1. Evergreen Long-Term Care Facility

2. Evergreen LTC 300 Beds 5-chair dialysis unit 20 Adult day care participants

3. Problems Redesign menus Kitchen renovation RD staffing Sustainability practices

4. Menu Planning Budget ($3.75/day for general diet) Nutrition (Seven therapeutic diets) Age-appropriate (texture, comfort food, food related social events)

5. Budget $3.75/day for three meals Use frozen vegetables and fruits Use inexpensive beverage

6. Nutrition General Menu Consistent with nutrition requirements for healthy adults Liquid Diet Clear/full Puree Diet Minimize chewing Provide adequate nutrition

7. Nutrition Dialysis snack Protein: 20 grams CHO: 28 grams Fat: 8 grams Sodium: 468 mg Potassium: 272 mg Phosphorus: 75 mg Fluid: 4 oz.

8. Nutrition Cardiac Criteria: 75 grams of fat or less 200 mg of cholesterol or less 2 grams (2000 mg) of sodium Menu options: Similar to regular menu Limited sodium/cholesterol but tasty Not “missing out” on favorite foods

9. Nutrition Calorie Controlled/Diabetic (4 CHO at breakfast, 5 CHO at lunch/dinner) 1800 calories Easy carbohydrate counting Delicious menu options Very similar to general menu Not “missing out” Variety Dessert with each meal!

10. Nutrition Lacto-Ovo Vegetarian (consumes eggs/dairy products) Less expensive because no meat products Reason for choice: Plant based diet Visitors complain Healthful choices Lower in fat/calories Inexpensive

11. Adult Day Care Menu One week menu: Breakfast, lunch, afternoon snack Purpose: Increase PO intake of residents Increase socialization Keep in Mind : Correct textures Variety, comfort food, age appropriate

12. Adult Day Care Menu Socials everyday! Popcorn/movie Bingo Kitchen tour Doughnut ( yum!)

13. Equipment Small Kitchen (Adult Day Care) Coffee Maker Food processor Soup Kettle Griddle Popcorn machine Waffle baker Fryer Conveyor toaster

14. Equipment-small kitchen The items shown represent the Adult Day Care kitchen:

15. Equipment Old Kitchen- Replacement Steamer Puree Molds Food warmer (steam table) Shelving Thermometers Delivery carts/vinyl covers

16. Equipment-old kitchen

17. RD Staffing Budget Workload for long term care, dialysis unit, and adult day care 4 week schedule

18. Budget Planning Total $250,000 $87,500 for clinical nutrition manager ($70,000+25% for benefit) $163,000 for consulting dietitians $163,000/($35/hour)/(52 weeks/year)=90 hours/week 3 part-time dietitians (30 hours/week each)

19. 4 Week Schedule CNM: 9 am to 5:30 pm M-F RD A: 7 am to 1 pm M-F, 25 hrs in long term care, 5 hours in dialysis unit RD B: 11 am to 5 pm M-F, 25 hrs in long term care, 5 hours in dialysis unit RD C: 11 am to 5 pm M-F, 25 hrs in long term care, 5 hours in adult day care Take turns to cover Saturday shift

20. Sustainability Plan Sourcing local, seasonal, or sustainably grown products Providing and promoting varied and balanced food options Increasing the purchase from fairly and responsibly certified sources

21. Local, Seasonal, Sustainable Gaining familiarity with regional agriculture and seasonal products Getting connected with local/sustainable farms Determining potential areas to improve local sourcing Setting up an interdisciplinary group Marketing Personal purchase

22. Varied and Balanced Increasing choices of low fat/fat free dressing Replacing food high in fat, sugar, and sodium with healthier choices Providing food and nutrition pamphlets/newsletters Offering various food choice (vegetarian, ethnic, gluten free) Demonstrating healthy cooking methods

23. Fair Trade-Coffee Aspretto Coffee Fair trade- improves farmers well being Higher quality Better for environment Part of sustainability plan Good for conscience

24. Questions??