparing employment advertisements, offer letters and employment agreements.

Once the staffing flow is developed, the position can be entered into the Position Control. (See Chapter VI) This will allow you to determine what your needs are and who will fit each job and shift.

Try to keep things simple and avoid creating too many job descriptions. Include ancillary tasks, such as checking physical inventory, “as-needed” tasks to be performed at the discretion of the employee under the direction of the manager and other duties as needed to meet the needs of the operation. Let’s face it, a cook is a cook in the morning at 5 AM or in the afternoon at 12 PM, or in the evening a 8 PM, and ancillary tasks may be scheduled on V. Staffing, personnel and scheduling – pg. 112 the grid or pop up any time. The cook is still in the production area and should be relied on to take care of necessary tasks beyond cooking in that area.

Orientation program Critical to success is an effective orientation program, which is a meeting or series of events at which introductory information or training is given to those starting a new job. The effectiveness of your orientation program may make or break the employee. Orientations should cover all important aspects of the department, the operation as a whole and your policies and procedures. A good orientation cannot be rushed or hurried through. A good orientation program helps to avoid performance problems and promotes longer retention of staff.

Words to the wise: never create a position or shift for a specific person; create positions and shifts for operational needs.

Food Service Tune-up – pg. 113

VI. Understanding the Budget – pg. 114 CHAPTER SIX

VI. Understanding the budget— Hit or miss

The key ingredient is knowledge

Food Service Tune-up – pg. 115

Food service budgets are typically developed based on many factors or components. Understanding each component gives an operator the knowledge to understand variances—which are the differences between actual costs and budgeted or expected costs.

Annual budgets may coincide with the calendar year, January to December, or may follow a different fiscal period, such as July through June, depending on the financial schedule of the organization.

Typically a budget has daily, weekly and monthly components. There are 365 days and 52 weeks in a year, but neither of these two factors is evenly divisible 12. As a result, some months have more days than others. When you divide a total annual budget by 12, in some months, level costs will not track the same from month to month. This is true for payroll, scheduled purchases and payments, even workdays and customer counts. Often a budget is set up to follow the peaks and valleys in a schedule. The peaks and valleys would anticipate periods when the payroll rises and falls as a result of changes in the work schedule or if a holiday results in an increase or decline of customers or orders during that period.

Understanding how the budget was developed will give the operator the knowledge and information needed to control and proactively address questions and opportunities as they come up.

Understanding how the budget is monitored - daily, weekly, or monthly - gives the operator ways to find out how the operation is performing… and to spot problems before they get too big to handle. VI. Understanding the Budget – pg. 116

Budget components of a food service operation The budget components of a food service operation include these common areas: - All food (or food by category) - Supplements - Supplies - Chemicals - Repairs - Small equipment - Other

Food is often sub-divided into categories such as: - Meat - Dairy - Produce - Beverages - Bakery - Grocery - Frozen - Supplements (which may either be part of food or in a separate category)

What is the advantage of sub-dividing food?

If, you have a food cost problem during the budget year, subcategories are useful helping you analyze where the problem is. Suppose produce expenditures were way up last week… why was that? By looking at variances you can ask questions to learn what happened. Did customers want more fruits and vegetables due to hot weather? Did a new supplier over-deliver or over charge? Did a

Food Service Tune-up – pg. 117 shortage spike some prices? Did a change in the menu increase buys of higher cost produce? What is a zero-base budget? A zero-base budget starts at zero and is built up to cover each component of cost. To prepare a zero-base budget, start out by determining who your customers will be and how many you will serve. Then choose the menus, the serving styles, the portion sizes, the portions per person, special services, and so on.

It’s a good idea to build your budget from a zero base so you will really how much money is required to operate your department. If you haven’t been tracking past information correctly or thoroughly, it will take time and effort the first time through, but in moving forward you will operate with confidence.

The other method of simply increasing next year’s budget dollars by simply increasing this year’s actual expenditures by a percentage does not set the bar high enough and avoids responsibility. It is also a quick way to entice your superiors to have a contractor or consultant come in to evaluate your operation and ask you questions.

Let us look at a quick example.

A small new hospital or long term care facility is making plans for opening a food service operation and has employed the services of a consultant to help in the process:

Information needed: - Bed size and fill rate (these projections can be obtained from administrative staff) VI. Understanding the Budget – pg. 118

- Cost areas or services offered: Café, Coffee Shop, C-Store, Catering, Catering annual events, Room Service, Tray Service, Dining Room Service, Buffet, Home-delivered meals, other… - Revenue areas: Identifying revenue areas is an important part of your budget creation process. Identify all the retail or cash generating areas. Include external and internal non-cash generating areas funded by transfer payments, such as department meetings or business luncheons for guests. Also determine if you are going to provide outside services such as Catering or out- patient nutrition consultation and make sure the costs of these activities are charged for and allocated correctly.

All this information is brought together to formulate a budget by week. The weekly budget can then can be extended for a year (be sure to account for holidays, seasonal changes in patient population). Or, divide by 7 to obtain a daily rate and multiply by 365(or 366) to create annual figures. Commonly used computations and benchmarks

Meals served You will need to know the total number of meals you serve. Sounds simple doesn’t it? Unless you serve only patient or resident meals, you will need a way to convert meals served to the cafeteria, catering customers, etc. to an equivalent number of patient meals. To determine this

Food Service Tune-up – pg. 119 number you will need one or more non-patient meal factors.

Steps to determine meal equivalents - Determine the food and supply cost of the meal served to patient/resident on a regular diet – this is your patient meal factor - Determine the cost of purchasing the same items in your cafeteria – this is your non- patient meal factor for converting cafeteria meals to patient meal equivalents - If you have additional retail outlets with a different pricing structure than your cafeteria, perform the above steps to determine the non-patient meal factor for these areas - Cost internal catering at actual cost of food and supplies and divide by patient meal factor to obtain meal equivalents - Price external (real money) catering according to your facility policy. Divide total by non-patient meal factor to obtain meal equivalents - Track floor (pantry) supplies and department transfers. Total cost of these items and divide by patient meal factor to determine meal equivalents (Note: If these supplies are actually charged to the user department AND you receive a credit for them on your monthly financial statement, do NOT also take meal credit for them as this would artificially inflate number of meals served.)

VI. Understanding the Budget – pg. 120

Meal Count Summary Record the following daily - Actual number or patient/resident meals - Number of cafeteria non-patient meal equivalents - Number of non-patient meal equivalents for other areas - Floor supply and transfer meal equivalents (if not shown as cost to another department on financial report)

Then

- Total meals for each day - Total meals for the month

See sample form at end of this chapter.

Meals per man-hour The number of meals produced divided by the amount of labor hours in the department. Caution: the standard for meals per man-hour will depend on the type of service offered (all tray line, wait staff, retail or buffet).

Patient hours per day The amount of labor hours in the department divided by number of patients or residents.

Menu cost per day Take a representative average count of the meals served per day from Meal Count Summary. This can vary depending on meal service such as: dinner meal only, lunch and dinner or breakfast, lunch and dinner. Divide

Food Service Tune-up – pg. 121 the cost of the food preparation by the count of meals to get the menu cost per day.

Check average (retail) Total revenue dollars divided by number of customers gives you the check average. In retail operations it may be useful to perform this calculation by meal… e.g. breakfast, lunch or dinner so you will know where to focus marketing efforts.

Non-productive hours or dollars Non-productive time includes benefit hours such as personal time off, sick time, vacation, holiday, etc. Non- productive dollars are the pay and expenses that are incurred for non-productive time and activities. These amounts can be accumulated or accrued each month and charged against the budget in a number of ways. The method used can give an artificial appearance of being over or under your labor budget. If your budget includes non-productive hours or dollars, ask your bookkeeper or accountant to give you some examples of how to measure labor productivity with and without counting the non-productive hours and dollars.

Inflation and costing factors See CPI information and explanation, below.

The menu Food purchases driven by the menu normally comprise 40-50% or more of your total budget. The menu also drives labor costs for serving different types of customers (retail, resident, patient and out-patient). Understanding how the menu influences food purchases and labor costs will help you control these. Over the longer term, the menu drives capital expenses (purchasing kitchen VI. Understanding the Budget – pg. 122 equipment). When you are designing food service upgrades, investigate how your choice of menu will affect equipment purchases. Measuring and monitoring the budget What is the best way to measure and monitor the budget?

The best analogy is to manage it like your checkbook. The deposits are based on the monthly or weekly allotment of dollars to run your department and the checks are the withdrawals to pay for your purchases. You should stay on top of where you stand at least weekly. Know your budget amount at any time and cross-check it with accounting. Keep good records in your department; don’t depend on accounting for everything.

Another important tool is to lay out your expected income and expenses for several weeks or months in advance and see if you will soon run into a budget shortage or surplus. If a shortage is coming up, figure out in advance if you can reduce expenses or change when you incur an expense. If a surplus is coming up, look ahead to the next shortage and see if you can pre-buy what you will need.

One way to get smiles from management is to regularly generate a small surplus… not one that will cause them to reduce your budget next year, but enough for them to look at you as a no-surprise guy or gal.

Buy based on needs, not the budget divided by 12 or 52. Base your purchases on the census, customer count and other measurable statistics. Remember there are 52 weeks in a year and with an annual budget divided by 12 there will be at least 4 months when there are actually 5

Food Service Tune-up – pg. 123 weeks. This is the time when by looking ahead, you can spend a surplus early, and stock up to deal with a five- week month. Some operations account for this by scrolling dollars.

Accruals and their effect on the budget An accrual is a way to prepare a budget that adjusts for the different number of days and weeks that occur month to month.

Here is an example

Accrual example for October with 31 days

Average Weekly Purchases $1,470

Divide by 7 days in a week / 7

To get daily purchase rate $210

Multiply by days in the month *31

To get budget accrual for the month $6,510

Accruals give the accountants the ability to extend out a period that is calculated by the exact month for the reporting period. It is important to remember that an accrual can have a positive or negative effect on the budget. Find out how the accounting is done at you facility and understand the effects it will have on your budget performance.

Other variances What else can negatively affect my budget that might not be apparent? - Payment terms VI. Understanding the Budget – pg. 124

- Payment practice – are purchases charged to your department when the invoice goes to accounting or when accounting pays the invoice - Surcharges - Incorrect posting of expenses, revenues or credits to your budget line items

If labor charges appear to be higher or lower than the budget, here are some points to consider:

How many weeks of payroll were paid in the current budget month, 4, 5 or even 6. Some businesses pay 2 times a month instead of bi-weekly. This results in 24 payments per year versus the typical 26.

Other factors that could cause a variance are: - Overtime (pay rate) - Over scheduling (more than allotted hours worked) - Holidays - Vacation - Worker compensation cases - Retirement - Benefits - Bonus - Other

The bottom line is that the only area you can really control is your productive hours—the number of hours in a working day that your staff is actually on the job. You need to learn enough about your budget process so that you can demonstrate on paper what work is done, meals prepared and served, for the supplies and labor expense incurred.

Food Service Tune-up – pg. 125

In most operations, overtime and the higher pay rate it absorbs, is the biggest factor under your control. Monitor it and avoid it unless really necessary.

Hourly wage… weighted and unweighted How do I correctly calculate an average hourly wage? Remember, a true average hourly wage must be weighted. What exactly does that mean?

The examples below show the difference between a weighted ($9.42) and unweighted ($9.71) calculation: Weighted Not Weighted Wage Hours Extended Cook 15 40 600 Cook 15 Worker 12 8 96 Worker 12 Cashier 8 16 128 Cashier 8 Waiter 6 40 240 Waiter 6 Worker 6 40 240 Worker 6 Worker 9 24 216 Worker 9 Worker 12 24 288 Worker 12

68 192 1808 Simple Average $9.71 Wage weighted $9.42

What is the difference, about 3 % about 7.5 K on a 250 k budget

Budgeting for food cost increases How do you forecast for food cost increases?

For planning next year’s budget, you need to know the inflation and costing factors for the past year. This can be a challenge, but there are ways to deal with it.

First, keep eyes and ears on the news and make your own assumptions as to the prices to expect in different cost categories that impact what you buy. Check the Consumer Price Index information and explanations on VI. Understanding the Budget – pg. 126 the Bureau of Labor Statistics (BLS) Web site, http://www.bls.gov/cpi/

Next, ask your vendors what increases they are forecasting for the different types of products. There are two ways to do this… - Ask informally, at various points during the year, what the vendor’s company is forecasting - Then, as you get closer to contract time, ask the vendor for a price increase forecast that would be incorporated into the contract for the next while.

If you are part of a purchasing group, ask your contact as well.

Cost and price dynamics The key point is that you need to come up with estimates of the cost changes in the raw materials, supplies and equipment that you will need in the coming year. This is extremely helpful in budget negotiations because if you are asking for an increase, you have figures from credible sources to back up your requests. The accountants need backup to support budget numbers, especially increases.

The other side of the budget has to do with the prices charged for the meals sold. Every operation is different with respect to prices. It is useful to understand how your operation sets prices and to find out what the constraints are. Sometimes meals are supplied to some residents on fixed price contracts, so the Dining department has to do its part in buying good food at the best possible price for the item needed. Even with higher

Food Service Tune-up – pg. 127 priced menus, it is important to get the best value for the dollar spent.

As you progress in responsibility in the food service career, your ability to understand the cost and price dynamics for your operation will become more important. Now is as good a time as any to learn how to navigate the budget.

The CPI market basket The CPI market basket represents recent price increases for all the consumer goods and services purchased by urban households. Price data are collected for over 180 categories the BLS has grouped into 8 major groups. These major groups, with examples of categories in each, are as follows:

- Food and beverages (ham, eggs, carbonated drinks, coffee, meals and snacks); - Housing (rent of primary residence, fuel oil, bedroom furniture); - Apparel (men’s shirts and sweaters, women’s dresses, jewelry); - Transportation (new vehicles, gasoline, tires, airline fares); - Medical care (prescription drugs and medical supplies, physicians’ services, eyeglasses and eye care, hospital services); - Recreation (television sets, cable TV, pets and pet products, sports equipment, admissions); - Education and communication (college tuition, postage, telephone services, computer software and accessories); VI. Understanding the Budget – pg. 128

- Other goods and services (tobacco and smoking products, haircuts and other personal care services, funeral expenses).

Indexes for all of the above categories are published at the U.S. city average level. Due to limitations in sample size, however, many of the smaller expenditure categories are not available at regional and local area levels. Instead, related categories are aggregated and published as part of a more comprehensive category.

You need to explore the Web site for yourself to find out past cost increases in the commodities you purchase in your geographic area.

Remember, this data is about PAST increases, but it is helpful to know what the trends are so you can attune your eyes and ears to news that shapes the trends and to ask questions of your vendors as to what is impacting them… “will the latest hurricane change the price of flour in our area in the next few months?” How to stay on budget What should you do to stay on budget?

Track expenses that flow into the budget Track the expenses that flow into your budget internally (in your own department) to determine day-to-day status. Do this job yourself! Be sure you know every second whether you are under- or over-budget in the different categories.

Monitor your budget by day, week and monthly; compare year-to-date with last year’s year-to-date.

Food Service Tune-up – pg. 129

Track physical flows and inventory Track everything that enters your department… deliveries of food and supplies, equipment, workers. Be sure that staff know how to physically count delivered items and to record differences on the invoice or shipping documents. Make sure staff moves delivered items to the correct storage locations.

Track everything that leaves your department… meals delivered, special lunches prepared for managers or visitors, prepared food donated to soup kitchens, food thrown away because it is past the use by date, loaned supplies and equipment, staff making errands or being borrowed to help another department.

Account for everything on paper with requisitions, request forms, tally sheets. Collect the tally sheets every few days and transfer the data to spreadsheets.

Verify actual meal counts and food transfer information.

Compare physical and book inventory at least monthly. Take inventories weekly if you are having shrinkage problems. Compare your inventory figures with last month and the same time last year.

Days-on-hand inventory (by supply item) The days-on-hand inventory calculation is useful to ensure that you have enough supplies of a particular type (e.g. flour) to take you through the next delivery. Remember… it is a good idea to have enough supply to take you through the day AFTER the next delivery, in case there is a delay in the delivery.

Example of days supply on hand VI. Understanding the Budget – pg. 130

Physical inventory 50.0 Lbs Divide by daily needs / 12 Lbs To get days supply on hand 4.2 days

Delivery in how many days? 3 days Covered? (supply 1 day more than delivery) Yes

How often to take physical inventories Physical inventory. Should it be done weekly, monthly or annually and why?

Taking a physical inventory is a critical function of managing inventory. An accurate inventory provides information on food cost, theft and order patterns, especially over ordering. It can be done at different frequencies depending on the situation.

How many days of inventory should be kept? Generally, never keep more than a week. This amount will allow enough to cover for an emergency but won’t tie up too many dollars spent on products that sit idly on the shelf. Excess inventory also makes FIFO – first in, first out – stock rotation more difficult.

For many items, the quantity on hand should not vary from week to week because you should buy only what you will use in the next week. But based on usage, changes in census, holiday-time menus, the inventory for specific items may move up and down. If you are scaling recipes and using a purchase guide, a pattern of inventory on hand should form.

Food Service Tune-up – pg. 131

Track food industry and service trends Watch for market trends that affect your menu items, ask your vendors for updates, scan trade magazines for outside forces impacting food availability and prices.

Learn about new service technologies and methods. If something might reduce labor, improve timeliness or flexibility, find a way to give it a try.

Track revenue that is credited to the budget Track your credits: internal—inside the food service operation, department—credits from other parts of the facility, and credits from external vendors. Know your numbers. Keep copies of invoices organized by month and chronologically organize your transfers and catering, total them for the month.

Use an accounting system to keep track of the numbers and to produce reports. Learn how to design new reports to give you better information. Creating a Position Control Process to manage labor How will a Position Control help manage the labor budget and staffing?

A Position Control is a very detailed schedule complete with wages and some times non-productive hours information. It tells you how many labor hours you have available. This is very useful at budget time. It allows you to make decisions on filling vacancies, such as whether two part-time employees would meet your needs better. Pay rates can be easily calculated by using this tool. This tool can also help communicate departmental needs to VI. Understanding the Budget – pg. 132

Human Resources and the administrative staff when new services are in the works or budget decisions have to be made.

Position hours Name Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat 1 Supervisor Relief 5:30 -1:30

2 AM Cook 5:30 -1:30

3 Am Dining Service Aide 6:00-2:30

4 Am Dining Service Aide 6:00-2:30

5 Am Dining Service Aide 6:00-2:30 6 Hostess 1O:00 -7:00

7 Prep/Plater 11:00-7:00

8 PM Cook 11:00-7:00

9 Pm Dining Service Aide 4:00-8:00

10 Pm Dining Service Aide 4:00-8:00

See definition or explanation of FTE at chapter end. The impact of the menu on the budget The menu and dining style has great impact on your budget. The factors of a menu include: - Type (selective or non selective) - Number of items offered (appetizers, salads, entrées deserts, beverages and other) - Cycles (weekly, biweekly, monthly) - Areas (retail, café or meal on wheels) - Style of service (Room Service, Tray Service, Dining Room Service, Buffet, Home- delivered meals)

Determining the cost of a menu What is the best way to determine my menu cost? Menus can be costed out based on your vendor pricing but

Food Service Tune-up – pg. 133 remember, it will never be “perfect math.” What does “perfect math” mean?

Perfect math must be considered in determining menu cost. For example a case of chicken breast may cost out at $.59 each at 24 per case. If only 22 are served and the 2 extra chicken breasts are extra (they don’t generate a meal credit to your income for the day), that $1.18 of cost must be factored into the cost for that day. The actual cost of the chicken is $.64/serving, not $.59.

24 pcs x .59 = $14.16/cs

14.16 ÷ 22 serv = .64/serv

Here are other factors that impact the cost with suggestions for controlling them. - Over production—fine tune forecasting the number of diners and provide buffer meals that can be heated and served to diners over quota. - Not following the recipe amount—train staff in following recipes - Over cooking—train staff to follow recipes instructions; make sure ovens are calibrated correctly - Over portioning—make sure portion size on recipe and spreadsheet are the same; train staff to follow portion size; use correct utensil, level servings - Over purchasing—sharpen your inventory pencil and buy only what you need - Theft—train supervision to control access to the kitchen and storage areas VI. Understanding the Budget – pg. 134

- Chemicals – are titrations correct; does dishmachine have a leak Dealing with budget problems What do I do if I am over/under budget? - Obtain all the information you have about the items with variances - Check to see if your information matches the physical inventory, especially if the variance is being calculated with another department’s records - Ask for the ledger that shows all the posted information to your budget, does it match your records? - Are old or prior period invoices included in the amounts that have a variance? - Is the month-to-date correct or was an extra day for the next month counted? - If the payroll labor dollars are off, is this a month with an extra payroll period?

In summary, by understanding how the budget is put together and the factors that influence it, you are in a better position to identify and track variances and to take action to control them.

Taking action means examining the information that flows into the budget. Keep copies of invoices, requisitions, cash sales report, census information and special event work sheets. This information can provide you with explanations or justifications for current and future variances.

Food Service Tune-up – pg. 135

Every penny of cost will count whether it is in food, supplies or chemicals, or labor. In the end, the costs add up. Knowing how the costs all come together will help you comply with the budget and to justify changes in the next budget cycle. Learning about FTE17 To make sure that you schedule within your allotted hours you need to know the number of Full Time Equivalents you have and the number of full and part-time staff that make up this number meet the staffing needs of your operation.

Many times it is necessary to alter a schedule to accommodate resident needs or to accommodate requests from staff. This cannot be effectively accomplished without a working knowledge of daily operations, hours allocated to specific positions and position task lists. Each position in the department is budgeted a specific number of hours to properly accomplish each service. All positions are looked at annually at budget time and changes are made if necessary. Position hours are decided by the needs of the operation: - Full or part time shift - Number of days needed to fill the position - Number of staff needed to cover the total number of days needed for the week

The number of FTEs for operations is determined by taking the number of hours per day X number of days to be covered X number of staff necessary divided by 40.

VI. Understanding the Budget – pg. 136

For example: - Morning cook - 7 days per week - 8 hours per day - 2 cooks needed per day - 7 (days) x 8 (hours per day) = 56 hours per week - 56 (hours per week) x 2 (cooks necessary)=112 hours needed per week - 112 (hours needed per week)/ 40 = 2.8 FTEs for this position

Dining Room Server - 7 days per week - 4 hours per day - 5 servers needed per day - 7 (days) x 4 (hours) = 28 hours per week - 28 (hours per week) x 5 (servers needed) = 140 hours needed per week - 140 (hours needed per week)/ 40 = 3.5 FTEs for this position

An FTE is not a person but represents the number of hours necessary to fill a position and complete the necessary tasks. The FTE is an integral component of schedule as it tells you how many hours are allocated for each position.

Note: The FTE division factor can also be 7.5 or 37.5 depending on the factor your operation uses or considers as an FTE.

Food Service Tune-up – pg. 137

Twelve budget tips to consider

» Be aware of the vendors with the great price on one or two items that you need. Ask if there is a surcharge for delivery or a minimum order. When you add it all up, it may cost your more.

» Always compare “apples to apples,” this will allow you to get the best idea of the actual cost. For example how do you compare liquid coffee to dry? Simply convert to yield ounces, divide by ounces per serving and this will make the cost comparable.

» Consider the application of the products you are creating. Maybe frozen asparagus will be just as good or better for making asparagus soup.

» Log in your leftovers and cross reference them with your production sheets so they can be utilized in the upcoming menus. Use this information when VI. Understanding the Budget – pg. 138

forecasting the amount you will need the next time this menu is served.

» Use functional garnishes. They are already part of the recipe and can really make the dish look good while keeping cost down.

» When costing food always set up a reference cut to refer to. This will ensure your cuts are not too small or big. Use a scale for portions, too.

» Know your yields for various raw products to create known quantities of finished dishes. This can avoid over-purchasing.

