Ambiance and Appetite

News and Views to Strengthen Your Healthcare Foodservice Operation™

Ambiance SPRING 2015 and Appetite Controlling Labor Costs Making the Most of Managers

A publication of Gordon Food Service® Welcome to

News and Views to Strengthen ™ Your Foodservice Operation™ ENRICH

A quarterly publication of Gordon Food Service® ISSUE 15 · SPRING 2015 EDITOR “Change is the only constant in life.” So goes the famous quote by Heraclitus. Andy Maier But it doesn’t take a Greek philosopher for you realize the pace of change in MANAGING EDITOR the healthcare industry and how it’s managed today. Danielle Bloom One big change both acute care and senior living are facing is the evolution CONSULTING EDITOR of government reimbursement being tied more and more to the quality of Robin Watson care. Smart operators are looking for new ways to balance savings with EDITORIAL DIRECTOR ® Dana Fillmore, RD, CP-FS improved quality of care. Gordon Food Service is excited to share many ways to do just that in this edition of Enrich. Read on to help prepare yourself as the EDITORIAL ADVISORS Dana Fillmore, RD, CP-FS spring winds of change continue to blow. Sara Kwiatkowski, RD Gerry Ludwig, CEC Whittier Health Network, a Gordon Food Service customer based in Massachusetts, shares its story about how making cleanliness and sanitation RECIPE DEVELOPMENT Ed Westerlund, CEC a priority has helped them to provide both a consistent quality of care and increase resident satisfaction. One tip you’ll read from them is that staff RECIPE NUTRITION Jessie Waalkes, RD training on daily expectations and proper use of chemicals is one of their keys to success. In fact, you’ll hear about staff training in a few other articles as RESEARCH ANALYST Ashley Moritz well. We recognize that labor costs are often the highest cost to a healthcare

PHOTOGRAPHY foodservice operation, and managing labor appropriately will help you best Julie Line, Big Event Studios manage those costs. Keep your eye out for tried-and-true ideas for keeping Adam Wasilewski your staff engaged, including specific advice on resolving employee conflict. FOOD/PROP STYLIST Joanie Homrich This issue covers other ideas to help improve quality outcomes, such as the importance of proper hydration when providing care and the importance of ACCOUNT MANAGER, ADVERTISING Danielle Bloom ambiance at meal time. The reality of our busy life often creates challenges that restrict what we can do at mealtime in healthcare operations. But don’t DESIGNER Mandy McCarthy let that stop you. We have motivating ideas that real operators have put to

PRODUCTION MANAGER the test to make a difference. For example, we’ll share some great recipes Deb Daniels that allow you to serve favorite foods in a hand-held manner for patients or residents who cannot use silverware. And you can use some of those same innovative recipes as a way to offer more hand-held options in your cafeteria and increase grab-and-go sales. Read on—and prepare—so that you assure the winds of change blow success your way. Published for Nursing Home and Hospital Foodservice Directors as well as Senior Meal Program Operators, this publication provides timely information about food and service trends, industry information, regulatory and legislative updates, recipes, and new products. It is our goal that customers know Gordon Food Service understands their industry, their needs, and that we have the tools, resources, and solutions to help them be effective and efficient operators. DANA FILLMORE, RD, CP-FS, Editorial Director. Dana Fillmore manages Healthcare The opinions, beliefs, and viewpoints expressed by the Marketing for Gordon Food Service. Previously Dana was the Manager of Nutrition contributors to Enrich™ magazine do not necessarily reflect the opinions, beliefs, viewpoints, or official policies of Services for Gordon Food Service, providing expertise in matters related to nutrition Enrich magazine or of Gordon Food Service Inc. Enrich and food safety for all Gordon Food Service customers. Her professional membership in magazine and Gordon Food Service Inc. do not guarantee the Academy of Nutrition and Dietetics and her background as Adult Foster Care the accuracy of all published works. All works submitted to Consulting Dietitian and Clinical/Foodservice Dietitian supports her specialty in Enrich magazine for publication become the express nutrition and foodservice. Her professional food safety certification is supported by the property of Gordon Food Service Inc. No reproduction of National Environmental Health Association. the contents of Enrich magazine, in whole or in part, may be made without the express written consent of Gordon Food Service Inc. Copyright 2015, Gordon Food Service Inc. All Rights Reserved. Enrich, GFS, and Gordon Food Service are trademarks of Gordon Food Service Inc. Other company, product, and service names may be the trademarks or service marks of others. 51891/6M 14 10 26 features columns in the kitchen

6 AMBIANCE AND APPETITE 10 ENHANCE 24 MINI CHICKEN-SALAD PUFFS The right lighting, sounds, Making the Most of Managers aromas, and colors 26 SPAGHETTI AND SPINACH FRITTATA encourage eating. 22 MANAGER’S MEMO Just Add Water 28 TUNA MAC-N-CHEESE BITES 12 PITCH THE FORK 30 SMOKED-BEEF EGGPLANT BISCUIT New takes on fi nger foods 32 INDUSTRY UPDATE open up opportunities for fl avor Cost-Effective Services, and variety. High-Value Results 14 CLEAN BY DESIGN 33 ASK THE DIETITIAN New protocols are spot on What are GMOs and How ™ at Whittier Health Network Do I Tell if a Product In Every ENRICH in Massachusetts. Contains Them? 2 WELCOME TO ENRICH 18 CONTROLLING LABOR COSTS 34 ENGAGE Top ways to hold the line on Resolving Employee Confl ict 34 ADVERTISER INDEX the budget’s largest line item. On the Cover: Learn how one health network's push for excellence reaches beyond the kitchen on page 14.

ENRICH | Spring 2015 3 SIMPLE

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See page 34 for more information. ENRICH | Spring 2015 5 Ambianceand Appetite by: Erin Rogers

vette Green and Mary Czyzyk clearly recall THE IMPORTANCE OF AMBIANCE the most enjoyable meal they’ve had as Most seniors enjoy at least a certain level of mealtime residents at Inglis House, a long-term care pleasantness when they are at home. No wonder, then, Ycenter in Philadelphia. that when they move to a long-term care or assisted-living It was the September 2014 luncheon for residents who community, the lack of that ambiance takes its toll. The had birthdays that month. The luncheon took place in majority of residents in nursing homes (50–75%) leave the central dining room, which was set with round tables, a quarter or more of their meal uneaten. Furthermore, linens, and real glassware and silverware. The meal, set out weight loss is common and many automatically receive a on long tables for residents to see, was served in stages: doctor’s order for nutrition supplements to help prevent Shrimp and potato skins for appetizers, sirloin steak for the the weight loss. main course, and sparkling cider and New York cheesecake Reversing those statistics might be as simple as for a sweet ending. improving the ambiance of the dining room, says Robert “There was a nice centerpiece and music, and we could Jenkens, Board President at the Center for Excellence smell the food,” says Czyzyk, who is 60. “There were in Assisted Living, an Oakton, Virginia-based nonprofi t people out there serving, and you could smell the food,” collective of 11 organizations dedicated to improving adds Green, also 60. “It was fantastic.” assisted living. Their memory of that meal underscores what everyone For eight years, Jenkens directed the Green House knows, but what’s often forgotten in long-term and Project, a physician-created nursing-home and assisted- assisted-care communities: Appetizing, enjoyable meals are living model centered around residents’ desires, not about much more than food. The ambiance surrounding institutional needs. Meal preparation and enjoyment are a dining experience—the lighting, the aroma of the room central to the idea of the Green House Project, in which and even the temperature—can elevate an ordinary meal residents live in small homes and take an active role in to greatness or reduce a good meal to blandness. planning and even preparing meals. Residents of Green

6 Gordon Food Service FEATURE: AMBIANCE AND APPETITE

Appetizing, enjoyable meals are about much more than food.

