Hospital, Nursing Home and Residential Facility Foodservice Trends in the U.S.
Table of Contents
- Chapter 1: Executive Summary
- Scope and Methodology
- Scope
- Methodology
- Consumer survey methodology
- Industry Framework and Drivers
- Insight Capsule
- Fast Facts
- Foodservice Usage & Outlook Tracker
- Insight Capsule
- Fast Facts
- Share of Stomach: Sales Analysis
- Insight Capsule
- Fast Facts
- Hospitals & Restaurant Brands
- Insight Capsule
- Fast Facts
- Hospital Foodservice Trends
- Insight Capsule
- Fast Facts
- Hospital Program Analysis
- Cleveland Clinic
- UCLA Medical Center
- University of Washington Medical Center
- Hospital Foodservice Management
- Self-management versus contract management
- A loyal—and growing—following?
- The tighter the budget becomes, the more outsourcing becomes attractive
- Bottom line: contracts grow but overall revenue flattens
- Aramark
- North America Health Care Sector
- Strategy: partnering in patient care, custom menus, branding
- Partnering in patient care
- Custom menus
- Branding
- Sodexo Inc
- North American Health Care
- Health care foodservice strategy: high-value custom offerings, nutrition services
- High-value custom offerings
- Nutrition Services
- Compass Group PLC
- Compass Group North America (CGNA)
- North America Health Care Sector
- Strategy
- Personalized Care
- Retail Branding
- Retail Strategy
- Healthcare Services Group, Inc.
- Sales analysis
- Foodservice strategy
- Chapter 2: Industry Framework and Drivers
- Overview
- A massive captive foodservice audience
- Employee meal opportunity: $1 billion
- 53,000 locations and counting
- Table 2-1: Hospital, Nursing and Residential Facility Establishments, 2005-2009
- 6.4% of U.S. workforce, with higher than average earning power
- Table 2-2: Hospital, Nursing and Residential Facility Employee Earning Power, 2009
- Healthcare employment trends assure more mouths for foodservice to feed
- An employment behemoth that is only getting bigger
- Aging population to drive employment need—and patient foodservice need
- Table 2-3: Population Projection, Age 65+ and Age 85+, 2010-2025
- Nursing and residential care job growth to be twice the rate of hospital employment
- Table 2-4: Healthcare Employment Projections, 2008-2018
- Hospitals
- Overview and hospital types
- General hospitals
- Special hospitals
- Rehabilitation and chronic disease hospitals
- Psychiatric hospitals
- Community hospitals
- Almost a million beds and 40 million admissions
- Table 2-5: U.S. Hospitals, by Type and Operational Characteristics, 2009
- General hospitals predominate
- Table 2-6: Hospital Facility Establishments, by Type, 2005-2009
- Average length of stay stable over time, with demographic variations
- Table 2-7: Average Length of Stay Trends, Gender Analysis, by Age
- Hospital patient meal opportunity: millions and millions served
- Table 2-8: Inpatient Meal Opportunity, Community Hospitals, 2000-2008
- Patient illnesses and treatments strongly determine foodservice approach
- Male and female admission rationales significantly different
- Table 2-9: Surgical Procedures, Type of Procedure, by Sex
- Table 2-10: Hospital Earning Power & Foodservice Labor Expense,
- by Hospital Type, 2009
- Nursing and Residential Care Facilities
- A more labor-intensive environment calling for greater degree of salary allocation
- Assisted living facilities
- Table 2-11: Nursing and Residential Care Facility Earning Power
- & Foodservice Labor Expense, by Type, 2009
- Residential care licensing types evolving toward “assisted living” terminology
- State licensing and regulatory approaches
- Institutional model
- Housing and services model
- Service model
- Umbrella model
- Multiple levels
- Services, demographics and fees
- McDonald’s watch out: assisted living meal opportunity may be a billion a year
- Inpatient meal opportunity outstrips that of hospitals
- Service assessment
- Room and board rates