» A sharp knife and slicer are not only less dangerous than dull ones but they also give a better yield.

» Understand the difference between “as-purchased” and “edible purchased.” Factor the differences into your purchases.

» Make sure your “selling cost” covers all costs (miscellaneous supplies such as, spices, condiments, packing and so on). This is the same as your mechanic adding a charge for “shop supplies” to all service invoices. The above items are the shop supplies of foodservice.

» Ask your dishwashing crew how much waste is coming back from the meals you send out. Do something with this information. Look at your portion sizes, your recipes and your menu. You get no extra credit for serving expensive asparagus if your customer prefers green beans.

Food Service Tune-up – pg. 139

» Take inventory monthly and review how much is on the shelf. Seek to turn over your full inventory every week. This can significantly improve budget performance .

New Year! New goals! New budget! And making a resolution to achieve the goals and meet the budget!

» Adapted from: Budgeting Strategies for your Foodservice Department by Wayne Toczek, CEO of Innovations Services, Dietary Manager Magazine (a publication of Dietary Managers Association), July/August 2008.

VI. Understanding the Budget – pg. 140

Keeping your resolution will depend on having well- planned goals and budget, understanding the goals and budget, developing a plan to meet them, executing the plan, and importantly, being flexible enough to see a roadblock as an opportunity to take the scenic route – in other words, Plan B.

Understanding how the budget was built is the key to making it work. Most budgets are reasonable – knowing how it was built takes on even more importance if you are in the position of needing to prove that budget you have is not consistent with the resources required to meet the established goals.

Not understanding the budget often results in a staff response “It’s not in our budget” to requests made by residents, family members and other departments. This type of response spreads throughout the community and can have a lasting impact on how residents’ families and future residents feel about the ability of your facility to provide quality support and care.

Developing a zero base budget gives you the information that you need to manage the dollars allocated to your department. This is best done at the beginning of the budgeting process. So you inherited a budget that seemingly has no rhyme or reason? Choose not to be a victim of your budget; instead, do a zero based budget for your department so you will know the dollars required to achieve the goals of the department – whether those in place at the time the budget was approved or are a new direction for your department. You can then have informed discussions with your supervisor about additional resources needed or actions that might need to be postponed.

Food Service Tune-up – pg. 141

Analyzing the budget, skills and operations The following tools are requirements for developing or analyzing your budget: - the resident census by care level, menu, production specifications, current prime vendor price list, supplement use, staff skill assessment, equipment available, types of service offered, assistance provided by other departments during meal service, clean-up process and any additional component specific to your facility. - With this information you can cost your menu and extend it to a total annual food budget. Similarly, determine the labor – number or cooks, etc. needed to produce, serve and clean-up. Now that you know your base costs, ask yourself some questions about each of the categories:

§ Menu – is there enough variety? How do residents select their meals? Is there another way that would offer better service without increasing production costs? Do you have recipes for every menu item? Do have production sheets and use them correctly?

§ Product specifications – Are you using brand and generic products appropriately? Could you use brand name products where the resident will see the label and comparable quality house brand products where label is not seen (name brand soda vs. Grade A Fancy green beans)? Do a self check. If you have several brands of the same product on your shelves, it is a good indicator that you are “cherry-picking” based on price, not using specs VI. Understanding the Budget – pg. 142

based on quality needed to produce the end product desired. Do you participate in a buying group? If yes, do you maximize its potential by full participation? If not, are their opportunities available? Are you taking advantage of drop incentives? Payment incentives?

§ Skill assessment – Does you staff have the skills needed to scratch produce the items on your menu? If convenience preparation is needed to compensate for inadequate staff skills, is the cook’s salary that required for a cook or for a person who finishes an already prepared product? Were staffing requirements adjusted when the change to convenience was made? (i.e. do you still have a baker but all desserts have been purchased ready made for years?) Is staff well trained? Food cost is as much the result of what happens to it after it comes through the door as what it costs to purchase it.

§ Equipment availability – Are critical pieces of equipment in poor repair resulting in hours of overtime and/or menu substitutions or use of higher cost convenience items?

§ Staffing – Do you have enough staff to cover your staffing plan? Do other departments provide the agreed-upon assistance? Does your staff incur mindless overtime, i.e. early clock-in or late clock-out?

§ Measurement – Do you have a system in place to measure performance to budget by category each month? Does your staff understand the budget as appropriate to their role?

Food Service Tune-up – pg. 143

Negotiating change Now that you understand you budget, use your understanding as a framework to discuss the needs of your department with your supervisor – “If I had more money in the budget, we would be able to ………”

Include requirements and costs for implementing processes, services or systems that are not currently in place…a new oven or new meal delivery system and the training needed to use it effectively. What about justifying purchasing group fees based on overall benefit to organization? Throwing more money at a broken system will not fix it – have a plan associated with results for every dollar you request.

Use plate waste, meal rounds, weight loss reports and customer comments as opportunities for self-examination in which you seek clues to providing increasingly better food and service to your residents. It becomes a matter of perception – instead of complaining about what you don’t have, focus on the best possible use of the resources that you do have to provide the best possible experience for your residents, their families and your community.

VII. Regulatory Considerations – pg. 144 CHAPTER SEVEN

VII. Regulatory considerations

Doing it the way it should be.

Food Service Tune-up – pg. 145

First and most important: Food safety!

Food safety is one of the most important and critical components to any food service operation. Failing to pay attention and understand the implications can lead to an abrupt ending to the business and your career. It happens to be a top reason for emergency room visits.

In the area of food safety “Knowledge is Power” and this knowledge should extend from you to the person washing dishes and emptying trash at night. Let us face facts: whether as worker or manager, you are responsible for food safety.

The key to running a safe operation is awareness. Everyone should be aware of the potential for a problem and the preventive measures that should be practiced. Making everyone aware is much like the awareness you get when you get a new vehicle. Suddenly as you are driving on the road, you see… your car… there, and on the other side, your car, again. Did everyone go out and buy your type of car that day? No, they were always on the road, but now that you are paying attention, you see them everywhere.

The same principle needs to work with food safety. As a manager or supervisor it is your duty to be the person in charge and leading from the front and teaching safe preparation procedures. As a worker, you need to follow safe preparation procedures.

Employees are the biggest cause of food borne illness, so every effort should be made to keep them enlightened. The principle that “knowledge is power” is the basis for the PIC or Person In Charge in food safety. Someone in your operation must be in charge of food safety from VII. Regulatory Considerations – pg. 146 open to close. Even if he or she steps out, a designee must be on site. Who is the PIC? According to the food code, the Person In Charge is defined as follows:

The license holder shall be the person responsible for the food service operation or retail food establishment. The license holder may be the person in charge or shall designate a person or persons in charge and shall ensure that a person in charge with applicable knowledge is present at the food service operation or retail food establishment during all hours of operation.

The knowledge required is outlined below. If you or the designee cannot answer correctly or if the food preparation procedure is visibly wrong, even if you are certified, you really are not in charge and you will be cited for both the violated procedure and the PIC requirement PIC: demonstrate knowledge or assign responsibility Based on the risks of food borne illness inherent to the food operation, during inspections and upon request, the person in charge shall demonstrate to the licensor the applicable knowledge of food borne disease prevention, application of hazard analysis and critical control point principles, and the requirements of this chapter as they relate to the food service operation or retail food establishment at the time of inspection. The person in charge shall demonstrate this knowledge by compliance with this chapter, by being certified in food protection as specified in rule 3701-21-25 of the administrative code of

Food Service Tune-up – pg. 147

Ohio, or by responding correctly to the inspector's questions as they relate to the specific food operation. (All states have food codes. You should know the details of the code in your state.)

According to Ohio Administrative Code Chapter 3717-1, the areas of knowledge include:

(1) Describing the relationship between the prevention of food borne disease and the personal hygiene of a food employee;

(2) Explaining the responsibility of the person in charge for preventing the transmission of food borne disease by a food employee who has a disease or medical condition that may cause food borne disease;

(3) Describing the symptoms associated with the diseases that are transmissible through food;

(4) Explaining the significance of the relationship between maintaining the time and temperature of potentially hazardous food and the prevention of food borne illness; Explaining the hazards involved in the consumption of raw or undercooked meat, poultry, eggs, and fish. - Stating the required food temperatures and times for safe cooking of potentially hazardous food including meat, poultry, eggs, and fish; - Stating the required temperatures and times for the safe refrigerated storage, hot holding, cooling, and reheating of potentially hazardous food;

VII. Regulatory Considerations – pg. 148

(5) Describing the relationship between the prevention of food borne illness and the management and control of the following: - Cross contamination, - Hand contact with ready-to-eat foods,

(6) Explaining the relationship between food safety and providing equipment that is: - Sufficient in number and capacity, and - Properly designed, constructed, located, installed, operated, maintained, and cleaned;

(7) Explaining correct procedures for cleaning and sanitizing utensils and food contact surfaces of equipment;

(8) Identifying the source of water used and measures taken to ensure that it remains protected from contamination such as providing protection from backflow and precluding the creation of cross connections;

(9) Identifying poisonous or toxic materials in the food service operation or retail food establishment and the procedures necessary to ensure that they are safely stored, dispensed, used, and disposed of properly;

(10) Explaining the details of how the person in charge and food employees comply with the Hazard Analysis and Critical Control Point (HACCP) plan if a plan is required by this chapter, or an agreement between the licensor and the food service operation or retail food establishment; and explaining the responsibilities, rights, and authorities assigned by this chapter to the: (a) Food employee,

Food Service Tune-up – pg. 149

(b) Person in charge, and (c) Licensor.

In summary make sure you have a person in charge who can understand the questions asked by the health official or auditor. It is a good idea to have as many of your staff trained in ServSafe (full certification) and Employee ServSafe (3.5 hours class) and have a copy of the current food code available. Getting training on food safety To get the training you need, attend a food safety class and get certified in areas such as: - ServSafe - HACCP - Local health department seminars - Continuing education seminars

ServSafe certification ServSafe certification is offered as part of the National Restaurant Association Educational foundation and is available everywhere throughout the year. The organization will provide information on the classes and types. Types of classes can vary from a one-day class to a 16-hour course. Managers and supervisors should complete the 16-hour course and really take the time get the most out of the course. Relax. The classes are very well planned and with a little attention and effort you can pass the test and learn a great deal about food safety. You will be much more relaxed if you are the PIC when the health department arrives at your door.

Dr. Stephen Covey once said that some people go to college for the degree, not the education. That’s VII. Regulatory Considerations – pg. 150 dangerous in the food safety realm, so if you take a course, make sure you understand the content. Save your textbook. Refer to it and teach others what you have learned.

Employee ServSafe is a very good course for introducing food safety. It is a macro view of the full certification covering the four core topics such as: - Employee Hygiene - Cleaning and Sanitizing - Time-temperature abuse - Cross contamination

To find a ServSafe class in your area, visit: http://www.servsafe.com/TrainingSearch.aspx

HACCP course What is the course on Hazard Analysis Critical Control Point? Will it teach as much as ServSafe?

Food safety is assured when operators effectively apply the seven HACCP principles in their facilities.

HACCP is being recognized as the most efficient way to ensure the safety of food products. This course follows the classic approach to Hazard Analysis Critical Control Point (HACCP) and covers the scientific basis and methodology of HACCP.

Upon completion of this course, individuals will be able to identify the critical safety issues involved in the handling, preparing and serving of safe food. Students will understand current HACCP methodology and will develop the record keeping and verification skills needed for the implementation and maintenance a current HACCP plan.

Food Service Tune-up – pg. 151

In-service training What else should you do? We suggest that periodically you ask your facility to conduct a regular in-schedule of in-service training covering food safety topics. There are many resources available on the web and through an education and consulting company, such as Innovations Services. They offer a complete in-service training program covering a variety of critical subjects that can be tailored to your facility and staff.

Employee orientation Make sure your facility has an effective employee orientation program with a major concentration on food safety covering such topics as: - Preventing Food borne Illness - Food Temperature Control - Personal Hygiene - Preventing Cross Contamination - Preparing/Serving Food Safely - Cleaning and Sanitizing

Free resources Get familiar with free resources on the Web sponsored by the United States Department of Agriculture (USDA) and the Food and Drug Administration (FDA).

The USDA Food Safety Information Center provides food safety information to educators, industry, researchers and the general public.

The FDA’s Center for Food Safety and Applied Nutrition CFSAN, in conjunction with the Agency's field staff, is responsible for promoting and protecting the public's health by ensuring that the nation's food supply is safe, VII. Regulatory Considerations – pg. 152 sanitary, wholesome, and honestly labeled, and that cosmetic products are safe and properly labeled.

See Chapter XII for a full listing of references and websites.

Get to know your local health inspector Develop a relationship with your local health inspectors. They can provide a wealth of information and keep you up to date on issues and trends.

In summary, food safety is one of the most important areas to focus on in your business. This task cannot be done by one person alone. Arm all your staff with the knowledge and make them aware of their role in ensuring food safety. Strive to have as many personnel as possible go thru a food safety training course. Navigating the regulations To make your facility a success, you need to learn to navigate through the regulations and regulatory groups (local, state, federal and certification groups) without limiting your operation.

It all begins with the USDA Food code. This is the basis for food safety in the food service industry and understanding and interpreting it correctly can allow you the confidence to make informed decisions and stay out of the news media for improper practices.

About State-level food codes The Department of Health of each state takes the Food Code and develops its own set of regulations. This is typically done every four to five years. One of the most important resources to have is a copy of your state’s food

Food Service Tune-up – pg. 153 code (and additional local codes, if they exist), and prepare or purchase a quick reference to it.

Understanding the intent of the regulations and the changes made to them over time is critical for deciding whether the procedures in your operation need to change… before an auditor writes you up. Simply ask your local health inspector how to get a copy, or go to your state and local health department web sites.

About FDA food code The following information about the Food Code was adapted from the Introduction to the Food and Drug Administration Food Code, 2005 edition.

The Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) of the U.S. Department of Health and Human Services (HHS) and the Food Safety and Inspection Service of the U.S. Department of Agriculture (USDA) produced the 2005 edition of the Food Code.

This edition of the Food Code provides practical, science- based guidance and manageable, enforceable provisions for mitigating risk factors known to cause food borne illness. The Code is a reference document for regulatory agencies that ensure food safety in food service establishments, retail food stores, other food establishments at the retail level, and institutions, such as nursing homes and child care centers. Food safety is a top priority for HHS and USDA, and they endorse and encourage the adoption of the Code.

After the 1993 Food Code was issued, it was revised and updated every two years through 2001. In 2001, FDA, in VII. Regulatory Considerations – pg. 154 collaboration with USDA, CDC, and the Conference for Food Protection, decided to move to a 4-year interval between publications of complete Food Code revisions.

In 2003, the FDA issued a Supplement to the 2001 Food Code that updated the 2001 Food Code to address current science, and several recommendations made by the 2002 Conference for Food Protection with which the FDA, CDC, and USDA concurred.

The latest edition, the 2005 Food Code, constitutes the first full edition of the Food Code published since 2001 and contains the Supplement updates, additional changes reflecting current science, emerging food safety issues, and the 2004 Conference for Food Protection recommendations.

Ensuring safe food remains an important public health priority for our nation. An estimated 76 million illnesses, 325,000 hospitalizations, and 5,000 deaths are attributable to food borne illness in the United States each year. For some consumers, food borne illness results only in mild, temporary discomfort or lost time from work or other daily activity. For others, especially pre-school age children, older adults, and those with impaired immune systems, food borne illness may have serious or long-term consequences, and most seriously, may be life threatening.

The risk of food borne illness is of increasing concern due to changes in the global market, aging of our population, increasing numbers of immunocompromised and immunosuppressed individuals, changes in consumer eating habits, and changes in food production practices.

Food Service Tune-up – pg. 155

Navigating the regulators What are the different groups out there? What do they do? Who regulates who?

Department of Health Your local department of health issues the License that hangs on your wall. They can be a great resource for information and understanding the regulations regarding food safety. This department inspects your operation several times a year and the person inspecting your department is a called a Sanitarian.

The Department of Health inspects restaurants or other food establishments that prepare or serve food for human consumption. For the purposes of health regulations, this definition includes mobile food service operations, catering operations, and vending machine locations. In the United States, a license from the local health department is generally required to operate a food establishment. To reduce the risk of food-borne illness, local food codes contain certain standard requirements. These requirements are checked by a Sanitarian or health inspector during an inspection of a food establishment

The frequency of inspection will depend on your classification with respect to healthcare and criteria for susceptible populations you serve.

The Sanitarian or Health Inspector will want to see the Person In Charge, a clean kitchen and good food safety practices. VII. Regulatory Considerations – pg. 156

Who is the inspector? The Encyclopedia of Public Health explains that a sanitarian is a person who is trained in the sanitary sciences, biology, chemistry, geology, physics, and math. He of she works as an inspector or health official in the public sector or private industry, reviewing programs and enforcing local laws to protect the public's health.

As a public health professional, his or her responsibilities may include food sanitation and safety; air, water, and environmental protection; inspection of water-well and sewage-disposal systems; control of insect pests, and animals; disease control and epidemiology; housing, occupational, and institutional safety and sanitation; and nuisance control. Many states require Sanitarians to be registered and to maintain registration and continuing education.

About the Joint Commission The Joint Commission on Accreditation of Healthcare Organizations (JCAHO, or Joint Commission) evaluates and accredits more than 15,000 health care organizations and programs in the United States. An independent, not- for-profit organization, The Joint Commission is the nation’s predominant standards-setting and accrediting body in health care. Its mission is to continuously improve the safety and quality of care provided to the public through the provision of health care accreditation and related services that support performance improvement in health care organizations.

Tough participations is voluntary, most hospitals are Joint Commission-certified, and many retirement communities, assisted living and nursing homes are as well.

Food Service Tune-up – pg. 157

Joint Commission standards address the organization’s level of performance in key functional areas, such as patient rights, patient treatment, and infection control. The standards focus not simply on an organization’s ability to provide safe, high quality care, but on its actual performance as well. Standards set forth performance expectations for activities that affect the safety and quality of patient care. If an organization does the right things and does them well, there is a strong likelihood that its patients will experience good outcomes. The Joint Commission develops its standards in consultation with health care experts, providers, measurement experts, purchasers, and consumers.

Joint Commission Surveys The Joint Commission surveys healthcare facilities approximately every three years. Healthcare institutions that passed with a good score and whose self-assessment is realistic might not be surveyed for four years. If a patient incident makes the newspaper or an institution reports a sentinel event (a signal of a serious outcome), the surveyor may come back at any time. Survey dates are no longer announced prior to the visit.

During a survey, the auditors inspect everything from doors, floors, walls, ceilings, storage to patient records. They talk to staff and patients. Any patient care (clinical) area or clinical support area (such as linen distribution, facilities workshops, power plants, etc) is inspected.

The survey team can include one, two, three or more health care professionals, including a physician, an engineer, nurse or hospital administrator who has senior management level experience.

VII. Regulatory Considerations – pg. 158

See the appendix for a mock Joint Commission survey check list.

Always be ready for a survey or audit The best defense is a good offense. Take proactive measures and self-monitor, work with other healthcare and food-service organizations in your area to do peer reviews or hire a knowledgeable consultant to conduct an audit. Self-inspections, peer reviews and audits give your operation the OPPORTUNITY to recognize and correct issues before they are spotted by an outside agency. It is very important for your staff to understand that the fundamental reason for surveys and inspections is to protect the life and safety of the patients and residents in your care; therefore, meeting the survey standards should be part of your daily operation. If you are always ready, you won’t have to worry about when they might arrive at your door.

Nursing home inspections The Centers for Medicare & Medicaid Services (CMS) is the component of the Federal government's Department of Health and Human Services that oversees the Medicare and Medicaid programs. A large portion of Medicare and Medicaid dollars is used each year to pay for nursing home care and services for the elderly and disabled.

State governments oversee the licensing of nursing homes. In addition, states have a contract with CMS to monitor those nursing homes that want to be eligible to provide care to Medicare and Medicaid beneficiaries. Congress established minimum requirements for nursing homes that want to provide services under Medicare and Medicaid. These requirements are broadly outlined in the Social Security Act (the Act). The Act also entrusts the

Food Service Tune-up – pg. 159

Secretary of Health and Human Services (DHHS) with the responsibility of monitoring and enforcing these requirements. CMS, a DHHS Agency, is also charged with the responsibility of working out the details of the law and how it will be implemented, which it does by writing regulations and manuals.

CMS contracts with each State to conduct onsite inspections that determine whether its nursing homes meet the minimum Medicare and Medicaid quality and performance standards. Typically, the part of State government that takes care of this duty is the health department or department of human services. The State conducts inspections of each nursing home that participates in Medicare and/or Medicaid on average about once a year. If the nursing home is performing poorly, however, the State inspectors may go in more frequently. The State also investigates complaints about nursing home care.

During the nursing home inspection, the State looks at many aspects of quality. The inspection team observes resident care processes, staff/resident interaction, and environment. Using an established protocol, the team interviews a sample of residents and family members about their life within the nursing home, interviews caregivers and administrative staff. The team reviews clinical records.

The inspection team consists of trained inspectors, including at least one registered nurse. This team evaluates whether the nursing home meets individual resident needs. In addition, fire safety specialists evaluate whether a nursing home meets standards for safe construction. When an inspection team finds that a home VII. Regulatory Considerations – pg. 160 does not meet a specific regulation, it issues a deficiency citation.

The regulations cover a wide range of aspects of resident life, from specifying standards for the safe storage and preparation of food to protecting residents from physical or mental abuse or inadequate care practices. There are over 150 regulatory standards that nursing homes must meet at all times.

Surviving surveys in long-term care How can you be ready for a survey, audit or inspection all the time?

You should never have to prepare for a state survey or local inspection - Be ready every day by completing your own quality monitoring audits - Train your staff to be ready; and hold mock audits from time to time so that they know how to respond to the inspector. - Eliminate the opportunity for problems “clean as you go” goes for all staff” - Evaluate your department regularly and have others look at it with “fresh eyes” - Understand and refer to regulations

Fact: 32% of citations are for #371-sanitation faults, 10% of surveys occur on weekends.

Being ready daily means: - Do the job right every day even when no one is looking - Audit your self and continually improve the process and department

Food Service Tune-up – pg. 161

- Never over look or look the other way at the standards - Never accept being sub-standard – if you notice a problem without addressing it, you have just told your staff that is the standard YOU are willing to accept

Complete your own quality monitoring audits, regularly - Follow a regular routine of audits, both announced and unannounced - Evaluate the data - Involve the staff - Peer review the department - Do you have a HACCP program?

Train your staff to be ready - Hold regular in-service training - Have a formal, structured orientation program - Tap into your vendors - Make sure your RD participates - ServSafe-certify as many staff members as possible (at least train them with Employee ServSafe)

Eliminate opportunities for problems happening - Drawers - Drying methods - Chemical dispensing units - Bent pans - Broken of chipped plates - Bins - Thermometers - Fans VII. Regulatory Considerations – pg. 162

- Clutter

Evaluate your department regularly - Complete walk-throughs and look at the department with fresh eyes - Involve the staff - Develop an opening and closing check list that covers every part of the kitchen - Invite other departments to help look for issues

Understand and refer to regulations - Have a copy of the food code - Have a copy of the F-tags related to your department

» F-tags or Federal tags are rules that govern nursing practice in long term care. The tag numbers are used to show their location in the rules. The surveyors from the state or federal government use those rules to monitor your operation and cite you for errors. If an infection control rule is violated, you would be cited under the f-tag for infection control.

Food Service Tune-up – pg. 163

Understanding the PIC

» Adapted from: Understanding the Person In Charge according to the food code prepared by Wayne Toczek for the Senior Resources Alliance Web site, www.sranet.org, February, 2008. Everyone is concerned with food safety. When it comes to food safety “knowledge is power,” which is the basis for the Person In Charge or PIC. Someone must be in charge in your operation from open to close and even if they step out, a designee must be on site.

