the demographics of flavor - gordon food service magazine - 2015 fall.pdfa quarterly publication of...

A publication of Gordon Food Service®

FALL 2015

News and Views to Strengthen Your Healthcare Foodservice Operation™

The Demographics of Flavor

There's No Place Like a Household

Generational Demographics and Staff Management

Engaging Staff for Higher Quality Care

6 GENERATIONAL DEMOGRAPHICS AND STAFF MANAGEMENT Top ways to foster teamwork among workers from different age groups.

12 THE DEMOGRAPHICS OF FLAVORPleasing palates plays a key role in health, nutrition, and attracting clients.

14 THERE’S NO PLACE LIKE A HOUSEHOLDRenovation and innovation create a sense of home at Michigan care center.

18 POPULATION HEALTH MANAGEMENT

Coordinated care delivery improves clinical and fi nancial outcomes.

10 ENHANCE Serving Guests with Dementia

22 MANAGER’S MEMO Fighting Foodborne Illness

32 INDUSTRY UPDATE Updates on professional standards, proposed regulations, and more

33 ASK THE DIETITIAN What is Carb Counting?

34 ENGAGE When staff is treated well,

guests also benefi t.

24 EGGPLANT ARTICHOKE SANDWICH

26 ASIAN MOONBEAM CHICKEN

27 SEVEN-GRAIN FRENCH TOAST

28 AUTUMN VEGETABLE STROGANOFF

29 SAUTÉED COD

30 GRILLED BRAISED PORK SHOULDER

features columns in the kitchen

5277

7/6M

DANA FILLMORE, RD, CP-FS, Editorial Director. Dana Fillmore manages Healthcare Marketing for Gordon Food Service. Previously Dana was the Manager of Nutrition Services for Gordon Food Service, providing expertise in matters related to nutrition and food safety for all Gordon Food Service customers. Her professional membership in the Academy of Nutrition and Dietetics and her background as Adult Foster Care Consulting Dietitian and Clinical/Foodservice Dietitian supports her specialty in nutrition and foodservice. Her professional food safety certifi cation is supported by the National Environmental Health Association.

News and Views to Strengthen Your Foodservice Operation™

A quarterly publication of Gordon Food Service®ISSUE 17 · FALL 2015

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 effi cient operators.

The opinions, beliefs, and viewpoints expressed by the contributors to Enrich™ magazine do not necessarily refl ect the opinions, beliefs, viewpoints, or offi cial policies of Enrich magazine or of Gordon Food Service Inc. Enrich magazine and Gordon Food Service Inc. do not guarantee the accuracy of all published works. All works submitted to Enrich magazine for publication become the express property of Gordon Food Service Inc. No reproduction of 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.

Welcome to

ENRICH™

EDITORAndy Maier

MANAGING EDITORDanielle Bloom

CONSULTING EDITORRobin Watson

EDITORIAL DIRECTORDana Fillmore, RD, CP-FS

EDITORIAL ADVISORSDana Fillmore, RD, CP-FS

Sara Kwiatkowski, RDGerry Ludwig, CEC

Denise B. Scott, MHA, LNHA

RECIPE DEVELOPMENTEd Westerlund, CEC

RECIPE NUTRITIONJessie Waalkes, RD

RESEARCH ANALYSTAshley Moritz

DESIGNKristen Lesondak

PHOTOGRAPHYJulie Line, Big Event Studios

Chuck Whitman

FOOD/PROP STYLISTMichelle Callaghan-Hale

ACCOUNT MANAGER, ADVERTISINGDanielle Bloom

PRODUCTION MANAGERDeb Daniels

ON THE COVER: Seven-Grain French Toast. See page 27.

The spirit of quality care, cost control, and improving the customer

experience continues to spark innovative ideas in the realm of healthcare

foodservice. This issue of Enrich™ highlights some outstanding examples of

operator innovation throughout the continuum of care. Meadow Brook

Medical Care Facility in Bellaire, Michigan, shares how they are embracing

resident-centered care through the neighborhood concept. It’s exciting

to see the ways they are working through the foodservice challenges this

philosophy introduces and are providing positive outcomes.

The evolution of the Affordable Care Act is energizing the concept of

Population Health Management. Food and nutrition professionals are

in an excellent position to provide value to your organization in terms of

preventive health measures for chronic conditions. A feature article points

out some concepts for you to consider.

Think of the generational cross section you serve in terms of both your

customer base and the workers you employ. In today’s population, you are

easily serving and/or working with three, four, or maybe more generations.

Each generation in your client base craves different fl avors, and each

generation in your employee base prefers a variety of work approaches.

Read on to learn ideas about adjusting your management style and your

menu to meet these needs. Our culinary focus presents fabulous recipe

ideas for the different generations.

Enjoy the refreshing stories featured here. We trust they will inspire

innovation as you work toward providing quality care and an improved

experience for your guests.

3ENRICH | Fall 2015 3

ENRICH | Summer 20154 Gordon Food Service 5

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Today’s healthcare foodservice workforce likely includes everyone from a 58-year-old supervisor to a 41-year-old chef to a 30-something dining-room server. And don’t forget the

nutrition intern. She’s just 20.

The generational cross section of workers can easily span four decades and an equal number of generations, with people of all ages serving in both supervisory and subordinate roles. From a management standpoint, this creates challenges when it comes to getting everyone working together as a team. People from different generations have different ideas about what work means, and different expectations about everything from training to treatment to advancement and compensation.

In other words, there’s no one-size-fi ts-all approach to staff management. Indeed, recognizing and understanding generational cultural differences is a big part of the management challenge today. So says Dan Longton, President and CEO of Florida-based TraitSet®, a workforce-management service provider.

To facilitate inter-generational harmony, Longton advises, remember that all employees are of value to the operation—otherwise, they wouldn’t have been hired in the fi rst place. You don’t want to lose any of them to turnover because

replacement is very expensive and time-consuming.

“Within every generation there are people who have a strong work ethic, great integrity, and abundant skills,” Longton says. “Employers need to conduct assessments and develop training to make sure everyone fi ts the operation’s needs and, ultimately, the guests’ needs.”

Working to understand employees’ needs, training them, and building on their strengths can lead to higher satisfaction scores from guests—including patients, residents, family members, and other guests. And that results in a positive outcome—and image—for the operation and a stronger work environment for the team.

FACILITATING UNDERSTANDINGWhile certain defi ning characteristics are true for each

generation (see sidebar: “The Generations by the Numbers”), Longton warns against stereotyping individuals. Not all boomers are work-focused; not all Gen Xers are slackers, etc. Instead, he suggests, use these descriptions as starting points for understanding and addressing the differences and values of each generation.

For example, Longton says it’s important for managers to know that boomers expect face-to-face communication with the boss instead of an email (so make a point of speaking to them directly); that Gen X looks for a work-life balance (so establish fl ex-time with them whenever possible); that millennials need space to show their strengths (so practice a “hands-off” management style with them as much as you can); and that Gen Z expects to be able to check texts or social media (so set workplace policies that let them know when they can, such as during breaks at work).

“Being the boss who ‘gets it’ is very important,” Longton explains. “Accepting and understanding generational differences allows you to stay ahead.”

HELPING FIND THE “BEST FIT” FOR YOUNG WORKERSIn the team-development sessions that Gordon Food

Service® Customer Effectiveness Manager Ken Wasco conducts, managers often gripe about millennial workers—“They’re impossible to manage. They get bored so easily. They don’t care the way we used to.”

To that, Wasco retorts, “Blah, blah, blah. … You need to learn ways to use all of their differences to your advantage.”

If millennials love working as a team, Wasco says, they will deliver as a team when you set expectations, communicate daily, and offer feedback that keeps everyone focused. And, because younger workers come to the table equipped with a lifetime of hands-on high-tech experience, savvy managers will put those skills to work for the organization.

“Not every millennial is a tech genius, of course,” Wasco says. “But all of them want to be best utilized. You have to get to know millennials personally to fi gure out their ‘best fi t’ in your organization.”

Getting employees to their “best fi t” starts with understanding your organization’s culture. That, Wasco points out, means constantly assessing the values and goals of your business. Tradition may be the very reason clients select your care center. It’s also possible some of those traditions are outdated and in need of change. It’s the organization’s job to know which assets to keep and which ones to change. It’s the manager’s job to get the team to apply those assets.

One way to start this process is by using empathy training to understand those you serve. Workers from younger generations, Longton maintains, may have a diffi cult time appreciating the struggles of the older residents they encounter each day. To learn how it feels to be older or have an impairment, try wearing sunglasses in a dimly lit room, or wear a pair of mittens while you eat.

“Empathy is recognizing how a person feels and responding to that,” Longton says. “We need to remind ourselves and our employees of this all the time.”

THE ROLE OF ROLE-PLAYINGEmpathy also facilitates better manager-employee

relationships. Longton uses role-playing in multigenerational

By Scott Langford

People from different generations have different ideas about

what work means.

FEATURE: GENERATIONAL DEMOGRAPHICS AND STAFF MANAGEMENT

By Scott Langford

Generational Demographics and Staff Management

76 Gordon Food Service ENRICH | Fall 2015

classroom training, to emphasize the point. Have a millennial play the role of a boomer, responding to questions and situations as he or she thinks a boomer would react. Then, reverse the roles.

