This article is sponsored by DiningRD. This article is based on a Senior Housing News discussion with Mark Holmes, the National Director of Culinary Operations for the Goodman Group, Mary Ann Thurman, the Director of Culinary and Dining Services for Vetter Health Services, and Andrew Poole, the Chief Operating Officer for DDS. This discussion took place on May 17th, 2024 at the DISHED conference. The article below has been edited for length and clarity.
Senior Housing News: Mark, nutrition has been a pillar of the Goodman Group for a long time. What nutrition activities are the most successful?
Mark Holmes: I think the social aspect of dining and eating is such a huge part of resident life. People look forward to it.
We work on the mantra of we’re only as good as the last meal we served. Every single time that we open our doors, we know we have to meet a lot of expectations. It changes day by day. It’s not just driven by health aspects, it’s also cultural and traditional aspects as well.
SHN: Mary Ann, we’re seeing residents stay in assisted living for a much longer period of time. That often also means making accommodations for specialized diets and texture modifications. How do you find the best way to handle these cases?
Mary Ann Thurman: We all need to make sure that our admission agreement is wide enough to accommodate all those needs. If someone has a texture modification or a therapeutic need, and that’s the only reason why they might move on to the next level, then why shouldn’t we accommodate that? If you have a good program, you need to train your staff, and that’s probably the component that’s missing at this point in time.
SHN: Often, we hear from residents that there’s too much food. How are you balancing providing nutritional balance while avoiding excessive waste?
Andrew Poole: Well, I think that the most important thing that you can do is have a relationship with your resident. Every time that you have contact with that resident, how much food are they leaving behind? Are they intimidated by what’s on the plate and not eating any of it at all? As you get to know that resident and track that, you can sort of start to scale back and then give them the appropriate plate.
Holmes: I look at wasted food, and determine what it means. I focus on the needs of the residents rather than what looks good on the menu. How do we translate that so that people can be successful and not feel wasteful?
We want to make them successful in our dining program, us successful with reducing our food waste, and also there’s a financial impact down the road as well.
Thurman: It’s important to have protein-centered and nutrient-centered items, and showcase those a little more glamorous.
SHN: Andrew, how are you handling rising food costs with culinary expectations from residents?
Poole: It’s really sort of generated the grassroots going back to scratch cooking. Value-added products are no longer affordable for most communities. The focus is on training your chefs on how to do more with less, but that means you’re buying ingredients rather than products.
SHN: How do you make blended food or special diets interesting to residents?
Poole: About a third of residents are going to have textured modified diets throughout the course of their progression, whether it be permanent or temporary. If you’re not doing that right, the best that you can do is a 66%, right? You’re barely passing. You need to approach these items as if you’re making a completely separate meal. You’re not taking everything that the residents would have on their plate, throwing it in a blender, and creating a texture modified bowl of food for them. If you approach each ingredient and modify it individually, and then compose your dish, you’re going to come up with something that’s palatable.
Thurman: In addition to what Andrew said, it’s a matter of making sure that your team understands what it is that they need to do. Making it taste like it’s supposed to taste is very important. Never combine two components that you wouldn’t normally have on a plate.
Holmes: I approach it more from the ingredient specification. I replaced whole muscle meats with things like ground beef. Then also one of the things is going back and taking the stigma away from food.
Before we get to that process where we’re mechanically altering things, I try to focus on how we do that with the ingredient rather than the end result.
SHN: Mary Ann, do you have a hydration program that has worked just from your experience?
Thurman: I think something as simple as having a nice display, chilled water, and changing the fruit in it on a routine basis. If it’s in front of the residents, they’re more apt to drink it as opposed to having to ask for it.
SHN: Mark, what are you seeing of resident preference related to ingredients, organics, nutrition, supplements, et cetera? How do you respond to this?
Holmes: I would probably approach it from a food-first program. Organics are really great ingredients. However, they don’t fit into every single person’s budget.It’s the ability to not think globally, but rather think in smaller versions. We can offer an organic salad. We don’t have to offer the whole meal as organic.