WHO IS THAT SOMEONE?

It is defined by the food code as: VII. Regulatory Considerations – pg. 164

» The license holder shall be the person responsible for the food service operation or retail food establishment. The license holder may be the person in charge or shall designate a person or persons in charge and shall ensure that a person in charge with applicable knowledge is present at the food service operation or retail food establishment during all hours of operation.

The knowledge is defined as below and if you or the designee can not answer correctly or if the procedure is visibly wrong, even if you are certified, you really are not in charge and you will be cited for both the violated procedure and failing the PIC requirement.

PIC—demonstration of knowledge. Based on the risks of food borne illness inherent to the food operation, during inspections and upon request the person in charge shall demonstrate to the licensor the applicable knowledge of food borne disease prevention, application of the hazard analysis and critical control point principles, and the requirements of this chapter as they relate to the food service operation or retail food establishment at the time of inspection. The person in charge shall demonstrate this knowledge by compliance with this chapter, by being certified in food protection as specified in rule 3701-21-25 of the administrative code, or by responding correctly to the inspector's questions as they relate to the specific food operation.

The areas of knowledge include:

1. Describing the relationship between the prevention of food borne disease and the personal hygiene of a food employee;

Food Service Tune-up – pg. 165

2. Explaining the responsibility of the person in charge for preventing the transmission of food borne disease by a food employee who has a disease or medical condition that may cause food borne disease;

3. Describing the symptoms associated with the diseases that are transmissible through food;

4. Explaining the significance of the relationship between maintaining the time and temperature of potentially hazardous food and the prevention of food borne illness;

5. Explaining the hazards involved in the consumption of raw or undercooked meat, poultry, eggs, and fish.

- Stating the required food temperatures and times for safe cooking of potentially hazardous. food including meat, poultry, eggs, and fish; - Stating the required temperatures and times for the safe refrigerated storage, hot holding, cooling, and reheating of potentially hazardous food;

6. Describing the relationship between the prevention of food borne illness and the management and control of the following:

- Cross contamination, - Hand contact with ready-to-eat foods,

7. Explaining the relationship between food safety and providing equipment that is sufficient in number and VII. Regulatory Considerations – pg. 166

capacity, and Properly designed, constructed, located, installed, operated, maintained, and cleaned;

8. Explaining correct procedures for cleaning and sanitizing utensils and food contact surfaces of equipment;

9. Identifying the source of water used and measures taken to ensure that it remains protected from contamination such as providing protection from backflow and precluding the creation of cross connections;

10. Identifying poisonous or toxic materials in the food service operation or retail food establishment and the procedures necessary to ensure that they are safely stored, dispensed, used, and disposed of properly;

11. Explaining the details of how the person in charge and food employees comply with the H.A.C.C.P. plan if a plan is required by this chapter, or an agreement between the licensor and the food service operation or retail food establishment; and

12. Explaining the responsibilities, rights, and authorities assigned by this chapter to the:

- Food employee, - Person in charge, and - Licensor

Ohio Administrative Code Chapter 3717-1

Food Service Tune-up – pg. 167

In summary make sure you have a person in charge who can understand the questions asked often by the health official. Have as many of your staff trained in ServSafe (full certification) and Employee ServSafe (3.5 hours class) and have a copy of the current food code available

Food safety watch tip—water Water is considered food so ………………………………

CNN ran a story 12/4/07 on the safety of water reporting that the bacteria level of ice was higher than toilet water from the men’s room.

What does this mean to you? Make sure your ice machines are cleaned and sanitized regularly. (Best 2 times per month, better 1 per month.) This means emptying the machine, cleaning the bin and then sanitizing it. Make sure the drain has the required air gap in place per code (if it is too close it can become the ladder for the bacteria to climb in your machine). Check the filter and change it per manufacturer recommendations, or add one to the water line. Make it a policy and procedure and be able to prove it if asked. Regulations: what you can do, not what you can’t do

» Adapted from Regulations: what you can do, not what you can’t do, by Wayne Toczek, Dietary Manager Magazine (a publication of Dietary Managers Association), January 2008

Senior continuing care is one of the most regulated industries in the country. How we choose to comply with those regulations will make an enormous difference in VII. Regulatory Considerations – pg. 168 how our customers, the residents who live in senior care facilities and those who own and manage those facilities, feel about the service they receive.

With the threat of funding cuts being the norm and financial penalties for non-compliance ever more frequent, owners and managers are tempted to take the service route that seems to have the least risk.

On the surface, this makes sense. When you look at the broader picture, does it really make sense to stop serving hot dogs because you are afraid the resident will choke? The hot dog is an American food icon. Wouldn’t it better serve those living in our facilities if we looked at all of the resources available to us and tap into those sometimes hidden employees in dining and environmental services so we have an extra set of eyes to assist in monitoring the meal?

With a minimal training investment, service workers can become part of the resident care team. A hidden benefit – these employees will be much less apt to take a shortcut that would negatively impact service next time.

The process of balancing risk and cutting edge service begins with understanding the regulation, its intent and the outcome desired. Regulations are in place because of facilities that are not meeting service requirements. “Progress and innovation in the dining service program should not suffer because of the regulations or even budget constraints”, says Oliver Walker, Vice President of Operations, Covenant Retirement Communities.

Service and food quality enhancements improve resident satisfaction, survey results and marketing possibilities. Sometimes, it is just a matter of boiling the regulation

Food Service Tune-up – pg. 169 down to a simple solution geared to meet the needs of the resident, not a complicated system to meet the requirements of the regulation.

Regulations require resident care facilities to have a planned menu, to post that menu and, in most cases, to offer the menu appropriately modified to meet diets prescribed by the physician.

This is where resident dissatisfaction often begins—at home, they have been making food choices without fear of the food police showing up, then circumstances require that they move into a senior facility where meals are planned for them.

Those regulations that require that diets be modified do not say how strict the modification needs to be. In fact, the American Dietetic Association takes the position that a very liberal interpretation should be used for seniors living in a medically managed environment.

Would you rather have a piece of pie like that served to everyone else at your table or would you think having a carbohydrate controlled fruit is the perfect substitute? Quality of life is important to the management of many disease states—so why not serve a smaller portion of the pie to residents who have diabetes?

Food cold? Serving meals on time a problem? Are you going to hire another dining services employee or totally re-think the way you are providing service? You can add an employee to speed up the process. You can buy another new heat support system – or – you can take a step outside the boundaries of traditional thinking – the way everyone else is doing it – and re-invent the way you provide service. How about getting tray assembly out of VII. Regulatory Considerations – pg. 170 the kitchen? Better yet, how about getting rid of tray service all together except for those for whom it is medically necessary?

Wouldn’t point of service meal assembly feel more like home? Food delivered in bulk to the area where the residents eat, dished up and handed to them along with the beverage they have just chosen is much more like the way they have eaten all their life. There is no tray line going on in the kitchen, so dining services staff are available to assist with meal service at a place where they can see the resident as a person.

When completing your purchasing specifications, think quality first – which product best matches the needs of your menu, recipes and flavor expectations of your customers? You may save money in the end by purchasing a higher quality, more expensive purchased product. Yield and resident satisfaction may far outweigh the few cents difference between the right product and the least expensive product.

David Hennis owner of Hennis Care Centers of Ohio says “Keep it simple and make it satisfying to the customer. The regulations and cost will take care of themselves.”

What time to get up in the morning? What time would you like to get up when you retire? Imagine this – you are living in your own home, arising at 8:30 a.m. because it matches your sleep needs and your love of late night television and then… you move to a retirement community where they serve breakfast at 7:00 a.m. – “State regulations,” says the Dining Services manager, “and by the way supper is at 5:00 p.m., state regulations.” Regulations do not say what time meals must be served. They say that no more than 14 hours

Food Service Tune-up – pg. 171 can elapse between the evening meal and breakfast the next day, unless a substantial evening snack is offered to all residents. Offered is the key word; the resident has the right to refuse the snack. Such services as continental breakfasts and snack carts provide an additional service opportunity and, with a little planning, enable you to meet the time between meals requirement.

Weight loss problems at your facility? Think food before supplements. Though traditional supplements have their place, real food offers more opportunities to increase calorie and protein consumption. Fortify the food items selected, offer an additional snack, use molds and pastry bags to present puréed foods looking like they did before they were puréed, or add food items, such as fruit bowls and finger sandwiches to the afternoon hydration cart. What is the person offering these items wearing – something that looks like they just came out of the operating room or a restaurant style uniform. The answer will make a difference in the perception of the food being served.

Viewing the regulations as a challenge and testing the waters with innovative approaches to producing food and serving your customers will be one of the decisive factors in making your community stand above others in an ever more competitive marketplace.

VIII. Technology Issues – pg. 172 CHAPTER EIGHT

VIII. Technology issues

Dishing up the maximum mix and turning on a dime.

Food Service Tune-up – pg. 173

Technology in the institution There is little doubt that technology has moved the food industry forward. The information age will be here a long time as was the industrial revolution. Since the expansion of the Internet, information travels in nanoseconds. The greater velocity of information has accelerated the pace of everything in business. Success is not measured by the quarter or month but daily, hourly and even by the minute while some may even argue the second (or less). Using the right technology mix allows food services to make quick decisions and turn on a dime like never before.

Looking at critical technology issues in food service helps managers make decisions as to what technology is needed, how much technology should be applied, what gains are possible, the amount of work to maintain a system and so on. The way you assemble the pieces and connect with the customer or patient defines performance. Creating the optimal customer/patient experience is a moving target and the business of food service, as we know it, is continually evolving. The concept of competitor is becoming less meaningful and is giving way to the idea that there are more choices that can be put together to create better solutions. Focusing too much on competitors and not on solutions puts you in the past, not in a future full of opportunities. Critical technology issues

Interfaces There are a lot of technologies available and finding a one-solution company to solve all your issues may never be possible. An interface is the aggregate of means by VIII. Technology Issues – pg. 174 which people interact with a machine, device, computer program, or other complex tool.2 Your systems need to fit together and communicate. When considering a system; whether it tracks the temperatures of your refrigerators, your production, cash control or patient diet office you need to make the necessary information flow connections. Some companies have a major portion of what you need or will use and have solved this issue or have programmers to implement a custom solution for you (usually for additional fees). If you are buying many different systems on your own, then fitting the pieces together adds complexity and possibly extra cost. Your diet office program may need to be interfaced with your patient information systems or your cash registers may need to digitally communicate with your accounting systems. As computerization increases in importance and new systems are added, so does the need to interface your systems. The more work the computer does the greater the productivity gains.

Infrastructure costs Infrastructure includes the equipment and basic support services for computing, particularly company, intercompany or even national networks. What investment and operating costs will your company incur implementing and running a system? Answering this question requires that you have a system architecture, a technology inventory, an operations plan and a development plan on which to base the cost estimates. These documents and estimates can be prepared by your own staff or by outside contractors and consultants.

Cannibalization of processes and revenues Cannibalization refers to the business process whereby engaging in one activity or practice necessarily eats into

Food Service Tune-up – pg. 175 another activity or practice. For example, instead of calling in a registered dietitian to analyze recipes, this job can be done quickly and easily by an employee using a diet analysis program on a computer. Cannibalization can take place within a department, between departments, or across the organization. Cannibalization is an increasing concern as e-commerce and e-business flourish since the efforts to cash in on the new commercial medium often sacrifice other business practices and sales channels.

New systems may mean that large parts of functions such as diet office, catering, production planning, etc. change and automation could eliminate jobs or even create new ones. New sales channels have become possible in that many food services receive catering requests via the Internet and now get requests from a wider and different customer base than before. Take for example the hospital that has “Grab and Go” meals ready for pick up by area businesses through an online order process. Some companies contract out or outsource human resource, payroll and other services to Internet-enabled companies located in other countries. Ordering, inventory and even nutrition analysis are done regularly online and by software packages. Rethinking the workplace is an ongoing critical technology issue.

Identifying fads versus trends So what is a fad and what is a trend? The speed of business and the turnover of products and services get faster every day. Many a company has bought into a new software package or a computer-aided piece of equipment only to find the bugs were not fully worked out or the vendor goes out of business or is bought out and the service and support expected is not rendered. As always, check references to each company’s people and VIII. Technology Issues – pg. 176 services. Establish contacts with other companies and consultants in your field who have experience with the new thing. Attend trade shows. Join user groups associated with packaged solutions. Participate in professional groups where people in your industry meet and take part in continuing education. All these activities are invaluable for keeping up with new developments and finding answers to problems.

Diversification/brand challenges Each product is unique and software and hardware do not do everything the same or perform the same functions. Test drive everything before you buy. Many companies offer demonstrations and test kitchens, so do your homework and always keep your organization’s best interests in mind. Some companies are great at POS (point of sale) but are not so good in other areas or their product lacks the customizability you need. They may do one or two things well but the diet office; accounting or catering software may lack the ability to deliver what you need. The key for successful testing is to develop a test plan that includes examples (“use cases”) of the work performed in your operation. When a solution that will substantially impact your processes, develop use cases for the new work flow. Then methodically test to be sure the candidate solution will handle your use cases. If it does not, ask the vendor to commit in writing that they will customize or configure the solution to meet your needs.

Lack of resources Can we say more to describe this age-old ongoing critical issue? Institutional food service in business and industry is usually not the core business of the company where they reside. In healthcare, it is a part of the core business but is considered a support service. It is hard to compete

Food Service Tune-up – pg. 177 with the MRI machine that could generate ten percent of the hospital’s bottom line or the nursing home that has to make budget with Medicare reimbursement. Food service is usually seen as a cost and not a revenue center by the accounting folks and your marketing hat is sometimes all you have to wear that can offset this position.

Sell the facts after careful research that efficiencies and cost savings can be made with new technologies. Smart vendors can help you hone your sales pitch to the powers to be. Sometimes you can get gains as spin-offs of other institutional efforts like computerized charting or if the entire facility implements a new POS system. A great food service makes for happy patients, residents, employees, potential employees and influential others. These happy people are the sign of a great facility. This line of thinking can change the attitude so that the food service necessity becomes an amenity.

Budgets move SLOWER than technology Each year we as managers make budget proposals and we are competing for a limited piece of the pie. Moore’s Law holds that computing power doubles every 18 months.19 By the time you make a purchase, it may likely be obsolete. You may need to maintain a system longer than you like including both software and hardware upgrades. Be sure to account for needed upgrades in your budget. Foodservice software overview There are many software packages today. Some have been around a long time and have been improved and changed continuously to meet the challenges of the industry. The functions follow the flow of the tasks required for running a foodservice operation. These VIII. Technology Issues – pg. 178 systems are by no means stand-alone and are increasingly connected to other systems in the institution. Employees swipe their ID to buy food and the cost is deducted from their next paycheck, creating a cashless transaction. You may have an arrangement with your broadline distributor and even secondary vendors where invoices are on a quick pay system. This usually involves the companies deducting invoice dollars from an account your facility maintains at a minimum balance to pay electronically. Below we will categorize these systems based on common features and function.

Payroll Payroll software tracks the time clock and reports hours to the payroll department. Some programs have scheduling modules and other upgrades available.

Financial management software The flagship role of this category is the POS (Point of Sale) system. POS can mean a retail shop, a checkout counter in a cafeteria, or the location where a transaction occurs. More specifically, the point of sale often refers to the hardware and software used for checkouts—the equivalent of an electronic cash register. Management reports and uses during operation include sales record, production timing, dining room management, customer loyalty programs, gift cards, reservations, food cost report, tracking of labor cost and budget compliance. Managers can run a host of reports on the data generated and manage the unit as appropriate with information in hand.

Food production software This is where a lot of communication takes place with the kitchen staff. Managers direct the activities of the kitchen

Food Service Tune-up – pg. 179 and production staff by generating pull lists (thawing schedules), preparation lists, production sheets sorted by employee or area, recipe distribution, food safety instructions (ex. CCP – critical control point). Newer systems also automate data collection such as temperature logs, manipulation of equipment controls and supply HACCP (Hazard Analysis and Critical Control Point) documentation.

Inventory management software Tracking inventory by entering data or using bar code systems are the current common methods of getting the information into the software to get your answers. You can manage and calculate values for physical and perpetual inventories. Generating supply requisitions lets you know what is leaving the storage areas and also plays a role in security. Still there is no replacement for making an actual physical count to assure your system is using accurate data. Garbage in, Garbage out…

Menu planning software The menu is the most important tool in a food service unit. Automation of this process over the past few years has improved and eased many aspects of management. You can conveniently write the menu and add, subtract and tweak it until you are sure it will succeed with the customer/patient group it targets. Costs are easily obtained and no one this author knows would want to regress to “the good old days.” In the best case, the software will download your distributors’ prices but in a more labor-intensive route, your staff may have to keep pricing and description data up to date. This software is especially useful in writing special diet menus through automation. Doing this by hand in the past required a lot of time and therefore labor dollars. You can easily VIII. Technology Issues – pg. 180 compare the menus to nutrition standards and to the diet manual you use. Cycle menus and calendar days are easily set and stored. Printing and the creation of electronic documents are key functions because you need to get the menu information to customers wherever they may be. Menu boards can be updated from your desktop computer. Catering, holidays and specials are easily archived so that their return is made easier.

Forecasting and purchasing software Purchasing was one of the early computer-assisted functions that was automated and its evolution was driven to a great extent by the distributor part of the industry. The lion’s share of e-commerce is done business to business and the business to consumer dollar volume pales in comparison. Now you can buy any time anywhere by logging into your distributor’s web site using the software on their server. Many forecasting and purchasing systems interface with the other systems to help you analyze sales records, count customers, create forecasts, analyze RFPs (Request for Proposal), determine food costs, track purchase orders and rebates. These days, the distributors offer capable systems as part of their service or you can buy or pay a service fee to get these functions from kitchen management software companies.

Clinical management and meal service software Whatever type of menu system you have, there is most likely a software system out there to help. Many will create menus for print or send digital versions to the patient’s bedside and are easily customizable, allowing you to implement changes more easily than any time in the past. You can sort by the service, service area and production sequence. Mass customization where each menu is individualized is possible and additions such as

Food Service Tune-up – pg. 181 patient identifiers easily allow for meeting regulatory standards. For the dietitian these systems improve accuracy and provide better information creating an important improvement. Nutrition counseling, screening and assessment are tracked. Drug nutrient analysis, food intakes, calorie counts, nutrient analysis and patient- specific information are created, tracked and used to enhance patient outcomes and in general make for better medical nutrition care.

One example of integrated food service software for healthcare organizations is The Resident Manager published by Innovations Services. For information about Resident Manager features, refer to the About Innovations Services section at the end of this book. Selecting software In selecting software, always work with your information services staff. Identify any limitations, such as compatibility with the operating systems of your company computers, network issues and other systems to interface with. Outline your objectives for production, inventory, purchasing, functions, etc. Produce a list of documents, charts and reports you need and digital versions of the same. Look at your needs first and then buy the software as opposed to buying software and trying to adapt your facility to it.

Do verify that your software is customizable and identify the vendors that sell these products. Word-of-mouth, professional groups, trade shows, publications and vendor contacts are common methods to find what is needed and fits the bill. As always, develop a test plan with use cases and try it before you buy it.

VIII. Technology Issues – pg. 182

Look to the future and how easily the system is to live with. Ongoing costs include implementation, support, training, licensing, service, upgrades and supplies. Cost justification is not just the upfront dollars, but the money spent over the life of the system. Involve your staff from the beginning and get the input you need and ideas you did not think of. The human element of employees adapting, customer satisfaction and communication during the change process is critical. Give everyone time to prepare and adjust. Overall trends Trends shaping technology in the food industry include a shift away from the single meal focus toward planning over a greater number of meal periods to gain efficiencies. A better integration of production, service, cost control and all the various constituencies is possible. A shift away from POS (Point of Sale) to POS (Point of Service) is taking place. All the customization and information instantly at the operation’s fingertips means satisfaction expectations can be met as never before. Cost control and efficiencies for revenue enhancement are tracked by the second. Things are speeding up (speed of service focus) and everything can be done in less time. Tying your information together and tuning it gives operations a competitive edge. Focusing on the guest/customer/patient is coming into play as never before. Getting the institution connected to employees and the people they serve is reaching to operate continuously at a new level. Organizations want to keep customers because it is more profitable to keep them than get new ones. Looking at the lifetime value of a customer instead of each individual sale is a new and successful way of doing business.

Food Service Tune-up – pg. 183

IX. Kitchen design and technology – pg. 184 CHAPTER NINE

IX. Kitchen design and technology

The latest and greatest stuff, a fantastic dish!

Food Service Tune-up – pg. 185

A few words about design What is design and how does it apply to food service? Design means: - to make a detailed plan of the form or structure of something, emphasizing features such as its appearance, convenience, and efficient functioning - to plan and make something in a skillful or artistic way - to intend something for a particular purpose.20

An opportunity to be involved in the design of a kitchen, pantry or retail area is a great learning experience for anyone. The most important feature or area is to have a productive flow from receiving to distribution. Design companies or architectural firms are critical to make sure all code requirements are met BUT they have may have no real idea of what a day in the operation is like. Your input to the design is very important and can save you many headaches and other frustrations later.

Everything is important, from the floor to the walls, so if you are participating in the design process make sure you explain the flow of work and understand the materials that can be used so you can provide practical input. Space is always a valuable commodity in design. Nooks and halls can inhibit kitchen flow. An open plan is better with fewer walls except for storage of chemicals and bulk items.

Searching for equipment and specifications can be a real challenge if you go it alone. Use local equipment representatives to assist your research. Consider setting IX. Kitchen design and technology – pg. 186 up an account with a supplier so you can use their systems in your search and get the best real-time information possible.

You should always build flexibility into your design by making sure as much of the equipment as possible is movable. While you can’t do it with everything, such as sinks, most equipment today has options to permit movement. This allows you to make adjustments in layout as your service evolves. Answers to guide design Before the design process begins, here are some questions to answer:

1. Amount of production daily (how many meals will be coming out of your operation)

2. Type of service you offer: See Chapter one for more information on this: - Retail - Buffet - Room Service - Tray-line - De-centralized service - Family style - Waitstaff service - Cook-chill

3. Menu

4. Staffing levels (which will depend on production, service and menu)

Food Service Tune-up – pg. 187

5. Flow of food out of the kitchen

6. Budget

7. Other big factors—what do you have to work with; what are your limitations? - Power: Steam, gas, electric? - Hood size and venting - Floor layout and design. Design tips to consider

Floor design - It is not possible to have too many floor drains in your operation. - Make sure the floor is pitched to ensure flow to drains

Dish washing machine - High temperature or low - Ask your chemical representative for input on the design or type. (Generally they can explain the pros and cons on the various types available and most appropriate for your business)

Power - When possible, use drop cords (from racks or the ceiling) to allow better cleaning and flexibility in moving equipment around. - You have a choice of drop cords depending on your budget—hanging, coil or retractable. IX. Kitchen design and technology – pg. 188

Mop closet - A mop closet should be big enough to hold dispensing units and store chemicals and cleaning supplies. - A nice feature is to have is a hose hook for power cleaning of the floor.

Shelving - The key here is to get maximum usage of the square footage. - There are many types of shelving but consider casters to allow better cleaning and flexibility in rearranging storage areas as your inventory changes - Consider light colored casters for carts because they tend to mark the floor less and can be clearly seen when cleaning.

Flooring - Consider a tile floor with a ridged surface to improve traction. This will help prevent employees from slipping. - Consider the drain configuration carefully; think about the various ways the kitchen might be laid out in the future and be sure your drains will suit different layouts. - Consider corner guards and cove base protection that can stand up to the beating corners and walls get from carts. Durable Diamond plate fabricated materials can help to protect corners and walls.

Keep these thoughts in mind as you work on design changes to your facility.

Food Service Tune-up – pg. 189

Products with new technology - Are you up to date on advances in equipment and product? – If not, attend a trade show - Are you tapping into the new items that save time and money? - What do you know about liquid coffee versus ground? - Will you use thickeners, or pre-thickened or dispense thickened?