“Once you internalize what it’s like to be in someone else’s shoes, you learn that the differences between the generations aren’t so bad,” Longton says. “Different, but not bad.”

For managers, Longton says, the toughest battle is to avoid projecting values on the workforce. For example, an older boomer manager may resist high-tech training and instead apply a method that doesn’t resonate with millennials or Gen Z workers.

“If you force a younger worker to sit through a seminar instead of offering an online tutorial, you’re probably not getting your message across,” Longton says. “You need to speak

the right language.”

Another excellent way to improve working relationships among the generations is to use the buddy system. Pair two workers from different generations on the same job, and each will learn best practices from the other. This approach, Longton says, helps each learn that there’s more than one way to provide effective service and care.

WISDOM OF THE AGESThe bottom line is that, no matter how much training a

manager conducts, success is a matter of constant attention to individuals and staff dynamics in order to know when to be a drill sergeant and when to simply direct traffi c. As time marches on, new generations enter the workforce—and it’s important to evolve. Having a happy workforce is essential to long-term success, Longton says. But, as important

BABY BOOMERS* (born 1946-1965)

Known as the “Me Generation,” they’re focused on personal fulfi llment, getting ahead, being in charge, and doing what it takes to get the job done. They appreciate recognition for a job well done, and they’d rather be coached than ordered around.

GENERATION X (born 1966-1976)

Often called “slackers,” they tend to be indifferent and skeptical about things. They want to have fun at work, and often have a hard time separating home and work. They enjoy group projects, and they want written goals to track their achievements.

MILLENNIALS (born 1977-1992)

This a very coddled generation. Many never held a job until graduating from college. Having grown up with personal computers, they’re tech-savvy, enjoy working in teams, and want frequent and ongoing feedback.

GENERATION Z (born 1993 and after)

This is a diverse generation, and its members look for diversity in the workplace. They expect lines to be blurred and work structure to be in constant fl ux. They’re also tech-savvy; they text frequently on their ever-present mobile devices but often lack verbal-communications skills.

* DIFFERENT RESEARCH FIRMS’ DEFINITIONS OF GENERATIONAL DATE RANGES VARY. THESE ARE THE DATES USED BY CHICAGO-BASED TECHNOMIC INC.

as generational harmony is, managers and workers of all generations must recognize they’re part of a business—one with a mission that affects people’s lives.

Learn MoreAsk your Customer Development Specialist how TraitSet and the Gordon Food Service Catalyst®

suite of services can help you manage employees of all ages more effectively.

The Generations by the Numbers

E

ENRICH | Fall 2015 98 Gordon Food Service

E

In coming years, foodservice providers at healthcare centers can expect to see more people with dementia. The population

is getting older: Baby boomers are turning 65 at the rate of about 8,000 a day, according to AARP statistics. The faster the senior population grows, the greater the incidence of dementia, which affects 14 percent of adults ages 71 and older. Dementia is already a public health challenge, as it consumes 20 percent of Medicare dollars.

To properly serve this growing market, foodservice professionals must must adjust to provide service with compassion that encourages those with dementia to eat well. Among the tactics: Constant communication with the individual, and their families, even as language skills fade. Encouraging eating so they maintain weight. Using comfort foods—whatever that means to that individual—to stimulate appetites and encourage eating.

Eating enough is especially important for the elderly, maintains Gordon Food Service® Healthcare Marketing Manager Dana Fillmore, RD, CP-FS. Food gives people strength, and helps maintain a healthy weight that can be so advantageous in overall well-being and healing. For that reason, Fillmore suggests focusing on helping to assure adequate calories for those with dementia.

“Often the value of maintaining weight is more important than the nutritional value of the diet,” Fillmore says, adding that adequate hydration is critical as well.

COMMUNICATION AND COMFORTCommunication is the most

important tool in properly meeting the needs of those with dementia.

As long as they are able, they should make their own food decisions. Family can help, in suggesting favorite foods and recipes, and aiding staff in making decisions when an individual is no longer able.

Forgetfulness is a sign of early stage dementia; people often forget to eat, or they overeat, Fillmore says. To jog memories, gently remind them that it’s mealtime. A calm and pleasant dining room makes mealtime enjoyable. That means soft music, but not noise, such as clanging pots and pans, or loud voices. Give them as much time as they need to eat, and as much as possible allow them to select what they want to eat, as well as the portion sizes they desire.

ADJUSTING AS DEMENTIA PROGRESSES

As dementia progresses, the affected individual can become agitated when he or she feels confused. Don’t rush them, and don’t force them to eat or drink, Fillmore advises. They might want to leave the dining room; if so, allow them to dine in their room, or make sure that they eat a snack later.

Later-stage individuals lose language, and often use gestures—e.g., a hand swat or pounding the table—to communicate dissatisfaction. Respond to such behavior patiently and with compassion. Address the person by name, maintain eye contact, and consider a soothing touch, say a hand on an arm, to calm them.

“It’s about being calm, trying to identify what the person is trying to communicate,” Fillmore says.

People with diminished motor skills or diffi culty swallowing might need adaptive dinnerware in order to to ingest enough calories. Solid-color plates and contrasting solid-

color placemats make food more recognizable—patterned plates can be confusing. Plates with lips allow diners to push food onto fl atware without spilling it onto the table. Cups with lids make drinking easier, and elegant “dining scarves” protect the clothing of diners who might be messy eaters. Have someone sit with individuals with advanced dementia throughout the entire meal, to keep them company, make sure they eat, and address any challenges.

KEEPING TRACKAs long as the individual can tell

dining services what he or she wants to eat, respect those wishes—and record them, in anticipation of the days when language skills are lost. Fillmore fi nds that most will gladly eat foods that connect them with the past—chicken and fresh vegetables for someone who had a rural upbringing, or maybe seafood for someone who grew up on a coast.

All in all, the keywords are communication, compassion—and calories.

“Your goal is to help them,” Fillmore says. “We need them well-nourished and hydrated to stay healthy.”

by: Erin Rodgers

Serving Guests with Dementia

Dementia is a general term that describes a decline in mental ability that affects everyday activities such as communicating, traveling, dressing, hygiene, and eating, Alzheimer’s disease is a type of dementia, and accounts for about 60 to 80 percent of cases, according to the Alzheimer’s Organization website alz.org.

Enhance...

By Erin Rodgers

E

COLUMN: ENHANCE

10 Gordon Food Service

See page 34 for more information.

By Erin Rodgers

See page 34 for more information.

by: Scott Langford

The Demographics

of flavor

by: Scott Langford

GENERATION Z (Born 1993 and after)

“A lot of shakes—such as banana-oat shakes, or an orange-creamsicle shake with ice cream and protein powder—are popular,” Carter says. “There’s even a rise-and-shine shake that has bananas, Greek yogurt, and orange juice.”

But fl avor is only one part of the satisfaction equation. At senior-care centers and long-term-care settings, offering options and “anytime menus” in addition to the day’s main entrée, Carter advises, means there’s always a choice, just like at home.

“Sure, you may like pork chops, but you may not feel like eating them today,” Carter says. “The ‘anytime menu’ is just like being able to open the fridge and choose something else—a burger, a fi sh sandwich, a grilled cheese.”

When it comes to feeding younger hospital patients, employees, or guests in the dining room, Carter favors a more trend-driven menu that emphasizes health and fl avor, with foods such as edamame and quinoa, and beverages infused with slices of fresh fruit and herbal accents.

Ultimately, no matter what audiences you serve, the goal is the same—customer satisfaction. So matching the right foods, on-trend fl avors and food choices to patients, residents, employees, and guests is a step in the right direction.

THEIR HOME, THEIR CHOICEBeing responsive to clients' and guests’ tastes is essential, but

so is accommodating their needs in other ways. Carter urges senior-living centers to adjust service to create a more homelike environment. For example, it’s no longer appropriate to serve breakfast from 7 a.m. to 9 a.m. only.

Hospitals also need to pay attention to hours of service. Providing food when a patient is hungry is important. The patient gets vital nutrients, and the hospital doesn’t waste food by serving a plate that’s not wanted and goes uneaten.

“Ultimately, you don’t recover if you don’t eat,” Carter says. “And, when you do eat, it needs to be a good experience—evidence shows that food quality and dining service have a big impact on patient satisfaction.”

While not every satisfaction survey has questions directly related to foodservice, delivering personalized service and making diners happy makes a big difference when it comes to fi lling out scorecards.

“There are many things people in hospitals or senior centers can’t control, but food is one of the things they can control,” Carter says. “So if you’re not providing a choice for the different generations you’re serving, you’re missing a satisfaction opportunity.”

“If you’re not providing a choice for the different generations

you’re serving, you’re missing a satisfaction opportunity.”

Visit any care-center dining room and you’ll fi nd people who grew up listening to Glenn Miller swing, Frank Sinatra croon, Chuck Berry rock, and Bob Dylan protest.

When it comes to healthcare foodservice, the challenge—whether the setting is a hospital, nursing home, assisted-living center, or senior community—is satisfying the tastes of a multigenerational client base. Or, as a baby boomer might put it: “Different strokes for different folks.”

