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Dietary software showcase: a sampling of LTC food service software through the eyes of its vendors and users.

These days, everything is computerized, right? Well, not quite. Despite a proliferation of computer programs designed to assist with everything from incontinence to reimbursement, the food service programs in the vast majority of nursing homes have yet to jump on the software bandwagon.

But the software is out there - and facilities using it report being impressed by the results: accuracy, enhanced OBRA compliance, happier residents and families, less time, less waste, less chance of human error and much less aggravation.

From nutrition label printing to tray preparation to resident intake tracking, many vendors are predicting that food service programs in all LTC facilities will be fully computerized within the next five years. Many of the software packages on the market today were developed specifically for LTC use and, equally important, the technology now available allows programs to be designed with the computer novice in mind.

The following is only a sampling of the programs available and the facilities using them. All of the packages described have additional modules that allow users to upgrade and enhance their programs as their needs evolve.


GeriMenu, from GeriMenu Software, has been available for seven years. Almost all of the company's 420 clients in the US and Canada are LTC facilities. When a resident is admitted, basic information, such as type of diet, restrictions, likes and dislikes and required supplements, are entered into the computer, along with the master menu plan for each diet (up to 30-week cycles and special holiday meals).

A day or two prior to each serving day, the program prepares a tray ticket for each resident for each of that day's meals. The food selections, portions, etc., are all based upon the resident profile entered during admission. Substitutions are made automatically for foods the resident dislikes, portions and textures are adjusted, and special problems are brought to the staffs' attention before the trayline is started.

Because the program prints out production tallies of every serving item needed (the number of regular, pureed, chopped or ground portions), the cooks know precisely how much of each type of food to cook for each resident. The tray tickets remain with the trays to the point of service and the staff and residents know exactly what is being served. The system also generates resident care and diet spreadsheets, selective menus and snack and nourishment spreadsheets.

GeriMenu offers several additional modules such as a CASIO Digital Diary Module which can be taken on rounds, and a recipe and nutritional analysis option which includes inventory control, over 400 recipes and a nutritional analysis capable of storing information on up to 84 nutrients for each ingredient.

Company vice-president Jim Harrity, RD, stresses that the software is designed for the computer novice and has a built-in, context-sensitive HELP system. The package also comes with audio cassette training tapes and a tutorial system.

GeriMenu has been in use at the 191-bed, Elmhurst Extended Care in Providence, RI, since the facility opened six years ago. Food Service Director, Karen Peloquin considers herself fortunate that she and her 33 staff members never had to provide the services manually - Elmhurst was one of the first facilities to use GeriMenu. It took about 30 days to get the program up and running: keying resident profile information, creating the master menu and editing the food items file. Now, Peloquin uses the program to print individualized tray tickets and nourishment stickers for every resident every day.

GeriMenu also generates production sheets that go to the kitchen's hot, cold and miscellaneous food stations and inform the staff of the exact amount of each item that is required for the tray line. Substitutions for dislikes and dietary restrictions are made automatically and appear on the tray tickets and the production sheets.

"The program also allows us to do some special things for our residents," says Peloquin. By inputting tray notes, she can alert the staff to residents' birthdays and provide the celebrant with something special at each meal: a rose at breakfast, a cake at lunch and a card at dinner. Also, by deleting a meal on a particular day on the master menu, Peloquin can then add holiday or theme meals, as well as Elmhurst's weekly "monotony-breaker" meals and "Super Wednesday" dining room meals.

Using the system, the staff not only knows exactly what food is needed for that day, they also know what will be needed two days from then. For example, if roast beef is on the menu for Wednesday, the staff knows that top round must be transferred from the freezer to the walk-in refrigerator on Monday to be prepared for the Wednesday meal. Inventory planning is also expedited.

GeriMenu also generates calorie intake recording sheets and weight check sheets, both of which are used for interdisciplinary care planning meetings, which often include residents' family members. Nourishment consumption reports are generated in the form of daily rosters for each of the three snacks provided. Those rosters are sent up to each unit of Elmhurst with a list of all the residents on the unit, the exact snack each resident should be receiving and space for notes on how much is actually consumed and any problems with consumption.

One nutrition assistant is responsible for all of the daily print-outs on the computer. "It takes her about three hours to print out all of the information and about two hours to coordinate the information and put the tray tickets together, "says Peloquin, adding that the system's organized data presentation also helps with the State inspection. "Inspectors are able to look at the data we've printed out and compare it to the services actually provided, and see that what we're doing is not just paper compliance."