Use common sense about partially processed foods - Don’t mistake the latest and greatest for convenience. - Pre-made is not new - Consider the application. If you will be processing food yourself, buying pre- processed may unnecessarily increase cost. - Know what justifies the cost. (If you will be paying more to buy carrot sticks and fresh broccoli florets, will you also reduce the labor hours worked in cold food preparation to offset the cost?) - We don’t consider pre-processed fresh vegetables or sliced meat new to the industry. Situations where pre-processed foods may be warranted include situations where it can: 1) save a large amount of labor or enable the preparation to be completed within a limited time, such as a large catering event, 2) get around a space limitation, such as a filled walk-in refrigerator, or 3) complete a job despite a broken piece of equipment. IX. Kitchen design and technology – pg. 190

Product development—convenience or smart - Remember you are hiring cooks - not can openers - Only look at convenience items as a last resort - Think strategic scratch – combine prepared, partially prepared and scratch cooking to get the best possible combination of menu items that your cooks’ skill set can produce – don’t spend time making tomato soup from scratch when nearly every customer base would prefer Campbell’s – on the hand, a fresh pot roast slow cooked in the facility will likely be a winner - Most operations don’t make cookies from scratch, frozen baked is good and fresh pre- made, delivered in bags is lazy or crazy!

What about new equipment—will it allow - A better yield - A better product - A better end result from a lesser product? - Labor savings? - Will it pay for itself?

The Accutemp machine - Meat typically looses 20% versus 5% with an Accutemp cooker - Utility savings - Heat on demand

A food processor - Can Slice, dice and mince

Food Service Tune-up – pg. 191

- This will save on processed fresh vegetables - Don’t skimp here – make sure that you buy one that is capable of meeting all of your needs

Pre-made items (made in YOUR kitchen) - Think about planning a menu strategically. Maybe have stuffed cabbage on a weekend prepared by cook-in-training. It is an easy meal and it can be prepared, packaged, stored and be ready to go later in the week. Just what is technology…… - The application of tools and methods: the study, development, and application of devices, machines, and techniques for manufacturing and productive processes - Method of applying technical knowledge: a method or methodology that applies technical knowledge or tools20

According to MAFSI (the Manufacturers' Agents Association for the Foodservice Industry), technology, when used appropriately, equals productivity.

The speed of technology, whether computer based or in kitchen design, is such there is always something better than what you just purchased. It came out the day after your purchase. In the food service industry it can help with every aspect—from desk to kitchen. To get the most out of the technology, you should understand how it can benefit your operation now and better position your operation for the future.

IX. Kitchen design and technology – pg. 192

For example, an investment in an induction pellet charging system may not be in the best interest for an operation running a tray-line if the end goal is to provide more point of service in the future. However, in the right circumstances, it may be applicable and work to your advantage.

It is important to determine if using the new equipment will reduce cost, improve quality or enhance flexibility enough to pay for itself over time. Understanding the payback period and return on investment can help justify a purchase or replacement of equipment or software to your supervisor.

When planning a new kitchen you should weigh whether the technological advances you are seeking fit with the vision and intent. Demonstrating this functional fit will further support your economic justification for obtaining the equipment you want. Useful terminology and tools Here is some useful terminology for evaluating technology projects:

Payback Period Payback Period is the length of time required to recover the cost of an investment. Calculated as:

Cost of Project ÷ Annual Cash Inflows

All other things being equal, the better investment is the one with the shorter payback period. For example, if a project cost $100,000 and was expected to return $20,000 annually, the payback period would be $100,000 ÷ $20,000, or 5 years.

Food Service Tune-up – pg. 193

There are two main problems with the payback period method: - It ignores any benefits that occur after the payback period, and so does not measure profitability - It ignores the time value of money

Because of these two reasons, other methods of capital budgeting like Net Present Value (NPV), Internal Rate of Return (IRR), or Discounted Cash Flow (DCF) are generally preferred.21

Return on Investment Return on investment (ROI) - A performance measure used to evaluate the efficiency of an investment or to compare the efficiency of a number of different investments. To calculate ROI, the benefit (return) of an investment is divided by the cost of the investment; the result is expressed as a percentage or a ratio.

(Gain from investment – Cost of Investment) ÷ Cost of Investment = ROI

ROI is a very popular metric because of its versatility and simplicity. That is, if an investment does not have a positive ROI, or if there are other opportunities with a higher ROI, then the investment should be not be undertaken.21

Determining energy efficiency To determine the energy efficiency of a particular machine go to: www.fishnick.com, home of the Food Service Technology Center (FSTC), an industry leader in commercial kitchen energy efficiency and appliance IX. Kitchen design and technology – pg. 194 performance testing. The FSTC, operated by Fisher- Nickel, Inc, has developed over 30 Standard Test Methods for evaluating commercial kitchen appliance performance. There are many useful facts are on this site. Equipment is rated and there is a Lifecycle & Energy cost calculator that can assist in equipment selection decisions and justification of new purchases. Approaching kitchen technology decisions It is estimated that over 65% of equipment purchases are due to replacement. How can an informed decision be made about all of the new and advance technologies? Since it is always improving, how do you decide on the basic type as well as the bells and whistles? As equipment needs replacing what should you purchase? How do you determine if there will be a payback? Can a new purchase replace more than one type of equipment? How do you quantify efficiency improvements, “green” benefits and real labor saving benefits?

The best path towards a decision is to understand your needs: current menu format, future needs or vision, current operational and labor challenges.

New technology can never compensate for poor quality work or the lack of proper training. However, less expensive ingredients or finished products can sometimes be improved—increased tenderness or better moisture retention and content. It may enable better productivity, reduce human error, increase yield, improve flavor, enhance presentation and help make safer products.

Technology is never limited to just equipment. Improvements are possible in food products from packaging, energy efficiencies and resources to portion

Food Service Tune-up – pg. 195 control. Advanced equipment or processes can also help protect food safety.

Purchase equipment that is practical for the needs of your operation. A pot and pan washing system may be practical if your style of service generates a high volume of pots and pans that continually need cleaning. The benefit of this equipment may improve sanitation of the pans while reducing labor and turn over in the washing function, perhaps even reducing the number of pots and pans you will need to produce your menu.

Even the best technology is only as good as your ability to use it. Understanding the basic difference between a convection and conventional oven can have a major impact on the quality, taste and appearance of the end product. New equipment may also impact your recipes and the types of service you can offer your patrons.

When staff is trained to understand the operating principals of the equipment, product quality can improve a lot. For example, the temperature and placement of the product in the oven can have a dramatic impact on how good it is.

So what is the best way to understand and obtain the best technology out there, FOR YOU? Principles for kitchen technology decisions First understand these basic principles when making a purchase of new equipment: - Your needs today, next year and foreseeable future - Appropriateness of the equipment for your operation IX. Kitchen design and technology – pg. 196

- Is it too much for your operation? Will your staff be able to use it with proper training? - What improvements should you expect by using this product? - Is a pay back involved with the equipment? - Will the results justify the cost? - Are the features something that your operation will use? - Do you have the power requirements? - Will it fit in your current configuration and floor plan? - Can you see it working somewhere else in your facility? - Can you get an experienced operator to demonstrate it to you so you understand how it works from the user’s viewpoint? - What training and support is involved? - Can you get it into your department – check door width and height for large equipment

Once these questions are answered, your decision for the purchase can be better understood and justified Think through your technology decisions Technology is only as good as one’s ability to understand and use it. For example a slow cooking oven that can cook over night with minimized moisture loss should not become a holding cabinet for food. Recipes and training should be adjusted toward using the technology to maximize results.

Think outside the box. For example, consider using a blast chiller for more than just cook chill. You might be able to develop a frozen meal program for home-delivered meals,

Food Service Tune-up – pg. 197 a puree-formed food program or even a line of special frozen meals for your retail program.

But be sure that these service innovations are realistic for the customers you have today or reasonably expect to attract with a new marketing program. In this example, you can see that a new piece of equipment, because it can do more, might expand revenue opportunities. However, you need to work with the facility sales and marketing department to be sure they would be willing to try out some of these possibilities and support your request to purchase the equipment and pay for the training needed.

The traditional principles of food service quality and safety still apply and need to be maintained to ensure consistency when using new kitchen technology. Look for advancing technology in these areas: - Cooking equipment: This technology is typically use to enhance the cooking process from slow cooking to fast cooking - Meal delivery and transport: This helps to get the food from kitchen to a remote assembly site, a mobile service unit, the bed side or to dining areas, wherever they may be - Food safety and sanitation: This is used to meet the standards for food safety such as sanitizing, ware washing and proper drying procedures. Pot and pan washers are good to investigate if the need is warranted. Auto-dispensed paper towels or soap not IX. Kitchen design and technology – pg. 198

only enhance the hand washing procedure but also offer savings by controlling the usage. - Conservation: reduce consumption of an increasingly costly resource—water, such as automatic water dispensing and automatic flushing systems - Service or serving equipment: This technology such as induction stoves, impingers or microwave ovens, can be used in the front of the house, such as the dining room, service area or waiter stations, to prepare food right in front of the customer, such as omelets or heated sub-sandwiches. - Food Preparation and dispensing equipment—portioning to processing: reduce labor (payroll savings) and make portion sizes more consistent (reduce food waste). - Design technology: ventless kitchens reduce the capital cost of renovating an old kitchen or building a new kitchen; drain systems and floor cleaning systems can simplify kitchen cleaning and sanitizing. - Processing and packaging technology including pre-formed bags, bag weighers and fillers may enhance the shelf life, or storage capability and create portion controlled packages of food for service or retail sale Case study: making the decision Should we brew coffee from ground beans or from liquid concentrate.

Food Service Tune-up – pg. 199

On the surface it appears that changing from grind to concentrate will increase costs. Calculating the cost per ounce for brewed coffee shows a higher cost for brew from concentrate. But, consider these points: - The common perception of “liquid coffee” is negative - Technology has come a long way with coffee - Concentrate is commonly used in many places that you may not have expected

Here are the facts: Liquid coffee (Pros) Brew coffee (Pros) - On demand when the - Less costly for large-volume customer requests a cup needs (if you have the - Less labor to brew brewing equipment) - High volume - Flexible price/quality trade- - 100 % usable offs possible - Less likely to be stolen - Filters are not needed Brew coffee (Cons) - Less mess - Can be messy - Safe (machine is not hot to - Made in batches touch) - Easy for waste or theft Liquid coffee (Cons) - More steps to brew - Perception: not real coffee - If a mid-day request comes - Requires space in freezer in you may have to brew a - Less flexibility in trading off whole pot for one cup price versus quality - Grounds in the cup

The biggest challenge may be overcoming the simple fact that it is not “brewed fresh.” This barrier can be solved with a simple taste test with your customers. To win over decision-makers, explain how the coffee brewing process works and how the move to liquid coffee is a major trend in the industry.

IX. Kitchen design and technology – pg. 200

Fact: 35% of the coffee made from brew is wasted so theoretically your actual cost is 35% more than you think when comparing cost per ounce. This substantially equalizes the cost per ounce.

Fact: Reduction in labor when producing coffee from concentrate due to reduced cleanup: filter, wrappers, brewer.

With this information you can decide depending on your goals. Due to the particulars of your operation, your decision could vary.

A word of caution: make sure your purchase, however innovative and high tech, is NSF-approved and must be of commercial construction to be effectively used in your operation. The role of consultants in kitchen design When planning a kitchen or pantry in a school, health care center or independent restaurant environment, you should always hire a consultant. Period.

Sure you may have run a kitchen for 20 years and you know how you like your food to be prepared and you just love your triple deck boiler-steamers. But, don’t miss the opportunity to learn how to do things better, faster cheaper.

Have you kept up on the changing industry trends? Do you know about new technology that may save you money? Do you really know as much as you think you do about the design process and work flow? Unless you are really unusual, the answer is no, no, no… for a good reason. You’ve been busy doing what you do best.

Food Service Tune-up – pg. 201

A renovation or re-design is an opportunity to take advantage of the expertise of someone who does these things frequently. So here’s why you should you consider hiring a consultant for $10-30K on a project (depending on size). Some of the benefits are:

Leveraging new trends and technologies A dealer consultant or an independent consultant will keep up with the new trends and the new technologies. This includes items that can generate a positive return over the long haul. In many cases, the savings on one or two devices will repay the consultant’s fee.

Maybe you think, “I have an architect, he can do it.” Unfortunately, this is hardly ever the case. If he claims he can do it for you and save you the money, it is likely that he or she is hiring a dealer consultant or an independent consultant to provide the consulting and will include the extra charge in the architecture fees. So you are paying for it already. You could probably save yourself some money by hiring your own consultant to work directly with the architect.

Typically, an architect doesn’t really understand how the equipment is used and the many little things that can cost you later in operation. Architects have the tendency to recommend what they have “seen before” and not what’s new in the industry so you will probably get old-new, not new-new. The new equipment or technology that will benefit your operation will not be spec’d unless someone (you and your consultant) do the work to understand how it will be used in your operation. IX. Kitchen design and technology – pg. 202

Get help in “going green” Some of the new technology that should be considered focuses on efficiency and “going green.” Manufacturers are putting a lot of effort into going green. From their manufacturing facilities to the products they turn out they are trying to lead the industry in making a better product without sacrificing our earth, health or the quality of the product you produce.

One example is the foam used in the walk-in cooler/freezer panels. The installed base of these panels and many of them sold today are made from solvent- based foam. As a result of the green trend, these panels are now being made using a water-based solution. After much research, some manufacturers have created a better product, and one that is also better for the environment. The initial cost may be a little higher, but when the cost savings of greater efficiency kick in, you can save money in the long term as energy prices continue to rise.

So if you’re bidding out a job, remember that in going green “It’s not all about the low number!” You need to understand the relative efficiency of the green product as well as its impact on the environment from manufacture through disposal. After more companies switch to greener technologies and end user demand increases, the prices will decline further.

Going green example: exhaust hoods Significant improvement has been made in exhaust hoods. This is not the proverbial, “It’s just a stainless steel box.” Exhaust hoods generate significant operating costs over the year:

Food Service Tune-up – pg. 203

- From the fan that drives the smoky air up into the hood, through the filters and to the outside - From the amount of conditioned air that is being sucked out of your kitchen and the adjacent dining and service areas (if you are lucky enough to have it) - From the amount of make-up air that is required (air that has to be conditioned and driven into the space to replace the air being sucked out by your hood.)

Some products address a lot of these issues with the low CFM (Cubic Feet per Minute of air) throughput. The combination of the patent pending arch top and the front mounted high velocity exhaust slot reduces the amount of exhausted CFM by 45% compared to traditional CFM rates. This translates into an annual electric and gas savings of up to 40%). Another nice feature of the newer hood designs is it brings the filters to the front of the hood, making them easier to clean. Now you don’t have to climb over the equipment to reach them (We know you are).

Example: Combi-oven An under utilized technology, no longer really new, is the combi-oven. The combi-oven is both a convection oven and a convection steamer, hence the term “combi.” This combination allows you to utilize both functions allowing for shorter cooking time and enables you to make an all- around better product.

The combi-oven can also do the work of “boilerless” ovens and ovens with boilers. “Boilerless” means the unit employs a steam generator to create steam in the cavity IX. Kitchen design and technology – pg. 204 rather than using the boiler method of boiling water and creating the steam.

Boilers require constant maintenance you must be sure your incoming water is just right so as not to void your boiler warranty. When a boiler goes bad, you can usually get a new steamer for the price of the repair. However, a boiler is required when you want to have a steamer run your tilting kettle.

Example: ice machines How you make ice illustrates how new technology can solve age-old problems.

One good ice innovation is a method of running ice from one ice-making head to two locations. The ice runs through a tube to a bin location or dispenser location. The ice is that of the nugget type which is good for hospital patients and nursing home residents with its soft chewable texture. The heat and the noise of the ice machine is removed from the dining and serving area and put in a different location, and the ice is then pumped through a tube to the locations.

As ice is needed, the ice-making head will switch to the location needing the ice to fill its demand. This saves you money on multiple ice machines and is perfect for the healthcare industry. - Environmentally friendly - uses up to 60% less water than cube icemakers - Flexible – the icemaker installs 20 or more feet away from the dispenser with the exclusive ice-through-a-tube technology - Quiet – no noisy ice harvest cycles

Food Service Tune-up – pg. 205

- Compact – fits in spaces cube ice machines can’t

Example: convection microwave Another piece of technology that may fit your operation is a convection microwave. Since the days of the Jetsons television family and smellavision this concept has come leaps and bounds into reality. The convection microwave has a microwave generator, infra-red radiant heat and air convection to throw at your food product. You have probably seen this technology in a Subway restaurant if you asked for a “hot sub.” What you also may have noticed is there is no need for a costly hood and vent, either. The product comes out in 90 seconds that smells, tastes and actually is pizza, or a sub, or an entree.

Trade-offs: avoid spec’ing the wrong equipment Thinking through the complexities and trade-offs of new cooking capabilities and maintenance issues is another reason to hire a consultant! An architect doesn’t know about these things. So if you bid the project out and your architect specs the wrong equipment, you will discover that you need to buy more just to keep even. And that makes the dealer happy that you have to buy the correct piece from him because he has the contract.

Get advice tailored to your situation Understanding what technology is available and how it works will better enable you to make well-informed decisions. These products may help in all aspects of your operation—if they fit your menu and service objectives. The key is to select the technologies that suit your operation and to train your staff on the proper procedures and application of the products you purchase.

IX. Kitchen design and technology – pg. 206

With so much new technology out there it’s hard to explain it all in a chapter. That’s another reason to hire a consultant, to have advice tailored to your needs, your menu and your operation. Descriptions of new kitchen technology Here are examples of new kitchen technology to consider in any make-over.

Induction heating Induction heating is the heating of a conducting material caused by inducing an electric current in it. It is used in several new ways to heat food or the vessels food is prepared in.

Induction pellet charging system An induction pellet is a plate on which you can place a food vessel for cooking or to keep warm. The pellet can be heated up by induction on demand in a few moments by placing it on the charging system induction ring.

Boilerless Describes a means to produce hot water or steam on demand. Press a button, water flows through a coil and is heated instantly. Often smaller than systems with boilers, boilerless heaters can be used in the serving area or kitchen, are reliable and generate less waste heat.

Fast cook An oven unit with a catalytic converter that will not require a hood in most municipalities. You also don't need a water or gas hookup. Fast-cook ovens differ from simple microwaves in that users categorize them as kitchen equipment, whereas microwaves often find their

Food Service Tune-up – pg. 207 way out to wait stations in the dining room, according to data cited by Hessel, "Operators are recognizing that these units are ovens. But they can go front or back of house.

Combitherm® A combination oven/steamer used for multiple purposes: steaming, baking, roasting, thawing, reheating, and various other cooking functions. In the past, a variety of cooking processes required multiple pieces of equipment. Considering space limitations and rising personnel costs, the Combitherm combination oven/steamer offers multiple cooking functions with one piece of equipment, saving both space and labor cost. The Combitherm combination oven/steamer is both a supplement and a replacement for some of the traditional cooking units found in most commercial kitchens. It enables the operator to produce high quality meals efficiently. The ability to use one combination oven for various cooking methods represents only one of the many economical and versatile capabilities of the Combitherm

Combitherm® Combination Oven/Steamer/Smoker While the combi-oven functions as a smoker, it also operates in all standard cooking modes for steam, convection, and a combination of steam and convection heat without any transfer of residual smoke flavor. The versatility of the oven offers the ability to cold smoke salmon, add hickory-smoked flavor to baby back ribs, and follow with an oven load of baked custard without a trace of smoke. IX. Kitchen design and technology – pg. 208

Cook chill An advanced preparation method whereby food is prepared, rapidly blast-chilled and held under controlled chilled storage at 3°C until rethermalized for service.

Rethermalization RETHERM or Rethermalization is a process whereby cooked food that is cold is reheated to serving temperature. Also called Regeneration or Regen for short.

Blast chill Blast chillers provide an excellent tool for chilling bulk and solid foods in covered pans and shallow containers, usually achieving 40 degrees F in less than two hours. They are available in sizes and configurations to fit almost any volume requirement or budget.

Radiant heat In cooking, the absorption of radiant heat seals the surface, allowing food to retain its natural flavors and moisture.

Impingement technology The concept relies on small jets of hot air under pressure being forced around the food, heating it two to four times faster than a conventional oven can, depending on the product. The shorter cooking time means less evaporation and moisture loss, so that food is browned and crisped without drying out.

Burner-baffle system microwave technology Cooks food up to 15 times faster than traditional cooking methods and does not require placement under a hood.

Food Service Tune-up – pg. 209

Infrared InfraWave cooking equipment is a relatively new technology that allows you to cook your food as you would with a standard oven, but it only takes half the time. The technology that makes this possible is called infrared technology. It works because it uses wavelengths of infrared light to heat up food at a faster rate. In fact, Infrawave ovens can cook up to 50 percent faster than a conventional oven without any preheating.

Induction cooking Induction heating is a method that detects the plate becoming warm when it comes in contact with a special surface. The special surface is not hot to the touch. The plate, however, has a special metal plate inside the porcelain that will become hot when it is contacted by the special surface.

Self cleaning floor The kitchen flooring in restaurants, hotels, institutions and commercial food vending facilities in general is subject to frequent spillage from waste products. Such waste products may be in the form of spilled liquids, semi-solids, and small solids and may include grease, oil, water, and an infinite variety of food products.

Spilled waste products may create a sanitation hazard as a hot kitchen is a natural breeding ground for harmful bacteria that may be caught in tile grout, and around pipes, drains or other kitchen fixtures. Because of the immovable nature of man kitchen fixtures, cleanliness is difficult to maintain.

Stringent health codes in most states require that kitchens in commercial food vending facilities receive daily IX. Kitchen design and technology – pg. 210 cleaning. Daily cleaning of walls, counter tops, appliances and floors involves a great deal of hand labor consuming a considerable amount of time. In addition, the waste products may create a health hazard in that spilled food products are often wet or sticky, creating a high risk that kitchen personnel may be injured in a fall.

A self-cleaning floor can be flushed with pressurized water that then flows down drains throughout the kitchen area. Some kitchens floors are basically grates that permit spilled items as well as wash to flow into a drainage system under the floor.

Ventilated ceiling An alternative kitchen exhaust system for kitchens where aesthetics and open spaces are required.

Air curtain—cold A design for a refrigerated display case in which a flow of cold air flows down from a hood to a vent beneath.

Air curtain—hot A design for a warm or hot food display in which a flow of warm air flows up from a vent to a hood.

Food Service Tune-up – pg. 211

X. Catering the best impression – pg. 212 CHAPTER TEN

X. Catering the best impression—advanced marketing

All the tips for catering success

Food Service Tune-up – pg. 213

One of the most exciting jobs you can perform in food service is the catering. It can be a great opportunity for you to “show off” your skills and those of your department. A successful catered event can leave a long- lasting impression with the customers you serve. To make that impression the best in can be, follow these simple steps:

Tip !! Under-promise and over-deliver—make sure the client’s expectation is clear!!!!!!! Scheduling the event The first step is the scheduling of the event. Set up time with the client to hammer out the requirements and to set expectations. Ask as many questions as you can. This is the time to verify: - Date of the event and dates for cut off and cancellation - Schedule times—Time for set up, serving (for each course), staff breaks, cleanup, breakdown, closing. - Work time for each activity. This will allow you to staff and charge correctly for the labor cost incurred. - Customer count. This should be as close as possible to the actual attendance. Discuss a cut off date and time for final count and minimum and maximum counts should be set in advance. Menu and pricing The complete menu should be covered beverages, appetizers, main entrée and desserts, even condiment X. Catering the best impression – pg. 214 preference. This menu will then be costed per person then multiplied by the visitor count to determine food cost for the event.

Tip: Working backwards sometimes helps. Ask the client for a budget number and determine what menu, props and entertainment you can offer within that amount.