Creating craveable menus means striking a balance between health-driven nutritional needs and the desire for delicious choices that meet nutritional guidelines,

stay within budget, and assuring they can be—as much as possible—provided when patients or residents want it.

We are ushering in a culture change. In nursing centers, most residents are members of the silent generation but, incoming clients tend to be baby boomers. And, with hospitals transitioning patients into some form of assisted care, instances of more than one generation living and dining together will become more frequent.

Care centers of all types need to ask themselves: ‘Who lives here?’ ‘When was the last time I checked my menu?’ ‘Am I asking clients what they want to eat?’

TRADITION AND BEYONDPay attention to what different generations desire and

compare that to what your menu offers. This is critical to pleasing palates and attracting clients, according to the online senior-living resource aplaceformom.com. Residents of senior-living centers today are looking for a place to continue enriching their lives, and crave-worthy fl avors are part of that equation.

The silent generation prefers meat and potatoes. Baby boomers also are predominantly traditional but have an adventurous streak. Meat and potatoes, yes, but they may prefer sweet-potato fries to a baked or mashed potato.

One big reason why boomers are more adventurous than the silent generation is travel. Gordon Food Service® Nutrition Resource Center Menu Specialist Sharon Carter, RD, notes that members of the silent generation often saved up to take one big trip after retirement, whereas boomers traveled frequently throughout their working lives. Exposure to different cultures and different foods broadened their diets, a factor that care communities need to consider.

“Asian food can be a tough sell for the silent generation,” Carter says. “That was never part of their diet. Boomers, on the other hand, are more receptive to what they called ‘Chinese food’ while growing up.”

SHAKE THINGS UP AND SATISFYFor the sake of nutrition, protein, calories, and fl avor,

senior-living centers are serving shakes as a satisfying fl avor-delivery system that can easily be tailored to individual tastes, no matter the generation.

THE SILENT GENERATION (Born 1945 and before)

Sources: Dana Fillmore, Sharon Carter, Flavor & the Menu, Technomic Inc.

WHAT EACH GENERATION CRAVES

BABY BOOMERS (Born 1946-1965)

MILLENNIALS (Born 1977-1992)

GENERATION X (Born 1966-1976)

FOOD FEATURE: THE DEMOGRAPHICS OF FLAVOR

Learn MoreAsk your Customer Development Specialist how TraitSet and the Gordon Food Service Catalyst® suite of services can help you manage employees of all ages more effectively.

E

They rank taste and fl avor as most important. They like to be able to customize what they eat.

Fish and seafood Chinese foodSandwiches—besides burgersMexican foodBarbecue foodSalad with ranch or Caesar dressingBeef dishes

They like traditional foods with a twist. Think sweet potatoes instead of baked potatoes or shedded-beef tacos instead of steak.

They grew up during the Great Depression and World War II. Its members prefer simple, traditional foods.

Roast turkeyMeatloafGrilled cheeseTomato soupEgg-salad sandwichesMashed potatoesGreen beans, peas, carrots

These diners are curious eaters who prefer more exotic foods.

Mexican foodChinese foodJapanese food/sushiMediterraneanWood-fi red pizza Herbal, authentic foods

They value a wide variety of fl avors and dining experiences.

Chinese foodMexican foodBarbecueChicken dishesBreakfast foodCajun fl avorsMiso

PizzaBurgersChinese foodMexican foodPasta dishesVeg-centric dishes


As culture change continues to transform the senior-living industry, many established skilled-nursing centers are faced with the need to create new physical environments that better support

emerging-care models. Readers of Environments for Aging magazine identifi ed “Renovations versus Building New” as one of their top three issues for 2015 and beyond.

Administrators at Meadow Brook Medical Care Facility, an Antrim County-owned community in Bellaire, Michigan, decided that it’s not an either-or proposition—they renovated one building and added a new structure to ensure they could deliver on the Household Model of care.

“We started talking about culture change probably eight to 10 years ago,” says Anne Walsh, CDM, CFPP, Director of Dietary Services. After an encounter with the Pioneer Network—early advocates of person-directed care—administration and staff began exploring such concepts as personhood, learning circles, loneliness, confl ict resolution, and social isolation.

Meadow Brook eventually contracted with Milwaukee-based Action Pact, a culture-change company recognized for developing and promoting the Household Model, to help transition from a traditional nursing-home approach to an atmosphere of genuine home.

“They did extensive training with us and we visited other communities to see the Household Model in action,” Walsh says. “We incorporated as much of the person-centered care approach as we could into our existing program.” But you can’t implement a true Household Model without building actual households. So the county went to voters with a millage request to fund Meadow Brook’s plan.

The millage tax increase was approved, and construction began in the summer of 2012. When it was completed in December 2014, the number of beds was increased from 113 to 133, short-term rehab was added to the list of Meadow Brook services, and the entire community was reorganized into seven distinct households.

EVEN MORE LIKE HOME“Six households have 20 residents and one has 10, just

because of the structure of the building,” Walsh says. “Each household contains a foyer, living room with fi replace, den with a computer, dining room, front and back kitchens, and a series of bedrooms—most of them private, though we have a few for married couples or people who prefer roommates.”Each household has a front porch and doorbell. “It feels like you’re entering somebody’s home rather than visiting an institution,” Walsh says.

“We keep doors open so aromas can drift through the households and stimulate

residents’ appetites.”

Along with these changes in the physical environment comes a greater emphasis on self-determination. Residents can wake up naturally rather than on some pre-determined schedule. That means they can have breakfast whenever they like. They can also snack when they want to, selecting items from a well-stocked refrigerator and pantry.

“The household kitchens are open 24/7,” Walsh says. “There’s always someone who can whip up a cheeseburger at midnight, if that’s what a resident wants.”

The back kitchens are where the bulk of food production takes place. “Each back kitchen is a satellite to our central kitchen. We prep in the central kitchen and deliver it to the satellites. For example, we’ll deliver raw pork chops for them to cook. We do a lot of homemade soups and desserts, so we prepare them in the central kitchen. Each household is also free to make its own cookies, brownies, and other sweets.”

Residents can help bake goodies in the front kitchen, and they often pitch in to snap beans or make salads, but state rules dictate that production cooking take place in back kitchens. Each is equipped with a range, oven, microwave, refrigerator, freezer, disposal, dish machine, and steam well.

“We keep doors open so aromas can drift through the households and stimulate residents’ appetites,” Walsh notes.

Because food is prepared closer to where it’s consumed, it retains more nutrients, looks more attractive, and is served at the ideal temperature. Those factors, along with less-stringent dietary policies, tend to increase consumption and reduce weight loss.

EMPOWERING RESIDENTS“Residents can basically eat what they want,” Walsh

explains, noting that Meadow Brook follows the Pioneer Network’s recommendation to allow the most liberal diet possible. “We follow a general diet that’s nutritionally healthy for everyone and we also prepare texture diets. But we only offer therapeutic diets if a resident wants one for comfort reasons. We also provide carb counts for that reason.”

This was Meadow Brook’s approach before the switch to the Household Model, so menus haven’t changed much with the transition, though Walsh plans to move from a four-week to a fi ve-week cycle. Menu preferences haven’t changed much either.

“Midwest comfort food remains the favorite, just as it always has,” Walsh says. “Otherwise, we’re continuing a long-term trend toward even more homemade dishes and fresh fruits and vegetables. When I started here 25 years ago, made-from-scratch was the standard. Then the industry drifted away from that. Now it’s back.”

Residents can grow vegetables and herbs in raised garden beds outside household back doors and staff will integrate fresh-picked produce into meals. In addition, residents can fi sh from a backyard pond stocked with trout and have their catch prepared for them.

Noting that “One of our households hates fi sh,” Walsh says that meal preferences are easily accommodated with an à la carte menu. “A resident who doesn’t like the main entrée of the day, can always get a hamburger, cheeseburger, omelet, Belgian waffl e, or something.”

“We’re continuing a long-term trend toward even more homemade dishes

and fresh fruits and vegetables.”

There’s No Place Like a

by: Tom Dixon

Household

About the Household ModelAction Pact, a Milwaukee-based company credited with developing the Household Model, describes the concept as “a person-centered approach that shapes the physical environment, organizational structure, and interpersonal relationships in ways that create an atmosphere of genuine home, while providing elders with clear opportunities to direct their own lives.”

The Household Model separates a traditional facility or new development into distinct households of 14 to 20 residents, each with its own kitchen, dining room, living room, and often a den, patio, front porch, and other traditional private-home features.

Each household has decision-making autonomy and is consistently staffed. Residents get up when they want, bathe how and when they want, go to bed when they want, eat when and what they want, and decide how they will spend their day.

FEATURE: MEADOW BROOK MEDICAL CARE


Food preferences are monitored via informal daily feedback and a formal resident food committee, which meets monthly. Each household submits a shopping list for its kitchens, which Walsh uses to create her food order.

A NEW WAY TO WORKIn conjunction with the Household Model, Meadow

Brook has implemented a “universal-worker” concept that transforms the way services are delivered to residents.

