The current healthcare environment has most nursing homes scrambling to control costs in all departments. Money is being squeezed now more than ever and administrators are desperate to trim costs wherever possible without negatively affecting resident care. Next to the nursing department, the food service department represents one of the top “spenders” in a long term care facility. While it is essential that the resident eats and drinks there are some areas in the dietary department which should get a closer look to assess for any wasted dollars. The consultant dietitian is a valuable resource who can offer a new set of eyes to review areas in the kitchen such as purchasing, receiving, production, storage and supplement usage just to name a few. Many consultant dietitians have years of experience in management along with clinical expertise. They have run a kitchen, purchased food, planned menus and understand food and supply costs. A consultant dietitian is extremely adept at identifying areas of waste and ways for tighter controls. They also offer the advantage of working with numerous facilities and can offer advice based on experience.
Excessive food and supply costs are one of the top reasons for an out of control food service department. The following list contains key areas a consultant dietitian will review to uncover hidden waste.
- Poorly planned menu: Writing a menu “on the fly” is not a desired practice. Having a set cycle menu is ideal. Menus must meet regulatory guidelines but need to offer variety, eye appeal and sensory stimulation. The menu must be planned taking into account the available staff and equipment. Menu items must be appropriate to the season: i.e. do not serve watermelon in January. The manager should know how much the menu is supposed to cost.
- Over production: No cook wants to run out of food. To avoid this issue, a cook knows about how much to make and will tend to make “a few extra” just in case. These “few extra” end up getting thrown out or become lunch or dinner for some of the staff. The cook should have a production record to indicate how much of each item to prepare. Watch for the amount of leftovers after each meal. If a whole pan of lasagna is leftover, you have an over production problem and it needs to be fixed.
- Poor purchasing practices: The manager must order from approved suppliers and the facility should be part of a group purchasing program to receive better pricing. Order guides should be used to track inventory on hand and amount to order. Over purchasing increases the likelihood that the food will deteriorate. Under purchasing can lead to trips to the grocery store and increased labor costs. Use par stock on items such as spices, sugar, flour etc. Limit the ordering to one person, preferably the manager.
- Failure to check deliveries and poor storage practices: Refrigerated items must be received at 41 ̊ F or below and frozen foods at 0 ̊ F or below. Frozen foods should show no signs of thawing and refreezing. First in, first out should be enforced. Storage areas must be secure to limit the temptation of theft.
- Lack of standardized recipes: Standardized recipes and portion control must be followed in order to keep costs within budget. If it is left up to the cooks to prepare an item without a recipe, the costs will skyrocket. Cooks should not be allowed to “wing it” and use their own ideas as far as food preparation. It is imperative that recipes are used for all items, even Jell-O!
- Excessive waste in preparation: Make sure cooks are weighing and measuring accurately. If a recipe calls for 8 pounds of ground beef and the cook puts in 10 pounds because it is easier, there is a 2 pound waste which can add up quickly. Over production of even 10 percent costs a facility an average of $15,000 per year!
- Poor portion control: The spreadsheet should list the appropriate portion for each food item. Employees need to be monitored to make sure the portion is not too large or too small. The consultant dietitian will monitor this when watching meal service.
- Theft: No one wants to talk about it, but theft or pilferage happens. People are desperate and when the manager goes home, temptations are everywhere. Theft costs you lots of money, be diligent and make sure employees know that taking food is stealing and is a crime.
- Excessive use of supplements: The consultant dietitian can evaluate the appropriateness of the number of supplements being provided to residents. The dietitian can monitor the resident’s acceptance of supplements. Substantial cost savings can be attained by this review.
- Poor accountability: The manager must be aware of all items coming in and going out of the department. All food and supplies must be accounted for by the manager. This includes special catering, supplements, nourishments, free meals and floor stock. Do not allow unauthorized personnel to come into the kitchen and remove food or supplies without accounting for it with the manager or supervisor.
If the average 100 bed nursing home could save just 3 cents per meal they would save over $3000 per year! The Nutrition Care Systems Consultant Dietitian is a valuable resource to identify cost savings throughout the department. Ask them to carve out a few extra hours at their next visit to review food and supply costs and you may be looking at thousands of dollars in savings.