Tip: Come to the client meeting prepared with menu options, ideas for the theme, and ranges of price for different numbers of visitors. If client has given you a preliminary budget, come prepared with several menu suggestions with the customer’s price range.

Tip: Know the labor costs involved so, if necessary, you can explain to the customer how many staff will be serving and the hidden tasks they will be performing.

Tip: Let the client know that buffet service is not always less expensive than waited service. Wait staff If a wait staff is desired then you must calculate your cost and the price you will charge. The labor costs and price should be based on a weighted average hourly rate with taxes and benefits included. Refer to the Budget chapter for an example of how to determine a weighted average hourly wage. China and disposable expectations Discuss the china options you have available as well as the type(s) of disposables that you have available. Make sure that you know exactly what the customer expects you to use.

Food Service Tune-up – pg. 215

Supporting a theme Whether you buy, rent, provide from inventory, or produce from labor, a price should be associated with the décor or theme: This could be as simple as flowers or center pieces or could be as complex as ice sculptures and chocolate fountains. Cost and price summary The cost and price for the event is based on more than food. Be sure to include the cost of labor for preparation, service, breakdown and clean-up. Be sure you know who will pay for the space… the client, or you… and charge accordingly. Include the cost and price for use of china or disposables and utensils you supply. Also charge for use of props and entertainment. Account for any taxes that you may have to pay. Serving the food There is a range of food service options: - Buffet—Set up for speed. Allows guest to self serve or be served quickly, assembly- line style - Waited—Table-side traditional service with a waiter who takes your order and serves your food - Banquet style—Limited choices, sometimes pre-selected, served waiter style to tables but very quickly - Action station buffet—Like a buffet but with food sautéed or assembled as patrons go thru the line - Or a combination buffet with waited service for dessert X. Catering the best impression – pg. 216

- Interactive stations—Different areas with cooking or assembling of food (sushi, sautéing, or carving); servers could be dipping chocolate or making omelets - The type of menu or service can be customized to the event. For example, interactive and sample stations can encourage group socialization and “mingling.” Organizing the business

Master binder Here are tips for organizing your catering business.

Set up a master binder by month, January to December. Also, have a 31 tab in the front of the binder. The 1-31 section will hold your master function sheets for the current month organized by date, and the January– December section will hold the finished form, invoices and other notes so you can refer or duplicate the event a year from now.

The January–December section will also help you to budget for the next year since all your events are available to develop costs and revenues for the budget lines related to the catering business.

Catering equipment inventory Don’t confuse the catering equipment inventory with the inventory that supports your daily business (food and supply inventory). The catering equipment inventory is the catering equipment you use to complete the jobs you take on. This might include food transport containers,

Food Service Tune-up – pg. 217 serving equipment, heaters, fans, folding tables, portable dance floors, decorations, linins, utensils, glasses, etc.

There are basically two choices for catering supplies—buy or rent. Some things are best rented and others should be bought and kept as part of your inventory.

Basic to any program are chaffing dishes trays and beverage dispensers. These should be kept on hand and can be disposable or reusable. Traditional catering supplies are good to have on hand. Planning ahead can really help you build your inventory up without breaking your budget.

Decorations can be bought at flea markets, garage sales, Good Will or Salvation Army stores. The great thing about these items is they don’t all have to match. Using other materials such as marble tiles, ceramic tiles, or even baskets add character and uniqueness to your spread. Purchase material swatches and assorted linens to add color and interest to a table. Even a string of Christmas lights can a make a serving table attractive.

To present options in an organized manner we provide a sample work sheet at the end of this chapter. Catering checklist Here are some critical points to put on your own catering checklist: - Budget - Date and location - Function time - Set up time X. Catering the best impression – pg. 218

- Type of reception – you will need to consider time of day, day of week, and season - Theme for the menu and for décor - Approximate number of guests - What type and color linens - China or disposables - Decorations – flowers, etc. - Room arrangements - Rentals - Menu - Take down time Important basic information - Make sure you explain that events will be billed for the greater of the final guaranteed number or actual number of customers - Require that the final number of customers that you will bill for (whether they show up or not) should be set no later than 48 hours prior to function. - Set minimum requirements such as “for events ” - No less than 48 to 24 hours notice is required for all cancellations and/or changes depending on type of event. - Require that the fee be paid in full before the start of the event. Require that a deposit of at least 1/3 be paid at the time the event is confirmed. Consider setting a minimum payment even if the event is cancelled. This is to cover costs of making arrangements, including purchasing food, renting equipment, scheduling staff to work.

Food Service Tune-up – pg. 219

- Consider seasonal and regional restrictions, some substitutes may be necessary. - Schedule a walk-through of the area with the client. Rules of thumb - Make sure the menu is appropriate to the time of day and length of event (consider food safety requirements). - Are there any known food allergies, religious needs or special diet or ingredients restrictions for the guests (e.g. Kosher, no red meat or food allergies). - Bar and beverage requirements—full bar or limited service only. Consider providing non- alcoholic options.

Service staff reference - One Waiter/waitress = 20 people for served entrees - One Waiter/waitress = 50 people for buffets - One bartender per = 100 people One Waiter/waitress = 30 people for passed hors d’oeuvres - One Waiter/waitress =75 people for a buffet of hors d’oeuvres - One chef = 50 people for each action station

Seating capacity - 48” table – 4 to 5 customers - 54” table – 6 to 7 customers - 60” table – 8 to 10 customers X. Catering the best impression – pg. 220

- 72” table – 10 to 12 customers

Staffing suggestions: - Picnic style 1 per 75 - Buffet 1 per 30 - Preset Meal 1 per 30 - Traditional Meal 1 per 20-25 - Black tie 1 per 10/minimum of 2 - Banquet style · Waiter staff 1 per 50 · Server 1 per station or as needed

Other service styles—terms you may encounter - French – Food is partially prepared in the kitchen, brought to the dining room and then finished on rechauds on a gueridon. Each plate is arranged on the gueridon and then placed in front of the guests. - Traditional family style – All food items are completely prepared in the kitchen and placed on platters or in bowls, then placed in the center of the table. - Russian – Food items are prepared and portioned in the kitchen, placed onto platters and plated by the waitstaff in front of the guest. The waitstaff uses a fork and large serving spoon to plate the dish. - Plated – Food items are completely prepared, plated, and garnished in the kitchen. The plates are carried to the dining room and placed in front of the guests. - Butler – Guests serve themselves from platters carried by waitstaff.

Food Service Tune-up – pg. 221

Last minute details - When do you need your final guest count? - Be sure to make a final site inspection before setup. - Will additional space be needed for food and beverage preparation needs? - In door or out door? What if it rains? - Traffic flow

Tip: Fans help fly control. Circulating blowing fans make it hard for flies to land on food and also can keep food cooler.

Things to remember - Menu and food delivery times with kitchen staff assigned to the function are on the work sheet - Have necessary changes to the packing of supplies been communicated? - Are deliveries and final checks scheduled? - Confirm that all flowers, linens, or other specialty items have been ordered as necessary for upcoming events and understand delivery times. - Check staffing levels and times for upcoming events and for the next day of work. - Communicate any necessary changes in scheduling to the staff. - Prepare a sample place setting (or diagram), a floor plan with table assignments, and side work assignments for all plated meals. Give staff a detailed, accurate, and informative pre-meal presentation with time for questions and answers. X. Catering the best impression – pg. 222

- Communicate guest counts and timing changes to the kitchen during the event. - After breakdown, clean, launder and return all equipment and food items to the proper place: Overlays to the Catering Office, dishes to the dish machine or the china room, table linens to linen bags and bins, clothes (skirts, vests, aprons, ties, etc.) returned to linen closet or rental service.

Special events form (external clients) The Special Events form on a following page is a worksheet for management and the external client to record agreed-on event particulars. It informs the client of your understanding of her expectations and informs the on-site team of what has to be done.

Dining services request (internal clients) The Dining Services Request form on a following page is a worksheet for management and the internal client to record agreed-on event particulars. It informs the client of your understanding of her expectations and informs the on-site team of what has to be done.

Food Service Tune-up – pg. 223

Here are some forms to ramp up your catering activity:

- Special Event planning form—to work with an external client to plan an event - Marketing Dining Service Request—to organize the workers and resources internally to conduct the event. and 24 catering tips to add pizzazz to your catering operation. X. Catering the best impression – pg. 224

Special Event planning form (external)

Theme Total cost Date Time Premeal activity Time Location

Menu appt Other entrée [Coffee,cookies,etc…….. veg starch Bread Dessert Beverages Ice water,Coffee,Tea ,Milk,Ice Tea, Other

Table setting Table cloths Entertainment Napkins Music Center piece Other[musician] Menu covers [type]

Staff participation guidelines [Dress up,formal etc……]

Advertisement Menu Posted Families invited Free to staff

Table arrangemuse back of form Check box to see back of f Additional set up Please describe

Other comments

Approval Administration

CC: Nursing Maintenance Activities Housekeeping

Food Service Tune-up – pg. 225

Marketing Dining Service Request form (internal)

Marketing Dining Service Request form

Items needed: Provide brief description of product and presentation expectation

Individual Description

Bulk Description

Item total Budget amount per item or total cost

Special instructions : This is a door to door presentation. Items will be presented on a platter. Product will be part of hospitality basket . This is a boxed lunch.

Amount needed

By when DATE TIME

Made Fresh

Dining Services to assemble ?

Packaging material provided ? Delivery to ;

Other instructions

Request by: Today's date X. Catering the best impression – pg. 226

24 catering tips to add pizzazz Here are 24 tips to add pizzazz to your catered events without breaking your budget.

1. Search the secondhand shops for trays and platters. The nice thing about them is they do not have to match, but should be made of material that can be sanitized.

2. Look for swatches of cloth in all sorts of colors, they are great to “crumple up” on the table and cover layers of your table

3. Use a variety of boxes to create different levels. This can give intrigue and add more excitement to the table.

4. Ceramic tile, marble and glass blocks are great to use and available at any home improvement store.

5. Need a nice carving board? Look for a round wooden table top that is brand new, available at most home improvement stores. (Make sure finish is food grade)

6. Purchase a small portable NSF-approved burner and a non-stick pan for a quick action station (keep a fire extinguisher nearby).

7. Landscaping blocks make nice tray stands and add levels to excite the eye. (Run them thru the dish machine to make sure they are clean. Make sure you purchase them new.)

Food Service Tune-up – pg. 227

8. Christmas lights are great to use to decorate a table. (Keep the cord out of the way so your customer does not trip.)

9. Glass blocks make nice décor and are available at home improvement stores.

10. Wire chaffing dishes can be dressed up by “draping” them with table cloths or colored pieces of cloth.

11. Baskets make great utensil holders. Purchase them at local stores and line them with cloth napkins.

12. To create a fancy ice ring for any punch, use a round angel food cake pan filled with ice and fill it with sliced oranges and lemons.

13. Take dipping chocolate to a new level. Use wooden skewers as the dipping utensil for items such as marshmallows, rice crispy treats, strawberries, pineapples, bananas and other fruit. (Watch out for excessive browning, so do this at the last minute and in batches.)

14. Red cabbage makes a nice underliner for fruit displays.

15. Always think of the flow of the customers through the area when setting up a table. Where are they coming from; where are they going? Consider the scatter system. In other X. Catering the best impression – pg. 228

words have stations arranged to keep the crowd moving through the area.

16. Use small fancy picture frames to illustrate the food description. (Make sure the penmanship is good or do them on the computer.)

17. For outside functions, use circulating fans to blow on certain displays of food that the flies might like. The fans help keep them off the food.

18. Glass mirror tiles make great trays for food items and as level tops for different sections of the display. (Check for smears to keep them looking sharp.)

19. Look for décor that matches your function. For example, if you are doing an Asian function, maybe use a Wok display and even a bamboo blind to cover a table instead of a table cloth.

20. Retain space when using ice with larger ice chunks. (They melt more slowly and will compensate for melt-off water and dripping.)

21. Think about where to put utensils when they will not be used. Four-inch tiles are great and make nice décor—available you know where.

22. Make functional center pieces such as bread rings that are simply done in a bundt pan. Put a nice champagne glass in the center as the garnish.

Food Service Tune-up – pg. 229

23. Always think about the uniform. Keep some nice chef coats and black aprons ready. Use them, even if the servers are not chefs.

24. Consider making the desserts smaller. Maybe put a variety on the plate. (This will allow guests to sample several, usually there is something for every one.

These tips can save you monies and add excitement to your event. Charge for the décor with in your proposal and soon all will be paid for. Let us face it, if WE did not have the décor we would have to rent it, and the client would pay anyway. So at least let the items pay for themselves.

Bonus tip—action stations Action stations with a person creating gorgeous food can be exciting for the customer at little or no additional cost. Action stations could include: Sushi stations, stir fry, quesadillas or fajitas, sandwich samples, grilling (outdoors), salads tossed or in wraps, carving to create a bananas foster dessert. The list is only limited by your imagination.

Remember: Plan ahead and think out how you will do it down to every last detail, including training the staff, with leaving enough time to work out the kinks.

X. Catering the best impression – pg. 230

Other ways to generate revenue Advanced Marketing: Catering, Retail, Promotions and Gaining the Hearts and Minds of the Crowd

Food is creative, marketing is creative and in general the food business is a place where creative people can make their mark. Few industries offer such an opportunity for people to distinguish themselves as does the food service profession. Marketing, the driver of food service innovation Marketing is an ongoing process of planning and executing the marketing mix (Product, Price, Place, and Promotion) of products, services or ideas to create

Food Service Tune-up – pg. 231 exchange between individuals and organizations. Marketing tends to be seen as a creative industry, which includes advertising, distribution and selling. It is also concerned with anticipating customers' future needs and wants, which are often discovered through market research.

Essentially, marketing is the process of creating or directing an organization to be successful in selling a product or service that people not only desire, but also are willing to buy. Therefore good marketing must be able to create a "proposition" or set of benefits for a price for the end customer that delivers value through products or services. Marketing is a strategic backbone to food industry product development and the value is created by the ability to innovate.

Innovation is inherent in all industries and in this sense represents the creation of customer value. Many technologies and items are around for a long time before someone perceives a customer need and opportunity and puts the pieces together to create a new and salable product.

As an example, the pizza industry needed a way to deliver pizzas across town and developed a box that enabled customers and delivery drivers to move the product to customer locations at almost out-of-the-oven freshness. The fast food industry has taken long-standing products like sandwiches and fried foods and had equipment developed that assures consistency of product across multi-unit organizations.

The products themselves in this case are not as innovative as the fact that the fast food industry revolutionized the production process and the equipment X. Catering the best impression – pg. 232 needed to produce the products. They basically created a whole new set of equipment to support the production in a new way for food that had been around for a long time. This use of innovation allowed new markets to develop. The average food service manager and caterer will not invent the equipment but will buy the innovations available to match their business and vision. Creating value through catering Let’s explore the various aspects of catering and how the pieces can be used to create value for your operation. Food is a never-ending parade of new dishes and developments to tempt and please the customer. Ideas are limited only by the people running the business. People who plan meetings and social events inspect banquet and catering menus, carefully. Many of these menus are run of the mill. That’s an opportunity. Innovation is not magic but an ongoing, disciplined process.

Each client needs to be asked about his or her wants and needs. Not only are they planning a reception, meeting or general event, but they want to express the uniqueness of their group. Clients can tell you about the group’s purpose, the member’s interests and provide the bits and pieces that make them who they are. Listen well and help them reach decisions that will make their event not only better and more interesting, but get them the complements that make them proud and bring them back to you for more.

One definition of catering is, “the prevention of embarrassment to the client.” Although not an official definition, it makes the point that the people heading up the event and bringing you the business have a lot at

Food Service Tune-up – pg. 233 stake beyond the money involved. Creativity brings satisfaction and generates additional revenue. Service themes and creativity create opportunity Themes governing the dining experience are not new, but with the proliferation of food types and ethnicities in the United States, they have come of age. Sophisticated props, creative foods, costumed staff along with staff and attendee involvement, all at an affordable price, are a win/win situation. Commitment to bringing such a program to the customer will bring about several results. - Caterers can achieve showbiz uniqueness. - Reaching higher price points is possible due to the perceived greater value of the theme. - The staff is energized by the achievement; their performance and involvement improves with the repeating of each event. - The more you can become a one-stop shop, the better control you gain over the event. - Because props are increasingly designed for easy installation, the reduced time allows for additional functions to be scheduled in the same space. - The less the client spends with outside vendors the more they can spend with your organization, so delivering the total experience is to your advantage. - When managed well, a food service operation that offers catering can generate considerable revenue. X. Catering the best impression – pg. 234

Creating the Customer Experience What operation would not like to add thousands to the bottom line? Designing great catered events is a talent that can be learned. Designing a theme party that is unique and a memorable dining experience is the mark of professionalism. Keep in mind the visual impact and the effect when the dining room doors open. That’s when the attendees make their first impression as to whether the event will be a memorable one. Much of the perception of food is in the presentation. The recipes do not have to be new or over the top. Many customers only order foods they are familiar with, so making it look attractive and attending to the details is what sets the experience apart.

For a range of suggestions about enhancing the customer’s experience, read, The Cost and Price of the Customer’s Experience, published by Innovations Services.

Breaks add value For meetings, breaks can often be sold to the organizers. These reinvigorate the attendees and yield extra profits. Remember to keep the price of these breaks affordable and make the menus reflect the client’s needs. Simple coffee carts to complex drink stations are the usual range of service, so decide with the client what they want and will pay for. Show pictures and diagrams of your more common setups to help the client visualize what you will do.

Staff—hidden performance talent? Another key to success is to involve not only the attendees but also the staff. Many times you can ask the staff to provide their own costumes, which is a cost

Food Service Tune-up – pg. 235 savings to the caterer. While black pants or skirts and white shirts are the usual attire… sometimes staff enjoy wearing something festive and appropriate to the event.

The person in charge should speak to staff prior to the event to be sure that the costumes will meet your professional standards of dress. This departure from regular work wear is actually a motivator and makes the job fun and can boost staff morale.

Add in prop fees The client pays a fee for your prop setup and you do the work. The beauty of props is that you can charge many times for using the props in your storage and they generate great revenue in and of themselves. Be sure the staff treat the props with care because keeping them in good condition means many uses and higher profits. An alternative to your own props is to partner with a special event firm for design décor. Also consider working out a business relationship with a talent agency for music and various acts like magicians or acrobats. This leaves you to concentrate on food and beverage and yet you have the perfect backdrop and atmosphere to complement your services.

Catering is a multi-billion dollar business and the nation’s phone lists show thousands of caterers. Catering has come a long way from the simple chicken dinner - the customer of today is looking for the total experience. This is hard work and a long hour business but if done right it is a lucrative way to make a living.

XI. Leading change – pg. 236 CHAPTER ELEVEN

XI. Leading change

Food for thought on the abandonment of what we do

Food Service Tune-up – pg. 237

» Adapted from: Leading change in your organization by Timothy L. Bauman, DHCFA, CDM, CFPP, Dietary Manager Magazine (a publication of Dietary Managers Association), November/December 2007

The only constant is change. Change is the only constant. Change alone is unchanging.

Heraclitus (535 BC - 475 BC) Greek philosopher

Usually there is no lack of ideas in food service organizations. What’s more often lacking is the willingness and the ability to convert those ideas into effective results. As managers, we lead change with our paid and unpaid staff. The major difference between for-profit and not-for-profit organizations is that the not-for-profit leader has many more constituencies to take into account when making decisions and leading change. For-profit organizations exist to make money for the owners and stock holders. The non-profit organization exists to bring about change in individuals and in society. Additionally in the non-profit organization, changes are often reflective of the greater society they serve.

How can food and nutrition leaders drive change and still keep employees motivated and productive? Skillful leadership of change is a crucial attribute for maintaining a competitive business advantage and often career survival.

XI. Leading change – pg. 238

Factors driving change Constant change in our industry requires an organization to adapt continually. As a program adjusts to the new environment, teams, leaders, managers and individuals may be required to change. Changes that begin with individuals, groups and programs can also flow into the business environment (and your department) and become a factor that causes a response in others. Responding to change with initiatives While there are many reasons why individuals and organizations change, the essential steps in change remain the same. First, we become aware of a need for change because we sense either a problem or an opportunity that commands our attention. (Develop Awareness).

Sensing the need for change, we begin to search for solutions that address the need. Food service managers have many options. For example, we may ignore the need and hope it goes away. We might talk to others who have managed similar challenges to see what insight we may gain (example: network at the annual professional group meeting). (Develop Insight).

We may simply take action to see what happens. (Develop Solution).

Once a response is chosen, we implement the strategy and continue working until we satisfy the need or accomplish our goal (Develop Performance).

Food Service Tune-up – pg. 239

Operational excellence Initiatives to achieve operational excellence are designed to sharpen performance and results in the business environment. These internally focused efforts may for example, come in the form of menu offerings that improve quality, profitability and responsiveness to shifts in our business.

Innovation Innovation initiatives are designed to create or capture new opportunities that emerge in the business environment. These focus on internal changes (yes, even the food service department) that produce totally new products and services.

Food service produces services and products, whereas the rest of the departments in healthcare facilities produce mostly services; so we have a lot to think about. Also these changes may include dramatic improvements in strategic capability, performance or potential. Adding new equipment for example, can facilitate innovation by creating food items previously unavailable to your clients/customers/patients. Essential change steps Living through change as food service professionals makes us part of the process with in our area and we are left to ponder how this all fits with change in the larger organization around us. Placed on a continuum, change can be defined in a series of five steps as follows; - Awareness (Personal leadership and influence) - Enrollment (Organizational sensitivity and respect) XI. Leading change – pg. 240

- Solutions (Fostering teamwork and problem solving) - Commitment (Negotiation of differences, resistance and conflict), and - Performance (Managing tasks and people).

Successful change requires teamwork and problem solving among organizational groups and individuals. Enrollment of group and individual objectives and strategies, as well as commitment, mutual action and support are essential if real change is to be produced.

Elements of successful change include: - Capability and Readiness: To what degree will targets resist or support this change? What level of stress existed among targets before the change was initiated? - Organizational Fit: To what degree will this change disrupt the organization? To what degree is this change inconsistent with the existing culture? - Synergistic and Innovative Solutions: Is there sufficient teamwork between sponsors and targets? Will the particular configuration of people involved with this change enhance its probability of success? - Sponsorship and Support: Will key initiating sponsors demonstrate sufficient commitment to the change? Will essential sustaining sponsors throughout the organization demonstrate sufficient commitment to the change? - Planning and Implementation: To what degree are the change agents sufficiently skilled for this effort? To what degree will

Food Service Tune-up – pg. 241

past implementation barriers be a potential problem?

With these considerations in mind, let’s review the five essential change steps.

Awareness In building awareness, effective change leaders develop an organization’s readiness and capability for change by focusing the attention of others on the opportunities or dangers that make change necessary. As an example; we may use biological research to show why food borne illness needs to be addressed. By helping people recognize the need for change, they foster ideas and actions that move an organization toward a constructive response, an operational improvement or strategic innovation. Successful change leaders often focus attention on these issues: - Demonstrating the opportunities and dangers presented by change. - Developing the readiness and capability of the organization to accomplish necessary changes. - Clarify the strategic and tactical priorities of the organization. - Initiating and supporting efforts to produce desired change.

Enrollment When people recognize the need for change, they react. People interpret change in many ways or perceive different opportunities and dangers. Organizations with many departments such as Nursing, Environmental Services or even volunteers will get many different views often causing a response to change in conflicting ways. XI. Leading change – pg. 242

If people have low agreement, they may operate in ways that: - undermine trust - try to take the safe route - attempt to work independently, or - act with guarded response.

There may be good reason for these beliefs if people and departments are insensitive to one another’s interests, methods and constraints. Unfortunately, most significant change requires cooperation and coordination. If people cannot be persuaded to work together, the organization’s response may lack focus. Essential energy may be diffused on several competing change solutions that satisfy narrow interests, but fail to garner the widespread support needed to improve the organization or produce real innovation.