Universal workers are staff members trained in all aspects of household service. “We’ve gotten away from ‘silos’—the idea that ‘I’m a Certifi ed Nursing Assistant or ‘I’m a dietary worker,’” Walsh says. “Now everybody is trained to fulfi ll all the functions a household needs. Each household has an RN clinical-care coordinator and a household coordinator—we think of them as ‘mom and dad’—and permanent staffers who do everything from cooking to cleaning to bathing residents.”

This smaller core of versatile workers is able to forge closer relationships with residents. “It really becomes more of a family,” Walsh says.

The move to a universal-worker system required new training for every staffer, which was a bit of a challenge, logistically and temperamentally.

“We had to send some people to another county for training,” Walsh explains. “And some people are just resistant to change—they didn’t want to take on new duties for their job. But the people who’ve stayed have really blossomed under this model.”

Another change Walsh faced was the decrease in the size of her department from 25 full-time people to six. “My role has changed, too,” she says. “I was in charge of one kitchen, now I’ve got eight. And I’m acting more as a mentor than a department head, helping all our staffers with all aspects of food.”

That includes food for community celebrations such as cookouts and parties. “These households are not isolated from each other,” Walsh says. Residents get together daily in activity rooms, the chapel, beauty salon, and therapy areas, and for events. It’s like one of those old-time neighborhoods where everybody hangs out on their front porch and all the services are just a short walk away.

The household and universal worker concepts had only been in effect for six months when Meadow Brook earned the highest marks possible in a defi ciency-free survey from the state of Michigan—indisputable proof of the value of the new approach and the staff’s skill at implementing it.

These are just the latest in a long line of innovations from Meadow Brook, which began operation in 1868 as the county “poor farm.” Almost 150 years later, it ranks as a Medicare Five-Star Nursing Home, and is much appreciated by the people it serves, earning an overall score of 95.7 percent in its latest family-satisfaction survey.In addition to skilled nursing, the community offers adult outpatient therapy and an end-of-life program. E

Lower Costs, Higher SatisfactionVetter Health Services, an Omaha, Nebraska-based owner and operator of long-term-care communities, reported in 2014 that a household-dining model using satellite kitchens results in lower net costs for communities and an improved dining experience for residents. According to Vetter’s study, a food-cost increase of 16 percent—driven primarily by increased inventory—was more than offset by a decrease in staffi ng costs. Food-quality rankings were far above national averages.

CUST. FEATURE: MEADOW BROOK MEDICAL CARE


Help fight the spread of healthcare-associated infections with Array®.

As always, start by following proper hand-washing and hand-sanitizing techniques. Preventing the spread of healthcare-associated infections is a hot topic in today’s healthcare facilities, and it’s important that your facility have a comprehensive cleaning and disinfecting program. Contact your Gordon Food Service® Customer Development Specialist for our Array chemical information sheet so you can be effective against infections like C.diff, MRSA, and norovirus.

Help fight the spread of healthcare-associated infections with Array

As always, start by following proper hand-washing and hand-sanitizing techniques. Preventing the spread of healthcare-associated infections is a hot topic in today’s healthcare facilities, and it’s important that your facility have a comprehensive cleaning and disinfecting program. Contact your Gordon Food Service

AN ARRAY® OF PRODUCTS TO REDUCE YOUR RISK

FEATURE: POPULATION HEALTH MANAGEMENT

The Affordable Care Act (ACA) continues to transform the way healthcare is administered in this country. One of the most significant developments thus far is the greater responsibility providers are

assuming for the cost and quality of care. Driven by provisions that penalize them for poor outcomes, providers are innovating and finding new ways to deliver effective care more efficiently.

Quite simply, explains Gordon Food Service® Healthcare Marketing Manager Dana Fillmore, RD, CP-FS, “We are moving from a fee-for-service structure to a value-for-service model.” This new model, she says, has tremendous implications for food and nutrition professionals.

Population Health Management (PHM) is one of the approaches developed in accordance with this model. The McGraw-Hill Concise Dictionary of Modern Medicine defines PHM as “the coordination of care delivery across a population to improve clinical and financial outcomes, through disease management, case management, and demand management.”

The goal of PHM is to minimize costs and improve the overall health status of a given population by providing care at the earliest and least expensive point in the care continuum. The emphasis is on disease prevention rather than managing health problems through acute interventions like tests, hospitalizations, and emergency-department visits.

“PHM was viewed as somewhat of a fad when it was introduced in 2010,” says Joe Damore, FCHE, a Washington, D.C.-based healthcare consultant. “By 2012 it was a trend. Today it’s a reality spreading across the country.”

According to Damore, half of all Medicare payments will be value-based by 2018, and many private insurance carriers are also supporting this model. “This is not a flash in the pan,” he stresses. “This will change the way all of us do business.”

FOCUSING ON CHRONIC DISEASEChronic health conditions are the most expensive to

treat, so they’re the focus of most PHM-prevention efforts. The U.S. Centers for Disease Control (CDC) reports that chronic diseases are responsible for seven out of 10 deaths each year, and treating people with chronic diseases accounts for 85 percent of the nation’s health costs.

The Milken Institute, a California-based think tank, estimates that seven chronic diseases—cancer, diabetes, hypertension, stroke, heart disease, pulmonary conditions, and mental illness—will account for $4.2 trillion in treatment costs and lost economic output by the year 2023.

Nutrition plays an important role in at least four chronic diseases—diabetes, hypertension, stroke, and heart disease—and evidence-based research continues to support good nutrition as a key preventive measure for other chronic conditions.

Obesity is the most harmful nutrition-related disease-risk factor, of course, and it remains epidemic in this country. The latest CDC study estimates that 34.9 percent of adults are obese, which is defined by the National Institutes of Health as having a Body Mass Index (BMI) of 30 and above.

The national childhood obesity rate—now about 17 percent—appears to have leveled off at the moment, and rates have declined in some places and among some groups, but disparities persist and the CDC indicates that severe obesity may be on the rise.

The prevalence of obesity is further justification for a continuum-of-care approach. Obesity must be addressed at every level of care, from the offices of pediatricians to workplace-wellness programs to hospitals to senior-care communities. That means that participation of and input from dietitians—who are uniquely qualified to deal with nutrition and weight issues—must be incorporated throughout the continuum of care.

Dietitians really should be members of all outpatient teams.

Population Health Management

by: Patrick Bax

19ENRICH | Fall 201518 Gordon Food Service

JOINING THE TEAM(S)“Dietitians (should) serve as members of the high-

performance interdisciplinary teams that are a hallmark of Population Health Management,” says Lauri Wright, PhD, RD, LD, Assistant Professor of Nutrition at the University of South Florida, College of Public Health. “The dietitian can manage data such as weight and lab values, counsel patients on an ongoing basis, advocate for medication changes, and monitor health outcomes.”

Dietitians, Wright maintains, should focus on obesity as well as its downstream consequences, including diabetes, heart disease, renal disease, congestive heart failure, cancer, and nutrition. Increasingly, dietitians will be expected to address these issues on an outpatient basis.

“That’s where healthcare is going,” Fillmore confirms. “The national trend is that inpatient care is decreasing and outpatient care is increasing. It’s time to start focusing on the value of food-and-nutrition services for outpatient delivery.”

Actually, Wright maintains, that’s why dietitians really should be members of all outpatient teams. “The benefit of the outpatient setting is the dietitian can work with the client at a more in-depth level and individualize the counseling to the client’s personal situation and readiness to change.”

Often, Fillmore says, outpatient nutrition care is more effective than an inpatient approach. “Patients in a hospital setting are stressed to such a degree they often can’t focus on anything but their acute health issues. They’re better equipped to hear what a dietitian is saying when they’re hearing it at home.”

Hospitals are tremendously invested in patients listening to and acting on dietitians’ advice, since failure to do so raises the risk of readmission, which can lead to financial penalties for readmitting hospitals. The ACA and the drive to reduce readmissions has helped give rise to Accountable Care Organizations (ACOs)—groups of hospitals, doctors, and other healthcare providers who come together to deliver coordinated, high-quality care.

ACOs are accountable not only to the patients they serve, but also to their provider members. Hospitals, for instance, must rely on skilled-nursing centers to provide proper follow-up care and nutrition following hospitalization.

“We’re seeing the development of preferred nonacute-care provider lists in the context of ACOs,” Damore says. Patients are free to receive follow-up care anywhere they (and their insurance company) please, but a hospital will provide a list of recommended providers.

“If you’re a skilled-nursing or rehab center, you want to be on that list,” Fillmore advises, though she says the

competition is tough, with most health systems selecting less than one third of the skilled-nursing locations in their markets. “Excellent nutrition care and a top-notch dining program can help put you there.”

EXPANDING YOUR SCOPEFood-and-nutrition services directors should be thinking

about ways to integrate themselves and their staffs throughout the continuum of care, Fillmore says. Do your research and show administrators how your skills and expertise can help address the health issues of any given population—whether it’s the overall market you serve or a subset of at-risk or condition-specific individuals. In many cases, doing the right thing can also generate revenue for your organization.

Here are a few ideas for expanding the scope of your services.

Community outreach. According to Fillmore, more hospitals and senior-care centers are including the larger community within their strategic focus. “Cafeterias and dining rooms are open and marketed to the public from day one, with an emphasis on fresh and healthy,” she says. “Walking trails are created and promoted for general use, and healthy prepared meals are available for easy takeaway by trail users as well as patient visitors and employees.”