We focus on what’s available locally. Locally doesn’t mean from the stand down the street.If it tastes good, if it’s presented well, it doesn’t always matter if those herbs came from the dark side of Mount Everest. It matters that those herbs are the best herbs that you could get within your financial budget.
SHN: Mary Ann and Andrew, what are you seeing of resident preference with those ingredients, organics, supplements, and how are you responding to it?
Thurman: I agree with Mark, we need to go food first. Something as simple as doing a yogurt smoothie is more exciting than a glass of Ensure. From that, what it all leads back to is the resident’s preferences, knowing their life story, and what you can focus on.
Poole: The demand is there, and it’s not going anywhere. As the population continues to change in senior living, folks who are used to certain diets are going to enforce that more and more. We put in hydroponic gardens in some of the communities, and it was something fun for the residents. Folks loved watching the garden grow. They love knowing where their food is coming from. They love knowing that there’s no pesticides, there’s no GMOs, it’s nutritious whole foods.
SHN: Mark, are there easy to use tools and resources that your operators use?
Holmes: We liberalized all our diets. The way that I could do that was we worked with a company that creates specific bespoke spice blends for us.
We have an Asian seasoning, which we use in fried rice and Asian dishes, sautéed vegetables. We have a warm spice that we serve with butternut squash and sweet potatoes. We really focus on the flavor. The cooks have those tools, instead of having to figure out measurements for different ingredients. Now they can just measure out a tablespoon of the product. It’s improved the flavor profile.
Thurman: Investment in a menu program is vital. Then you can work with your chefs, and you can modify any recipes in there. You can have your consistency. If an item was a flop, you can modify it. You can insert a different recipe. You can insert a different item on your menu. The time savings in that and the consistency that you have will go a long way.
Poole: One thing I always advocate for is leveraging technologies to create efficiencies. The impact that has on your labor is huge. Your menu system needs to talk to your electronic medical records so that you can get rid of that paper trail.
The goal is not necessarily to reduce labor, it’s to reallocate it. Now instead of chasing paperwork, your dining service director is meeting with residents, enriching their experience.
SHN: Do any of you have creative solutions for budgeting and money management when it comes to your dining programs?
Thurman: What we like to do is a simple spend down sheet, so having our managers make sure that they’re well aware of where they’re at within their budget, so they know what they have to spend. Along with that, when you work with any one vendor, then determine how many different areas you can work with them together and integrate.
Holmes: We’ve had to learn the ability to spin on a dime and then pick it up. I manipulate order guides. I work with my primary vendor to make sure that we’re getting the best price and the best outcomes from the regular items. We work with our GPO on making sure that we’re maximizing our rebates.
SHN: Do you have any tips for balancing menu expectations of the marketing department and the reality of staff executing recipes?
Holmes: I put my energy into becoming an ally of the marketing department, rather than the enemy. I work closely with them. I tell them all of our bumps and warts. I tell them what we can do, what we can’t do, and then I say, “What do you want us to do?”
SHN: Mary Ann, how do you make mealtime exciting?
Thurman: The basic option is to do theme days. Getting the residents excited about the next meal. Display boards with what’s coming up and working with your life enrichment program and making sure that they’re involved with anything that might be a theme day or something. Create the whole day around whatever that theme might be. Capitalize on any of the holidays or special days that are coming up and just celebrate life.
SHN: Andrew, would you be able to comment on any new standards for food, menus, and dining, especially as we’re preparing for the baby boomer generation to really enter into senior living?
Poole: That population has, throughout their lifetime, visited many countries and gone out to eat often.. They’re able to understand a much broader menu spectrum than what we would consider our traditional resident base. Along with that comes a different expectation for the types of food that you’re going to be serving.
Now residents have a great understanding of multiple different types of cuisine, how they should be prepared, how they should be presented. With that expectation is sort of a revolution of how we need to prepare those foods.
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