- An overwhelmingly female demographic
- Table 2-12: Assisting Living Facilities: Key Demographics, 2009
- Nursing homes
- Table 2-13: Nursing Facilities: Key Operational Statistics, 2010
- A higher degree of assistance required
- Less than half of nursing home residents can eat independently
- Table 2-14: Nursing Facilities: Patient Characteristics, 2010
- Mental health facilities
- Chapter 3: Foodservice Usage & Outlook Tracker
- Packaged Facts’ Consumer Restaurant Tracker
- Table 3-1: Foodservice Categories and Types
- February 2010 food retail momentum continues through October 2010
- Graph 3-1: Consumer Restaurant Tracker: Current Behavior: A Top Line View
- Looking ahead: Consumers more likely to save & spend on groceries than spend at restaurants
- Intended behavior portends full-service restaurant pullback
- Graph 3-2: Consumer Restaurant Tracker: Next 3 Months: A Top Line View
- Saving money remains at the forefront; intention to save spreads
- Graph : Consumer Restaurant Tracker: Future Behavior: Saving Money
- Foodservice usage and usage frequency
- Overview
- Limited-service restaurants
- Full-service restaurants
- Snack and beverage concepts
- Institutional foodservice
- Table 3-2: Foodservice Establishment Usage and Mean Use, 2010
- Foodservice and institutional foodservice usage analysis
- Note on reading charts
- Foodservice category use
- Age
- Graph 3-4: Foodservice Usage in Last Month, by Foodservice Category, Age 2010
- HH income
- Graph 3-5: Foodservice Usage in Last Month, by Foodservice Category, HH Income, 2010
- Work status
- Graph 3-6: Foodservice Usage in Last Month, by Foodservice Category, Work Status, 2010
- Population density
- Graph 3-7: Foodservice Usage in Last Month, by Foodservice Category, Population Density, 2010
- Institutional foodservice category use
- Gender
- Graph 3-8: Institutional Foodservice Use in Last Month, by Foodservice Category, Gender, 2010
- Age
- Graph 3-9: Institutional Foodservice Use in Last Month, by Foodservice Category, Age, 2010
- HH income
- Graph 3-10: Institutional Foodservice Use in Last Month, by Foodservice Category, HH Income, 2010
- Work status
- Graph 3-11: Institutional Foodservice Use in Last Month, by Foodservice Category, Work Status, 2010
- Population density
- Graph 3-12: Institutional Foodservice Use in Last Month, by Foodservice Category, Population Density, 2010
- Hospital Users
- Bottom line: dealing with illness correlates with foodservice use
- Relationship with food changes; foodservice plays important role
- Table 3-3: Hospital Users, Foodservice Use by Type, 2010
- Caregiver restaurant usage & food, health and diet attitudes
- Caregiving pressures may draw caregivers to full-service restaurants
- Table 3-4: Caregiver Restaurant Usage Frequency, Family and Fast Food Restaurants, 2010
- But kids also play a role
- Caregiving adds a layer of restaurant use
- Table 3-5: Caregiver Restaurant Usage Frequency, Family and Fast Food Restaurants, Kids, 2010
- Caregiving an added burden for parents
- Graph 3-13: Caregivers, Influence of Children
- And for grown children
- Graph 3-14: Caregivers, Influence of Age
- Hectic life of the caregiver reflected in food, health and diet attitudes
- Table 3-6: Caregiver Food, Health and Diet Attitudes, Strength of Agreement, 2010
- Chapter 4: Share of Stomach: Sales Analysis
- Summary analysis
- The future of hospital & nursing and residential care foodservice is bright
- With significant caveats
- Contract management may win share
- Cost cutting versus revenue generation
- Packaged Facts hospital& nursing and residential care market size and forecast
- Graph 4-1: Hospital & Nursing and Residential Care Foodservice Sales, 2005-2012
- National Restaurant Association market size and forecast
- Graph 4-2: Hospital & Nursing Home Foodservice Sales, Contract Management Share, 2001-2009
- U.S. Economic Census foodservice contractor market size
