A Master of Multi-Site Management

Ann Friedland

What do you call an onsite operator who's in charge of foodservices for a 240-bed hospital, five correctional facilities, a county Head Start agency, nine childcare and twelve senior centers, an extensive Meals on Wheels program and a shelter network? Eliana Schultz.

With a career that began with a position as a hospital clinical dietitian, Eliana Schultz, R.D., DHCFA, director of food and nutrition services for San Mateo County Health Services Agency, would officially be labeled as a healthcare operator in the foodservice industry. In truth, however, she's more like a community foodservice provider for 40 different sites throughout the county, which is located just south of San Francisco.

Satellite power
Nearly 60 percent of the food production at Schultz's base site, the San Mateo County Health Center, is satellited out to other organizations—and that doesn't even include the 4,000 meals per day produced in the adult correctional and juvenile facilities' own kitchens. And from a capacity point of view, Schultz believes the center has the potential to significantly expand its production in the future.

"We have the ability to dedicate about seventy-five percent of our production for off-site venues," she says, gesturing about at her large, 11,300-sq.ft. kitchen that was doubled in size in the mid-90's. (The $1.5 million kitchen remodel comprised phase one of the $140 million, hospital-wide renovation that was finally completed in late 2002.)

Looking to increase revenues through outside feeding contracts has been the logical path for Schultz and her staff, given certain limitations at the Health Center itself. The patient census there is at about 130, and as a result of the budget constraints typical of many healthcare facilities, late afternoon hours in the cafeteria have been cut over the years. Funds to renovate the cafeteria have been redlined, so seeking outside customers has been the best way to maintain production on an efficient scale.

"Quality patient care is such a costly service to provide that we, like most other healthcare facilities, have to turn to other resources to keep the necessary staff busy and highly productive," Schultz notes. "What makes us a rather unique operation is that we handle so many different programs; what makes us proud and excited is that we do them so well."

And you don't just have to take her word for it. Client surveys continually produce an 85 to 90 percent "good to excellent" rating for the department's food and service; the department was awarded all its childcare center contracts through positive word-of-mouth recommendations; and to earn its most recent contract (to provide breakfast, lunch and snacks for 600 children in the county's Head Start agency), Schultz's crew beat out a slew of other bidders that included local school districts. "We weren't necessarily the lowest bid, either, since cost was just one of the criteria," she notes.

A juggling act
The secret to coordinating all those different programs? A "super-cross-trained" staff and streamlined menus, for starters. Schultz says she's lucky in that a very low turnover rate among employ-ees has helped ensure a high level of performance consistency.

When new workers do come on board, they're trained first in all the relief positions so that they can automatically cover a variety of shifts. Then individual managers continue to cross-train as schedules permit.

"Training has always been an important part of the culture of our facilities, and is constantly emphasized," she says. "Individual evaluations are done with training as one of the employee's primary goals and objectives. The morale here is very high, and in part that is due to the commitment managers and supervisors have to maintaining a properly and thoroughly trained staff."

To keep food costs and production logistics under control, menus for the various programs mirror each other, with some modifications made as each client base warrants.

"For instance, we might send chicken drumsticks to childcare facilities on the day we're doing chicken cacciatore for the seniors," Schultz says. Children will also get wheat bread instead of the dinner rolls or French bread that go to seniors. "In other respects, daily production for all the sites is based on the same monthly-rotating, seasonal menu." Usually at least one of the entree choices for patient and hospital cafeteria menus is also the same as what's being delivered to the different sites.

When Schultz's department was awarded the Head Start contract last September, it significantly broadened the existing menu, which had been dominated by quickservice items.

"So far, the casseroles and more home-style meals have been extremely well-received by the children. In fact, we've heard that they've been asking their parents why they don't cook the way we do!"

With 40 different satellite sites that receive daily food deliveries, one might expect that the Health Center would be based on a cook-chill production model, but that's not the case. Although that capability was sought, budgets up to now have not allowed for it. However, Schultz notes she does rely heavily on a blast chiller, which is currently used to prepare the weekend meals for the Meals on Wheels recipients.

"That's allowed us to save some money and also increase the quality of the weekend meals for the frail elderly, since we'd previously had to purchase frozen meals from a vendor to cover the weekend," she explains.

In lieu of a cook-chill system, meals are primarily cooked-to-serve for same-day consumption and delivered in insulated containers to their various county-wide destinations in a fleet of eight vans. Food delivery slips included in each run must be filled out and returned by the site managers to ensure the proper temperature has been maintained and to get daily client feedback on the taste and presentation of each meal. Back at the kitchen offices, Special Program Dietitian Jennifer Stimson, M.S., R.D. reviews the slips to ensure quality control and to keep a pulse on customer reaction for the development of future menus.

The senior and childcare centers and shelters receive meals in bulk form, and have some level of finishing kitchen capability for serving and sanitation. But the Head Start program presented some new challenges. "The meals there are served to three to four different classrooms per site, with no prep areas available at all," Schultz notes. "So we're using lots of disposables."

Facing challenges
That was a challenge that was fairly easily met. Others, however, are proving more difficult. One looming menace is the threat of further budget cuts as California moves to resolve its current budget crisis (it presently faces a $35 billion budget shortfall and tactics used to address that are likely to deliver a major blow to such operations as the county health agency).

