Menu System: Diet Spreadsheets and Tray Tickets

Diet spreadsheets tell the servers what items residents are to receive based upon diet orders and the amount of each item (portions). This affects cost control, customer satisfaction, and regulatory compliance.

Portion control is one of the most important aspects of cost control. If portions are too large, it results in waste. If residents receive items they cannot have, this also results in waste when a second tray is prepared.

Portion control also affects customer satisfaction. People can become upset when someone gets larger portions than they do.

Portion control can also affect nutritional status if residents do not receive the amounts necessary. It can also affect survey results because if portion control is not followed, then diet orders from physicians are not followed.

Tray tickets ensure that the correct tray goes to the correct resident. In a manual menu system, diet spreadsheets and tray tickets are separate tools. In an integrated system, if the tray ticket lists exactly what each resident is to receive, based on diet orders, preferences, and selections, then the need for a diet spreadsheet is eliminated.

The important result is that each resident receives the proper meal items, in the proper amounts, based upon his/her diet, food preferences, and selections.

Menu System: Recipes

Recipes are critical for cost control, customer satisfaction, and regulatory compliance.

Recipes tell the cooks how to make items. Recipes should be quantified for the amount necessary for the meal. If they are not, the cooks may not take the time to adjust the recipes for the amount actually needed but just double or triple the recipe. This leads to overproduction, waste, and increased costs.

If the recipes are not followed, the product will not be consistent from one time to the next. Customers like consistency. They like to receive what they expect.

If the recipes are not followed, the residents will not receive the nutrients in the amounts necessary for health. They may receive too little or too much. Both can be detrimental. Poor nutritional status can affect survey results.

In a manual menu system, recipes need to be quantified by hand. This is time consuming! Some menu systems will quantify the recipes for the amounts entered. This is better, but someone must still determine the amounts needed. A computerized integrated menu system will take into account diet orders, food preferences, and selections and determine the quantification level of the recipes for a particular meal.

Menu System: Production Sheet

The production sheet is a report telling the cooks and aides what items to prepare, the amount of each item, and the amount to portion. This greatly increases accuracy of production by limiting over- and under-production and omission of items.

Increased accuracy assists in controlling costs. Over-production generally results in waste, which is money down the garbage disposal.

Increased accuracy also assists with customer satisfaction. If residents have selected an item and then they cannot have it because of under-production, they will be dissatisfied.

Under-production can also negatively affect surveys if residents do not receive what was planned on the menu.

Pre-production sheets are useful to tell the cooks what to prepare in advance and what to pull from the freezer.

With a manual menu system, someone must count the number of each item to prepare based upon diet orders, food preferences, and selections. Integrated computer systems will count the items and give a total.

Menu System: Order Guide

The order guide provides information on the food items and amounts that you need for each week or each ordering period. This allows for accuracy in ordering. This is especially important if the person normally doing the order is not available and someone else needs to do it instead.

Both over-ordering and under-ordering can negatively affect the food budget. It can also negatively affect regulatory compliance and customer satisfaction.

Some menu systems will calculate order guides (or grocery lists) based upon your menu and diet census. With manual systems, it is necessary to calculate the information by hand. However, once it is done, unless there are major census changes, it is accurate enough for the remainder of the menu cycle.

In the long-run, it is more efficient to calculate the products and amounts needed once at the beginning of the cycle and write it down in a logical format than to start from scratch each week for six months or the length of the cycle.

Menu System: Cost Report

A cost report is critical to meet the food budget. If you do not know what the meals cost, you cannot make informed decisions on how to stay within budget.

The most accurate menu system is one that will update the cost every time the menu is changed and every time new food prices are downloaded. Check with your supplier on what menu systems will obtain your prices and update the cost of your menu whenever you request it.

Another important feature of a menu system is one that will calculate the cost of not just your regular menu, but all your therapeutic and texture modified menus and then calculate a total menu cost based upon your diet census.

This total menu cost will always be higher than just the cost of your regular diet. If you try to operate your department using just the cost of the regular diet, you will be operating with inaccurate information.