- Table 4-1: Foodservice Contractor Revenue, Hospital & Nursing Home Share, 2007
- Foodservice contract management contracts grow while revenue flattens
- Table 4-2: Foodservice Contract Management Performance, 2008-2009
- Table 4-3: Foodservice Contract Management, Hospitals Contracts, 2008-2009
- Growth factors
- Industry growth to drive foodservice increase
- Hospital spending grew 5.9% in 2009; solid growth ahead
- Nursing home care expenditure growth rate to increase
- Graph 4-3: Hospital and Nursing Home Care Expenditures
- & Projected Expenditures, 2005- 2019
- Buoyed by government funding
- Table 4-4: Healthcare Expenditure Receipts, By Source
- Graph 4-4: Hospital and Nursing Home Care Expenditures & Projected Expenditures, Public Funding, 2009-2014
- Serving an aging population
- Table 4-5: Population Projection, Age 65+ and Age 85+, 2010-2025
- Table 4-6: Hospital, Nursing and Residential Facility Employee Earning Power, 2009
- Key hospital performance measure undervalues foodservice
- HCAHPS survey leaves out foodservice!
- So what?
- Meal opportunity analysis
- Inpatient hospital foodservice meal opportunity stagnates through decade
- Table 4-7: Inpatient Meal Opportunity, Community Hospitals, 2000-2008
- Meal opportunity highest among female and older patients
- Table 4-8: Inpatient Meal Opportunity, Gender and Age Analysis
- Outpatient hospital meal opportunity outstripped inpatient opportunity
- Table 4-9: Outpatient Meal Opportunity,
- Community Hospitals, 2000-2008
- Pricing and expenditures
- Average hospital check on the rise
- John H. Stroger Jr. Hospital of Cook County: foodservice expense primer
- Table 4-10: John H. Stroger, Jr. Hospital Of Cook County,
- 2009 Foodservice Expense Analysis
- Chapter 5: Hospitals & Restaurant Brands
- Restaurant brands at hospitals: a tug-of-war pitting health against revenue
- The dilemma
- A violation of trust?
- The bottom line: healthy brands have room to grow
- Restaurant brand penetration above 40%
- Table 5-1: Frequency of Brand Name Fast Food (BNFF)
- Franchises at 233 Academically Affiliated Hospitals
- Table 5-2: Food Outlet Analysis, U.S. Children’s Hospitals
- Barometer for fast food penetration at children’s hospitals set at 30%
- 1 in 4 children’s hospitals with fast food franchises
- Fast food presence influences food purchases and perceptions
- Does food purchasing at a hospital with a McDonald’s differ from those without one?
- Study parameters
- A strong McDonald’s skew!
- Table 5-3: Children’s Hospital Study, Fast Food and McDonald’s Purchases
- Why did they pick McDonald’s?
- Convenient location and child preference
- Table 5-4: Children’s Hospital Study, McDonald’s Purchase Rationales
- The Subway alternative
- Where are they now?
- 30,000 McDonald’s in the U.S. but only 32 in hospitals
- Mayo Clinic: “Live Well” and eat Zpizza
- Cleveland Clinic: McDonald’s on the way out; GO! Foods on the way in
- Ten-year battle with McDonald's coming to a close
- Fruit and walnut salad first offered here
- GO! foods a healthy option
- Brands galore
- UCLA Medical Center
- Johns Hopkins Hospital
- University of Alabama Hospital
- Other hospitals
- University of Pittsburgh's Magee-Women's Hospital's
- Children's Hospital of Philadelphia
- Massachusetts General Hospital
- University of Washington Medical Center
- Franchise cost analysis
- Local, independent brands; revenue-sharing
- Healthier restaurant profiles a better sell
- Contracts that address degree of risk-reward
- Chapter 6: Hospital Foodservice Trends
- Hospital Foodservice Trends
- Overview: trend prevalence and momentum
- Primary trends
- Room service and individualized patient care
- Customer service
- Wellness and nutrition
- Variety and culinary exploration
- Sustainability and green initiatives
- The need for speed
- Secondary trends
- Visual stimulation
- Catering
- Room service and individualized patient care
- Personal dining care: examples
- Variation in services
- Customer service!