House homes show far less of the unexplained weight loss that can occur in long-term care settings, Jenkens notes. Other research suggests that the link between ambiance and appetite may be underestimated. A review article in the May 2004 issue of Nutrition examined the effect of aromas, colors, food, temperature, and even the presence of other people on food intake. The article, which is demonstrably still relevant, concluded the presence of other people, particularly friends or family, increases food consumption. It found that food intake in a geriatric long- “Think about the challenges that restrict mealtimes, term care wing of a hospital increased when the hospital about the large-scale impersonal physical environment,” turned its dining room into a 1940s-style residential room, Jenkens says. Larger operations can do much to perk up with paintings, carpet, and china. It also found that food ambiance, whether it’s ladling soup into bowls in front choice and a comfortable eating environment improve of residents, playing soft mood music during meals, or nutrition status among hospital patients, and that music replacing giant tables with smaller, more intimate ones. or even lively noise prompt people to eat more. Among the many ambient factors that can be adjusted to “It’s important to consider ambient infl uences on food encourage eating: intake and food choice in an attempt to understand and alter eating behavior where needed,” wrote the authors, Lighting. Too-bright or too-dim lights can dampen Professor of Nutritional Psychology Nanette Ströebele, appetites, while soft incandescent lighting helps residents Ph.D. and Professor of Psychology John M. De Castro, Ph.D. see what they’re eating, and thus prompts them to eat more. AMBIENT ADJUSTMENTS Table settings. Food that’s served on real china The Green House model, founded in 2003, is just dinnerware set on a tablecloth with folded napkins is more taking root: About 86 homes are open in 15 states, and appealing than food presented on a bare table or tray. 125 more are under construction in another 11 states. Table size. A round or square table small enough Still, its principles can be replicated in larger, more to encourage conversation adds a crucial social factor traditional institutions. to meals.

ENRICH | Spring 2015 7 FEATURE: AMBIANCE AND APPETITE

Plating for success A well-executed plate is like a well-dressed person: Done just right, the various elements combine to create a pleasing, and in the case of plating, appetizing presentation. Sara Kwiatkowski, R.D., offers eight tips for designing an appealing plate of food. Use solid-color plates. Ornate patterns can be Pair foods to match residents’ expectations. distracting. Solid-color plates can be bright and You wouldn’t expect to be served peas with a colorful, or white. Use a plate with a contrasting BLT. Serve main dishes with sides that make sense. border or different color placemat to make it Think steak and potatoes, or a sandwich with easier to see. fries or cole slaw. Present a variety of food colors. “You wouldn’t Mix components. A meal of bowls—soup, pudding, serve mashed potatoes, cauliflower, and cod,” cole slaw, etc.—isn’t as appealing as a meal that Kwiatkowski points out. Instead, a plate of pink includes a plated component and a bowl. If your salmon, white mashed potatoes, and green beans staff finds itself with too many bowls or plates, would offer the same nutrition and in a more rethink the meal. Ideally, serve one dish at at time. appealing array of hues. Don’t overdo portions. Mounds of food that diners Serve a variety of textures. Something crunchy— can’t possibly finish are an appetite turnoff. Ask say, fried chicken—plated with a softer mashed residents how much they want; family-style service item and perhaps al dente broccoli is more helps immensely in this case. appealing than a plate of all soft or all crisp. Make sure residents know what they’re eating. Remember the garnish. Not all meals are vibrant in Have staff describe dishes they serve, just as they color. Consider parsley, a rose radish, or even carrot would at a nice restaurant. That’s especially shavings to add color and whimsy to presentation. important for named dishes, such as chicken divan or potatoes Anna. Instruct servers to use the dish’s name and describe it.

8 Gordon Food Service FEATURE: AMBIANCE AND APPETITE

Aroma. A dining room should smell neutral, advises “If it were me, I’d like something more than clinical Sara Kwiatkowski, RD, manager of the Nutrition Resource white,” says Burgess, Director of Food and Dining Services Center at Gordon Food Service®. “Neutral” means that the at the center, which has 190 residents in independent- dining room shouldn’t smell like people, chemicals, or even living and assisted-living quarters. food. “Ideally, residents will smell cooking in the hallway, A homey feeling. To go along with the spiffy server tops and that will entice them,” she says. and tablecloths, Burgess plans to replace industrial-looking vinyl flooring with vinyl that looks like wood. “It will make a huge difference for residents,” he predicts. Along similar “It’s important to consider lines, Inchauste uses real—and that means breakable— china in her dining room to add a homey feeling. ambient influences on food intake Messy eaters. Messy eaters can crush the appetites and food choice.” of other diners. Burgess and others say they cannot and will not segregate such diners; the key is to find residents willing to eat with them. “There are some who will and some who will not,” Burgess says. Providing dignified Sound. Keeping the noise of service to a minimum— clothing protection is helpful. easy on slamming doors or clanking carts—helps residents concentrate on their food and conversations with each Temperature. “It needs to be at a comfortable setting, other. Soft music in the background is fine, as long as say the mid-70s,” Kwiatkowski advises. If the dining room it’s low enough not to interrupt conversation. Spectrum is empty for hours before a mealtime, she suggests that Health Rehab and Nursing Center in Grand Rapids, staff adjust the temperature prior to service so it’s just Michigan, subscribes to satellite radio and plays something right for residents. different every day to appeal to its population, which Staff. “The real secret at the table is the presence of a varies in age from about 40 to 100, says Corinne Inchauste, very engaged team member,” Jenkens says. “It can’t be what Dietary Manager at the center. you see in so many homes—a feeding assistant shoveling Server uniforms. In 2014, Andy Burgess purchased food into people’s mouths. That doesn’t help.” colored tops for servers at Parkview Christian Retirement Indeed, adequate staff can help feed residents who Center in Portland, Oregon. The colored tops, which need help, and also add a pleasant ambiance to meals, replaced plain white ones, warm up the dining room, he Czyzyk maintains. says. Burgess also purchased colorful tablecloths, which he “It’s one of the times we can gather together, much like coordinates with seasons and holidays. a family running in a million different directions,” she says. “The ambiance has to be calm and inviting.” E

ENRICH | Spring 2015 9 COLUMN: ENHANCE

Enhance E ... by: Scott Langford

Making the Most of Managers

o paraphrase a familiar Here are a few ways an actively also care about our customers and expression, when the boss is involved manager makes a their loved ones.” away, the workers will play. positive difference: Lead by example. Despite the title, TYou hope this isn’t true in Be interested. “By showing a sincere managers don’t just manage; they lead. your operation, because healthcare concern for what’s going on and Make a conscious effort to be on the foodservice is serious business. But a learning from the staff, the manager fl oor with your staff and customers. manager can’t be there every minute. sets expectations about doing what “Relationship-building with everyone At most healthcare facilities, the it takes to get the job done,” says in the dining room during mealtime, food and nutrition services manager’s Ken Wasco, Gordon Food Service from workers to guests, shows you’re many responsibilities make it diffi cult Customer Effectiveness Manager. “The engaged,” Fillmore says. “Ultimately, to put in a lot of face time. Much of manager also validates authority when it’s about quality of care, and a lot of the work—menu planning, monitoring it comes time to give direction and that starts with good customer service.” food production and safety, ordering express opinions.” Multitask. Be everywhere, from food, nutrition care plans, and Communicate. “Managers need the prep kitchen beforehand to the scheduling, to name just a few—often to build trust, and that is best built cleanup afterward. “It’s OK to roll keeps a manager behind the offi ce interpersonally,” says Dan Longton, up your sleeves and help out during door or huddled over a computer. President of TraitSet®, a workforce- hectic moments, but don’t lose sight Still, the manager’s presence is management service provider in of the big picture,” Zamora says. “You important, and it’s not just because Naples, Florida. He says foodservice need to be a coach, explaining the of a fear the staff won’t work well plays a big role in caregiving, which why behind every job.” without supervision. In healthcare makes listening—to staff, residents, Treat staff fairly. Managers need to foodservice, having a visible manager patients, and visitors—vitally set clear policies and enforce the rules is a true asset, especially if that important. “Being a combination equitably. “Good managers encourage manager delegates effectively, pitches directive manager and social manager participation and training,” Longton in when needed, and is a diplomat in is a morale-builder for everyone.” says. “That way, everyone knows the dealing with staff, patients, residents, Listen. Managers need to be processes for handling things such as and visitors. accessible, either onsite or by food waste, which is vital to customer A manager constantly buried in phone. This shows the culinary safety and health.” paperwork who only takes time for team it has support, says Angie Offer praise. It’s the manager’s job cursory visits to the dining room Zamora, Corporate Director of to correct problems, but don’t forget or cafeteria is making a mistake. Culinary Services at Lutheran Life to offer praise and positive feedback. The manager who does a drive-by, Communities in the Chicago area. Workers, Wasco says, mirror the clipboard in hand to take a few “The culinary team is in direct contact personality of the person in charge. notes and move on, is missing with residents, families, and other Zamora agrees, and goes a step further: something. Observation alone workers, such as nurses, every day. “If you have a happy culinary team, cannot capture the entire picture, These people become some of the you’ll have happy customers.” E according to Dana Fillmore, RD, best sources for information and ideas. CP-FS, Gordon Food Service® And when we demonstrate that we Healthcare Marketing Manager. care for our teammates, it shows we

