Can anything be done to improve meal quality in nursing home?

I would address this immediately with the Administrator of the facility ( not the dietician).

If you see no corrective action in the course of one week, call the Ombudsman andwrite to the Joint Commision on Nursing Home Accreditation.

I'm going to take a somewhat contrary position and propose that management of nursing homes can extend beyond elder and diet specific issues and fall into the realm of good management, period. Restaurants don't survive by serving unappetizing and unhealthy food, nor are they able to tolerate ignoring customer's desires.

They're competitive; nursing homes if run more like a competitive business would be able to see the value of high standards across the board.

The facility I've taken Dad to 3 times for rehab falls in that category. When issues have arisen, I've gone to the DON or the Administrator, if staff isn't able to resolve the problem. I follow the chain of command and with the exception of a few problems last time (which I was unaware of as I wasn't able to visit as often), issues have been resolved satisfactorily.

This favorite rehab facility (also now expanding to long term care) hired a chef from one of the top upscale restaurants in the area. Menus were planned as if they were in fact operating a restaurant, but not at the level of lobster and prime rib offerings. There was a standard alternate menu with a good choice of items.

This facility also offered one free meal to one family member, a nice way to begin a relationship with the family as well as the elder.

Our first experience with rehab was when we were still novices. Food was generally good, always served hot in a manner hospitals use (warmth held into the food by covers, delivered on carts). If Mom didn't like the food, sometimes we supplemented with food from home, but if my recollection is correction the food staff could make accommodations for special diets.


I would first try to discuss the issue with management and find solutions at the facility level. If you go beyond and bring in an Ombudsman, it puts unwanted pressure and embarrassment on the management, which might in fact be willing to work with you and address the problem.

I like the "speak softly and carry a big stick" philosophy.

And remember, staff in these facilities are subject to criticism at perhaps a level seen only in hospitals. If attorneys, repair shops, restaurants and more found themselves explaining to oversight authorities, they might just tell the complaining person on the next visit that they're no longer handling his/her work, or the repair shop is booked for the next several weeks and can't accommodate them, or that the restaurant is already booked to capacity and it's suggested the complainer find another restaurant.

The highlight of the day for nursing home patients can and should be the food!
My step father was recently in a nursing home inside a hospital. It is called a Skilled Nursing Facility...It is a great place. Medicaid was paying for his stay.

He was there for 2 years until his recent passing 3 weeks ago. He enjoyed the food until recently and wanted a change. I talked to the dietitian and found out that he could design his own menu, from the choices she provided, for the next 21 days in a row...all 3 meals. Then it would repeat. And if he didn't see what he wanted on the menu, he could write in what he wanted! The dietitian was helpful to the extreme to try to get him what he wanted. So the key is ... get to the dietitian, find out what is possible, and if that doesn't work, escalate to the next level! Don't just accept the status quo without investigating!

My mom is also in a nursing home. There are at least two choices for each meal, and my mother's dislikes (rice and cottage cheese) are noted electronically on her "reciept" for each meal. You need to address this situation with the folks at the top.

GA is absolutely correct, address this with the facility before going outside to the Ombudsman.

But also remember that, simply knowing that there is an Ombudsman and Joint Commision out there is very empowering. At a point when my mom's care was substandard and there didn't seem to be anything anyone could do, asking the administrator why my next call shouldn't be the the Ombudsman and Joint Commision lit a fire like I'd never seen. Just keep it in your pocket.

Wouldn't it be better to complain to the NH first? Document the complaints and if there is no satisfactory response, then go to state authorities?

We were just talking about this yesterday. My friend wanted to celebrate the Rams first game in LA, so we had a “football” party and brought everyone’s family member from their care facility. The biggest complaint is they dislike the food. I recently obtained my Dental Hygiene Alternative Practice license and will have an opportunity to go into the facilities and see for myself. I have been a cook and know the joy and pleasure a good meal brings. What else to they have? I plan to provide oral hygiene and promote all healthy living. I intend to intervene on the behalf of any patient who needs help. Wish me luck. By the way, I would be kind but approach the administration. I grew up very poor, and cooking on a tight budget is nothing new to me, I have done it.

A young schoolgirl in Scotland had considerable success taking photos of her school lunches and posting them online, with comments (good or bad).

Never mind the dietitian: where's the cook? Who's in charge of the actual catering service? I like MsMadge's idea of a collective voice, but I'd add - build a relationship with the person who plans and delivers the menu. It's quite possible that when you see what budget s/he is working with you'll have more sympathy with her/him; but also s/he might well respond to someone actually taking a constructive interest in the service. It's hard to take pride in your work if nobody ever says anything about it.

My mother loves the food her nursing home serves. The menues look pretty healthy to me.

My aunts loved there food, too. Their nursing home was in another state.

Certainly not all care center food is bad. So sorry yours is!

First, the meals have to meet the health department rules that say low fat and low salt. That alone can make meals seem a bit flat.
Second, special diets have to have written orders from an MD. You can't just ask for a diabetic meal. It has to be ordered by your doctor. Same with gluten free; it has to have a doctor's order. The health department makes the rules, facilities just follow them.