- University of Washington Medical Centeruse of feedback
- The need for speed
- Examples
- Food safety
- Examples
- Minimizing disease transmission
- Examples
- Wellness and nutrition: the obvious is actually not obvious
- Pros to healthier hospital foodservice
- Cons to healthier hospital foodservice
- Wellness and nutrition initiatives in the upswing
- Menu labeling catching on
- Variety
- Examples
- Culinary exploration
- Examples
- Chefs on board
- Special discounts and incentives to dine in the hospital
- Would you make a trip to the hospital just to eat the food?
- Green initiatives
- Examples
- Visual stimulation
- Driven by restaurant competition
- Food as visual stimulation
- Catering
- Integrated technological systems
- Building staff collaboration, knowledge, and morale
- Chapter 7: Hospital Program Analysis
- Cleveland Clinic
- Overview
- Patient profile
- Table 7-1: Cleveland Clinic, Demographic Data, Treated Diabetics
- Foodservice programs and services
- Multitude of dining options
- Ousting chains
- Pizza Hut leaves; McDonald's stays
- Management split between Sodexo and AVI Food Systems
- Room service an extra: get a Founders Suite
- Foodservice growth trends
- Emerging trends
- 2009-10 foodservice initiatives
- Future initiatives
- UCLA Medical Center
- Overview
- Demographics
- Foodservice programs and services
- Signature Dining, anyone?
- Customized service
- The backend meets the front end: how it works
- A diverse menu to meet needs of a diverse population
- Café Med: serving 1.2 million customers a year
- Offerings and sales trends
- Catering at 10 years of age
- Foodservice growth trends
- 2009-10 foodservice initiatives
- Foodservice philosophy
- Overnight café
- Price increases
- Future initiatives
- UCLA Medical Center -numbers recap
- University of Washington Medical Center
- Overview
- Patient and employee profile
- University of Washington Medical Center
- 2009 statistics
- Harborview Medical Center, Staff Ethnicity
- Harborview Medical Center, Patient Ethnicity
- Foodservice programs and services
- General, renal, heart healthy, and low fiber/soft menus
- Room service reduces food and supply costs; limiting overtime reduces labor costs
- Equipment upgrading
- Plaza Café: local chefs, expanded offerings
- Harborview Medical Center
- Foodservice growth trends
- Emerging trends
- 2009-10 foodservice initiatives
- Future initiatives
- University of Washington Medical Center -numbers recap
- Chapter 8: Hospital Foodservice Management
- Self-management versus contract management
- Self-managed hospital foodservice still holds sway
- A loyal—and growing—following?
- An issue that stirs passion among the faithful
- Hospital CEO plays pivotal role
- The tighter the budget becomes, the more outsourcing becomes attractive
- Cost concerns favor contractors
- Outsourcing trend among government institutions?