Data Control Technology, Inc. has been offering its MENUTRACKER program since 1988. The system is now in use in approximately 250 LTC facilities, says company president Darcy Beckstrom. The program automatically selects and prints menus for each resident based on a resident profile created at admission (diet, likes and dislikes, food consistencies, etc.). The Selective Menu Option lets residents select meals independently from specific, pre-planned diets, and staff can use the Resident Profile Record System to make individualized changes to each resident's menu.

Special messages for needs related to utensils, allergies or trayline condiments are printed on each daily menu. Foods can be characterized by descriptions such as spicy, bland, hot or cold and automatically added or eliminated with a single entry. The system provides over 1000 recipes with special instructions, diabetic exchanges and nutrient analyses, and a diet spread-sheet provides an overview of diets and portions.

Data Control Technology offers additional programs to compliment their MENUTRACKER software, including a nutrient analysis program, an inventory and purchasing program and software designed to manage long and short-term food budgeting.

Masonic Homes, in Elizabethtown, PA, has been using MENUTRACKER since October of 1992 to provide two very different styles of service, says Director of Food Services Daphne K. Gulick, MS. In addition to the facility's 433-bed skilled and intermediate areas, the software is also used in the congregate living and personal care areas where Masonic Homes provides three meals per day for an additional 285 residents.

In the skilled and intermediate care (health care) areas, the three selections on the master menu (three entrees, vegetables and starches) are automatically compared with resident profiles of likes, dislikes and dietary restrictions entered into the computer after admission. If the first menu choice doesn't conform to the parameters, the program continues until a satisfactory substitution is found. When the food goes down the tray line, the computer-generated meal ticket shows exactly what each resident needs and wants. "There is no guessing involved," says Gulick.

In the 300-seat dining room in the congregate living and personal care area, Gulick uses the same master menu to provide a completely different style of service. Rather than using resident profiles, the residents choose their meals in advance from a printed selective menu generated by the computer. "Because the production sheets are read by location, we can make changes to the selective menu without interfering with the health care menu," Gulick notes.

Three Squares

Three Squares, a nutrition and food service management system for Windows, is a relative newcomer to the LTC market. The program has been available from Positive Input Corporation since July, 1994. Already, the software is being used by nearly 30 LTC facilities and the company's client list is increasing steadily, says company Vice-President John Nicholson.

Three Squares produces food-specific tray menus and nourishment labels, and develops recipes and production summaries while linking to a complete inventory/purchasing system that provides thorough cost analysis. A complete resident cardex system tracks diet orders, weights, dislikes, eating locations, etc.

Positive Input stresses that writing the program with the latest Windows operating environment technology makes it easy to learn and to operate. The company offers a free demo disk, telephone conferencing and on-site demonstrations. Nicholson notes that, because of the substantial reduction in food waste, as well as savings associated with computerized tray cards, nourishment labels and other benefits, "most facilities will experience a total investment payback within one year after implementation."

At Care Inn of Voorhees, a 270-bed LTC facility in Voorhees, NJ, Food Service Director Scott Goff has been using the Three Squares software since August of 1994. Goff and his 26-member staff have vivid memories of their "pre-computerized" days. "The amount of time we save with the system every week is staggering. When done manually, tray card preparation took about 30 hours per week, nourishment label preparation, 20 hours, food acceptance records, 25 hours, and food production, inventory and purchasing took 25 to 30 hours. Today, we're able to do data entry, generate reports, make changes, print out the tray cards and nourishment labels, all in about 15 hours per week."

The tray cards generated by the Three Squares program include the date, type of diet and each item served to every Care Inn resident. Meal ticket notes can be included to alert the staff to special needs such as customized utensils. Goff says the ability to generate the tray tickets and nutrition and supplement labels electronically has increased the accuracy of the food service and has helped the staff to deliver the meals in a more timely fashion. Nutrient analysis is available for each menu item. In addition, all of the facility's recipes are generated from the software, which also allows Goff to add new recipes.

Care Inn also uses the system to track weights with complete weight histories that include date of weighing, resident weight, target weight, and gains and losses over a 180-day period. By inputing a status message, the plus/minus 10-pound alerts required by OBRA are displayed automatically. Patterns of weight gain and loss throughout a 30-day cycle can also be generated in graph form.

Goff is able to produce production summaries indicating the total amount of each type of food used: the number of each item made, the number left over and starting and ending temperatures.

Of course, the true test of any new system is the visit from the state surveyor. Goff says he feels confident about Care Inn's March 1995 inspection. "I think the improved organization and the professional appearance of computer-generated cards and labels will be a real asset."
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Article Details
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Author:Bruck, Laura
Publication:Nursing Homes
Date:Jan 1, 1995
Previous Article:Update on HCFA's MDS revision.
Next Article:Computerization: one facility's road to success.

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