Successful leaders enable others to respond to change in cooperative ways, develop change solutions matching operational needs and preferences, and implement coordinated change strategies. They accomplish this by focusing on these activities: - Motivating the desire for mutual support. - Creating coalitions to support the development and implementation of change solutions. - Ensuring that change solutions and plans match the needs, culture and patterns of organizational members.

Solutions The creation of effective change solutions and their successful implementation heavily depend on problem-

Food Service Tune-up – pg. 243 solving capabilities of individuals and teams within your program. The ability to promote teamwork and innovative problem solving is perhaps the most important skill change leaders must possess. Effective leaders focus on these tasks: - Clarifying a common goal and emphasizing the need for interdependence in reaching the goal. - Seeking and valuing the input of others. - Contributing suggestions and influence for constructive outcome. - Managing the decision process to ensure change solutions are developed and implemented effectively.

To be successful, change leaders must demonstrate strong capabilities for interacting with others, appreciatively understand diverse viewpoints, creatively integrating ideas and implementing the resulting plans.

Commitment People may agree that your change solution and plan is a good idea but still fail to demonstrate the commitment needed to make the change a reality. In fact, serious opposition to your efforts may not even surface until it appears you are intent and capable of pressing for your desired change.

Resistance can take many forms from open defiance to simple inattention and foot dragging behavior. Either way, successful change depends on your ability to surface and resolve these conflicts quickly and effectively. Effective leaders know how to cultivate and exercise the political support needed to implement changes and ensure XI. Leading change – pg. 244 intended results are achieved. They accomplish this by focusing on these tasks: - Gaining active support of those who oppose or resist the change solution or plan. - Obtaining the operational sponsorship needed to ensure that change solutions and plans are implemented properly. - Sustaining support for change initiatives long enough to produce desired results.

Performance In the final stage of change, desired gains may finally become a reality. To ensure that this happens, change leaders must plan effectively and be able to help those assimilating and implementing change to do so effectively. This final phase involves these essential steps: - Managing the transition between the current and desired state. - Developing the abilities and willingness individuals need to produce the desired change. - Establishing the institutional supports needed to sustain the change once it has been achieved.

As managers we need a particular mindset for managing change: one that emphasizes process over specific content, recognizes organizational change as a person/unit by person/unit learning process rather than a series of programs, and acknowledges the payoffs that result from persistence over a long period of time as opposed to quick fixes.

This mindset is difficult to maintain in an environment that presses for meeting period budgets or short term

Food Service Tune-up – pg. 245 company goals but may be the only approach that will bring about successful change and innovation.

XII Resources and References – pg. 246 CHAPTER TWELVE

XII. Resources—references to support your program

All flavors blending just right

Food Service Tune-up – pg. 247

» This chapter is a review of the material used in the Nutrition Fellows Leadership Institute with the National Center for Nutrition Leadership a participative effort between DMA (Dietary Managers Association) and MOWAA (Meals on Wheels Association of America).

Here are some important resources that should be on your shelf in your operation. They are vital to your business; don’t let them collect dust! The FDA Food Code For help in understanding how to work with the Food Code, see the regulatory section in Chapter VII.

The Food Code is the result of a collaboration among the Conference for Food Protection; the Centers for Disease Control and Prevention and FDA of the Department of Health and Human Services; and the Food Safety and Inspection Service of the U.S. Department of Agriculture. The regularly updated Food Code focuses on enhancing food safety practices based on new scientific and programmatic information. It has been adopted by state and local government health departments across the U.S.

The Association of Food and Drug Officials reported in June 2005, that 48 of 56 States and territories have adopted food codes patterned after the FDA Food Code. The 48 states and territories represent 79 percent of the U.S. population.

The Food Code is revised to represent the most recent and best advice to ensure that food at retail is safe and properly protected and presented. Epidemiological XII Resources and References – pg. 248 outbreak data repeatedly identify five major risk factors related to employee behaviors and preparation practices in retail and food service establishments as contributing to food borne illness: - Improper holding temperatures - Inadequate cooking, such as undercooking raw shell eggs - Contaminated equipment - Food from unsafe sources - Poor personal hygiene

Food Code provisions address essentially four areas: - Personnel - Food - Equipment/facilities/supplies - Compliance and enforcement

You can obtain the FDA Food Code in PDF format from the following Web site: http://www.foodsafety.gov/~dms/foodcode.html Food for Fifty The title Food for Fifty by Mary K. Molt, published by Prentice-Hall, pertains to cooking for large numbers of people. The "bible" for all aspects of quantity food production, it provides tables and guidelines for food production basics, quantity recipes, and planning strategies.

For nearly 70 years it has been THE resource for students and professionals in quantity food production and foodservice management. Exceptionally comprehensive, this classic text/reference provides basic technical food production information; offers a wealth of high-quality,

Food Service Tune-up – pg. 249 standardized, quantity recipes applicable to most types of foodservices; and clearly explains the full range of generally accepted procedures and techniques involved in quantity food preparation. Very contemporary in perspective, it provides a host of “new tools” for helping food professionals and students meet quickly changing dining trends and satisfy the expectations of today's customer. Its content includes:

- Planning Menus & Planning - Eggs & Cheese Special Meals & Receptions - Fish & Shellfish - Food Production Information - Meat - Food Products Information - Poultry - Production Fundamentals - Pasta, Rice, Cereals, & Foods - Knives & Other Equipment with Grains, Beans & Tofu - Recipes - Salad & Salad Dressings - Appetizers, Hors d'oevres - Sandwiches and Special Event Foods - Sauces, Marinades, Rubs & - Beverages Seasonings - Breads - Soups - Desserts - Vegetables - Suggested Menu Items & Garnishes - Glossary of Menu & Cooking Terms Diet Manual Diet manuals are developed by and for food and nutrition service personnel in hospitals, nursing homes, schools, hotels and other institutions that feed large numbers of people based on the needs and interests of the population they serve. A diet manual for a nursing home will be very different from the diet manual for a school or even a hospital. A diet manual for a medical facility serves as a guide to physicians in prescribing appropriate nutrition interventions in these institutions.

XII Resources and References – pg. 250

The purpose of a Diet Manual is to provide clear-cut practical information and guidelines in diet therapy for normal and modified diets. The suggested guidelines or examples may require adaptation to specific situations and to individual requirements and preferences.

Innovations Services can provide advice and assistance for preparation of a diet manual. Policy and Procedures Manual Most organizations publish a policies and procedures manual internally to facilitate information search, that is, the ability of their employees to locate answers to specific questions efficiently and effectively.

Here are four reasons to develop and use procedures to document important processes: - Compliance—with the Food Code and the doctor’s or dietitian’s diet prescriptions for patients - Operational Needs—how to produce a range of meals using the particular equipment and ingredients available at the facility - Manage Risks—how to do food preparation and food service work safely while maximizing food safety for clients and customers - Continuous Improvement—means to ensure that process improvements are adapted by all staff swiftly and uniformly

Policies should be developed or approved by management and clearly describe operational goals and “best practices.” Objectives stated in the policies should be prepared in “SMART” format:

Food Service Tune-up – pg. 251

- Specific – Objectives should specify what they want to achieve. - Measurable – You should be able to measure whether you are meeting the objectives or not. - Achievable - Are the objectives you set, achievable and attainable? - Realistic – Can you realistically achieve the objectives with the resources you have? - Time – When do you want to achieve the set objectives?

Policy and Procedure Manuals may be in the traditional paper format or they may be on the facility’s Intranet. The important thing is that it is readily available for all staff to use.

Innovations Services can provide advice and assistance for preparation of a policy and procedures manual. Material Safety Data Sheets A Material Safety Data Sheets (MSDS) is a document that provides both workers and emergency personnel with the proper procedures for handling or working with a particular substance. MSDS’s include information such as physical data (melting point, boiling point, flash point etc.), toxicity, health effects, first aid, reactivity, storage, disposal, protective equipment, and spill/leak procedures. It is important to follow MSDS guidelines if a spill or other accident occurs.

MSDS's are meant for: XII Resources and References – pg. 252

- Employees who may be occupationally exposed to a hazard at work. - Employers who need to know the proper methods for storage etc. - Emergency responders such as fire fighters, hazardous material crews, emergency medical technicians, and emergency room personnel.

MSDS’s should be kept in a designated location where they can be quickly accessed and examined in event of an accident. They should be organized in a manner that is meaningful to the staff and/or emergency responders who may need to use them. You should periodically review your MSDS’s and replace older ones with current editions.

MSDS's can be obtained from a variety of sources: - Your laboratory or workplace should have a collection of MSDS that came with the hazardous chemicals you have ordered (don't throw them away!). Some organizations use commercial services to obtain printed, FAX or on-line copies of MSDS's. - Most universities and businesses have a collection somewhere on site. Check with the Environmental or Occupational Health Office or science librarian. - You can get them from the distributor that sold you the material. - The Internet has a wide range of FREE resources that carry MSDS’s for different industries. A place to start is http://www.ilpi.com/msds/faq/parta.html

Food Service Tune-up – pg. 253

If you have trouble finding them, contact the manufacturer's customer service department. Useful Web sites Here is a list of great Web sites. Every effort has been made to verify that these sites were still active at time of this writing. If the one you are looking for is no longer available, try a similar one or use a search engine to find those fitting your interest. www.FOODSAFETY.GOV Consider subscribing to EdNet. - EdNet is an electronic newsletter from the Food and Drug Administration (FDA), Food Safety and Inspection Service (FSIS), and the Centers for Disease Control and Prevention (CDC), providing updates on food safety activities to educators and others concerned about food safety www.fsis.usda.gov/home/index.asp Is a food safety site by the US Department of Agriculture. Visit the sub-page: www.fsis.usda.gov/Factsheets/Kitchen_Companion/index. asp to reach Your Safe Food Handbook. The online version has been optimized for accessibility. The illustrated PDF version is recommended for printing. Contents includes: Foodborne Bacteria, Shopping for Food, Storing Food, Food Preparation, Cooking Food Safely, Special Guidelines for Certain Food, Specific Preparation and Cooking Methods, Serving Food Safely, Transporting Food: Coolers, Picnics, and Bag Lunches, Food Safety for Food-by-Mail, Food Safety in an Emergency and Food Safety Contacts. www.smartbrief.com provides news for the restaurant/foodservice industry. SmartBrief publishes 55 co-branded, customized e-mail newsletters in partnership with leading trade associations, professional societies and XII Resources and References – pg. 254 corporations. More than 1 million professionals in 18 industries rely on SmartBrief every day to save them time and keep them informed with essential industry news and more. www.monkeydish.com/ is a customizable Web site for restaurant entrepreneurs created by The Restaurant Business magazine. You can adapt the format of the site to your own purposes to provide information you need for your own operation—everything from recipes, nutrition, operational tips to food trends and even weather reports for your area. www.fsdmag.com Fsdmag.com is dedicated to serving the information needs of the food service industry. It references numerous Web-enabled business resources to provide a one-stop center for industry information. FoodService Director is the only tabloid exclusively serving the vital segments of the non-commercial foodservice market. Reports on issues, ideas, and events impacting foodservice professionals in hospitals, nursing homes, colleges, schools, business and industry, transportation, correctional facilities, and military installations. More than 90% of this audience classify themselves as foodservice management USDA Food And Nutrition www.usda.gov/wps/portal/!ut/p/_s.7_ The US Department of Agriculture provides this Web site to harness the Nation's agricultural abundance to end hunger and improve health in the United States. USDA agencies administer federal domestic nutrition assistance programs. The Center for Nutrition Policy and Promotion (CNPP) links scientific research to the nutrition needs of consumers through science-based dietary guidance, nutrition policy coordination, and nutrition education. The Food and Nutrition Service (FNS), formerly known as the Food and Consumer Service, administers the nutrition assistance programs of the U.S. Department

Food Service Tune-up – pg. 255 of Agriculture. The Food Safety and Inspection Service (FSIS) ensures that the Nation's commercial supply of meat, poultry, and egg products is safe, wholesome, and properly labeled and packaged. This mission area also plays a key role in the President's Council on Food Safety and has been instrumental in coordinating a national food safety strategic plan among various partner agencies including the Department of Health and Human Services and the Environmental Protection Agency.

Fight BAC http://www.fightbac.org/ is the website of the Partnership for Food Safety Education (PFSE). It is an important resource to obtain Fight BAC! food safety and safe food handling campaign information.

The Partnership for Food Safety Education unites representatives from industry associations, professional societies in food science, nutrition and health consumer groups, the United States Department of Agriculture, the Environmental Protection Agency, the Department of Health and Human Services, the Centers for Disease Control and Prevention, and the Food and Drug Administration in an important initiative to educate the public about safe food handling practices needed to keep food safe from bacteria and prevent food borne illness. http://vm.cfsan.fda.gov/~lrd/haccp.html Hazard Analysis and Critical Control Point web site http://www.cfsan.fda.gov Food Service Codes and Regulations by state with links www.eatright.org This Web site, sponsored by the American Dietetic Association (ADA), offers an updated search engine to help you locate the wealth of content XII Resources and References – pg. 256 about diets and health accurately and quickly, providing timely, science-based food and nutrition information. www.restaurant.org Founded in 1919, the National Restaurant Association is the leading business association for the restaurant industry. Together with the National Restaurant Association Educational Foundation, the Association's mission is to represent, educate and promote a rapidly growing industry that is comprised of 945,000 restaurant and foodservice outlets employing 13.1 million people. The National Restaurant Association is a member of the International Hotel & Restaurant Association (IH&RA), a network of national associations, international chains, hotel operators, restaurateurs and supplier companies in more than 150 countries, representing over 750,000 establishments. Its mission is to protect, promote and inform the hospitality industry, which comprises over 300,000 hotels and 8 million restaurants worldwide, employs 60 million people and contributes $950 billion annually to the global economy. Other industry Web resources

Various food interest links - Cook's Thesaurus The Cook's Thesaurus is a cooking encyclopedia that covers thousands of ingredients and kitchen tools. Entries include pictures, descriptions, synonyms, pronunciations, and suggested substitutions. http://foodsubs.com/ - Culinary Schools - Culinary Arts Search Culinary School search engine for cooking and culinary schools. Culinary arts & Le

Food Service Tune-up – pg. 257

Cordon Bleu certification. http://www.culinary-school-search.com/ - Culinary Cooking Schools Institutes - become a culinary genius by attending a top rated culinary cooking institute near you. Apply today at the school of your choice. http://www.culinary-cooking-schools- institutes.com/ - Food and Health.communications - Buy great food and nutrition support materials (posters, pamphlets and more). http://www.foodandhealth.com/products.ph p?cat=15 - Food Service Direct - supplies over 12,000 essential items including foods, cookware, cutlery and paper supplies to restaurant and institutional chefs. http://www.foodservicedirect.com/ - Tex-Mex To Go - This is the place to go to get authentic Mexican food sent to you no matter where you are in the world. http://www.texmextogo.com/ - Cook's Illustrated - "America's Cooking Authority http://www.cooksillustrated.com/ - Busy cooks - Welcome from the Mining Company It's got recipes and everything you would ever want to know about how to successfully freeze food. Very helpful for newbies. http://busycooks.miningco.com/blpyr1.htm - Preserving Food Safely http://www.msue.msu.edu/msue/imp/mod0 1/master01.html XII Resources and References – pg. 258

- Mimi's Cyber Kitchen - (food, cooking, recipes, links, and more) http://www.cyber-kitchen.com/ - Foodies, The Great American Food Festival Online http://www.foodies.com/ - The Kitchen Link - What's cooking on the Net http://www.kitchenlink.com/ - Recipes - Top Secret Recipes on the Web http://www.kitchenlink.com/ - FoodShapes.com An award winning site from a food illustrator and graphic designer who has a variety of digital food images and clip art for your menus and brochures. http://www.foodshapes.com/fsca/fsca.html - Arbor Nutrition Guide http://www.arborcom.com/ - CuisineNet http://cuisinenet.com/home/?v=237 - Diabetic Gourmet Connection http://www.gourmetconnection.com/diabeti c - Dietetics Online http://www.dietetics.com/ - Food and Nutrition Information Center http://www.nal.usda.gov/fnic/ - Foodwine http://globalgourmet.com/ - Gourmet Connection http://gourmetconnection.com/

Food Service Tune-up – pg. 259

Recipes and culinary tips - American Heart Association's "Delicious Decisions". This interactive cookbook provides recipes and eating ideas based on the American Heart Association's adaptation of the Food Guide Pyramid. http://www.deliciousdecisions.org - Baker's Toolbox by Progressive Baker: Recipes and tips for baking from scratch. http://www.progressivebaker.com/formulas/ index.shtm - Better Homes & Gardens: Over 10,000 recipes. Click on "Recipe Center". http://www.bhg.com - California Cling Peach Board: Breakfast, lunch, dinner, and dessert recipes made with peaches. http://www.ccpgab.com/html/nav/foodservi ceTop.html - Canadian Military Recipes. Each recipe in amounts for both 50 servings and 250 servings. http://www.angelfire.com/bc/incredible/milit aryrecipes.htm - Del Monte Foodservice Recipe Search: Recipes featuring Contadina products. http://www.delmonte.com/foodservice/Reci peSearch.asp - Durkee's: Searchable by keyword or menu category. http://www.spiceadvice.com/foodservice/du rkeeNew/productsRecipes/recipes.html - Epicurious Cooking for Health Collection: Nutritious recipes that sacrifice fat, not flavor — featuring a new food each month. XII Resources and References – pg. 260

Browse the archive to find more choices. http://www.epicurious.com/cooking/healthy/ for_health/ - Epicurious Tips from Great Cooks: Take your pick —from how to cut fat and calories to great presentation and garnish ideas to how to microwave food well. http://www.epicurious.com/cooking/how_to /tips/ - Fiber Seekers: From General Mills, this site features tips for adding fiber to the diet, a fiber counter, and recipes using Fiber One. http://www.fiberseekers.com/ - 50+ Friends Club Cookbook: Recipes arranged by category, and flagged as appropriate for Diabetic, Heart Smart, Low Carbohydrate, Low Fat, Low Sodium, and Quick Meal. http://www.50plusfriends.com/cookbook/co okcrowd/index-5a.html - Fish FAQ http://www.wh.whoi.edu/homepage/faq.ht ml

» Food Network: - Recipes: searchable database includes 25,000 recipes, plus menu ideas; a variety of cuisines http://www.foodnetwork.com/food/re_collections/0 ,1977,FOOD_11656,00.html - Cooking: includes encyclopedia of terms and ingredient substitutions index http://www.foodnetwork.com/food/cooking - Video Demos: Watch a video demonstration online — how to carve a turkey, bone a chicken, or peel tomatoes; how to use a knife; how to sharpen a

Food Service Tune-up – pg. 261 knife. Requires a plug-in such as Quick-Time or Real Player. http://www.foodnetwork.com/food/ck_demos/

- Food Reference: A collection of recipes, plus food history, stories, humor, crossword puzzles, quotations, and trivia. http://www.foodreference.com - Food Resource: This site, maintained by Oregon State University, abounds with food- related reference. Check it for recipes and all kinds of information about food, from safety to phytochemicals. http://food.oregonstate.edu/food.html - French's Recipe Center: Searchable collection of recipes using French's products. http://www.frenchs.net/recipe/frenchs/brow serecipe.jsp - Global Gourmet - Destinations: Tips, recipes, and ideas for menu events inspired by the cultures of Mexico, China, India, South Africa, Italy, Brazil, and many other countries. http://www.globalgourmet.com/destinations / - Growlies for Groups: Large quantity recipes. http://www.members.tripod.com/~lotsofinfo /index.html - Healthcare Holiday Cooking (article from US Foodservice Healthnext) http://www.usfoodservice.com/flash/service s/ archive/healthnext/winter_2001/article5.htm l XII Resources and References – pg. 262

- Hot Trends in Catering (article from US Foodservice Healthnext) http://www.usfoodservice.com/flash/service s/ archive/healthnext/summer_2001/article7.ht ml - Indian Harvest Foodservice: Recipes using grain, rice, pasta, beans & lentils. http://foodservice.indianharvest.com/s.nl/sc. 9/.f - Naval Logistics Library Recipe Repository: http://www- nehc.med.navy.mil/hp/nutrit/RECIPES/ - Northarvest Bean Growers Association: College Foodservice Recipes. http://www.northarvestbean.org/html/colleg erecipes.cfm - Recipezaar: Anyone can join this site, post favorite recipes, and access all recipes posted by other members. http://www.recipezaar.com/ - Riceland Foodservice: Recipes using rice. http://www.riceland.com/food_service/rice/r ecipes/ - SYSCO Recipes: Search recipes by keyword or browse by category. http://www.sysco.com/recipes/recipes.html - Tone's Club: Searchable by keyword, product used, or menu category. http://www.tones.com/recipes.php - Top Secret Recipes: An online sleuth comes up with unofficial clones of famous recipes — from Hard Rock Cafe coleslaw to thin mint Girl Scout cookies! Very fun, and an

Food Service Tune-up – pg. 263

interesting site to browse. http://www.topsecretrecipes.com - University of Maine Cooperative Extension: Quantity Cooking in a Shelter Setting: 7 recipes that will feed 50 or 100 people. http://www.umext.maine.edu/emergency/9 007.htm

Associations - American Hospital Association http://www.aha.org/aha/index.jsp - American Dietetic Association (ADA) http://www.eatright.org/Public/ - American Meat Institute (AMI) http://www.meatami.com/ - American Medical Association (AMA) http://www.ama-assn.org/ - Council of Hotel and Restaurant Trainers (CHART) http://www.chart.org/ - Dietary Managers Association (DMA) http://www.dmaonline.org/index.html - Food Marketing Institute (FMI) http://www.fmi.org/ - Grocery Manufacturers of America (GMA) http://www.gmabrands.com/ - Institute of Food Technologists (IFT) http://www.ift.org/ - International Dairy Federation (IDF) http://www.fil-idf.org/ - International Dairy Foods Association (IDFA) http://www.ifda.org/ XII Resources and References – pg. 264

- National Association of College and University Food Services (NACUFS) http://www.nacufs.org/ - National Cattlemen's Beef Association http://www.beef.org/ - National Food Processors Association (NFPA) http://www.nfpa-food.org/index.html - National Pest Control Association (NPCA) http://www.pestworld.org/ - National Pork Producers Council (NPPC) http://www.nppc.org/ - National Restaurant Association (NRA) http://www.restaurant.org/ - National Restaurant Association Educational Foundation http://www.nraef.org/ - North American Association of Food Equipment Manufacturers http://www.nafem.org/ - Northwest Ohio Dietary Managers Association http://www.nwdma.com/ - Produce Marketing Association (PMA) http://www.pma.org/ - United States National Dairy Database http://www.inform.umd.edu/EdRes/topic/eg renv/ndd - Women Chefs and Restaurateurs http://www.womenchefs.org/

Food guide pyramid - Food Guide Pyramid Update: Press release, backgrounder, development and reassessment process, Q&A, resources

Food Service Tune-up – pg. 265

http://www.usda.gov/cnpp/pyramid- update/FGP%20docs/Additional%20Info.ht ml - Food Guide Pyramid development of the 2005 Dietary Guidelines for Americans (sixth edition) http://www.health.gov/dietaryguidelines/dg a2005/default.htm - Proposed Daily Food Intake Patterns for the Food Guide Pyramid http://www.usda.gov/cnpp/pyramid- update/index.html - USDA News Release: Scientific Update of Food Guidance Presented to Dietary Guidelines Committee, January 28, 2004 http://www.usda.gov/Newsroom/0049.04.ht ml

Additional resources - Agricultural Research Service http://www.ars.usda.gov/ - Agricultural Works Online http://www.agworks.com/ - American Council on Science and Health http://www.acsh.org/ - ARS/USDA Index of Food and Nutrition Internet Resources http://www.nal.usda.gov/fnic/etext/fnic.html - Codex Alimentarius http://www.codexalimentarius.net/ - Food and Drug Law Institute http://www.fdli.org/ - Food Institute http://www.foodinstitute.com/ XII Resources and References – pg. 266

- Healthy Youth! Health Topics Nutrition Links http://www.cdc.gov/healthyyouth/nutrition/l inks.htm - The Water Quality Information Center http://www.nal.usda.gov/wqic - USDA-FDA HACCP Training Programs http://www.nal.usda.gov/fnic/foodborne/hac cp/ - C.H.I.P.S. (foodservice books and videos) http://www.chipsbooks.com/

Health departments and restaurants associations - American Public Health Association and Public Health Resources http://www.apha.org/ - National Environmental Health Association http://www.neha.org/ - USDA Office of Public Health and Science http://www.fsis.usda.gov/OPHS/ophshome. htm - Public Health Practice Program Office http://http://www.phppo.cdc.gov/ - British Medical Journal http://www.bmj.com/index.html

Food safety resources - CDC Division of Bacterial and Mycotic Diseases http://www.cdc.gov/ncidod/dbmd/ - Centers for Disease Control and Prevention http://www.cdc.gov/ - Code of Federal Regulations (CFR) http://www.gpoaccess.gov/cfr/index.html

Food Service Tune-up – pg. 267

- FDA Bad Bug Book http://www.cfsan.fda.gov/~mow/intro.html - FDA-CFSAN Pesticides, Metals, and Chemical Contaminants http://www.cfsan.fda.gov/~lrd/pestadd.html - FDA Plan Review Guide http://www.cfsan.fda.gov/~dms/prev- toc.html - FDA Retail Food Protection References http://www.cfsan.fda.gov/~ear/retail.html - FDA Seafood Information and Resources http://www.cfsan.fda.gov/seafood1.html - FightBAC! http://www.fightbac.org/ - Food and Drug Administration http://www.fda.gov/ - FoodNet http://www.cdc.gov/ncidod/dbmd/foodnet/ - Microbionet http://www.microbionet.com.au/ - National Agricultural Library (USDA) http://www.nalusda.gov/ - National Center for Food Safety and Technology http://www.iit.edu/~ncfs/ - National Food Safety Database http://www.foodsafety.gov/ - Sterigenics (irradiation) http://www.sterigenics.com/ - USDA http://www.usda.gov/

XII Resources and References – pg. 268

Magazines Consider subscribing to the following magazines… check to see if your organization already receives them and ask to get on the internal routing list.