Jumping on this profit-boosting bandwagon doesn’t always require a new building. And you don’t have to go “all in” at once. Test the waters with a small pilot project first.

Cooking classes. Healthy-cooking demonstrations, onsite or elsewhere, are a specific community outreach tactic that can help combat obesity while strengthening your brand image. Consider charging a fee for your classes—check prices for other local cooking classes. Consider making cooking-class “prescriptions” a part of outpatient care.

Telemedicine. Technology can help dietitians improve outpatient care. For instance, Wright explains, patients can use technology to record their blood-sugar levels, food intake, and activity. The dietitian can make regular contact by phone, Skype, FaceTime and/or at-home visits to reinforce dietary behaviors and assist with disease management.

Prehab. Poor nutritional status has been shown to increase the risk of complications after major surgery and prolong recovery. Conversely, a 2014 study by Montreal’s McGill University found that a “prehabilitation” program incorporating nutritional counseling and exercise greatly benefited the recovery of colorectal cancer surgery patients. Consult with physicians about prehab programs you could offer.

Wellness programs. Virtually all large employers (200 or more workers) and most smaller employers offer at least one wellness program, according to a 2013 study

by the Kaiser Family Foundation, a leader in health-policy analysis. Dietitians can be particularly effective at promoting wellness, and are an important part of many wellness programs. Consider marketing your services to businesses on a contract basis.

Physician outreach. Individual physicians and practice groups must also improve outcomes, and thus can benefit from food-and-nutrition guidance. We Are For Children, a Grand Rapids, Michigan-based physician organization, offers its member practices three hours of in-office dietitian consultation per week, focused on improving Body Mass Index. General practitioners and specialty practices can use your expertise, so be sure to reach out to them.

This is just the tip of a very large iceberg of possible avenues. Be proactive in your quest, especially with services that don’t immediately generate new revenues. Show how your involvement will pay off by reducing healthcare costs while improving health outcomes. And by all means, advocate for legislation that supports inclusion and payment of food-and-nutrition services in these new models of care.

E

FEATURE: POPULATION HEALTH MANAGEMENT


Everyone plays favorites, and people from each

generation crave different foods and fl avors.

Some love the fl avors of their childhoods, and

others enjoy foods they remember from a vacation

or other special event. Whether it’s satisfying their

appetite or making an emotional connection, paying

attention to generational desires is sure to satisfy.

Feed their cravings

RecipesRecipes

by: Erin Rodgers

Fighting Foodborne Illness: The Gloves Are On

E

MANAGER'S MEMO

Gloves in and of themselves hold no magic power of protection. The magic

lies in using them correctly.

Learn MoreContact the Gordon Food Service® Nutrition Resource Center at [email protected] or for assistance with your food-safety questions or concerns.

For more information on germs, hands, and hand-washing, visit the American Society for Microbiology at microbeworld.org. The site also has an entertaining and informative handwashing quiz you can share with your employees.

2322 Gordon Food Service ENRICH | Fall 2015 23ENRICH | Fall 2015

Flu season is almost upon us, which means proper hand hygiene—good washing and proper glove use—can be a top way to prevent the spread of germs. Germs that cause colds, fl u, norovirus,

and other illnesses largely spread via human contact, and mostly by hands.

Experts estimate that hands transmit up to 80 percent of all infections. They are such an effective mover of germs that the Centers for Disease Control has launched the Clean Hands Save Lives campaign nationwide to encourage Americans to wash hands early and often during fl u season.

Because they cover hands, gloves offer protection against the spread of illnesses. “They create a barrier between the hands and food,” says Jessie Waalkes, RD, of the Gordon Food Service® Nutrition Resource Center.

The purpose of gloves, she stresses, is to prevent food from being contaminated with germs that cause illness.

Start with hands. Gloves hold no magic protective power. The magic lies in using them correctly. To start, gloves need to cover clean hands. Think about how you put on gloves—one hand pulls them over the other. If that hand isn’t clean, your dirty hands get the gloves dirty, Waalkes points out. To wash hands properly, use soap and warm water, wash for at least 15–20 seconds and include your wrists, backs of your hands, and fi ngernails, then dry thoroughly with a clean, disposable towel. Use the towel to open the restroom door to avoid re-contaminating your hands.

Choose the right gloves. The next step, according to the National Restaurant Association’s ServSafe® program: Select the right-size gloves for your hands. If they’re too small, they’ll be uncomfortable and will tear easily. If they’re too large, they’ll slip off. Make sure the gloves are in perfect condition—no rips or tears. Most foodservice gloves are latex, but non-latex varieties are available for the safety of workers and clients who are allergic to latex.

Apply gloves correctly. To put on gloves, hold them by their edges—the part that wraps around the wrists—to avoid contact with the surface area of the gloves.

Working with gloves. Once the gloves are on, behave as if you are working with bare hands. That means anytime you touch your hair or face, blow your nose, or go to the restroom, start with fresh gloves. Discard the old pair, wash your hands, and put on a new pair. Change gloves when switching tasks in the kitchen, say going from vegetable prep to taking out the garbage to moving to tray makeup. Also change gloves when they become visibly dirty or torn, and after an interruption in work, such as taking a phone call, and after touching dirty dishes.

Speaking of bare hands, they should never, ever touch “ready to eat” food that’s going straight to a consumer, Waalkes advises. Uncooked food, say raw meat, can be handled with clean, bare hands, but wash them and put gloves on before moving to another station.

Sometimes, even gloves aren’t enough to protect the food and the people you serve from cold and fl u germs. If you have a fever, are vomiting, or have diarrhea, stay home from work or ask to work in a non-food environment. Those extreme circumstances aside, gloves do offer excellent protection against fl u and other germs—as long as they’re put on clean hands, changed frequently, and used correctly.

Pickled Matchst ick Carrots

Yield: 32 1-oz. portions Recipe Manager code: rcomp058REORDER NO. DESCRIPTION AMOUNT

Water 1 qt.

661651 Seasoned Rice Wine Vinegar 1 pt.

151343 GFS Granulated Superfine Cane Sugar ¼ lb.

424307 Kosher Salt 3 Tbsp.

198161 Markon Matchstick-Shredded Carrots 2 lb.

PREPARATION INSTRUCTIONSWash hands. Wash all fresh, unpackaged produce under running water. Drain well. 1] Place carrots in a storage container. 2] Combine water, vinegar sugar, and salt to create a pickling brine. Mix until sugar and salt are dissolved. 3] Pour brine over carrots. Cover, label, date, and refrigerate for future service. Refrigerate at least 24 hours before use. [CCP: Refrigerate at 41º F or below.]

Eggplant Art ichoke Sandwich

Yield: 24 12-oz. portions Recipe Manager code: sand489 REORDER NO. DESCRIPTION AMOUNT

230812 GFS® Old World-Style Seven Grain Bread, thawed 48 slices

Recipe Fresh Herb Oil 12 oz.

269891 GFS Whole Artichoke Hearts, drained and sliced in half 4½ lb.

424307 Kosher Salt to taste

225037 Trade East® Ground Black Pepper to taste

Recipe Charred Eggplant Spread 72 oz.

Recipe Pickled Matchstick Carrots 36 oz.

794750 Capers, deep-fried and drained 1½ c.

220230 Baby Arugula Lettuce 6 oz.

NUTRITIONAL INFO (per serving)

Calories ................................................................. 592Fat ..........................................................................25 g.Sodium ..........................................................150 mg.Carbohydrates .................................................84 g.Protein .................................................................. 13 g.

Typical Cost per Portion: ..................$0.75

Yield: 24 12-oz. portions Recipe Manager code: sand489 REORDER NO. DESCRIPTION AMOUNT

Seven Grain Bread, thawed 48 slices

Recipe Fresh Herb Oil 12 oz.

drained and sliced in half 4½ lb.



Recipe Charred Eggplant Spread 72 oz.

Recipe Pickled Matchstick Carrots 36 oz.

794750 Capers, deep-fried and drained 1½ c.

220230 Baby Arugula Lettuce 6 oz.

TO PREPARE À LA CARTE:Wash hands. Wash all fresh, unpackaged produce under running water. Drain well. 1] Brush one side of 2 pieces of bread with the herb oil. Place oiled-side down on a heated flat griddle or grill. Cook until golden-brown. 2] Brush 3 oz. of artichoke halves with the herb oil. Place on a heated char-grill or broiler until just heated through. Season to taste with salt and pepper. 3] Spread 3 oz. of eggplant spread on the plain side of one of the pieces of bread. Place 1½ oz. of pickled carrots on top of the spread. Place the artichokes on top of the carrots. Sprinkle 1 Tbsp. of capers on top of the artichokes. 4] Place the second piece of bread on top of the sandwich, grilled side out. Slice in half diagonally. Place on a serving plate.