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iven their versatility, variety, and portability, it’s Tuna mac-and-cheese bites. Macaroni and cheese is no wonder that hand-held foods—sandwiches, prepared with the addition of tuna, peas, and carrots, biscuits, sweet and savory turnovers, and tacos, chilled until fi rm, and then cut into bite-sized pieces Gjust to name a few—are favorites throughout before rewarming. foodservice, and popular among healthcare employees and visitors looking for a quick bite to eat. And the utensil-free ease of eating makes many hand- Hand-held foods empower those with held foods indispensable when it comes to providing meals for those with limited dexterity or hand-eye coordination. limited mobility to eat independently Stroke, dementia, and Alzheimer’s—to name a few and still enjoy a variety of foods. conditions—can greatly impact a resident or patient’s ability to handle utensils. “Residents on a fi nger-foods diet need items they can easily pick up and won’t compromise their dignity,” Polenta wedges. Polenta, cooked in water or broth, is says Gordon Food Service® Nutrition Resource Manager chilled and cut into wedges or strips. Griddled or oven- Sara Kwiatkowski, RD. baked with a drizzle of olive oil, they become delectable morsels with a crisp exterior and a tender, creamy center. Hand-held foods empower those with limited mobility The wedges are perfect, paired with a dipping sauce, or to eat independently and still enjoy a variety of foods. Even added to a Mediterranean antipasto plate. better, thanks to innovative chefs and cooks, more and more delectable items are being freed from the fork. Pasta Meatballs. “Meatballs offer a great opportunity for primavera that can be picked up? Yep. Frittatas that can be creativity and fl avor in a bite-sized package,” says Gordon free-handed? For sure. Chicken salad served in tiny pastry Food Service Corporate Consulting Chef Gerry Ludwig, puffs? You bet. CEC. “In any combination—chicken, turkey, pork, lamb— the possibilities are virtuously limitless.” GRASPING THE HAND-HELD OPPORTUNITY Take a page from restaurant foodservice and innovate: There’s virtually no limit to what can be crafted into a Stuff them with cheese and spinach; serve them hand-held format. The following are just a few examples of alongside eggs at breakfast; offer them as snacks. Ludwig pickup artistry. recommends going “above and beyond” with meatball Spaghetti and spinach frittata. Cooked spaghetti is dipping sauces like honey-mustard, Asian-inspired soy- blended with spinach and other vegetables, plus egg as based sauces, or something creamy like Alfredo. Whichever binder. Baked in a pan, then cut into bite-sized portions, you choose, be sure to offer the sauce on the side for these frittatas offer the fl avor and variety of pasta dipping to keep things portable and clean. primavera in a creative and new presentation.

12 Gordon Food Service FEATURE: PITCH THE FORK

GLOBAL SANDWICHES Chicken salad might be traditional in the sandwich world, but served in a tender choux-pastry puff with slices of tomato and cheddar, it’s certainly not your grandma’s version. Chicken-salad bites are especially appealing because they need not be cut into pieces, a tactic that often results in food crumbling before it reaches the mouth. Draw on global flavors—particularly from Asian and Latin cuisines—for inspiration when it comes to creating mini versions of popular full-sized, hand-held sandwiches menued in commercial foodservice. Vietnamese banh mi sandwiches, with their mix of savory meats, pickled veggies, and herbs piled onto a soft French-style roll or baguette, are spot-on satisfying and offer lots of opportunity for innovation. While the traditional filling is chilled sliced pork or ham, the sandwich also adapts to warm varieties such as pulled pork or grilled chicken. The only constant here is a garnish of fresh herbs and fresh or pickled julienned veggies, which add crunch and contrast.

With a little creativity, nearly any food can be fashioned into a handheld that’s craveable and convenient.

NOT JUST FOR BREAKFAST Biscuits, too, are seeing a revival, and not just for breakfast. When the Chicago-based research firm Technomic Inc. asked David Wood, Culinaire International’s senior vice president, to predict trends for 2015, Wood called biscuits “the new ‘it’ ingredient in comfort-food trends.” Served on their own with a variety of spreads, studded with cheese, bits of ham or vegetables, or used for mini savory sandwiches, tender, flaky biscuits are both versatile and filling. They can be made ahead or purchased frozen and baked fresh for homestyle appeal. All in all, with a little creativity, nearly any food can be fashioned into hand-held meals that are craveable and convenient for people with limited dining options. E

For More Information See the Recipes section on page 23 for our spring lineup of delectable and easy-to-eat It’s also easy, Ludwig points out, to build a Latin-inspired hand-held items to add to your grab-and-go torta on a roll, baguette, sub bun, or kaiser roll. Braised retail and finger food menus. chicken tinga, pork carnitas, or beef barbacoa layered with Ask your Customer Development Specialist condiments—anything from lettuce and tomato to salsa, for additional recipes for hand-held items and sour cream, avocado, refried beans, jalapeños, and cheese— value-added products that can satisfy and pack in flavor and create a real opportunity for significant enhance the dining experience of all you serve. differentiation, especially for grab-and-go convenience.

ENRICH | Spring 2015 13 Clean by Design by: Tom Dixon

leanliness outranked food quality and flavor practices, treating every patient and resident as if they when Technomic Inc., a Chicago-based market- were family members. Melding this “family approach” research firm, asked consumers what’s most with the highest caliber of care has consistently earned the Cimportant in their restaurant experiences. The Whittier centers exceptional ratings from both customers cleanliness of dishware, glassware, and silverware was the and independent agencies. No. 1 answer. A clean interior, clean bathrooms, and clean The organization prides itself on providing highly kitchen and food-prep area also made the top 10 list. individualized care and gives each center the latitude to do It’s no great stretch to imagine that senior-living- so. However, there’s also a push to build efficiencies and foodservice customers feel much the same way. In establish best practices wherever possible. That was the fact, cleanliness may be even more of a concern for motivation for the “cleanliness tour” on which Ryan and these diners, given the association Michael Arcidi embarked. between hygiene, food safety, and “About four years ago, it came to health. Residents of senior-living “It’s really important for us our attention that different centers communities also rightly expect the were maintaining different cleaning highest cleaning standards in the to listen to what our standards, from floor surfaces to facilities they call home. customers have to say.” ceiling grids,” Ryan explains. None All these considerations were top of the centers had any problems of mind for Elaine Ryan, Director of passing health inspections, but Ryan Materials Management and Design and Arcidi were concerned about Planning for Whittier Health Network, as she accompanied inconsistency. “So we decided to do a walk-through of the Vice President of Operations on an impromptu tour of each center, looking at every aspect of cleanliness in different locations within Whittier’s network. every department.” Based in Haverhill, Massachusetts, Whittier Health STRUCTURING A CLEANING PROGRAM Network includes two acute-care rehabilitation hospitals, The duo took care not to make any positive or negative nine skilled-nursing facilities, a psychiatric hospital, comments on their stops. They returned to company transitional-care services, an institutional pharmacy, and headquarters convinced of the need to implement a more a home-healthcare agency. The company was founded in structured systemwide cleaning program. 1982 by Dr. Alfred L. Arcidi (CEO) and his sons Alfred J. (Senior Vice President), Michael (Vice President of “We didn’t have anybody at the corporate office the Operations), and Philip (Treasurer). individual facility directors could report to in terms of cleaning,” Ryan says, “so we wanted to provide some formal The Arcidis have built a healthcare-delivery system corporate guidance.” that incorporates traditional family values into everyday

14 Gordon Food Service FEATURE: CLEAN BY DESIGN

Whittier began to establish standard cleaning protocols— including appropriate cleaning chemicals—while training personnel in proper procedures. “We trained on everything from infection control to floor care to glass cleaning, everywhere from patient rooms to cafeterias,” Ryan says. “We also created housekeeping guides, listing tasks that need to be done daily, weekly, monthly, and so on. And we built an inspection process to control and evaluate the program.”