- Food Service Director is a magazine covering the food and beverage Business. It reports on the news, issues, ideas and trends that are impacting the non- commercial foodservice operations. - Restaurants & Institutions describes itself as the foodservice industry's most trusted source for food and business trend information and exclusive research. It is published 18 times a year. - Food Management magazine offers a free subscription. It reports on industry issues and events, operational topics and food trends that affect the non-commercial foodservice industry. - Catersource Magazine describes itself as the nation's leading and largest trade publication focusing on the latest in education, products and news for professional caterers. - Foodservice Equipment & Supplies Magazine is for dealers and distributors of foodservices equipment and supplies and people who design foodservice facilities and specify equipment and supplies for multi- unit chain operations.

Food Service Tune-up – pg. 269

For even greater enjoyment, feats you eyes on these additional accompaniments:

» Joint Commission checklist

» Food Code quick reference

» Glossary of terms and acronyms

» Footnotes

» References and sources cited Joint Commission checklist – pg. 270

Joint Commission checklist

JCAHO Mock Survey Date Document inadequate STATEMENT Standard Review to assess compliance compliance Nutritional status is assessed P.E. 1.2 Nutrition care policy when warranted by the patient’s needs or condition. Nutrition screening criteria (general, OB, Peds, Psych, ambulatory) Each admitted patient’s initial Assessment & Care Planning assessment is conducted within a time frame specified by hospital policy. P.E. 1.7 Time frames for assessments and follow ups Diet Manual The patient’s history and physical P.E. 1.7.1 all units signed, updated yearly examination, nursing assessment, and other screening assessments are completed within 24 hours of admission as Each patient is reassessed at P.E. .2 Clinical policies reviewed and signed off points designated in hospital yearly by DDS, CNM, and Medical Representative. policy. Staff members integrate the P.E. 3 Medical record review information from various assessments of the patient to identify and assign priorities to his or her care needs. - Date, time, signature, and title The hospital has defined patient P.E. 4 - Time frames (screening, initial, assessment activities in writing. and follow up) - Education needs/completed(to include diet and drug/nutrient interaction) - Charting format The hospital defines the scope of P.E. 4.1 - Evidence of interdisciplinary assessment performed by each care discipline. - Evidence of follow through with care plan and treatments Individualized assessments for P.E. 5 - Individualized age specific care infants, children, and planning. adolescents.

Food Service Tune-up – pg. 271

Document inadequate STATEMENT Standard Review to assess compliance compliance Each patient’s nutrition care is TX. 4 planned. An interdisciplinary nutrition TX.4.1 therapy plan is developed and periodically updated for patients at nutritional risk. Each patient’s response to TX.4.5 nutrition care is monitored. Nutrition care practices are TX.4.7 standardized throughout the organization. When appropriate to the patient group served by a unit, meals and snacks support program goals.

Authorized individuals prescribe or order food and nutrition products in a timely manner.

Responsibilities are assigned for all activities involved in safe and accurate provisions of food and nutrition products.

Food and nutrition products are distributed and administered in a safe, accurate, timely, and acceptable manner. Review results of division Environmental Audit performed by DFNS.

Joint Commission checklist – pg. 272

Document inadequate STATEMENT Standard Review to assess compliance compliance The nutrition care services meets patients’ needs for special diets and accommodates altered diet schedules. Nourishments are labeled and dated and comply with diet order. Nourishments are distributed 3 times daily.

Nourishments beyond expiration date are not observed in the unit kitchens.

Menus, diet orders, and nourishments are updated in the cardex prior to each service period.

Written physician order matches the meal served the patient.

Each tray identifies the patient name, room, and diet order.

Employees are wearing hair restraints and gloves. Items transported out of the department are wrapped or covered. TX. 4.1.1 Hot foods maintained in heated holding boxes are within temperature ranges of 160 ° to 180° for no longer than 1 hour. Patient meal service times are posted and followed. TX.4.2

Serviceware is clean, free of cracks, chips, and stains. Menu substitution log is maintained and signed by dietitian. TX. 4.3

Temperatures are recorded prior to meal service and foods are tasted. The supervisor completes a pre-meal service Plate and base warmers are operational and in use. TX.4.4 Shelving is free of rust and food debris. Items are removed from the boxes to promote airflow. Defrosting area is easily identifiable. Defrosting raw product is stored on the lowest shelf possible and away from cooked food.

Food Service Tune-up – pg. 273

Document inadequate STATEMENT Standard Review to assess compliance compliance TX.4.6 Floors and walls are in good condition.

Food is stored off the floor.

Dry storage temperature range from 50° to 70° as indicated on the storeroom thermometer. Storage rooms are dry, clean, and orderly.

Products are stored 6 inches from the floor and 18 inches from the ceiling. All inventories is dated and rotated.

Chemicals are stored separately from food supplies. Dented cans are stored in a designated area identified with signage. Cold storage areas contain 2 back-up thermometers and accurate readings for 40° F (refrigerators) and 0° F (freezer). Safety-release mechanisms on cold-storage walk-ins are operational. Dripping and condensation is not evident near stored food. Door shields are used if condensation is a problem. The leaders ensure that the competence of all staff members is assessed, maintained, demonstrated, and improved continually. HR.3 Randomly select 3 hourly, 1 supervisory, and 1 clinical personnel file and verify that the files contain the appropriate information.

An orientation process provides The 5 areas surveyors look at are: initial job training and information and assesses the staff’s ability to fulfill specified responsibilities.

1. Job specific orientation (competency) for any new hire since 1994 Ongoing in-service and other 2. Job description education and training maintain and improve staff competence.

Joint Commission checklist – pg. 274

Document inadequate STATEMENT Standard Review to assess compliance compliance 3. Performance Appraisal completed on a timely manner based on hospital or Wood Company policy. The hospital assesses each staff HR.4 4. Age-specific competencies for member’s ability to meet the any position with patient contact. performance expectations stated in his or her job description. 5. Credentials to include RD, CDE, CDM etc. Job descriptions and performance appraisal forms currently reflect each position and have been reviewed within the last 2 years. HR.4.2 Disciplinary action forms are completed according to Company (or hospital) policies and procedures. Discipline is progressively and clearly states expected outcomes for each counseling session. Competency forms are completed for clinical staff members on a quarterly basis and retained in the personnel file to support performance appraisal. HR.5 LD.2.4 Fire drills are conducted EC.2.10 Fire extinguishing equipment is serviced regularly. annually and verified by currently dated tag. A nonsmoking policy is EC.5 Ventilation exhaust ducts over cooking communicated and enforced equipment are professionally serviced every 6 months and labeled with the service throughout all buildings. date and signature of service employees. The department complies with the facility’s smoking policy. Verbally review policy. Sprinkler heads are unobstructed by equipment or boxes. Emergency exits and signage are clearly visible and unobstructed. The hospital takes action to IC.4 In-services for infection control. prevent or reduce the risk of nosocomial infections in patients, employees, and visitors. The hospital takes action to Food Service Director or designee attends control outbreaks of nosocomial Infection Control Committee and Safety Committee per hospital policy. infections when they are identified. Policies & Procedures for prevention of food borne illness blood borne pathogens, and Universal Precautions. IC.5 Policy and procedure for insuring employees are without open wounds or illness.

Food Service Tune-up – pg. 275

Document inadequate STATEMENT Standard Review to assess compliance compliance Patients are educated about PF .1 .5 All teaching materials are professionally potential drug-food interactions, prepared and reflect currently accepted professional practices. Resources are and provided counseling on published within the last 5 years. nutrition and modified diets.

Food – medication interactions are prevented by substitution of specified foods for more appropriate foods from the same food group.

Food/Drug Policy is documented in department P&P. All involved departments have signed off on the policy. The hospital ensures that CC. 7 Discharge policy. appropriate patient care and clinical information is exchanged when patients are admitted, referred, transferred, or discharged.

______Verify in medical record. Verbal orders of authorized individuals are accepted and transcribed by qualified personnel who are identified by title or category in the medical staff rules and regulations. Every medical record entry is dated, its author identified, and when necessary, authenticated.

A qualified professional with IM. 7. 7 Policy appropriate clinical training and experience is responsible for the clinical direction of patient care.

Verify in medical record. IM. 7. 8

LD. 2.11.2

Joint Commission checklist – pg. 276

Document inadequate STATEMENT Standard Review to assess compliance compliance The hospital has a planned, PI.1 Review department PI program. systematic, hospitalwide approach to process design and performance measurement, assessment, and improvement.

The needs, expectations, and satisfaction of patients; and

Staff views regarding performance and improvement opportunities.

PI.3.2.5 Satisfaction surveys are completed and corrective actions are taken and documented. Data on important processes and outcomes are also collected from quality control programs. The hospital systematically PI.3.2.6 improves its performance. Directors continuously assess ______Evidence of documentation when outcomes and improve their department’s __ do not meet standards. performance. PI.3.3.3

Directors maintain appropriate Employee teams are in place and utilized quality control programs. as the basis for unit performance improvement processes. Directors recommend space and Review all quality control manuals other resources needed by the (temperature logs and pre-meal checklists). Assess for completeness and follow up department. when problem documented. PI.5

Confidentiality, security, and integrity of data and information LD.2.6

LD.2.7

Review department policy. Question employees. LD.2.9

IM.2

Food Service Tune-up – pg. 277

Food Code quick reference Food Code reference Pg. 1

• Glove use limitations-single use gloves Equipment, Utensils and Linens Management and Personnel • Clean tableware for second portions & Materials for Construction and Repair Employee Health refills • Multi-use utensils and food contact • Reporting of diseases and medical • Refilling returnables surfaces-corrosion resistant, smooth, conditions • Food storage-clean, dry, 6-inches up easily cleanable, resistant to pitting, • Exclusions and restrictions • Prohibited food storage areas chipping • Removal of exclusions and restrictions • Vended PHF’s in original container • Cast iron • Employee reporting of illness • Preventing contamination during • Lead in ceramic, china, and crystal • PIC reporting to Health Department preparation • Copper • Preventing contamination by consumers • Galvanized metal Personal Cleanliness of food displays (sneeze guards, etc.) • Sponges • Hands and arms clean • Condiments-protection • Lead in pewter alloys • Hand washing procedure • Consumer self service operations • Lead in solder and flux • When to wash hands (Suitable utensils, buffets monitored) • Wood • Hand washing at hand sinks only • Returned and re-service of food • Non-stick coatings-utensils and cleaning • Prep sink • Miscellaneous sources of contamination • Non-food contact surfaces-construction • Hand sanitizers • Single-service and single use articles- • Fingernails Destruction of Food Organisms materials for construction • Jewelry • Cooking temperatures • Outer clothing • Microwave cooking Design and Construction • Plant food cooking for hot holding • Durability and Strength Hygiene Practices • Parasite destruction-freezing • Food thermometers-construction • Eating, drinking, tobacco use • Records retention-freezing • Food contact surfaces-clean ability • Discharge from eyes, nose, mouth • Reheating for hot holding • CIP equipment-clean ability • Hair restraints • V-threads • Handling animals Limitation of Growth of Organisms • Hot oil filtering equipment-clean ability • Frozen foods stored frozen • Can openers-contact surfaces-clean ability Supervision [Person in charge] • PHF’s-slacking • Kick plates-removable • PIC-present on site • Thawing-temperature and time control • Ventilation hood systems-filters removable • PIC-demonstration of knowledge • Cooling temperatures and time • Food thermometers-accuracy • PIC-duties • Cooling methods/loosely unwrapped sheet • Air and water thermometers-accuracy • PHF-hot and cold holding temperatures • Pressure gauges-accuracy Food • RTE PHF’s-date marking(day product is • Ventilation hood systems-drip • Sources-hermetically sealed container opened is day one) presentation • Sources, Specifications, and Original • Discarding of RTE PHF’s • Equipment openings, closing, and Containers • Time in lieu of temperature deflectors • Source-milk and milk products • Variance for processing • Dispensing equipment-protection of • Source-fish • Reduced oxygen packaging equipment and food • Source-molluscan shellfish • Vending machines-self closing door or • Source-wild mushrooms Identify, Presentation, and on cover • Game animals-source Premises Labeling • Bearings and gear boxes leak proof • Temperatures-receiving-hot and cold • Standards of identity • Beverage tubing not in contact with ice • Food additives • Honestly presented • Waste drains may not pass through ice • Shell eggs clean and sound • Food labels bins • Eggs and milk products pasteurized • May not conceal manufacturer dates • Condenser unit separated • Package integrity • Consumer advisory for raw or • Can openers on vending machines • Ice for cooling from potable water undercooked PHF • Molluscan shellfish tanks • Shucked shell fish-packaging and ID • Vending machines-automatic shut off • Shell stock-condition upon receipt Discarding or Reconditioning Unsafe, • Thermometers in hot and cold holding • Molluscan shell fish-original container Adultered, or Contaminated Food units • Shell stock-maintaining identification • Unsafe, adultered, or not honestly • Ware washing machine-date plate presented • Ware washing machine-pressure gauge Protection from Contamination • Not from approved source • Sinks and drain boards-self draining • Preventing contamination from hands • RTE food contaminated by employee • Equipment compartments-drainage -no bare hand contact with RTE foods • Food contaminated by employees, • Vending and bulk water machines-liquid -minimize contact with other foods consumers, or other employees through waste products • Preventing contamination when tasting contact with hands, bodily discharge, or • Case lot handling equipment-movability • Preventing contamination by separation, other means • Vending and bulk water doors and packaging, and cross contamination openings • Food containers labeled Special Requirements for Highly • Food equipment certification (NSF) • Substitution of pasteurized for raw eggs Susceptible Persons • Protection from unapproved additives • Prepackaged juice with warming labels (Food or color additives, sulfiting agents) may not be served Numbers and Capacities • Washing fruits and vegetables • Food in unopened original containers may • Sufficient cooling, heating, and holding • Ice as coolant prohibited as ingredient not be reserved equipment • Storage of food in contact with ice • Partially cooked PHF’s and raw sprouts • Manual three-sink compartment • Food contact with equipment and utensils • Substituting pasteurized for raw eggs requirements -only contact clean surfaces • Storage for clean and dirty dishes • In-use utensils between-use storage • Ventilation hood system adequate • Linens limited use as food contact • Washer and dryer provided • Wiping cloths If you apply for CEUs, you can receive the full-size Food Code quick reference from Innovations Services.com Food Code quick reference – pg. 278

Food Code reference Pg. 2

• Dispensing utensils for each item on • Air-drying locations for wiping cloths • Attachments to walls and ceilings buffet • Lubricating food contact surfaces • Studs, joists, and rafters may not be • Food thermometer provided • Reassembling equipment exposed • Thermometers for manual ware washing • Storage of equipment, utensils, linen, and • Light bulbs shielded • Test kit for sanitizers single-service articles, 6” up • HVAC vents • Prohibited storage areas • Insect control devices-design and • Kitchenware and tableware –handling, installation dispensing, and displaying • Toilet rooms-self closing doors Location and Installation • Soiled and clean tableware handling • Outer openings protected • Spacing or sealing of fixed equipment • Present tableware-removed • Exterior walls and roof-protective barrier • Elevating or sealing fixed equipment • Outdoor vending areas-overhead Plumbing System protection Maintenance and Operations • Hand washing facility-installation (110 • Outdoor service areas-overhead • Equipment-good repair degrees F) protection • Cutting surfaces-food condition • Back flow prevention-air gap • Walking and driving surfaces graded to • Microwave ovens • Back flow prevention device-design drain • Cleaning frequency of three equipment • Conditioning devices (filters, softeners) • Refuse areas curbed and graded to drain • Ware washing machines-operation • Hand washing facilities-number according to manufacturer’s instructions • Back flow prevention device required Numbers and Capacities • Ware washing sinks-use limitations • Carbonator- back flow prevention • Hand soap available • All sinks but mop three compartment sink • Hand washing sinks-location and • Hand towels/dryer available • Ware washing-cleaning agents placement • Soap and pt prohibited at other sinks • Ware washing-solution clean • Back flow prevention device-location • Hand washing signage • Manual wash temperatures • Conditioning device-location • Toilet paper available • Mechanical wash temperatures • Hand washing sinks accessible, use limits • Lighting intensity • Manual hot water sanitation (171 degrees • Prohibiting cross connections • Sufficient ventilation F) • Dressing areas and lockers necessary • Mechanical hot water sanitation Refuse, Recyclables and Returnables • Service sink-availability • Mechanical sanitation pressure • Indoor storage area • Junk in mop sink • Sanitizer concentrations • Outdoor storage area-concrete or asphalt • Combined detergent-sanitizers • Outdoor enclosure Location and Placement • Testing sanitizer concentration with kits • Receptacles-design • Hand sinks conveniently located • Utensils, thermometers, and gauges • Receptacles in vending machines • Toilet rooms convenient and accessible maintained, calibrated, and accurate • Outside receptacles-design • Employee facilities-location area • Single-service/use articles if no ware • Capacity of outdoor and indoor • Distressed food-segregation and location washing receptacles; available in food areas • Single-service/use articles may not be and next to hand sinks Maintenance and Operation reused • Women’s restroom receptacle covered • Physical facilities maintained in good • Cleaning supplies available for receptacles repair Cleaning of Equipment and Utensils • Storage areas/receptacles for waste • Cleaning frequency of physical facilities • Equipment fc and nfc surfaces and located to prevent contamination • Cleaning floors-dust less methods utensils clean or nuisance • Cleaning HVAC systems-vents and air • Pizza, pots and pans • Receptacles inaccessible to insects and returns • Cleaning frequency of fc surfaces and rodents • Maintenance tools may not be cleaned in utensils • Garbage in cans hand, prep, or dish sinks, or disposal of • Cooking equipment-cleaning frequency • Areas, enclosures, and receptacles-good mop water • NFC surfaces-cleaning frequency repair • Drying mops • Dry-cleaning methods (brushing, • Outside storage prohibitions • Limited use of absorbent materials on scrapping) • Receptacles covered floors • Cleaning methods • Drain plugs in place • Hand sinks cleaned and maintained • Loading of ww-large or fixed equipment • Areas and enclosures free of unnecessary • Toilet room doors closed • Rinsing procedures items and clean • Using dressing rooms and lockers • Returnables-cleaning for refilling • Cleaning receptacles-methods and • Controlling pests frequency • Removal of insects, rodents etc., from Sanitizing of Equipment and Utensils • Removal frequency premises and devices • FC surfaces and utensils shall be sanitized • Methods of removal • Storing maintenance tools, mops, brooms • Frequency of sanitizing FC surfaces • Approved disposal/recycling facilities • Unnecessary items and litter • Methods of hot water and chemical • Prohibiting animals sanitizing-exposure times Physical Facilities Materials for Construction and Repair Poisonous or Toxic Materials Laundering • Materials for floors, walls, and ceilings, Labeling and Identification • Clean linens smooth and easily cleanable • Original containers-labeled • Frequency of laundering • Floors, walls and ceilings designed, • Working containers-common name • Cloth gloves constructed and installed to be smooth • Sanitizer buckets • Storage of soiled linens and easily cleanable Operational Supplies and Applications • Mechanical washing • Exposed utility lines • Storage separation • Limited use of laundry facilities • Floor and wall junctures-covered and • Restriction-only chemical needed onsite sealed • Toxic chemicals used according to law Protection of Clean Items • Mats and duck board removable and and • Air-drying required for equipment and easily cleanable Applied to prevent contamination utensils • Wall and ceiling-coverings and coatings • Toxic containers may not be used for food

Food Service Tune-up – pg. 279

Food Code reference Pg. 3

• Approved sanitizers under conditions of nonrefrigerated storage conditions of non-refrigerated • Chemicals for washing produce and distribution; a food for which laboratory storage and distribution; • Boiler water additives evidence demonstrates that the rapid and (v) a food for which laboratory • Drying agents-criteria progressive growth of infectious or toxicgenic evidence demonstrates that the • Lubricants-criteria microorganisms or the growth of Salmonella rapid and progressive growth of • Restricted use pesticides-criteria Enteritidis in eggs or Clostridium botulinum can infectious or toxicgenic • Rodent bait stations contained not occurs, such as food that has an a and a microorganisms or the growth • Tracking powders pH that are above the levels specified under of Salmonella Enteritidis in eggs • Medicines-restrictions and storage paragraphs (B)(70)(c)(ii) of this rule and that or Clostridium botulinum can • Refrigerated medicines-storage may contain a preservative, other barrier to the not occurs, such as food that • First aid supply-storage growth of microorganisms, or a combination of has an a and a pH that are • Personal care items-storage barriers that inhibit the growth of above the levels specified under Stock and Retail Sale-Separation microorganisms. A food that does not support paragraphs (B) (70) (c) (ii) of • Separation by spacing the growth of microorganisms as specified this rule and • Chemicals below food under