G E N E R A T I O N Z ( B o r n 1 9 9 3 a n d a f t e r )

Eggplant Artichoke Sandwich

IN THE KITCHEN: RECIPES

Pickled Matchst ick Carrots

Yield: 32 1-oz. portions Recipe Manager code: rcomp058REORDER NO. DESCRIPTION AMOUNT

Water

661651 Seasoned Rice Wine Vinegar 1 pt.

151343 GFS Granulated Superfine Cane Sugar ¼ lb.

424307 Kosher Salt 3 Tbsp.

198161 Markon Matchstick-Shredded Carrots 2 lb.

PREPARATION INSTRUCTIONSWash hands. Wash all fresh, unpackaged produce under running water. Drain well. container. create a pickling brine. Mix until sugar and salt are dissolved. 3]3]for future service. Refrigerate at least 24 hours before use. [CCP: Refrigerate at 41º F or below.

Fresh Herb Oil

Yield: 86 oz. Recipe Manager code: rcomp234REORDER NO. DESCRIPTION AMOUNT

502146 Kitchen Essentials® Pomace Olive Oil 2 qt.

562688 Markon® Fresh Basil, trimmed 2 oz.

562696 Markon Fresh Chives, trimmed 2 oz.

272396 Markon Fresh Parsley, trimmed 2 oz.

562742 Markon Fresh Dill, trimmed 1 oz.

PREPARATION INSTRUCTIONSWash hands. Wash all fresh, unpackaged produce under running water. Drain well. 1] In batches, add the oil, basil, chives, parsley, and dill to a blender. Blend until smooth. 2] Transfer to a covered storage container. Cover, label, date, and refrigerate for future service. CCP: Refrigerate at 41º F, or below.

Charred Eggplant Spread

Yield: 106 oz. Recipe Manager code: spread017REORDER NO. DESCRIPTION AMOUNT

653270 Eggplant 6 lb.

432050 Primo Gusto Extra Virgin Olive Oil 1 c.



547336 Spanish Onions 1 lb.

322164 Chopped Garlic 1 oz.

572342 GFS Classic Hummus 4 c.

562769 Markon Fresh Italian Parsley, chopped fine 1 oz.

PREPARATION INSTRUCTIONSWash hands. Wash all fresh, unpackaged produce under running water. Drain well. 1] Peel the eggplant. Slice widthwise ¼" thick. Brush one side of each piece with olive oil. Season to taste with salt and pepper. Place on a heated, char-grill or broiler. Grill on both sides until just cooked through. 2] Place 1 oz. of olive oil in a heated nonstick sauté pan. Add the onion and garlic. Sauté until tender. Season to taste with salt in pepper. 3] In small batches, chop the eggplant and onion mixture in a food processor fitted with a metal blade until smooth. Transfer to a stainless-steel mixing bowl. 4] Add the hummus and parsley. Mix thoroughly. Season to taste with salt and pepper. Transfer to a storage container. Cover, label, date, and refrigerate for future service. CCP: Refrigerate at 41º F, or below.


2524 Gordon Food Service ENRICH | Fall 201524 Gordon Food Service 25ENRICH | Fall 2015

E

Asian Moonbeam Chicken

Yield: 1 12-oz. portion Recipe Manager code: pasta097REORDER NO. DESCRIPTION AMOUNT

764270 GFS® Boneless Skinless Chicken Breast Fillet, thawed 1 ct.

405170 GFS Canola Oil Pan Coating Spray ¼ tsp.



166722 GFS Asian Sesame Ginger Dressing 1½ oz.

721328 Primo Gusto® 10" Linguine Fini Pasta, prepared 1½ oz.

491209 GFS Far East Vegetable Blend, thawed 4 oz.

219550 Markon® Fresh Cilantro, trimmed and chopped ¼ tsp.

340022 Amoy Chow Mein Noodles ¼ oz.

TO PREPARE À LA CARTE:Wash hands. Wash all fresh, unpackaged produce under running water. Drain well. 1] Spray the chicken on both sides with pan spray. Season to taste with salt and pepper. Place on a heated char-grill or broiler. Grill on both sides until cooked through. CCP: Final internal cooking temperature must reach a minimum of 165°F, held for a minimum of 15 sectonds. 2] Add 1½ oz. of dressing to a heated sauté pan. Add 4 oz. each of linguine and vegetable blend to the pan. Toss pan to combine ingredients. Season to taste with salt and pepper. Cook until heated through. 3] Place pasta mixture in a warmed serving bowl. Sprinkle ¼ tsp. of cilantro over the top of the pasta. Slice the chicken widthwise on the bias and fan over the top of the chicken. Place ¼ oz. of chow mein noodles on top of the chicken.


Calories .................................................................548Fat ..........................................................................23 g.Sodium .........................................................380 mg.Carbohydrates ................................................. 53 g.Protein ..................................................................31 g.


Seven-Grain French Toast

Yield: 24 14-oz. portions Recipe Manager code: breakfast0506REORDER NO. DESCRIPTION AMOUNT

206539 GFS® Large Grade A Eggs 30 ct.

245570 1% Buttermilk 1½ c.

513873 GFS Pure Vanilla Extract 1 Tbsp.

299405 GFS Unsalted Butter Prints 1½ lb.

230812 GFS Old World-Style Seven Grain Bread, thawed 48 slices

197769 Bananas, peeled and sliced on the bias 4½ lb.

232068 GFS Maple Syrup, warmed 24 oz.

Recipe Candied Pecans 12 oz.

314668 GFS Powdered Sugar, placed in shaker 4 oz.

332682 Fresh Red Raspberries 3¾ lb.

PREPARATION INSTRUCTIONS Wash hands. 1] Break eggs into a stainless-steel mixing bowl. Whisk until blended. Whisk in the buttermilk and vanilla. Place in a 4" stainless-steel half hotel pan. Cover, label, date, and refrigerate for future service. CCP: Refrigerate at 41ºF, or below. 2] Slice the bread diagonally into triangles. Place in a covered storage container, separating layers by parchment paper. Cover, label, date, and refrigerate for future service. CCP: Refrigerate at 41ºF or below.

TO PREPARE À LA CARTE:

Wash hands. Wash all fresh, unpackaged produce under running water. Drain well. 1] Place 1 Tbsp. Of butter on a heated flat griddle or grill. Immerse both sides of 4 triangles of bread in the egg batter for about 15 seconds. Remove

from the batter and allow to drain. Place the bread on the griddle. Cook on both sides until golden-brown. CCP: Final internal cooking temperature must reach a minimum of 145°F, held for a minimum of 15 seconds. 2] Peel the bananas as needed for service. Slice on the bias ½" thick. Place 1 Tbsp. of butter in a heated, nonstick sauté pan. Add 3 oz. of bananas to the pan. Quickly sauté over mdium heat. Caramelize on one side. Cook until warmed, without over-cooking. 3] Shingle triangles, corner-side-up on a warmed serving plate. Ladle 1oz. of warmed maple butter syrup over the top of the French toast. 4] Spoon the bananas on top of the French toast. Sprinkle ½oz. of candied pecans over the top of the bananas. Top with powdered sugar and 5-6 raspberries.

Candied PecansYield: 16 oz. Recipe Manager code: rcomp05REORDER NO. DESCRIPTION AMOUNT

585068 GFS Pecan Pieces 1 lb.

108642 GFS Granulated Cane Sugar 3 oz.

PREPARATION INSTRUCTIONSWash hands. 1] Blanch pecan halves in boiling water for 30 seconds. Drain and allow to dry 1-2 minutes. 2] In a medium stainless-steel mixing bowl, toss pecans with sugar to evenly coat. Working in 8-oz. batches, fry in a heated 350ºF deep fryer for up to 1 minute, or until crunchy. Drain and place on a piece of parchment paper to cool. 3] Once cool, cover, label, and date for future service.


Calories ................................................................. 563Fat ...........................................................................31 g.Sodium ......................................................... 330 mg.Carbohydrates .................................................62 g.Protein ...................................................................11 g.


Seven-Grain French Toast


M I L L E N N I A L S (B o r n 1 9 7 7 – 1 9 9 2)

Asian Moonbeam Chicken

G E N E R A T I O N X (B o r n 1 9 6 6 - 1 9 7 6)

IN THE KITCHEN: RECIPESIN THE KITCHEN: RECIPES

26 Gordon Food Service 27

Sautéed Cod

Yield: 24 14-oz. portions Recipe Manager code: entree146REORDER NO. DESCRIPTION AMOUNT

227528 GFS® Bleached All-Purpose Flour 3 c.

461512 GFS North Atlantic Cod Loins, thawed 24 ct.

107891 GFS Butter Flavor Pan & Grill Oil 48 oz.

** White Wine 24 fl. oz.

413089 Markon® Cleaned Shallots, minced ½ c.

299405 GFS Unsalted Butter Prints 1½ c.

Recipe Creamy Risotto, warmed 6 lb.