“Surveys go out to all patients, residents, and family members.”

Whittier Health Network Given the differences among skilled nursing, rehabilitation, and psychiatric care, many variables HOSPITALS exist between individual sites. But all sites collaborated Whittier Rehabilitation Hospital—Bradford to develop a universal scorecard that rates cleanliness Bradford, Massachusetts performance on a scale of one to 10. Those scores are then Whittier Rehabilitation Hospital—Westborough converted to percentages. Over the past four years, average Westborough, Massachusetts scores have risen to the high 90s, and the Environmental Services staff at each center welcomes the inspection visits Whittier Westborough Transitional Care Unit as a way to validate its performance. Westborough, Massachusetts “We’ve made great progress,” Ryan says. “It wasn’t always easy—any change is met with a certain amount of The Whittier Pavilion Psychiatric Hospital Haverhill, Massachusetts resistance. But we kept emphasizing that everyone, from clinical RNs to dietary staff, plays an essential role in the betterment of their center.” That took the onus off specific SKILLED-NURSING FACILITIES individuals and groups and created a spirit of team unity. Daniels House Nursing Home “Today, we all take great pride in our centers.” Reading, Massachusetts

SETTING A TONE OF EXCELLENCE Hannah Duston Healthcare Center That pride is evident in foodservice spaces, where Haverhill, Massachusetts impeccable sanitation helps set the tone for top-notch Masconomet Healthcare Center dining experiences. From the formal elegance of skilled- Topsfield, Massachusetts nursing dining rooms to the more casual charms of hospital bistro cafés, guests are made to feel comfortable, respected, Nemasket Healthcare Center and safe. Middleborough, Massachusetts “The dining rooms are very upscale, with chandeliers, Oak Knoll Healthcare Center table linens, window treatments, and wood-like vinyl Framingham, Massachusetts flooring,” Ryan says. “The dietary staff provides table service. Bistro cafés offer patients and visitors the Port Healthcare Center opportunity to drop in for a coffee or sandwich.” Newburyport, Massachusetts Additional dining spaces throughout the centers cater to limited-mobility patients and residents. Sippican Healthcare Center Marion, Massachusetts Menus vary a bit between locations, so each center orders its own food via a website built and maintained by Whittier Rehabilitation & Skilled Nursing Center Ryan and her two-person staff. Ghent, New York “All the different departments can log on and see the products available from our approved vendors, along with Whittier Place Assisted Living Center Ghent, New York the proper forms and procedures. Our site links to vendor sites for ordering.”

ENRICH | Spring 2015 15 FEATURE: CLEAN BY DESIGN

Ryan oversees purchasing for the entire network, so, “Whether it’s clinical, foodservice, facility maintenance, or anything else, every aspect of need has to pass through this department for a purchase order.” Whittier centers purchase more fresh, whole foods than valued-added products. “Our planned goals for per-patient day costs are higher than many of our competitors,” Ryan says. “From the beginning, Dr. Arcidi insisted on top-quality meals because mealtimes are often the highlight of the day for patients and residents.”

“We built an inspection process to control and evaluate the program.” They’re likely to say that Whittier is always getting better. “We’re constantly renovating and upgrading centers,” says Ryan, who added design planning to her duties about 15 years ago. “I’ve got an entire design library now, fi lled Each center utilizes a four-week menu cycle for fall and with information on paint, carpets, wall coverings, and winter, and a three-week cycle for spring and summer. more, which we use to make sure our environments are as Nearly 90 percent of dishes are made from scratch. comfortable, welcoming, and homelike as possible.” Diners throughout the network generally prefer comfort Whittier is in the midst of several major renovations, foods like meatloaf, roast turkey, pot roast, and macaroni adding patient beds, updating therapy and living areas, and and cheese. But they also appreciate Whittier’s forays remodeling dining rooms at multiple centeres. into more adventurous fare—especially when there’s an interactive element involved. “We’re even building a new center next to an existing one so we can move residents into the new one with For instance, Ryan says, “We’ll assemble a list of minimum disruption before we demolish the old one,” ingredients and ask chefs to create a dish using them, Ryan says. “We’re just always on the move.” making sure to satisfy the nutrition requirements all meals have to meet.” Staff and customer tastings determine the The ever-increasing rate of change in healthcare winner, which is then integrated into menus. necessitates greater fl exibility and innovation on the part of providers. Whittier delivers on both counts as it continually Tastings are just one of the ways Whittier encourages seeks new ways to improve the care experience in all its feedback. “Surveys go out to all patients, residents, and communities—and exceed the expectations of patients, family members,” Ryan explains. “It’s really important for residents, and families. E us to listen to what our customers have to say.”

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Contact your Gordon Food Service® Customer Development Specialist for more information.

See page 34 for more information. Controlling Labor Costs by: Robert Bax

oing more with less” is more important than ever Healthcare Marketing Manager Dana Fillmore, RD, in healthcare. Driven by a confl uence of factors, CP-FS, says operators must walk a fi ne line when it comes including the Affordable Care Act, every sector of to reducing hours and eliminating positions. Dthe industry is feeling pressure to deliver services “There’s always a risk of overcutting,” she says. “If ‘‘ more effi ciently and cost effectively. you don’t have enough people or hours to do the job Healthcare foodservice is no exception. In years past, properly, you’re going to negatively impact customer nutrition departments could count on at least nominal service and employee attitudes, both of which will increases in operating budgets from year to year. But damage your overall quality of care.” Foodservice Director magazine reported in 2014 that a Fillmore encourages operators to pursue every sizeable number of hospitals saw their budgets stay the opportunity to make the most effi cient use of your labor same or decrease in 2012 and 2013 (see fi gure 1). And a and minimize the disruption of staff reductions. The majority of hospitals expected similar budget crunches following are some options worth exploring. in 2015. Nursing homes, long-term care centers, and senior- living communities fared a bit better than hospitals in 2012 and 2013 (fi gure 2). While they’re more optimistic about future budgets, many didn’t expect budget increases Turnover is a “hidden labor cost.” in 2015. How do healthcare foodservice operators cut costs when budgets are reduced or don’t keep up with infl ation? Foodservice Director reports that cutting staff hours Benchmark labor costs. “You can’t control costs if you and/or positions is the most popular tactic, with 52 percent don’t measure them,” says Michele Triche, Administrative of hospitals, 39 percent of nursing homes/long-term care Director at East Jefferson General Hospital in Metairie, centers, and 32 percent of retirement homes/senior-living Louisiana. Triche not only tracks the cost of labor, food and communities employing it. (Reducing menu items, the other Key Performance Indicators (KPIs), she also inputs next most-cited tactic, lags way behind.) her data into AHF Benchmarking EXPRESS. This program, That’s not unexpected, given that labor consumes so offered by the Association for Healthcare Foodservice, much of the foodservice budget—the majority of it, in enables users to see how their costs compare to other the case of hospitals (fi gure 3). But Gordon Food Service® operations in the system.

18 Gordon Food Service

FEATURE: CONTROLLING LABOR COSTS

The information is presented in terms of percentiles, so users can see how they rate compared to the 25th, 50th, and 75th percentile of operations in the system. Users also can sort results to compare themselves to operations with similar bed count, service type, and location. “When it comes to labor, I want to be in the lowest percentile,” Triche says. “That tells me we’re being labor- efficient.” Benchmarkers whose costs deviate from the norm will want to analyze their labor practices and look for improvements.

