FoodService Director’s 2012 Hospital Census is a snapshot of the hospital market, based on information from the 2010-2011 fiscal year, supplied by 50 hospitals.
Hospital Census Highlights
The 50 hospitals in our census had an average of 89,304 patient days in the 2011 fiscal year and operated, on average, with a staff of 65 FTEs. The hospitals purchased an average of $1.72 million of food in 2011, only a 1% increase from 2010.
- Seventy-six percent of respondents work in a self-operated foodservice program.
- Patient meals make up the majority—just barely—of meals served in the hospitals in our census. Fifty-two percent of meals served are to patients.
- Operators averaged $1.85 million in non-patient foodservice revenue in 2011, with 1,522 average daily cash transactions.
- The hospitals in our census were evenly split when it comes to offering an on-demand room service program. Larger hospitals—those with food purchases in 2011 of $1 million or more—were more likely to offer the service, with 71% offering the program. Those hospitals that run room service offer the program to all units.
- Eighty-four percent of hospitals make at least some purchases through a group purchasing organization.
Buying More Food
Fifty-four percent of respondents said their food purchases have increased so far in 2012, with an average increase of 5%. Operators in the midsection of the country are the most likely to see an increase. The breakdown, by geographic area:
West Continues Organic Push
Thirty percent of hospitals say they purchase organic products, with an average of 8% of food purchases being spent on these items. Once again this year, those in the West were more likely than those in the East and Central U.S. to buy organic items for their operations:
Local Purchases
Every hospital in this year’s survey said they source some items locally. Produce and dairy remain the most frequently purchased local products. What hospitals say they buy locally, by product category:
Beyond the Patient
When it comes to non-patient foodservice, hospital operators offer many different types of service, but by far the most common are retail, onpremise catering and vending. The percentage of operators whose hospital offers each service:
Patient Satisfaction Surveys
Sixty-six percent of hospitals are familiar with HCAHPS, and 30% of them have made changes in the foodservice department because of the survey. Changes hospitals have made to improve HCAHPS survey scores, by percentage:
Meal Counts Slightly on the Rise
In the current fiscal year, the majority of hospitals—54%—have experienced an increase in their total meal counts. How each service is measuring up so far this fiscal year, by percentage:
Behind the Numbers
A look at food purchases and patient satisfaction surveys.
Food purchases stayed relatively the same for hospitals in our survey, with only a 1% average increase between 2010 and 2011.
Very few hospitals—fi ve of 50—saw a decrease in food purchases. The largest decrease, 26%, was at New York City’s Continuum Health Partners. Barry Schlossberg, director of food & nutrition for the system, said a large hospital, Long Island College Hospital, left the system, which accounted for the drop.
Conversely, Sanford Health, in Fargo, N.D., saw one of the largest increases in food purchases between 2011 and 2010, at 26%. Lisa Gibson, director of food service, said the increase was due to more patients visiting the system, which has two hospitals in Fargo. Sanford Health recorded 119,000 patient days in 2010 and 124,355 in 2011, a 5% increase.
Gibson says the patient volume increase was due to the hospitals gaining a larger presence in the marketplace and not because of adding new facilities or beds. “We’ve been ahead of all of our [patient] projections,” Gibson says. “We have been partnering with smaller medical centers. Some of the increase in patient volume is coming from the regional area where we’ve not had a presence before. We’re getting referrals from those areas.
“Sanford is also becoming more well-known for a lot of things, especially research in diabetes, breast cancer and heart disease,” she adds.
More patients translates to more families who eat in the system’s retail operations, Gibson says. Eighty-five percent of Sanford’s meals are served to non-patients. Gibson’s retail operations include two cafés, three coffee bars and two smaller cafés in clinical buildings.
Allan Livingood, dietary director at Preston Memorial Hospital in Kingwood, W.Va., also attributes his increase in food purchases—28%—to more patients. Preston Memorial saw a 7% increase in patient days between 2010 and 2011. A new bariatric surgeon was a big patient draw, according to Livingood.
In addition to more patients, more people dined in the cafeteria at Preston in 2011 than in 2010, according to the director. Livingood says he didn’t make any operational changes or add any employees with the increase in customers. “We only have an hour and a half service for lunch, so the employees just pick up their pace a little bit,” he says. “We just increased our production a little bit.”
Patient satisfaction surveys
Hospital foodservice directors are no strangers to patient satisfaction surveys such as Press Ganey. This year, a new survey, HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems), comes into play. HCAHPS is the fi rst national, standardized, publicly reported patient satisfaction survey. HCAHPS is important because, starting this year, a percentage of the Medicare and Medicaid reimbursement hospitals receive is contingent upon how the hospital does on the HCAHPS survey. Despite its importance, only 66% of the hospitals in our survey said they were familiar with HCAHPS.
This is most likely because, unlike Press Ganey, HCAHPS does not have food-specifi c questions. However, a patient’s experience with food greatly affects certain categories, such as the overall hospital experience.
Operators working in contract-managed accounts were most likely to know about the survey, with 92% of those operators in our survey saying they were familiar with HCAHPS. Additionally, our survey found that 100% of hospitals with food purchases of $1 million or more in 2011 were familiar with HCAHPS. Only 48% of hospitals with less than $1 million in food purchases were familiar with the survey.
In addition, only 30% of operators in our survey who are familiar with HCAHPS have made changes as a result of the reimbursement requirements. Sanford’s Gibson is one of the hospitals in our survey that has made changes due to HCAHPS.
“There’s a whole list of things, small and large, that we’ve done as a result of HCAHPS,” Gibson says. One example is purchasing new dishes for casseroles so that the presentation of those dishes is enhanced. Another example is changing some processes for assembling patient trays. For example, milk is now the last item placed on the tray so that it remains cold during delivery.