562696 Markon Fresh Chives, sliced thinly 1 oz.

863564 Salsa Fresca, drained 24 oz.

252921 Parmesan Cheese 6 oz.

562769 Markon Fresh Italian Parsley, trimmed to sprigs ½ oz.

PREPARATION INSTRUCTIONS

Wash hands. Wash all fresh, unpackaged produce under running water. Drain well. 1] Season the flour with salt and pepper to taste. Dredge both sides of the cod in the flour. Place 1 oz. of oil in a heated sauté pan. Place the cod in the pan skin-side up. Cook on both sides until golden-brown. CCP: final internal cooking temperature must reach a minimum of 145°F, held for a minimum of 15 seconds. Remove from the pan. Pour off excess oil. Add 1 oz. of white wine and 1 tsp. of shallots. Bring to a boil. Add 1 Tbsp. of butter. Swirl pan until butter has melted. 2] Place 4 oz. of warmed risotto in the center of a warmed serving plate. Place the cod on top of the risotto. Pour the white wine butter over the cod. Spoon 2 oz. of salsa over the top of the cod. Using a microplane, shave ¼ oz. of Parmesan over the top of the salsa. Garnish with a parsley sprig.

Creamy Risotto

Yield: 8 1/8 lb. Recipe Manager code: rcomp243REORDER NO. DESCRIPTION AMOUNT

261564 Hearthstone® Chicken Broth, warmed 1½ gal.

432050 Primo Gusto® Extra Virgin Olive Oil 2 oz.

198307 Markon ¼" Diced Onions 1 lb.

322164 Minced Garlic 2 Tbsp.

662429 Short Grain Arborio Rice 2 lb.

** White Wine 8 fl. oz.

164259 Primo Gusto Grated Parmesan Cheese ½ lb.

PREPARATION INSTRUCTIONS

Wash hands. 1] Place chicken broth in a sauce pot. Bring to a boil. Keep warm. 2] Add olive oil to heated rondeau. Add onions and garlic. Cook until onions are translucent and tender. Add the risotto, wine, and enough broth to cover the rice. Bring to a boil. 3] Simmer over low heat. Stir frequently, adding broth a little at a time, until the both has been absorbed by the rice and rice is tender but still firm to the bite. Add cheese. Mix together with a rubber spatula. Season to taste with salt and pepper. 4] Spread out in a 2" full stainless-steel hotel pan. Once cooled, cover, label, date, and refrigerate for future service. CCP: Refrigerate at 41ºF, or below.


Calories ............................................................... 420 Fat ......................................................................... 25 g.Sodium ........................................................ 530 mg.Carbohydrates .................................................23 g.Protein .................................................................24 g.Typical Cost per Portion: .................$0.50

Sautéed CodB A B Y B O O M E R S (B o r n 1 9 4 6 - 1 9 6 6 )

Autumn Vegetable Stroganoff

Yield: 24 12-oz. portions Recipe Manager code: entree145REORDER NO. DESCRIPTION AMOUNT

685442 GFS® Alfredo Sauce Mix 3 qt.

721344 Primo Gusto® 10 Inch Fettuccine Pasta 3 lb.

432050 Primo Gusto Extra Virgin Olive Oil 1½ c.

469730 Brussels Sprouts, quartered and blanched 2¼ lb.

864447 Fresh Baby Cremini Mushrooms, quartered 2¼ lb.

677960 Turnips, trimmed and julienned on a mandoline 2¼ lb.

199079 Jumbo Sweet Potatoes 2¼ lb.

462551 Markon® Roma Tomatoes, trimmed, seeded, and diced 12 oz.

562769 Markon Fresh Italian Parsley, trimmed and chopped ½ oz.

PREPARATION INSTRUCTIONS 1] Bring large pot of water to a full, rolling boil. Gradually add pasta and return to a full boil. Stir occasionally to prevent pasta from sticking. Cook to preferred tenderness. Drain immediately once done. 2] Rinse in cold water. Place in colander and allow to drain. Transfer to a storage container. Add 1 oz. of olive oil. Mix thoroughly. Transfer to a covered storage container. Cover, label, date, and refrigerate for future service. CCP: Refrigerate at 41ºF, or below.3] Pour 1 gal. hot water into a nonreactive rondeau. Whisk 2 packages of Alfredo sauce mix into the water. Continue

whisking until mix has dissolved and is smooth. Cover and let stand 3-4 minutes. Bring to a boil. Simmer 1-2 minutes. Cover, label, date, and refrigerate for future service. CCP: Refrigerate at 41ºF, or below.

TO PREPARE À LA CARTE:Wash hands. Wash all fresh, unpackaged produce under running water. Drain well. 1] Place 1 Tbsp. olive oil in a heated, nonstick sauté pan. Add 2 oz. of Brussels sprouts. Sauté until tender. Add 2 oz. each of mushrooms, turnips, and sweet potatoes. Season to taste with salt and pepper. Sauté until just warmed through. 2] Add 4 oz. each of warmed Alfredo sauce and warmed fettuccine to the vegetable mixture. Swirl pan over medium heat until just warmed through. Season to taste with salt and pepper. Spoon pasta mixture onto a warmed pasta bowl. Sprinkle ½ oz. of tomatoes on top of the pasta. Sprinkle ½ tsp. of parsley over the pasta.

Autumn Vegetable Stroganoff


Calories ................................................................. 272Fat .......................................................................... 10 g.Sodium ........................................................ 600 mg.Carbohydrates ................................................ 40 g.Protein .................................................................. 7 g.

Typical Cost per Portion: ................. $1.00

B A B Y B O O M E R S (B o r n 1 9 4 6 - 1 9 6 6 )


**Available through the retail market.

IN THE KITCHEN: RECIPESIN THE KITCHEN: RECIPES

29ENRICH | Fall 2015

Grilled Braised Pork ShoulderS I L E N T G E N E R A T I O N ( B o r n 1 9 4 5 a n d b e f o r e )

Gri l led Braised Pork Shoulder

Yield: 24 8-oz. portions Recipe Manager code: pork065REORDER NO. DESCRIPTION AMOUNT

Recipe Oven-Braised Pork Shoulder 6 lb.


Recipe White Bean Hash, warmed 6 lb.

TO PREPARE À LA CARTE:Wash hands.

1] Brush 4 oz. of pork shoulder with olive oil. Place on a heated char-grill. Cook on both sides until just warmed through. CCP: Final internal cooking temperature must reach a minimum of 145°F, held for a minimum of 15 seconds. 2] Spoon 4 oz. of warmed white bean hash on the center of a warmed serving plate. Place the pork on top of the hash.

Oven-Braised Pork Shoulder

Yield: 15 lb. Recipe Manager code: rcomp414REORDER NO. DESCRIPTION AMOUNT

Water 1 gal.

578347 Pork Base 4 Tbsp.

570109 Markon® Jumbo Spanish Onions, small dice 1 lb.

322164 Chopped Garlic 2 Tbsp.

273937 Trade East® Whole Bay Leaves 4 ct.


150232 Davis Creek Meats® Shoulder Butt Boneless Pork Steaks 24 lb.

PREPARATION INSTRUCTIONSWash hands. Wash all fresh, unpackaged produce under running water. Drain well. 1] Bring 1 gal. of water to a boil. Add the pork base, onions, garlic, and bay leaves. Stir until base has dissolved. Reduce to a simmer. 2] Using olive oil as needed, season pork with salt and pepper. Place oil on a heated flat griddle. Place pork on the griddle, browning on both sides. Divide steads between two 4" full hotel pans. 3] Pour two qts. of stock in each hotel pan. Cover tightly with foil. Place in a heated 300ºF convection oven. Cook until tender. 4] Move cooked pork to two 2" hotel pans to cool. Once cooled, cover, label, date, and refrigerate for future service. CCP: Refrigerate at 41ºF, or below.

White Bean Hash

Yield: 8¾ lb. Recipe Manager code: side172REORDER NO. DESCRIPTION AMOUNT

267581 GFS® Dry Navy Beans 2 lb.

Water 1 gal.

110601 Gordon Signature® Roasted Chicken Base 2 Tbsp.

647220 Trade East Zesty Country Seasoning 2 Tbsp.

432050 Primo Gusto Extra Virgin Olive Oil 2 oz.

200778 Markon Jumbo Spanish Onions, small dice 1 lb.

551325 Leeks, thin sliced 1 lb.

198536 Markon Jumbo Celery, small dice 1 lb.

460890 Yellow Bell Peppers, small dice 1 lb.

322164 Chopped Garlic 2 Tbsp.


225037 Trade East®Ground Black Pepper to taste

241502 Markon Brussels Sprouts, quartered 2 lb.

PREPARATION INSTRUCTIONSWash hands. Wash all fresh, unpackaged produce under running water. Drain well. 1] Place beans in a stainless-steel mixing bowl. Cover with cold tap water. Cover, label, date, and refrigerate for 24 hours. CCP: Refrigerate at 41ºF, or below. 2] Drain water from beans into a large rondeau. Add chicken base and country seasoning. Bring to a boil. Simmer beans until tender. Add water, if necessary. Leave enough liquid in the beans so they are slightly soupy when done. 3] Place oil in a heated rondeau. Add onions, leeks, celery, peppers, and garlic. Sauté until cooked through. Season to taste with salt and pepper. Add Brussels sprouts to the beans. Simmer over low heat until Brussels sprouts are cooked through but still firm to the bite. Add sautéed vegetable mixture. Simmer 1-2 minutes.