- Bottom line: contracts grow but overall revenue flattens
- Table 8-1: Foodservice Contract Management Performance, 2008-2009
- Table 8-2: Foodservice Contract Management, Hospitals Contracts, 2008-2009
- Table 8-3: Foodservice Contractor Revenue, Hospital & Nursing Home Share, 2007
- Aramark Corp
- Foodservice operations
- Sales analysis
- North America Business and Industry Sector
- North America Education Sector
- North America Health Care Sector
- Patient foodservice
- Retail foodservice
- Facility services
- Strategy: partnering in patient care, custom menus, branding
- Partnering in patient care
- Custom menus
- Branding
- Table 8-4: Aramark by the Numbers
- Sodexo Inc
- Corporate Foodservice
- Education Foodservice
- North American Health Care
- North American Health Care Foodservice
- Patient dining services
- Visitor & staff dining services
- Retail foodservice
- Health care foodservice strategy: high-value custom offerings, nutrition services
- High-value custom offerings
- Nutrition Services
- Market trends & Sodexo response
- Health care expenditures
- Patient consumerism
- Shortage of health care personnel
- Table 8-5: Sodexo by the Numbers
- Compass Group PLC
- Compass Group North America (CGNA)
- Sales analysis
- Foodservice strategy
- Room for growth
- It Takes You - Eat Local
- Leveraging role of single-source provider
- Selective acquisitions
- North America Health Care Sector
- Patient Foodservice
- Senior Living Foodservice
- Retail Foodservice
- Support Services
- Strategy
- Personalized Care
- Retail Branding
- Retail Strategy
- Table 8-6: Compass Group by the Numbers
- Subsidiaries
- Healthcare Services Group, Inc.
- Sales analysis
- Foodservice strategy
- Future growth
- Table 8-7: Healthcare Services Group, Inc. by the Numbers
- Miniprofiles
- AVI Food Systems, Inc
- Unidine Corp.
- Prince Food Systems, Inc.
- Appendix
- Works Referenced
Abstract
However, uncertainty looms in the form of government healthcare spending; the enactment of the Patient Projection and Affordable Care Act; and addressing state and federal budget shortfalls. We view contract management companies as potential winners of a budget crunch.
- Among the conclusions drawn in the report, foodservice programs should not only emphasize women’s nutritional and other health-driven considerations, but also be informed about the different ways women view food generally, whether at home or at restaurants. This need is even more pronounced at assisted living facilities.
- The report also concludes that a wealth of opportunity exists to tailor foodservice programs around family caregivers. Under these circumstances, a person’s relationship with food may understandably change, and foodservice plays an important role. This explains why those dealing with illness are more apt to use a variety of foodservice types.
- And while the presence of restaurant brands can provide hospitals with a health dilemma, we view hospital-based restaurant establishments as a component of foodservice consumers expect. Restaurant brands that forcefully play the health card can offer a win-win proposition for hospital foodservice.
- The report also identifies the following trends as “primary” with positive momentum: Room service and individualized patient care; customer service; wellness and nutrition; variety and culinary exploration; sustainability and green initiatives; and the need for speed.
- In a unique approach to quantifying market opportunity, the report assesses “meal opportunity” for inpatient and outpatient hospital, assisted living, and hospital employee settings.
Key coverage includes:
“Share of stomach” analysis
“Share of stomach” hospital and nursing and residential facility sales analysis, which includes 2005-2012 expenditures trends for the hospital and nursing and residential facility segments, with forecasts for 2010, 2011, and 2012.
Consumer restaurant tracking
Via our proprietary Consumer Spend Tracker, Packaged Facts places consumers’ hospital foodservice use within context. This includes directional analysis on recent and intended consumer behavior related to food & foodservice usage; foodservice usage and usage frequency by foodservice category, including limited-service, full-service, snack and beverage, bars and taverns, and institutional foodservice; and targeted analysis of hospital foodservice and associated user food, diet and health attitudes.
In-depth trend analysis and market participant analysis
Report coverage also includes:
- Targeted analysis of hospital foodservice users and associated food, diet and health attitudes.
- Trends related to the presence and growth of restaurant-branded hospital foodservice, supported by analysis of leading hospital foodservice programs.
- Trends related to hospital foodservice, including but not limited to room service and individualized patient care, customer service, wellness and nutrition, variety and culinary exploration, sustainability and green initiatives, the need for speed.
- Three leading hospital foodservice programs, with a focus on foodservice trends, initiatives, and metrics.
- Hospital foodservice segments of three leading foodservice contractors (Aramark, Sodexo, and the Compass Group) and one nursing home foodservice contractor (Healthcare Services Group, Inc.).
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