“You can make a much stronger case when you go into budget meetings with numbers and comparisons.”

work ethic, and integrity, customer service skills, and Another advantage of benchmarking: “You can make a even propensity for antagonistic behavior. Langton says much stronger case for your department when you go that most TraitSet users experience at least a 50 percent into budget meetings with numbers and comparisons,” reduction in hidden labor costs. Triche says. Focusing on employee engagement and training will also Reduce turnover. Turnover is a “hidden labor cost” for reduce turnover, Fillmore says. “Give people the right tools healthcare foodservice, says Dan Longton, President and for the job and make them feel challenged, respected, and CEO of Naples, Florida-based TraitSet,® a workforce- appreciated.” management service provider. The typical cost of turnover Schedule smartly. Little scheduling mistakes can make for positions earning less than $30,000 annually is a big dent in your labor budget, Longton maintains. “You 16 percent of the employee’s yearly salary, according don’t want to pay overtime,” he says. “Nor do you want to 2012 data from the Center for American Progress, a to give part-timers more than 30 hours a week, or your Washington, D.C., think tank. health-insurance costs will soar.” Longton’s solution? “Hire the right people in the first TraitSet offers a web-based scheduling solution that place,” he advises. Operators can use systems like TraitSet “locks in” how many hours each employee can work, to conduct online behavioral assessments of job candidates. so you can’t make mistakes. It also offers a number of Assessments measure such traits as readiness to work, employee-convenience features, including the ability to

20 Gordon Food Service FEATURE: CONTROLLING LABOR COSTS

view schedules from smartphones and tablets, which can package them with a bar code for scanning by the self- help further reduce turnover. checkout system,” he says. George Carasquilla, Resident Services Director at Park Reset your budget every year. Allen Alvarado, Executive Place of Elmhurst, a life-care community in Elmhurst, Chef at Lapeer County Medical Care Facility in eastern Illinois, takes a different tack. “One of the things we Michigan, uses zero-based budgeting to justify every labor monitor is making sure staff doesn’t clock out more than dollar spent. “Every year, we sit down and calculate the seven minutes past their scheduled time to leave, as this bare-minimum hours needed to get the job done, and we will automatically add an additional 15 minutes to their allocate labor budgets based on that.” time,” he says. Alvarado says that changing food-delivery methods, Cross-train employees. “Cross-training staff is one equipment, technology, bed counts, and facility of the most effective ways we have to control labor enhancements can have a huge impact on labor needs, and costs,” says Lora L. Arnold, RD-LD, Corporate Dietitian this approach takes those changes into account. Over the at Barbourville Health and Rehabilitation Center in years, it has helped him shave shift hours without affecting Barbourville, Kentucky. service. If conditions warrant extra labor during the budget “Having employees with skills in many different year, “I make it up by increasing revenue, reducing our cost positions makes it easier to cover the schedule without of goods,” he says. incurring expensive overtime. And we can cover the Make more money. The flip side to cutting costs schedule using fewer workers, without negatively is generating additional revenue to pay for labor. impacting production.” Moneymaking opportunities can include branding, Limit labor-intensive food production. While “made catering, coffee or other food kiosks, grab-and-go service, from scratch” can be a great competitive differentiator, not and offering nutrition-support services to patients and the every menu item needs to involve complex preparation. community outside your four walls. E “Look at your less-popular dishes first and weigh the higher costs of value-added items against the potential labor savings,” Fillmore advises. Automate where you can. If sales don’t justify the labor For More Information required to maintain third-shift foodservice or satellite Ask your Customer Development Specialist how locations, consider an unmanned micromarket instead. the TraitSet workforce management program Micromarkets, which bridge the gap between vending available to Gordon Food Service customers machines and full-service cafeterias, allow customers to via Catalyst® can help you control labor costs. select food and pay for it themselves. Catalyst also offers a variety of sales-building Niles Gebele, Nutrition Services Director at Marion strategies that can help grow revenue to offset labor costs. General Hospital in Marion, Ohio, is introducing a system that enables associates to swipe their badges to pay for purchases. “We’ll make most of the items fresh and

ENRICH | Spring 2015 21 COLUMN: MANAGER'S MEMO

Just Add Water by: Erin Rogers

orinne Inchauste knows a Have drinks always available. That Provide helpful implements dehydrated resident when means during activity time as well for dysphagia patients. Inchauste she sees one. as at snacks and meals, Inchauste suggests sipper cups and “nosy” cups, C “They go from being says. Hydration carts stocked with which let users tuck their chins while out and about to just sitting,” says fruit-fl avored water (watermelon drinking, to help residents who have Inchauste, a certifi ed dietary manager and cucumber are popular) can also diffi culty swallowing. Thicker liquids, at Spectrum Health Rehab and encourage residents to drink and such as shakes or puréed (and not Nursing Center in Grand Rapids, help staff remember to keep them boiling hot) soups, can be consumed Michigan. “They’re shutting down, hydrated, she says. slowly and also help keep dysphagic they’re getting weaker.” Think beyond water. While water residents hydrated. Weakness and lethargy are among is the best hydrator; cranberry or Keep tabs on residents taking the milder symptoms of dehydration grape juice works well, too. Brightly diuretics. According to Minsky, in an older population. Insuffi cient colored drinks, especially those with a seven of 10 seniors take a diuretic intake of liquids also can lead to red hue, appeal to dementia patients, or medication that acts as a diuretic. urinary tract infections. It can Inchauste says. These medicines prevent swelling, prevent pressure sores from healing such as edema, but are dehydrating as and lead to malnutrition, as liquids well; people on these medicines must transport nutrients throughout the be ultra-vigilant about hydration. body. Weight loss, diarrhea, and Let residents know they Consider electrolyte water. constipation are also side effects of need to consume more Dehydration throws off the body’s dehydration. Extreme dehydration electrolyte balance, which can lead can result in death. liquid, and ask them for to arrhythmia and cardiac arrest, Getting patients and residents to help in doing so. Minsky says. To prevent this, consider consume enough liquids—roughly electrolyte water such as SmartWater 3.7 liters a day for a man over for certain residents, not sports 70 and 2.7 liters for a woman over drinks fi lled with sugar. Electrolyte 70, according to the Academy of Think beyond liquids. For those water hydrates and provides patients Nutrition and Dietetics—is easier who would rather eat than drink, with potassium and magnesium, said than done. Older people can provide foods with high water compounds needed to keep the heart forget to drink; those with dysphagia content, such as fi nely chopped or in good shape. Bananas also contain or dementia might fi nd it physically puréed vegetables, low-sodium broth both compounds and are hydrating, diffi cult to swallow liquids. and consommé, Jell-O, ice cream, Minsky adds. and sherbet. Here are nine steps to get residents Communicate with residents. on the road to proper hydration. Be aware of dehydrating foods. Let residents know they need to High-sodium foods leach water consume more liquid, and ask them Keep water in the rooms. A from the body, as do sugars and for help in doing so. That might be 16-ounce pitcher of fresh water, some artifi cial sweeteners as well more effective than a water pitcher or within reach of the resident’s bed as caffeine, Minsky says. Consider hydration cart. or chair, will help encourage drinking. replacing them with hydrating “It really is amazing when you The hash marks on the bottle foods—fresh fruits and vegetables, can help staff keep track of water involve the residents in their own chopped fi nely enough for residents care,” Inchauste says. E consumption, says Bonnie Minsky, to eat without diffi culty. Microwave a Certifi ed Nutrition Specialist the pieces for 10 or 15 seconds to and owner of Nutritional Concepts, soften them and make them more a nutrition consultant in chewable, she advises. Northbrook, Illinois.

22 Gordon Food Service Just Add Water Recipes by: Erin Rogers Give Them a Hand

troke, dementia, and Alzheimer’s can all greatly impact a person’s ability to Seat independently with utensils. Hand-held foods empower those with limited mobility to eat independently while enjoying a variety of foods. What's more, hand-helds offer diners in your cafeteria—busy visitors and employees alike—a quick, convenient meal option that's perfect when they're on-the-go.

