Last updated on June 15th, 2023
This case study is published in collaboration with Angelina Balestino, a graduate student at Marywood University and future Dietetic Intern at Valley View Rehab and Nursing Center, Montoursville, PA. All research and data used in this study were captured by Ms. Balestino as part of her undergraduate honors thesis on Food and Food Service Satisfaction for Marywood University where she is currently pursuing her Master of Science in Nutrition.
About Valley View Rehab and Nursing Center
Valley View Rehab and Nursing Center provides both short-term and long-term care to over 100 residents in Montoursville, Pennsylvania. The skilled nursing care they provide includes physical therapy, occupational therapy, speech therapy, therapeutic recreation, social services, short-term therapy, and dementia care. For dining and nutrition services, they partner with Culinary Services Group, a Top50 food service management company headquartered in Westminster, Maryland. The company provides full-service dining and nutrition for the community including procurement, menu planning, meal service, and staffing.
A recent independent study conducted by a graduate student at Marywood University found that the residents of Valley View Nursing and Rehab are highly satisfied with the food and food service they receive in the community. Residents enjoy a wide variety of appetizing food choices. Residents within the community also feel empowered to change the dining program through their feedback. While there is always room for improvement, most residents surveyed were pleased with the food service they received at Valley View Nursing and Rehab.
The Importance of Resident Satisfaction
For most restaurants, customer satisfaction is the key to a successful operation. Without it, few restaurants are able to keep their doors open long. Yet in many long-term care communities, resident satisfaction is often overlooked. Residents in long-term care are often not seen by dining staff as customers who deserve an outstanding experience each time they enter the dining room. This can have dire consequences for residents. Residents who are unhappy with the food available in a community may face nutrient and energy deficiencies from not consuming a wide enough variety of food. This can lead to other health problems and an increased risk of chronic disease. Unsatisfied residents ultimately increase long-term care facilities’ morbidity and mortality rates, which is why understanding the components of resident satisfaction and working to continually improve them is so important.
Research and Data Collection
How satisfied are residents living in Valley View Nursing and Rehab with the quality of food and food service they receive? A small study using survey responses from twenty-six residents living in the community sought to provide answers to that question. These residents were pre-screened to ensure they were cognitively intact enough to accurately answer retrospective questions about their dining experiences before participating in the study. The average age of the residents surveyed was eighty-four. Seventeen of the twenty-six residents were female, all were caucasian. * Fifty-two percent of respondents had been in the community for a year or more and fifty percent expected their stay to be long-term while seven percent expected their stay to be short-term.
The study relied on the FoodEx-LTC survey for conducting research on resident satisfaction. This assessment asks questions regarding four domains of food and food service satisfaction.
*The researcher was limited by a small sample size and racial diversity. This limits the ability to generalize the results of this case study to wider populations.
The Four Domains of Food Service Satisfaction:
1. Enjoying Food and Food Service
How residents are enjoying the food and food service? Do they anticipate meals? Are meals well-prepared, served in a pleasant atmosphere, and with adequate service?
2. Exercising Choice
Do residents believe they have choices about the food they eat? Are they are able to work with the food service department to have their personal food preferences met?
3. Cooking Good Food
Do residents have confidence in the ability of the food service team to create a variety of foods that taste homemade and look appetizing
4. Providing Food Service
Is the food residents are served prepared correctly? Are the food service staff friendly, helpful, and courteous?
Overall Satisfaction
This small study found that eighty-six percent of the residents were satisfied with the food and food service in this community. The researcher noted that the facility’s food service company, Culinary Services Group, has put many procedures in place to ensure the highest level of resident satisfaction. Residents are able to have a voice in the food they are served through monthly food committee meetings. A separate resident peer group also provides feedback and suggestions on new seasonal menus before they are put in place in the community. Culinary Services Group conducts thorough independent audits to ensure compliance with state guidelines and survey readiness. These internal audits include weekly test trays to assess food temperatures, portion sizes, and food appearance as well as monthly meal rounds to assess resident satisfaction. To ensure all nutritional guidelines are being followed, the registered dietitian on-site meets with every resident during the admission process and completes a food preference questionnaire. Then, they meet quarterly with each resident as part of a diet compliance audit to ensure meals align with diet orders, adaptive equipment, and supplemental needs.