(vi) that may contain a Terms: Explained preservative, other barrier to the growth of microorganisms, “Highly susceptible population” means or a combination persons who are more likely than other people in the general population to experience food paragraph (B) (70) (a) of this rule even though borne disease because they are the food may contain an infectious or immunocomprised; preschool age children, or toxicgenic older adults; and obtaining food at a facility (vii) of barriers that inhibit the that provides services such as custodial care, growth of microorganisms. health care, or assisted living, such as a child (viii) A food that does not support or adult day care center, kidney dialysis center, the growth of microorganisms hospital or nursing home, or nutritional or as specified under paragraph socialization services such as a senior center. Microorganism or chemical or physical (B)(70)(a) of this rule even Highly susceptible population” mean persons containment at a level sufficient to cause though the food may contain an who are more likely than other people in the illness. infectious or toxicgenic general population to experience food borne microorganism or chemical or disease because they are: physical containment at a level (a) immunocomprised; preschool age “Highly “Potentially Hazardous Food” sufficient to cause illness. children, or older adults; and (a) Means a food that is natural or synthetic (b) obtaining food at a facility that provides and that requires temperature control services such as custodial care, health because it is in a form capable of care, or assisted living, such as a child or supporting: adult day care center, kidney dialysis (i) The rapid and progressive growth of “Utensil”: temperature sensing probes of food center, hospital or nursing home, or infectious or toxicgenic microorganisms; temperature measuring devices; and probe- nutritional or socialization services such as (ii) The growth and toxin production of type price or identification tags used in contact a senior center . Clostridium botulinum; or with food. (iii) in raw shell eggs, the growth of Salmonella Enteridis. Person in Charge- demonstration of “Potentially Hazardous Food” means a food knowledge that is natural or synthetic and that requires (b) Includes a food of animal origin that is The person in charge shall demonstrate temperature control because it is in a form raw or heat-treated; a food of plant origin this knowledge of compliance with this capable of supporting the rapid and that is heat-treated or consists of raw chapter, by having no critical violations progressive growth of infectious or toxicgenic seed sprouts; cut melons; and garlic-in-oil during the current inspection, or by being microorganisms; the growth and toxin mixtures that are not modified in a way certified in food protection as specified in production of Clostridium botulinum, or in raw that results in mixtures that do not rue 3701-21-25 of the Administrative shell eggs, the growth of Salmonella Enteridis. support growth as specified under Code, or by responding correctly to the This includes a food of animal origin that is raw paragraph (B)(70)(a) of this rule. inspector’s questions as they relate to or heat-treated; a food of plant origin that is (c) Does not include: the specific food operation. heat-treated or consists of raw seed sprouts; (i) air-cooled hard-boiled egg with shell cut melons; and garlic-in-oil mixtures that are intact, or a shell egg that is not not modified in a way that results in mixtures hard-boiled, but has been treated to A two-compartment sink may not by used for that do not support growth as specified under destroy all viable Salmonellae; ware washing operations where cleaning and paragraph (B)(70)(a) of this rule. This does (ii) a food with an a value of 0.85 sanitizing solutions are used for a continuous not include an air-cooled hard-boiled egg with or less; or intermittent flow of kitchenware or shell intact, or a shell egg that is not hard- (iii) a food with pH level of 4.6 or tableware in an ongoing ware washing boiled, but has been treated to destroy all below when measured at process. viable Salmonellae; a food with an a value of seventy-five degrees Fahrenheit 0.85 or less; a food with pH level of 4.6 or (twenty-four degrees Celsius); below when measured at seventy-five degrees (iv) a food, in an unopened Fahrenheit (twenty-four degrees Celsius); a hermetically sealed container, food, in an unopened hermetically sealed that is commercially processed container, that is commercially processed to to achieve and maintain achieve and maintain commercial sterility commercial sterility under

Glossary of terms and acronyms – pg. 280

Glossary of terms and acronyms A fresh basket of terminology…

AHA American Hospital Association AOA American Osteopathic Association; organization of osteopathic physicians; credentialing body accredits participating medical schools and hospitals BLS Bureau of Labor Statistics Broadline Distributor Broadline distributors try to offer a full line of products for the food service industry. They attempt to be a one-stop shop source for all the main items such as meat, produce, groceries, canned and dry items, chemicals, paper supplies and small equipment. CCRC Continuing Care Retirement Community; usually consists of homes or apartments for independent living; rooms or studios for those who need some assistance with activities of daily living; and a long term care facility for those who need higher levels or care; contracts often require residents to stay within the community for lifetime needs CDM Certified Dietary Manager – certified managers have completed a basic foodservice management and clinical nutrition course, have passed a national exam and are certified by the Dietary Managers Association, are required to participate in continuing education to maintain certification CFPP Certified Food Protection Professional – certification is through Dietary Managers Association, requires 5 hours continuing education every three years CPI Consumer Price Index

Food Service Tune-up – pg. 281

Can cutting Sampling products for purchase and to check that you are getting a product that meets your specifications. Literally it is to open a can and check for overall quality, taste, texture and appearance followed by your evaluation. Contracts By definition a contract is an agreement between two or more parties, especially one that is written and enforceable by law Cost-plus pricing This pricing method takes into account cost as defined in the contract (most contracts have specific clauses that define “cost”) plus a percent over the cost to arrive at the final price. Cycle Menu A menu that covers a number of days or weeks and begins at the beginning at the end of the menu; for example, an 8 day cycle would begin with day one on the 9th day; a 4 week cycle would begin again with week one after the last day of week four DCF Discounted cash flow (DCF) is a way to calculate the dollar value of a project or investment that takes into consideration the time value of money—a dollar received today is worth more than a dollar received next year. All future cash flows are estimated and discounted by an interest rate that reflects the risk of the investment to give them a present value. When you deduct the cost of making the investment from the present value, you get the net present value (NPV). Dead stock items purchased for a special event or previous menu cycle that are no longer used; these should have a designated storage area (shelf) so they don’t interrupt the order/inventory flow Demographic A portion of a population as defined by characteristics such as age, ethnicity, medical condition, income, geography, occupation or interests. DHCFA Distinguished Healthcare Foodservice Administrator Glossary of terms and acronyms – pg. 282

Edible yield factor This is how much remains after preparation. Terms in this include AP (as purchased), which is the amount at purchase, and EP (edible portion), which is the amount, left after preparation. Your edible yield factor is expressed by the following calculation: EP ÷ AP. FIFO First In First Out as in a storeroom, the first can of tomatoes put in the storeroom should be the first one out of the storeroom Forecasting The process of estimating future needs and how much to order so you can tie your existing inventory with what your cooking efforts remove from the shelves. GPO Group Purchasing Organization; several customers or a contractor representing several different facilities who join together to negotiate pricing and service considerations that would not be available to any of the individual organizations; examples include Premier and SRA as well as many regional organizations Group purchasing Several businesses and/or institutions with similar interests come together by combining their purchasing activities in order to achieve savings through volume buying. The groups’ purchasing power is increased only when the volume of purchases for the group is significantly larger than it would be for individual facilities. HACCP Hazard Analysis Critical Control Point – a seven step process recommended for use in the storage, service and preparation of food to assure its safety HFAP Healthcare Facilities Accreditation Program of the American Osteopathic Association; surveys participating healthcare facilities whose physician base practices osteopathic medicine; participation is voluntary HIGPA Health Industry Group Purchasing Association IRR The Internal Rate of Return (IRR) is a measurement similar to an interest rate that states the annualized compound yield that can be earned on

Food Service Tune-up – pg. 283 invested capital. A project is a good investment if its IRR is greater than the yield from alternate investments (investing in other projects, buying bonds or putting money into a bank account). Individual Rights Medicare and Medicaid have regulations outlining respect for individual rights. These industry-specific standards and regulations apply to certain types of institutions including many in healthcare Intranet: An intranet is a private network that is contained within an enterprise. The main purpose of an intranet is to share company information and computing resources among employees. An intranet can also be used to facilitate working in groups and for teleconferences. Inventory The ongoing maintenance of your facility’s list of goods and materials, or the actual goods and materials held in order to deal with the fact that the delay in producing food is longer than the delay in delivery and serving. Inventory valuation This is the dollar value of an item, specific category or everything on hand at a given point in time represented in a dollar figure. JCAHO Joint Commission on the Accreditation of Healthcare Organizations; surveys participating healthcare facilities according to current standards of participation; participation is voluntary LD Licensed Dietitian, requirements for licensure are defined by state licensure laws and vary from state to state with a few states still not requiring licensing of nutrition professionals LOS Length of stay - a term commonly used to measure the duration of a single episode of hospitalization. Inpatient days are calculated by subtracting day of admission from day of discharge. However, persons entering and leaving a hospital on the same day have a length of stay of one Glossary of terms and acronyms – pg. 284

List-minus pricing This pricing method uses the distributors’ established price list minus a contractually defined percent. Typically chemicals and beverage systems are offered at list-minus pricing while most other things are cost-plus pricing. MRI Magnetic Resonance Imaging – a highly detailed scan of a body area needing diagnosis Menu spreadsheet Shows the list of menu items approved for specific diets, usually by day or menu cycle. Must be approved by RD. Substitutions for these menu items must be logged. NSF National Sanitation Foundation – certifies construction of utensils, small and capital equipment as meeting standards for ability to clean properly NPV Net present value (NPV), is way to calculate the dollar amount in today’s money, of the benefits of a long- term project. It is used to compare competing projects and to estimate the economic benefit of a capital budget or purchase. Ombudsman person not affiliated with a healthcare provider who serves as resident advocate in the investigation and resolution of complaints expressed by or on behalf of a resident in a healthcare facility Order Guide a list of all items to be purchased in order to produce your menu and maintain your department in a safe and sanitary condition; most useful when the order guide is customized to the menu cycle PIC Person in charge as required by Food Code surveyors P&P Policy and Procedure individual or a series in a manual that describes what needs to be done and the process for doing it Par Setting a minimum purchase amount to store till needed – most items with a par level are not perishable

Food Service Tune-up – pg. 285

Prime vendor a supplier with whom you have an agreement (usually a contract) to be your primary supplier of a specified item or line of items RD Registered Dietitian, have completed a BS degree in dietetics and a dietetic internship and passed a national registration exam. Registration is coordinated and monitored by the Commission on Dietetic Registration of the American Dietetic Association; requires continuing education in enhancing skills in area of practice RFP Request for Proposal as in asking a supplier to bid on items that you wish to purchase Reference cut a portion of a menu cut as an example for service staff to use as a guide when portioning Retherm Heating process that brings an already cooked item back to serving temperature ServSafe A food safety program sponsored by the National Restaurant Association Education Foundation Sheet-to-shelf Items in storage are arranged in the same sequence in which they appear on the physical inventory sheet Shrinkage Theft Skip day is the practice of ordering food one day ahead of your order day cut off. This allows you to have advance knowledge of out of stock items and allows you to decide on alternate choices, if needed. This practice can also prevent “Panic Orders” that often end up costing you extra money. Smart Menu Specifications (food specs) Are a detailed list of requirements or particulars in specific terms and there are a few government and private publications available that define these. Go to your favorite online bookseller and do a search to select a publication to suit your needs. Static Menu A menu that does not change, for example, a room service menu in a hotel room Glossary of terms and acronyms – pg. 286

Weight Net weight (weight without packaging) and drain weight (weight without the packing liquid) affects your yield and price value.

Food Service Tune-up – pg. 287

Footnotes

1. Miller, Jack E. and David V. Pavesic, John Wiley & Sons, Inc. 2. Wikipedia 3. Microsoft Book Shelf 2000 4. Trend Watch Chart Book 2002, American Hospital Association, Chapter 3: Utilization and Volume 5. Buerhaus, P.I., Implication of an Aging Registered Nurse Work Force, JAMA: 2000:283: 2948-2954 Distribution of RN Work Force by Age Group 6. Sloan, Top 10 Trends to Watch and Work On, Food Technology, April 2003 7. Health Industry Group Purchasing Association 8. Hovenhamp, Herbert Competitive Effects of Group Purchasing Organizations – Purchasing and Product Selection 9. HIGPA, Group Purchasing Organizations – The Facts 10. McNeely, Scott CEO, Sun Micro Systems 11. Webster’s New Millennium Dictionary 12. Landy, Frank and Jeffry Conte, Work in the 21st Century, Wiley-Blackwell, ISBN 0-07-283022-0 13. Halpern, D.F., Teaching Critical Thinking Across Domains, American Pyschologist 53: 449-455 14. Roullier, J.Z. and I.J. Goldstein, The Relationship Between Organizational Transfer Climate and Positive Transfer of Training, Human Resource Development Quarterly 4: 377-390 15. Gates, Bill, reporting from MSNBC.com 16. Lickert, R., New Patterns of Management, McGraw- Hill Education, 1961 Footnotes – pg. 288

17. D’Wolf, Jim, Dining Services Core Management Competencies, LEC, Cincinnati, OH 18. Covey, Stephen Seven Habits of Highly Effective People, Simon & Schuster 19. Moore, Gordon E., Cramming more components onto integrated circuits, Electronics, Volume 38, Number 8, April 19, 1965. 20. Encarta World English Dictionary 21. Investopedia.com 22. Hessel, Jeff, from the session Accelerate Your Profits and Customer Satisfaction with Speed Cooking, North American Association of Food Equipment Manufacturers (NAFEM) 2007 conference.

Food Service Tune-up – pg. 289

References and sources cited

Chapter I - An overview of foodservice - The roles of the nutrition professional and technician, prepared by Cynthia Hilliard, Operations Specialist Consultant, Innovations Services. Used with permission. - Toczek, Wayne and Argenziano, Chip More than a meal….creating a masterpiece! Nursing Home Digest, Vol. 2, Issue 4. Chapter II - The menu is everything - Miller, Jack E. and David V. Pavesic Menu Pricing and Strategy , John Wiley & Sons, Inc. - Bauman, Timothy L. DHCFA, CDM, CFPP Analyzing Customer Demographics for Menu Planning, Healthcare Foodservice Trends, (The quarterly magazine of the American Society for Healthcare Food Service Administrators), Vol. 5, Issue 2 Chapter III - Purchasing goods and services - Bauman, Timothy L. DHCFA, CDM, CFPP Group Purchasing Organizations, What the Manager Needs to Know, Healthcare Foodservice Trends, (The quarterly magazine of the American Society for Healthcare Food Service Administrators), Vol. 5, Issue 1 References and sources cited – pg. 290

- Grossbauer, Sue, RD Foodservice Management and Food Safety 2006 Dietary Managers Association ISBN 0-9753476-5-9 - Hovenhamp, Herbert Competitive Effects of Group Purchasing Organizations – Purchasing and Product Selection - Toczek, Wayne and Linda Handy, RD Safe Dining for the Susceptible Customer, published by Innovations Services. - Health Industry Group Purchasing Association (HIGPA), http://www.higpa.org. Chapter IV - Production systems - Herbert, Sharon Tyler Food Lover’s Companion: Comprehensive Definitions of Nearly 6000 Food, Drink and Culinary Terms, 3rd Edition, Barron’s Educational Services - Knight, John B. and Lendal H. Kotschevar Quantity Food Production, Planning and Management, 2nd Edition, Van Nostrand Reinhold Chapter V – Staffing, personnel & scheduling - Bauman, Timothy L. DHCFA, CDM, CFPP Solid Staff – No Money Needed, Dietary Manager magazine (a publication of the Dietary Managers Association), May 2007 - Drucker, Peter, Classic Drucker, A Harvard Business Review Book, ISBN 1-4221-0168-1 - Grossbauer, Sue, RD Foodservice Management and Food Safety 2006, Dietary Managers Association, ISBN 0-9753476-5-9 - Guion, Robert, Distinguished Professor Emeritus, Bowling Green State University, for research assistance

Food Service Tune-up – pg. 291

- Halpern, D.F. Teaching Critical Thinking Across Domains, American Psychologist 53, 449-455 - Landy, Frank and Jeffrey Conte, Work in the 21st Century, McGraw Hill, ISBN 0-07- 283022-0 - Lickert, R., New Patterns of Management, McGraw-Hill Education, 1961 - Roullier, J. Z. and I. J. Goldstain, The Relationship Between Organizational Transfer Climate and Positive Transfer of Training, Human Resource Development Quarterly, 4, 377-390 Chapter VI – Understanding the budget - Toczek, Wayne, Budgeting Strategies for your Foodservice Department, Dietary Manager Magazine (a publication of Dietary Managers Association), July/August 2008 Chapter VII – Regulatory considerations - Loken, Joan K. The HACCP Food Safety Manual, John Wiley & Sons, Inc. - ServSafe Essentials, 4th Edition, National Restaurant Association Education Foundation - Toczek, Wayne and Linda Handy, RD Safe Dining for the Susceptible Customer, published by Innovations Services http://www.innovaservices.info/systems.html http://haccpalliance.org/alliance/training.html - Toczek, Wayne Understanding the Person In Charge according to the food code, Senior Resources Alliance Web site, www.sranet.org, February, 2008. http://www.sranet.org/?page_id=C09AA18A -E348-482D-C74E7093631A9921 References and sources cited – pg. 292

- Toczek, Wayne Regulations: what you can do, not what you can’t do, Dietary Manager Magazine (a publication of Dietary Managers Association), January 2008 Chapter VIII – Technology issues Chapter IX – Kitchen design and technology Chapter X – Catering the best impression – advanced marketing - Toczek, Wayne and Peter Benton, The Cost and Price of the Customer’s Experience, published by Innovations Services. Chapter XI – Leading change - Bauman, Timothy L. DHCFA, CDM, CFPP Leading change in your organization, Dietary Manager Magazine (a publication of Dietary Managers Association), November/December 2007 Chapter XII – Resources—references to support your program

Food Service Tune-up – pg. 293

About the Authors Timothy L. Bauman DHCFA, C.D.M., C.F.P.P.

Tim holds the title of Distinguished Healthcare Food Service Administrator (DHCFA) and has been the food and nutrition services director at Wood County Hospital in Bowling Green, Ohio for the past eighteen years, starting his food industry career in 1973.

Tim received his bachelor’s degree from the University of Toledo in management and E-Commerce, graduated the Dietary Managers Program at Owens Community College, and is a certified dietary manager. Tim has been a member of the National Board of Directors for A.S.H.F.S.A. (The American Society of Healthcare Food Service Administrators), an affiliate of the American Hospital Association. He was the 1998, 1999 and 2001 recipient of the A.S.H.F.S.A. “Chip off the Bloch” award for innovation in food service. Tim was the 2006 recipient of the Jacques Bloch award, the highest healthcare foodservice industry award.

In August of 2008 Tim became a member of the Nutrition Fellows Institute as a Fellow in Nutrition. He is an item writer for the CBDM (Certifying Board of Dietary Managers) helping create the exam for Certified Dietary Managers, along with being a regular publisher in several food service professional magazines. Tim is Chairman of the Advisory Committee for the College of Family and Consumer Sciences at the Bowling Green State University (BGSU) program for dietetics. He instructs the “Business Management in Dietetics” course for BGSU. Tim is president of Bauman Business Solutions Ltd., a food service consulting firm. Tim is a regular speaker at major industry seminars and workshops including the American Dietetic Association, A.S.H.F.S.A., the Dietary Managers Association (DMA), local and regional chef’s associations and wherever key topics on foodservice management are in demand.

Get your copy of the book: Tim: [email protected] About the authors – pg. 294

Wayne Toczek CEO of Innovations Services

Wayne is founder and CEO of Innovations Services, a food service training and consulting company to the restaurant, education and healthcare industries.

Wayne received his bachelor of science degree at Indiana University of PA in dietetics in 1987. He is the author of the cultural change book called “The Dining Experience.” This book has been receiving great reviews and is sold in every state, as well as internationally. His second book, “The Cost and Price of the Customer’s Experience” has been recently published and is a hot topic with all segments of the industry. His third book, “Safe Dining for the Susceptible Customer” explains how to achieve good inspection outcomes. He gives seminars on many aspects of food service in healthcare and also speaks for health care organizations and at many food shows.

He has personally surveyed hundreds of foodservice operations over the past 23 years and has worked as District Manager for one of the largest contract foodservice management companies in the country. His experience as a Civil Moneys Penalty (CMP) consultant for the state of Indiana provides him with a unique perspective on challenges in the foodservice industry. He is a Sanitarian RDE for the state of Ohio. Wayne is an instructor for ServSafe and Employee ServSafe, food safety education and certification programs from the National Restaurant Association Educational Foundation.

He is co-owner of The Lapatea restaurant in Norwalk, Ohio, specializing in good food and great service. This concept is on the cutting edge and soon to become a sought-after franchise in the foodservice industry. Wayne has created fun and interesting training videos, software for long term care, posters and cartoons for the foodservice industry and is the author of many articles about foodservice and innovative dining programs for professional magazines.

Get your copy of the book: [email protected]

Food Service Tune-up – pg. 295

About Innovations Services Here are more products from Innovations Services. Visit www.innovaservices.info for more information. The Cost and Price of the Customer’s Experience by Wayne Toczek and Peter Benton

» Understand the foundation concepts of customer service

» Learn ways to determine if you are successfully giving the service your customer expects

» Define misconceptions about customer service

» Understand staff responsibilities and opportunities for growth in a culture that focuses on the customer’s experience

» Understand the training needed for the culture change

» How to use the “customers shoes“ as a learning tool

About Innovations Services – pg. 296

Safe Dining for the Susceptible Customer by Wayne Toczek and Linda Handy, RD

» Understand key inspection targets—and how to fix them

» Proactive measures to prevent future problems

» What training will equip your staff to stay in compliance

» How to limit liabilities in your operation

» Quick tips to ensure a good inspection outcome

Food Service Tune-up – pg. 297

Resident Manager software Published by Innovations Services

» Plan meals and menus

» Determine ingredients quantities for volume production

» Organize meals by where they will be served

» Prepare meal tickets and seating charts, snack and utility labels

» Track resident weight and issue alerts if needed

» Leverage resident food preferences

» Prepare reports on all aspects of food production and more.

About Innovations Services – pg. 298

The Dining Experience by Wayne Toczek

» Understand the core principles of a dining experience

» Determine what will work best in your community

» Understand your logistical challenges and solutions

» Learn to use the checklist of must haves and nice to haves

Food Service Tune-up – pg. 299

Poster training Educate staff on the job with information-rich posters on many areas and tasks of food service. See them at: http://www.innovaservices.info/training_posters.htm

Food Storage Substitutions Sculpere Seasonings Soups & Sauces Portion Control How to Wash Your Surviving a Starchy Hands Survey Situations Recipe Tips and Working with Dining Room Secrets Produce Skills Cooking Retaining Food The Art of Techniques Temperature Garnishing

About Innovations Services – pg. 300

Manuals to encourage standard policies Innovations Services customizes manuals to the unique features and needs of your operation. Here are some examples:

Diet Manual This Diet Manual is designed as a resource to guide and assist the physician, dietitian, dietary staff and other members of the healthcare team to promote optimal nutritional care for all residents. It represents the clinical dietitian’s interpretation of current concepts of geriatric nutrition and has been approved by the medical staff. It was developed in accordance with applicable statutes

Clinical Quick Reference This Clinical Quick Reference will help you understand the clinical documentation guidelines that Innovations Services recommends. This tool was developed to ensure that all staff use the same standards and to prevent confusion as to minimum charting requirements.

Policy and Procedure Manual This Policy and Procedure Manual outlines current protocols within the Dining Services Department. It is designed to ensure that all employees have clear written direction to guide their activities and decisions. The Dining Services Manager is responsible for maintaining a current manual. All employees are responsible for knowing and adhering to current policies and procedures.

Contact Innovations Services for more information. http://www.innovaservices.info/index.html

Food Service Tune-up – pg. 301

Thank you…

A special thanks to Cynthia Brown Hilliard, Operations Specialist Consultant, Innovations Services for her many contributions including careful reading, thoughtful comments, suggestions for sequencing the chapters to be of most value to readers, and preparing sections including the Glossary of terms and acronyms, the Footnotes and the References and sources cited.

Many thanks to Peter Benton, our freelance collaborator and editor, Informed Decisions ([email protected]), for converting streams of consciousness, seminar handouts, training sheets, work papers, unpublished and published articles into a readable, logical flow.

Both Cyndi and Peter made strenuous efforts to make sure we both kept on track with our goals for Food Service Tune Up.

And to Ari, thank you for the great pictures!

Ari Sutton creates custom illustrations and fine art in a range of media including oil, acrylic, watercolor, pencil, ink, serigraph, monotype and other styles. He has written a curriculum for art classes and can teach art classes for adults and children. Visit http://www.arisuttonstudios.com.