Like any contract-service provider, Schultz also faces the ongoing threat that her operation might lose an existing contract to a competitor. In healthcare, where administrators constantly must seek to manage costs, contracts are frequently under review. Because her operations have already been streamlined, Schultz admits that if the San Mateo operation were to lose a significant amount of business, it would be nearly impossible to cut staffing to compensate.

Growing the business
For that reason, one of her biggest challenges is a continuing search for additional revenue sources. With patient counts at the Health Center expected to remain flat for the foreseeable future, other program revenues are critical to defray basic service costs and Schultz, Gruber, and the Health Center team continue to look for every opportunity to do so.

Schultz has her eye on board-and-care as well as longterm care facilities as possible future clients. She's also working to develop marketing materials that can be used to better promote the value of her department's services to other potential customers within the county.

One possible opportunity she mentions is to find ways to extend foodservices to residents in some nearby senior living apartments. If cafeteria hours can be extended into the early evening, a special discount program could be developed for them. Another plan suggested by Schultz's hospital site foodservice director, Elly Gruber, is to establish a coffee cart with prepared salads and sandwiches in a large corridor of a nursing wing. Alternatively, by using just one cashier, Schultz may be able to open access to the cafeteria in the evenings with only prepared grab-and-go items available in the cafeteria's new cold food merchandiser.

Schultz already knows the grab-and-go choices would be a hit, since they debuted during the cafeteria's recent facelift, when selections such as Caesar and teriyaki chicken salads and sushi rolls were made available because construction disrupted regular line service for a week.

Many customers asked that the grab-and-go options be retained once the hot line was back up and running. "They're now our biggest sellers," Schultz says.

"We fill up the merchandiser every morning at 10:30 with 40 to 50 of the items, and by 12:30 they're completely gone. They've ended up increasing our participation by five to ten percent a day." (Currently, the cafeteria serves about 350 meal equivalents per day).

Star catering
Catering is another area in which Schultz is determined to increase revenues. "With regards to the future, I'm really getting most excited about the catering business," she claims. Armed with a new, official name, Star Catering, along with printed brochures and business cards, Schultz and her team are ready to take their catering services "on the road" to other county departments.

Gruber, Catering Coordinator Bill Chenoweth, and Chef/Manager Tony Washington have put together offerings to "set our services apart from other, more informal catering vendors in the area," according to Schultz.

"Our catering strategy is to focus on more black-tie events such as fund-raisers and community benefit programs. We'll see the kind of impact we can make within the other county departments before branching out into the community in general."

A special tasting session the Star Catering team recently sponsored introduced county department heads and supervisors to some of their signature delicacies. Already, however, their reputation had been building.

"Back when we first attempted to offer catering services, we were lucky to get to do cookies and punch," Schultz recalls. "No one trusted the department to prepare and serve food for truly fancy occasions." She and her team slowly but surely proved them wrong. A few years ago, for a large Health Center fundraising drive, the department got the job of catering the afternoon open house, while a commercial catering company scored the evening's black-tie dinner. The results? No comparison: the afternoon service went off without a hitch impressing administrators; but the dinner was cold, and the service lackluster. It was just the break the department needed. Since then it has taken on increasingly formal affairs, such as retirement dinners and most of the Health Center's opening events over the past couple of years, polishing a growing reputation for quality food and smooth, impressive service.

Current catering revenues run about $150,000 per year, but the goal is to soon double that with the new marketing efforts.

A community services provider
About half of Schultz's $9.3 million annual budget goes toward supporting foodservices at three adult correctional and two juvenile detention facilities, which combined serve approximately 4,000 meals a day.

While Gruber runs the day to day operations and maintains compliance with policies and procedures for the Health Center's foodservices, the correctional facilities require more involvement from Schultz herself. She retains responsibility for policy and procedural managers while onsite operations are handled by "very good managers that I trust implicitly," she says.

During weekly meetings, Schultz, her correctional foodservice staffs, and the leadership at each facility hammer out the practicalities of fulfilling ever more complicated mandates regarding HACCP and food safety regulations and menu requirements. The managers and supervising cooks work with Correctional Dietitian Michele Castano to develop four-week cycle menus, while balancing religious and restricted diets (including a growing number of diabetic and AIDS-related diets).

A former ASHFSA president who remains active in its commit-tees and appreciates the value professional associations bring, Schultz clearly relishes the wide-ranging scope of her operation and the unusual position of having her fingers in several foodservice segments simultaneously. But it wreaks havoc with benchmarking programs. "Our food costs are competitive and our productivity is exceptional," she notes. "But our Bay Area labor costs are high, and that combination really complicates the benchmarking process. Our numbers have actually been challenged by data base managers because the mix is so unusual. It's hard to find a facility that's really comparable to ours."

And if Schultz has her way, that challenge won't get any easier. "We'd like to keep adding our outside contracts and increasing our productivity. We truly see our opportunity as one of becoming a dedicated and quality foodservice provider for a full range of community needs."

PHOTOGRAPHY BY DAVID TOERGE