With a little creativity, nearly any food can be fashioned into a hand-held meal that's just as convenient as it is craveable. Mini Chicken Salad Puffs

24 Gordon Food Service IN THE KITCHEN: RECIPES

Mini Chicken Salad Puffs Pâte Choux Cream Puffs Yield: 24 8-oz. portions Recipe Manager code: sand478 Yield: 88 oz. Recipe Manager code: rcomp371 REORDER NO. DESCRIPTION AMOUNT REORDER NO. DESCRIPTION AMOUNT 617760 GFS® Cooked, Shredded White Meat Chicken 3 lb. 206539 GFS Large Grade A Eggs 16 ct. 198536 Markon® Jumbo Celery, small dice 2 c. Water 1 qt. 191043 GFS Shredded Mild Cheddar Cheese ½ c. 299405 GFS Unsalted Butter Prints 1 lb. 597082 Red Peppers, diced ½ c. 108642 GFS Granulated Cane Sugar 1 tsp. 596973 Jumbo Red Onions, diced ½ c. 153550 Coarse Kosher Salt 1 tsp. 562769 Markon Italian Parsley, chopped finely ½ c. 227528 GFS Bleached All-Purpose Flour 1 qt. 432750 Pepper Mill® Fat Free Honey Dijon Mustard Dressing 3 c. PREPARATION INSTRUCTIONS 424307 Kosher Salt to taste Wash hands. 1] Break 14 eggs into a bowl. In a nonstick 225037 Trade East® Ground Black Pepper to taste sauce pot, combine water, butter, sugar, and salt. Bring to a Recipe Pâte Choux Cream Puffs, sliced 72 ct. boil. 2] Add the flour and stir with a heat-resistant spatula 588381 Markon Roma Tomatoes, 1 until the mixture begins to pull away from the sides of the sliced into ⁄3 oz. slices 1½ lb. pan. Continue working the mixture until all of the flour 182570 Markon Romaine Hearts, sliced thinly 3 c. is incorporated and the dough mixture forms a ball. Mix 1 minute over medium heat. 3] Place dough mixture in a PREPARATION INSTRUCTIONS stainless-steel bowl of an electric mixer fitted with a paddle Wash hands. Wash all fresh, unpackaged produce under attachment. Allow to cool 4–5 minutes. 4] Set mixer on running water. Drain well. 1] Place chicken, celery, cheese, low speed. Add cracked eggs 1 at a time, ensuring each egg red peppers, red onion, parsley, and dressing in a stainless- is incorporated into dough before adding the next. Mix steel mixing bowl. Mix thoroughly. Season to taste with salt until dough is smooth. 5] In small batches, place warm 3 and pepper. Place in a storage container. Cover, label, date, dough in a pastry bag fitted with a ¼" or ⁄8" opening. 6] and refrigerate for future service. CCP: Refrigerate at 41ºF, Pipe immediately onto an oiled parchment-lined sheet tray. or below. Pipe the dough in 1 oz. amounts, about 1½" high, 1" apart. 7] Break 2 eggs into a stainless-steel mixing bowl. Add a small amount of water and whisk thoroughly. Lightly brush TO PREPARE À LA CARTE: dough mounds with egg wash. 8] Place in a heated 400ºF Wash hands. Wash all fresh, unpackaged produce under convection oven for 10 minutes. Reduce heat to 350ºF. running water. Drain well. 1] Place 3 puff bottoms on a Bake until golden-brown. CCP: Final internal cooking serving plate. Place 1 tomato slice, 1 oz. of chicken salad, temperature must reach a minimum of 145°F, held for a 1 and ⁄8 oz. of lettuce on top of each bottom. Place top minimum of 15 seconds. 9] Turn off oven and open door 2". on lettuce. Remove when cool.

NUTRITIONAL INFO (per serving) Calories...... 374 Fat...... 18 g. Sodium...... 340 mg. Carbohydrates...... 28 g. Protein...... 24 g. Typical Cost per Portion:...... $1.00

ENRICH | Spring 2015 25 Spaghetti and Spinach Frittata

26 Gordon Food Service IN THE KITCHEN: RECIPES

Spaghetti and Spinach Frittata TO PREPARE À LA CARTE: Yield: 26 6-oz. portions Recipe Manager code: pasta094 Wash hands. 1] Place 8 pieces of frittata on an oiled metal REORDER NO. DESCRIPTION AMOUNT baking pan. Place a small amount of water on the pan and 721352 Primo Gusto® 10" Spaghetti Pasta 2 lb. cover with foil. Place in a heated 350ºF convection oven 432050 Primo Gusto Extra Virgin Olive Oil 1½ c. until warmed through. Place 2 oz. of warmed low-sodium 424307 Kosher Salt to taste marinara in a ramekin. Serve alongside frittata pieces. 225037 Trade East® Ground Black Pepper to taste Low-Sodium Marinara 560545 Markon® Cleaned Baby Spinach 4 c. Yield: 6 lb. Recipe Manager code: sauce568 261904 Markon Button Mushrooms, sliced thinly 4 c. REORDER NO. DESCRIPTION AMOUNT 597082 Red Peppers, small dice 1 c. 432050 Primo Gusto Extra Virgin Olive Oil 1¼ c. 198536 Markon Jumbo Celery, small dice 1 c. 547336 Jumbo Spanish Onions, small dice 1 c. 109620 Jumbo Spanish Onions, small dice 1 c. 198757 Markon Large Green Peppers, small dice 1 c. 191043 GFS® Shredded Mild Cheddar Cheese 4 c. 170895 Markon Stalk Celery, small dice 1 c. 164259 Primo Gusto Grated Parmesan Cheese 2 c. 322164 Chopped Garlic 3 Tbsp. 565148 Trade East Garden Seasoning 4 Tbsp. 428574 Trade East Italian Herb Seasoning 3 Tbsp. 874302 GFS Liquid Eggs 3 qt. 226074 No Salt Added Crushed Tomatoes 12¾ oz. 512109 Whole White Milk 1 qt. 562769 Markon Italian Parsley, chopped fine 1¼ c. 405170 GFS Canola Oil Pan Coating Spray 1 oz. Recipe Low-Sodium Marinara 3 lb. PREPARATION INSTRUCTIONS Wash hands. Wash all fresh, unpackaged produce under PREPARATION INSTRUCTIONS running water. Drain well. 1] Place olive oil in a heated, Wash hands. Wash all fresh, unpackaged produce under non-reactive rondeau. Add onions, peppers, celery, garlic, running water. Drain well. 1] Bring a large pot of water to and Italian seasoning and sauté until vegetables are tender. full, rolling boil. Gradually add pasta. Stir and return to a 2] Add tomatoes and simmer 20-30 minutes. Add parsley full boil. Cook to desired tenderness, stirring occasionally. and mix thoroughly. Simmer 1-2 minutes. Let cool. Transfer Drain immediately. 2] Rinse in cold water. Place in a to a nonreactive storage container. Cover, label, date, and colander to drain. Transfer to a large, stainless-steel mixing refrigerate for future service. CCP: Refrigerate at 41ºF, bowl. Drizzle a small amount of olive oil over the pasta or below. to prevent sticking. Mix thoroughly. Season to taste with salt and pepper. 3] Place spinach, mushrooms, red peppers, celery, onions, cheddar, Parmesan, and garden seasoning in the bowl with the pasta. Toss together until well-blended. 4] Whisk eggs and milk together in a separate stainless- steel mixing bowl. Season with salt and pepper. 5] Spray NUTRITIONAL INFO (per serving) a parchment-lined full sheet pan with pan spray. Spread Calories ...... 621 spaghetti mixture out evenly on the pan and press down Fat ...... 39 using a metal spatula until even with the top edge of the Sodium ...... 440 pan. Slowly pour the egg mixture over the top of the entire Carbohydrates ...... 40 Protein ...... 31 mixture. Lightly press down with metal spatula until all pasta is coated. 6] Place in a 300ºF convection oven. Cook Typical Cost per Portion: ...... $1.25 30-40 minutes, or until the center of the frittata is firm to the touch. CCP: Final internal cooking temperature must reach a minimum of 145°F, held for a minimum of 15 seconds. Allow to cool uncovered. 7] Slice into 1 oz. portions. Cover, label, date, and refrigerate for future service. CCP: Refrigerate at See more recipes like 41ºF, or below. Pulled Pork Bahn MI and Quinoa Pretzel Burger at gfs.com/enrich.