Calories ............................................................... 420 Fat ......................................................................... 25 g.Sodium ........................................................ 530 mg.Carbohydrates .................................................23 g. Protein .................................................................24 g. Typical Cost per Portion: ...............$0.50

IN THE KITCHEN: RECIPES IN THE KITCHEN: RECIPES


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COLUMN: ASK THE DIETITIAN

ask the dietitian by: Sara Kwiatkowski, RD

Q. WHAT IS CARBOHYDRATE COUNTING?

A. Carbohydrate counting is an approach to planning meals that focuses on the total amount of carbohydrates consumed. It’s an easy planning technique that allows for variety in food choices according to an individual’s preferences and lifestyle. Research shows that when individuals choose a variety of carbohydrate foods and keep the amount of carbohydrates consistent at each meal, they will achieve better blood sugar control. Consistent carbohydrate meal planning is a preferred treatment for individuals with diabetes according to the 2015 Diabetes Professional Standards. The nutrition label is one of the most important tools for carb counting.

CARB COUNTING IN ACTIONOne serving of carbohydrates is 15 grams. Here’s a good

example of how to count carbs based on the nutrition label for one slice of whole-wheat bread:

TOTAL

CARBOHYDRATES 20 g.

FIBER 3 g.

SUGAR 4 g.

To determine the number of carbohydrates:

1. Find the grams of total carbohydrates per standard serving size. This is the amount of carbohydrates in one standard serving. The nutrition label shows fi ber and sugars—subcategories of carbohydrates. Because sugars and fi ber are included in the total carbohydrates count, they don’t need to be counted.*

2. Divide the grams of total carbohydrates by 15.So, (Total Carbohydrates) / 15 = number of servings of carbohydrates. For example, to calculate the number of carbohydrate servings in a slice of bread containing 20 g. of carbohydrates, divide 20/15 = 1.33. The slice of bread would equal 1.33 servings of carbohydrates.

Because not all foods come with a nutrition label, carbohydrate lists are essential meal-planning tools. Examples of foods that are approximately one carbohydrate serving include:

• 1 small piece of fresh fruit (4 ounces)

• ½ cup of canned or frozen fruit

• 1 slice of bread (1 ounce) or 1 (6-inch) tortilla

• ½ cup of oatmeal (cooked)

• 3 cup of pasta or rice (cooked)

• 4 to 6 crackers

• ½ English muffi n or hamburger bun

• ½ cup of black beans or starchy vegetable

• ¼ of a large baked potato (3 ounces)

• q cup of plain, fat-free yogurt or sweetened with an artifi cial sweetener

• 2 small cookies

• 2-inch square brownie or cake without frosting

• ½ cup ice cream

• ¼ cup of sherbet

• 1 tablespoon syrup, jam, jelly, sugar, or honey

• 2 tablespoon light syrup

This list is useful for estimating the servings of carbohydrates in a food that doesn’t have a nutrition label.

Learn More Ask your Customer Development Specialist about the Gordon Food Service® Health and Wellness Guide, a comprehensive index of topics—ranging from food allergies vegetarianism—and resources to help operators maneuver around them.

Contact the Gordon Food Service Nutrition Resource Center at [email protected] or (800) 968-4426 for more information about diabetes and carb counting.

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*There are some standards to account for fiber from whole grain for advanced carb counters. Check with your registered dietitian.

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REFORM OF REQUIREMENTS FOR LONG-TERM CARE CENTERS

Centers for Medicare & Medicaid Services (CMS) released a proposal to revise the requirements long-term care centers must meet to participate in the Medicare and Medicaid programs. The proposed changes would update the regulations to refl ect industry progress. The proposal includes signifi cant changes and standard clarifi cations.

Among the hundreds of changes, it proposes to re-designate §483.35 “Dietary Services” as §483.60 “Food and Nutrition Services.” Taking resident preferences into consideration is consistently highlighted. Other areas of change and clarifi cation include dietitian qualifi cations, nutrition adequacy of menus, frequency of meals, use of feeding assistants, local food items, produce grown in on-site gardens, and more.

The proposed rule is in a 60-day comment period through mid-September. Find the full document at s3.amazonaws.com/public-inspection.federalregister.gov/2015-17207.pdf or search “Reform of Requirements for Long-Term Care Facilities.”

STANDARDS OF MEDICAL CARE IN DIABETESThe American Diabetes Association recently released its

2015 update to the Standards of Medical Care in Diabetes. This Position Statement covers all components of diabetes care, general treatment goals, and tools to evaluate quality care.

For more information, visit professional.diabetes.org/admin/userfi les/0%20-%20sean/documents/january%20supplement%20combined_fi nal.pdf or search “standards of medical care in diabetes 2015.”

QIS SURVEY FORMSThe CMS also has updated several of its QIS Survey

Forms. These forms are used by surveyors, and the documents are available for download. They make for a great guide to internal audit forms.

For more information, visit www.cms.gov/Medicare/Provider-Enrollment-and-Certifi cation/SurveyCertifi cationGenInfo/QIS-Survey-Forms.html or search “QIS Survey Forms.”.

OLDER AMERICANS ACT REAUTHORIZATION ACT OF 2015 (S. 192)

Reauthorization of the Older Americans Act (OAA) is ongoing in Washington, D.C.

OAA programs are critical in providing healthy meals to older adults. Citing that the cost of one month in a nursing home is the same cost as providing an OAA nutrition client with midday meals, fi ve days per week, for seven years, this meal service and the other OAA interventions are cost-effective measures that reduce chronic disease risk and improve quality of life.

Among other provisions, this bill encourages serving locally grown fresh foods, supports utilizing dietitians, and secures a level of funding for congregate and home-delivered meals.

The U.S. House of Representatives must pass this legislation before it goes to President Barack Obama for his signature.

SUPPLEMENT TO THE 2013 FOOD CODEThe U.S. Food and Drug Administration (FDA) issues

a new food code every four years and a supplement to the code every two years. The 2015 Supplement to the 2013 Food Code was released recently. Its key modifi cations include:

· Expanding the duties of the Person in Charge to include overseeing the routine monitoring of food temperatures during hot and cold holding.

· Expanding the type of information that should be included when a Hazard Analysis and Critical Control Point Plan is required by a regulatory authority.

· Emphasizing that cleaning and sanitizing agents should be available for use during all hours of operation.

· Clarifying the terminology in regard to the reporting of illness and the exclusion and restriction of ill food employees.

For more information visit fda.gov/Food/GuidanceRegulation/RetailFoodProtection/FoodCode/or search Search “FDA 2013 Food Code Supplement.”

AVIAN INFLUENZA UPDATE & RESOURCESGordon Food Service® has developed web page as a

resource for updates, background, egg substitute tips, and other relevant resources on the current and future state of the epidemic. Visit gfs.com/en/avianfl u.

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COLUMN: INDUSTRY UPDATE

CMS-20075 Nutrition

CMS-20053 Dining

CMS-20054 Infection Control

CMS-20055 Kitchen

CMS-20053 Dining

CMS-20092 Hydration

CMS-20093 Tube Feeding

INDUSTRYUPDATEUpdates on professional Standards, Proposed Regulations and More

As the culture-change movement accelerates in healthcare foodservice, person-centered care is increasingly emphasized—and succeeding at it requires a fully engaged staff.

“Employees who are engaged are more productive,” says New Jersey-based Healthcare Consultant Denise B. Scott, MHA, LNHA, adding that higher levels of employee engagement also enhance patient/resident safety. “They want to do better themselves, and they want their organization to do better. And, when you treat employees well, they treat patients and residents well.”

Here are Scott’s top tips for engaging with employees.

Foster trust. “Provide a safe place for people to ask questions and tell you things. You’ll hear about things that are simple and easy to fi x.”

Learn about staff. “People do better when they’re able to put to use their natural strengths, talents, and gifts. Make them feel that, every day, they have the opportunity to do what they do best.

Don’t think you have to have all the answers. “Step back and allow employees the space to think about the answers themselves. It’s OK if they leave with more questions than answers.”

Respond respectfully. “Allow employees to come up with their own suggestions or solutions, then react in a way that engages (rather than disengages) them.”

Set expectations. “Let employees know what constitutes a job well done.”

Properly equip staff. “The most engaged employees say ‘I have the materials and equipment to do my job right.’”

Mind the multigenerational dynamics. “Millennials may be a little more eager to speak about making a difference, but every generation wants to.”

Give yourself space. “Managers and leaders are always so busy and rushing to do more. Give yourself the opportunity to slow down and connect with staff and/or customers. Look beyond your four walls for ways to innovate.”

Pay it forward. “Engagement and person-centered care are tied together. When you raise the bar, the bar keeps getting raised.”

Inspire. “Awaken people to their potential and the little moments that give them the opportunity to make a difference.”

Have faith. “People want to do better. Help them.” E

Engagement and person-centered care are tied together.

Engage More Effectively with Staffby: Jane Meyers

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COLUMN: ENGAGE


Nothing says comfort food like a bowl of slow-simmered GFS® Fresh Soup. There are quality ingredients in every bite of the many zesty, savory, and satisfying flavors crafted to delight any regional palate. Make your diners feel right at home with ready-to-serve soup that tastes delicious and saves preparation time and recipe development.

Goodness by the Spoonful

825600 Smoky Poblano and Cheese

the demographics of flavor - gordon food service magazine - 2015 fall.pdfa quarterly publication of...

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