Enjoying Food & Food Service
The study found that residents at Valley View Nursing and Rehab were generally satisfied with their community’s food and food service. Residents looked forward to meals, with seventy percent reporting they maintained a robust appetite and desire to eat. The community received high marks on meal consistency, with eight percent of those surveyed saying that meals were always prepared in the same way. And while most residents, sixty-eight percent, said they never felt forced to eat things they didn’t like they may be served food they don’t like as a menu option. However, the researcher also pointed out that the residents are always offered a menu of alternate options if they don’t like the meal being served on any given day.
Exercising Choice
Choice and a continued sense of empowerment are important as we age. In this long-term care community, food selection was extremely important to eighty-five percent of those surveyed. Seventy-three percent of residents surveyed also felt they had the power to change the food service in their community. Sixty-one percent felt they were able to complain about the food as a way to affect change in the food service department. The survey indicated that residents here feel they do have control over their food choices. Ninety-two percent said they never worried that they wouldn’t get the food they had asked for. The researcher noted that residents at this facility are able to request an alternative item if they are dissatisfied with what is served to them.
Cooking Good Food
Residents gave high marks to the Culinary Services Group food services team. The company focuses on fresh ingredients and from-scratch cooking as a means of providing the highest quality of meals possible. Ninety-two percent felt the food service team was experienced and provided a wide variety of foods. Eighty-one percent were confident in the team’s cooking knowledge and ability to prepare a meal. Most importantly eighty-five percent said they received meals that were appetizing. Meals that are well-plated and look and smell tasty and appealing can make a big impact on long-term care communities that may face nutrient deficiencies and malnutrition among residents.
Providing Food Service
Residents surveyed spoke very highly of both the nursing staff at Valley View Rehab and Nursing Center and Culinary Services Group dining staff. Ninety-six percent said the staff was friendly and courteous. All the residents said staff would provide assistance if any was needed to help cut food. Most residents also said the food was freshly cooked and served on time (eighty-one percent) and at the proper temperature (seventy-seven percent). Seventy-seven percent of residents also felt they received the right amount of food. Eighty percent of residents in the community said the staff work hard to serve food everyone likes.
How Can Your Community Improve?
While this is a small study of just one community’s dining services, asking residents about their food service experiences is an easy way to continually improve outcomes for residents. This consideration will not only empower residents to have a positive experience in your community, but it may also prevent malnutrition, morbidity, and mortality.
Food service satisfaction can be closely linked to staff engagement and time spent with residents. In addition to regular assessments and monthly meetings on food service satisfaction, the dining room provides the perfect space for food service directors, chef managers, and registered dietitians to engage with residents, build trust and simply ask, “How are you enjoying the food.”
What is your community doing today to improve resident satisfaction during meals? At Culinary Services Group, we have many processes in place to ensure a high quality of service, including seeking out caring team members who want to provide the best possible experience for residents. We can help your community improve resident satisfaction too, contact us.
Culinary Services Group supports the growth and education of our team members. We’re pleased to be able to present Ms. Balestino’s research as a complement to both Culinary Services Group’s best practices for food service and the dedicated staff of Valley View Nursing and Rehab Center in Montoursville, PA.
About the Researcher:
Angelina Balestino graduated from Marywood University with a Bachelor of Science in Nutrition and Dietetics and a Science Minor with a Citation in Honors. She is currently pursuing a Master of Science in Nutrition and finishing a Dietetic Internship through Marywood University. She worked as a diet aide for Culinary Services Group at Valley View Nursing and Rehab Center during the summer of 2021 and will be completing her long-term care rotation there this November. This research was conducted as part of her undergraduate honors thesis on Food and Food Service Satisfaction of Residents in Long-Term Care. Her goal is to become a registered dietitian in a nursing home focused on resident quality of life.