ENRICH | Spring 2015 27 Tuna Mac ‘n’ Cheese Bites

28 Gordon Food Service IN THE KITCHEN: RECIPES

Tuna Mac ‘n’ Cheese Bites TO PREPARE À LA CARTE: Yield: 18 8-oz. portions Recipe Manager code: pasta095 Wash hands. 1] Using a #40 disher, scoop mixture onto REORDER NO. DESCRIPTION AMOUNT an oiled, parchment-lined sheet pan, leaving ½" between 1 635742 Primo Gusto® Pipette Pasta 1 lb. portions. Top each bite with ⁄8 tsp. of Parmesan cheese. Place 424307 Kosher Salt to taste in a heated 350ºF convection oven until golden-brown and 225037 Trade East® Ground Black Pepper to taste cooked through. CCP: final internal cooking temperature must reach a minimum of 145°F, held 432000 GFS® Clear Canola Salad Oil 2 Tbsp. for a minimum of 15 seconds. 2] Place 2 oz. of warmed 109620 Jumbo Spanish Onions, fine dice 1 c. Tuna Bites marinara in a ramekin. Place the ramekin in the center of 170895 Markon® Stalk Celery, fine dice 1 c. 1 a warmed serving plate. Sprinkle ⁄8 tsp. of parsley on top Mac ‘n’ Cheese 322164 Chopped Garlic 2 Tbsp. of the marinara. Place 8 tuna bites on the plate around 299405 GFS Unsalted Butter Prints 3 Tbsp. the ramekin. 227528 GFS Bleached All-Purpose Flour 6 Tbsp. Low-Sodium Marinara 512109 Whole White Milk 3 c. 411841 GFS Feather-Shredded Cheddar Cheese 3 c. Yield: 6 lb. Recipe Manager code: sauce568 REORDER NO. DESCRIPTION AMOUNT 164208 GFS Yellow American Cheese, shredded 3 c. 432050 Primo Gusto Extra Virgin Olive Oil 1¼ c. 518331 Trade East Paprika 1 Tbsp. 547336 Jumbo Spanish Onions, small dice 1 c. 874302 GFS Liquid Eggs 1 c. 198757 Markon Large Green Peppers, small dice 1 c. 103411 GFS White Albacore Tuna, drained 4 c. 170895 Markon Stalk Celery, small dice 1 c. 119458 GFS Peas & Carrots, thawed 2 c. 322164 Chopped Garlic 3 Tbsp. 164259 Primo Gusto Grated Parmesan Cheese 2½ c. 428574 Trade East Italian Herb Seasoning 3 Tbsp. Recipe Low-Sodium Marinara 3 lb. 226074 No Salt Added Crushed Tomatoes 12¾ oz. 562769 Markon Italian Parsley, chopped finely 1¼ c. 562769 Markon Italian Parsley, chopped fine 1¼ c.

PREPARATION INSTRUCTIONS PREPARATION INSTRUCTIONS Wash hands. Wash all fresh, unpackaged produce under Wash hands. Wash all fresh, unpackaged produce under running water. Drain well. 1] Bring a large pot of water to running water. Drain well. 1] Place olive oil in a heated, a full, rolling boil. Gradually add pasta and return to a full non-reactive rondeau. Add onions, peppers, celery, garlic, boil. Cook to preferred tenderness, stirring occasionally. and Italian seasoning and sauté until vegetables are tender. 2] Rinse in cold water. Place in a colander to drain. Transfer 2] Add tomatoes and simmer 20–30 minutes. Add parsley to a large, stainless-steel mixing bowl. Drizzle a small and mix thoroughly. Simmer 1–2 minutes. Let cool. Transfer amount of oil over the pasta to prevent sticking. Season to to a nonreactive storage container. Cover, label, date, and taste with salt and pepper and mix thoroughly. 3] Place the refrigerate for future service. CCP: Refrigerate at 41ºF, canola oil in a heated, nonstick sauté pan. Add onions, celery, or below. and garlic. Sauté until onions are tender. 4] Melt butter in a warmed, nonstick saucepan. Add milk and bring to a boil. Simmer 2–3 minutes, whisking frequently. Add cheddar, American cheese, and paprika. Whisk until the cheese has melted and the sauce is smooth. Slowly pour eggs into the sauce, whisking continuously. Simmer 2–3 minutes. 5] Add the onion mixture, tuna, peas and carrots, and 2 c. of Parmesan to the pasta bowl. Mix with a rubber spatula; do not overmix. Ladle 6 c. of warmed cheese sauce over the pasta mixture and mix. Place in a full 2" stainless-steel hotel NUTRITIONAL INFO (per serving) pan and let cool. Cover, label, date, and refrigerate for future Calories ...... 368 service. CCP: Refrigerate at 41ºF, or below. Fat ...... 22 Sodium ...... 700 Carbohydrates ...... 20 Protein ...... 28 Typical Cost per Portion: ...... $1.50

ENRICH | Spring 2015 29 Smoked-Beef Eggplant Biscuit

30 Gordon Food Service IN THE KITCHEN: RECIPES

Smoked-Beef Eggplant Biscuit PREPARATION INSTRUCTIONS Yield: 24 8-oz. portions Recipe Manager code: biscuit010 Wash hands. Wash all fresh, unpackaged produce under REORDER NO. DESCRIPTION AMOUNT running water. Drain well. 1] Place 2 oz. olive oil in a heated, 698520 GFS® Southern-Style Biscuit Dough 24 ct. non-stick pan. Add eggplant, tomatoes, and basil. Season to 533246 Brickman’s® Roasted Red Pepper Salad 1½ c. taste with salt and pepper. Cook over low heat until tender and liquid has reduced. 2] Place 2 oz. olive oil in another 778044 GFS Hickory-Smoked Shredded Beef Barbecue 1½ lb. heated, non-stick sauté pan. Add onions and garlic. Sauté 232424 Hearthstone® Roasted Beef Gravy 3 c. until tender. Season to taste with salt and pepper. 3] In Recipe Eggplant-Tomato Spread 8 oz. small batches, combine and chop the eggplant and onion 182570 Markon® Romaine Hearts, sliced thinly 1 c. mixture in a food processor fitted with a metal blade. Blend Recipe Toasted Sunflower Seed Spread 4 oz. until smooth. Transfer to a stainless-steel mixing bowl. Stir in zesty country seasoning and parsley. Place in a storage PREPARATION INSTRUCTIONS container. Cover, label, date, and refrigerate for future service. Wash hands. Wash all fresh, unpackaged produce under CCP: Refrigerate at 41ºF, or below. running water. Drain well. 1] Place the biscuits on a Toasted Sunflower Seed Spread parchment-lined sheet pan, spacing evenly. Bake in a Recipe Manager code: spread018 325ºF convection oven for 25–30 minutes or until golden- 1 Yield: 2¼ lb. brown. Let cool. 2] Drain peppers and slice into ⁄8" strips. Place in a storage container. Cover, label, date, and refrigerate REORDER NO. DESCRIPTION AMOUNT for future service. CCP: Refrigerate at 41ºF, or below. 337910 GFS Roasted Salted Sunflower Seeds 8 oz. 3] Hand-shred 1½ lb. of beef and place in a heated, non- 106968 GFS Extra-Heavy-Duty Mayonnaise 16 oz. stick pan. Add gravy and bring to a boil. Stir continuously, 285218 GFS Sour Cream 16 oz. adding water to adjust consistency, if needed. Keep warm 513806 Trade East Hulled Whole Sesame Seeds, toasted 1 ½ c. until needed. CCP: Final internal cooking temperature must 138300 Trade East Granulated Onion 2 tsp. reach a minimum of 165°F within 2 hours. 513881 Trade East Granulated Garlic 2 tsp. 513776 Trade East Ground White Pepper 1¼ tsp. TO PREPARE À LA CARTE: 424307 Kosher Salt to taste Wash hands. Wash all fresh, unpackaged produce under 225037 Trade East Ground Black Pepper to taste running water. Drain well. 1] Slice biscuits in half widthwise. Spread 2 tsp. of eggplant-tomato spread on the inside of the PREPARATION INSTRUCTIONS bottom half of the biscuit. Place on a warmed serving plate. Wash hands. 1] Place sunflower seeds in a food processor ] Spoon 1 oz. warmed beef on top of the spread. 2 Place fitted with a metal blade. Pulse-chop until fine. 2] Combine 1 ½ oz. of sliced peppers and ⁄8 oz. of lettuce on top of the mayonnaise, sour cream, granulated onion, granulated beef. Spread 1 tsp. of sunflower seed spread on the inside garlic, white pepper, and sunflower seeds in a stainless-steel of the top half of the biscuit. Place the top biscuit on top mixing bowl. Mix thoroughly. Season to taste with salt and of the lettuce. pepper. Transfer to a storage container. Cover, label, date, and Eggplant-Tomato Spread refrigerate until needed. CCP: Refrigerate at 41ºF, or below. Yield: 2 lb. Recipe Manager code: spread021 REORDER NO. DESCRIPTION AMOUNT 432050 Primo Gusto® Extra Virgin Olive Oil 1½ c. 198595 Eggplant, peeled and diced into 1" cubes 5 c. 588381 Markon Roma Tomatoes, trimmed 1 lb. 562688 Markon Fresh Basil, trimmed and chopped 1¼ c. NUTRITIONAL INFO (per serving) 424307 Kosher Salt to taste Calories...... 323 225037 Trade East® Ground Black Pepper to taste Fat...... 16 547336 Jumbo Spanish Onions, small dice 1 c. Sodium...... 800 Carbohydrates...... 29 322164 Chopped Garlic 2 Tbsp. Protein...... 14 647220 Trade East Zesty Country Seasoning 2 Tbsp. Typical Cost per Portion:...... $1.00 562769 Markon Italian Parsley, chopped finely 1¼ c.

