Food in Long Term Care – Bridging the gap between simple nutrition and a memorable dining experience

Of all the challenges (and complaints) we get in long term care settings, the quality of food (or lack of) seems to be at the top of the list. For many of our residents what they eat has less to do with getting the daily allotment of nutrients, and more to do with maintaining a connection to their past, their relationships and to memories that seem to fade each day. Food drives emotions, and quality dining experiences can improve the quality of care (and outcomes).

Food is a critical part of the care we deliver each day, but are we making it a priority each day?

For many providers daily dining is just part of the care plans associated with clinical operations. Other providers are taking the initiative to cast new visions to improve not only the quality, variety and nutritional value of resident meals, but the overall dining experience. With hospitality being their focus, they are finding ways to deliver quality and memories (and stay within budget).

As we work with aging services support organizations, we have the pleasure to be introduced to quality firms that are focused on impact and higher outcomes for residents served. With this in mind, we wanted to introduce the team from PDN.

A Case Study – PDN and Lymnblomsten Care Center

As chefs, senior dining consultants, and overall lovers of food, Dawn and Patrick Nickleson, owners of Passion for Dining and Nutrition (PDN), know two things to be true – choice and quality matter! Those truths are continually confirmed as they work with provider and partner organizations.

Conversations with representatives from the MN Office of Ombudsman for Long Term Care and the MN Department of Health reveal that complaints relating to food are on the rise. Residents are surveyed twice per year and asked questions related to food and dining. Survey questions are listed at the bottom of this article. All survey results are then shared with the public on the Minnesota Nursing Home Report Card.

The MN Department of Health provides two ways for providers to receive funds by using quality in improvement. Performance-Based Incentive Payment Program (PIPP) allows nursing homes to apply for a rate increase in exchange for implementing a quality improvement project. Quality Improvement Incentive Program (QIIP) is broader and easier to participate in than PIPP. To participate in a QIIP a nursing home must select one quality measure to improve.

PDN has partnered with providers on quality projects related to food and dining services.

Lymnblomsten Care Center in St. Paul, MN chose food enjoyment as a quality measure to improve for a QIIP and achieved a 14% increase in their scores. They discovered it’s not just about food. In addition to building the foundation with fresh menus, new recipes, and more scratch cooking, they included the residents in the conversation.

The first step in a food quality project is to ask the residents what they want. The next step is to act on what they have told you by changing menus and recipes, purchasing quality ingredients, evaluating workflow, and teaching skills. The third step is to solicit feedback and keep the residents engaged in the conversation.

A resident of Lyngblomsten recently shared with PDN, “Eating here is like going to a new restaurant and trying things on the menu, and I love it since I cannot do that now.” Her family added, “Looking forward to the food has given her a new outlook on life!”

Learn more about MN quality initiatives at

In 2017, CMS revised the LTC survey resident interview questions relating to food to the following:


  • Does the food taste good and look good?
  • Are the hot foods served hot and the cold foods served cold?
  • Does the facility accommodate your preferences?
  • Are you provided a substitution if you don’t like what is being served?
  • Do you receive snacks when you request them?
  • Are the snacks the types of snacks you like?


Additionally, the MN Department of Human Services (DHS) conducts annual Quality of Life (QOL) surveys of long-stay residents, short-stay residents and families. The Food Enjoyment questions for residents are:


  • Do you like the food here?
  • Do you get your favorite foods here?
  • Does the menu change enough?
  • Do you enjoy mealtimes here?


The family survey asks for a rating on the following:

  • Quality of food served to the resident
  • Menu choice of food available to the resident
  • Atmosphere at meal time


All survey results are shared with the public as part of the Minnesota Nursing Home Report Card. Learn more about the report card at

To contact PDN visit their website

Bill Shell, CPC |

Bill Shell, Business Strategist and Certified Professional Coach is CEO of Bill is passionate about the success of long term care and empowering leaders and teams to achieve success. He has over 30 years of experience in starting, growing and managing companies, organizations and leadership teams.

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