Menu System: Nutritional Analysis

The purpose of a nutritional analysis is to ensure that the menu meets the nutritional criteria in the diet manual for the regular, therapeutic, and texture modified diets. The most important aspect is that the average for the cycle meets the requirements.

Some menu systems can complete a nutritional analysis for each meal and each day for each diet. Some can complete a nutritional analysis for each week for each diet, which provides an average for the week. And some just provide an average for the cycle for each diet.

If the cycle average meets the criteria, in most cases this is good enough. It is normal to be higher some meals and days for certain nutrients and lower other meals and days. The advantage of having a more detailed nutritional analysis is that if something is too high or too low, it is easier to determine which food items are creating the effect and change them.

If menus are purchased, a nutritional analysis should be included. If menus are written and there is not a computer system to complete an analysis, completing one by hand is next to impossible. Instead, the diet manual should be followed and the completed menu checked manually to ensure that the proper number of servings from each food group is included, that items high in certain nutrients are included as indicated, and that inappropriate foods are avoided.

Menu System: Week-at-a-Glance

This component is simply an overview of the menu items for all meals for a particular diet for a week. It is an easy way for managers and cooks to see what will be served later in the week.

It can also be used to communicate upcoming meals to residents and families either through personal copies, posting on menu boards, in facility newsletters, or posting on the facility’s website. If used for posting on a menu board it may need to be enlarged so it can be read.

It is also a useful tool in planning holiday and special event meals. When a holiday meal is planned, compare it to the menu items the meals/days before and after. It may be necessary to adjust other meals/days to avoid repetition.

Menu System: Diet Manual

The diet manual has to be the basis for any menu system. A diet manual is based on the latest (within 5 years) scientific research. The menu must be based on scientific research for regular, therapeutic, and texture modified diets. The menu cannot be written on what someone “thinks” it should be or on what he/she learned 10 or more years ago in school. Things change. Science changes.

The first step in developing or revising a menu system is to choose a diet manual. There are several available, some of which are written specifically for long-term care. The diet manual must address the needs of your residents. For example, if you have the elderly-elderly in your facility, a diet manual with liberalized diets makes sense. If you also have the young-elderly for short-term rehab, you may need a diet manual that addresses diets that they may already be following, such as reduced fat, reduced salt, or diabetic.

If you are purchasing a menu system where the regular, therapeutic, and texture modified diets have been written for you, the first question to ask is on which diet manual is it based. If it is not based on a diet manual, you will need to review every recipe to see if it has been linked to the diets that are appropriate based on your diet manual. If it is based on a diet manual, determine which one and if it meets the needs of your residents. If it does not, look further or be prepared to review each recipe and make changes to reflect your diet manual. You need to receive at least one copy of the diet manual as part of the menu package if you will be using that diet manual.

If you are purchasing a menu system where you write the menus or enter your existing menus and then the system will create all the reports for you, check that you can link the recipes to the appropriate diets based upon your diet manual.

The diet manual can also help during surveys. If a surveyor questions something on the menu, and you can show that in the diet manual it states that the item is acceptable for that diet, then the surveyor has no reason to give a citation.

Remember that the menu is the basis for the management of the department and the diet manual is the basis of the menu.

Menu System: Importance

Technically, a menu is just a listing of food items to be served for one meal, day, or longer. A menu system has the components necessary to manage a food service department. Although the term menu will be used for this month’s topic, it really refers to a menu system.

The menu is the basis for everything that happens in the department. It determines food costs, the quantity and quality of labor necessary, equipment needs, storage requirements, customer satisfaction, and regulatory compliance.

Every facility has the choice of creating its own menu or purchasing a menu from another source, such as a consultant dietitian, food supplier, or menu software company. Whether developing, revising, or purchasing a menu, the menu must meet certain criteria including:

• Meet the nutritional needs of all residents;
• Meet federal and state regulations;
• Be attractive, appealing, and palatable to all customers;
• Meet department considerations; and
• Meet budget requirements, both for food costs and the cost of the menu itself and implementation.

Menu system components will be the focus for the remainder of this month