ENRICH | Spring 2015 31 COLUMN: INDUSTRY UPDATE

Cost-Effective E Services, High-Value Results by: Dana Fillmore, RD, CP-FS

The Affordable Care Act is in full swing. Reforms including departments such as Food and Nutrition Services continue to unfold throughout the continuum of care. and Environmental Services. In fact, a recent study shows Healthcare providers are adjusting to new rules and assisted-living communities offered a significant average planning for what’s yet to come. hour-rate increase for chefs and cooks as they focused Some experts say the fact that hospitals are experiencing on increasing the quality food and dining services. The an increase in outpatient care and a decrease in inpatient pressure to keep overall costs in line while at the same care hints at the success of previously implemented time increasing customer satisfaction and improving reforms. Decreased inpatient volume is anticipated to quality of care is causing astute industry leaders to focus continue despite the projected increase in the number of more on their employees. They recognize that employee Americans with insurance coverage. This change is likely engagement and satisfaction often lead to reduced driven by multiple factors, but experts say the financial turnover costs, improved customer service, and hence incentives tied to quality of care and keeping people out improved quality of care. Employee engagement demands of the hospital is a major contributor. The Centers for an emphasis on hiring the right person, proper onboarding, Medicare and Medicaid Services (CMS) reports that and continued development. E nearly 800 of the nation’s hospitals will face either no penalties, or will earn rewards based on their performance last year in the value-based purchasing program. That’s great news. On the other hand, CMS estimates that overall Joint Commission launches a Medicare payments will drop by roughly $330 million new information portal in 2015 due to penalties from the Hospital Acquired A new online resource at jointcommission.org/ Condition program. hai.aspx offers valuable information about In the midst of this change, forward-thinking healthcare hospital-acquired infection prevention, hand operators have been planning for new care models that hygiene, and resources specific to various healthcare settings (hospitals, skilled-nursing, will improve outcomes and reduce their risk of financial home care, etc.). penalties. They’re seeking ways to enhance their mix of offerings throughout the continuum of care and are coming up with innovative ideas to help the bottom line. Of particular interest, many healthcare systems are hiring community health workers to improve care delivery and Staff Attitude Affects address various social factors, such as providing meals or assistance with grocery shopping and meal preparation. Customer Satisfaction (Employment of community health workers is projected Findings from a recent study conducted by the University of North Texas Health Science to increase 21 percent through 2022.) President Barack Center’s School of Public Health reveal that Obama’s 2016 budget proposal included a hike in Meals patient satisfaction correlates more closely on Wheels and other nutrition programs, as well as a hike with staff attitude than with the way meals are in home-based supportive services to help seniors and delivered. Want to boost patient-satisfaction younger people with disabilities receive care at home. We scores? Train for outstanding customer service. don’t know if the proposed budget increases will pass, but the onus is on healthcare operators to introduce cost- effective services that will provide high-value results in every area of care. ENGAGE YOUR EMPLOYEES Hiring in the healthcare industry is in an upswing. The majority of the planned hiring is within ambulatory care, aligning with the projected increase of out patient hospital care and the push to provide care in lower-level settings. Labor is a significant cost for healthcare providers,

32 Gordon Food Service COLUMN: ASK THE DIETITIAN

by: Sara Kwiatkowski, RD

Q. WHAT ARE GMOs AND HOW DO I TELL IF A government would then have; and, ultimately, the effect PRODUCT CONTAINS THEM? on the farmers aiming to feed the world population. A. If you want to know if your product contains wheat, Consumers want to choose whether they will consume a fl avorings, and/or artifi cial sweeteners, you’d simply check product with a GMO and that information needs to be the ingredient label on your product because it’s required visible at the point of purchase. Many countries require by law through the Food and Drug Administration (FDA). this labeling. In the United States, some states have passed If you want to know if your product contains genetically legislation requiring labeling. For instance, on May 8, 2014, modifi ed organisms, you have to contact the manufacturer Vermont passed a law requiring the labeling of genetically to fi nd out. modifi ed foods by July 2016 for “food offered for retail sale.” This poses challenges for manufacturers distributing What exactly is a GMO? GMO stands for Genetically the same product to multiple states. The FDA supports Modifi ed Organism. GMOs are gaining a lot of attention voluntary labeling of GMOs and has issued guidance for from consumers, the foodservice industry, and the the food industry. government due to their increased use in the food supply and the public debate over their safety. GMOs also are used Understanding what GMOs are and where they can in research, production of pharmaceutical drugs, and gene be found, as well as consumer attitudes toward them, therapy. In agriculture, genetically modifi ed crops might be might help you decide if you should disclose this type of developed to improve nutrition profi les, increase yield, or information to your customers. If your customers have improve a crop’s ability to thrive in diffi cult environments. asked questions about GMOs, it might be worthwhile GMOs are not new; they have been in our food supply for to provide information in common eating areas such as more than 20 years. the cafeteria or dining room help educate them on this controversial topic. According to the U.S. Department of Agriculture, corn and soybeans are the most common genetically engineered To date, no ill effects have been proven in the human (GE) crops in the United States. Most are used as food population; however, several advocacy groups that oppose ingredients and animal feed. The FDA has our safety GMOs in our food supply claim the risks have not been in mind and, as a result, it requires that “food and food identifi ed or managed and would like more research done ingredients derived from GE plants must adhere to the on the subject, or, at minimum, have the product labeled same safety requirements under the Federal Food, Drug, accordingly. Being transparent about what you are serving and Cosmetic Act that apply to food and food ingredients can go a long way toward gaining trust and respect from derived from traditionally bred plants.” your customers. E So, why all the controversy with GMOs in our food supply? The key points are whether the FDA should require foods to be labeled as containing GMOs; what role the

ENRICH | Spring 2015 33 COLUMN: ENGAGE Engage …

Resolving Employee Conflict by: Ken Wasco

One of the most common sources of confl ict I see in foodservice operations is the tension between kitchen and serving staffs. There’s too often an “us versus them” Position the behavior, not the person, mentality that gets in the way of working toward as the impediment to success. what should be a common goal—providing a great customer experience. It’s up to managers to clearly demonstrate how teamwork better serves the customer and benefi ts the employees against each other to the detriment of your business. Here’s an approach that works. customers. Position the behavior, not the person, as the impediment to success. Then continue along these lines: Identify problem employees. If there’s a rift between the two sides of your operation, you have to heal it before you “What happens next is not going to be up to me. It’s can move forward. You know where the problem lies—or entirely up to you. If you choose to change your behavior, more specifi cally, with whom the problem lies. Bring the I will never bring this up to you again. But if you choose to problem-causing employee(s) into your offi ce, one at a keep doing what you’re doing, you are forcing me to take time, for a conversation that starts something like this: care of the situation. Just remember, it’s not my decision, it’s yours.” “I think you’re a good person. But I have to tell you that one of your work habits is standing in between where we That’s sure to be an uncomfortable conversation. But are today and how good this operation can really be.” it needs to happen in order to build a cohesive team that always puts the customer fi rst. E Put the ball in their court. Describe the problem behavior as you see it and tell the person how it’s setting

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