Date of Award


Degree Type


Degree Name

Doctor of Philosophy


Human Ecology

Major Professor

Mary J. Hitchcock

Committee Members

Jean D. Skinner, Marjorie P. Penfield, Robert H. Kirk


In 1981 nursing homes and hospitals with less than 100 beds in Kentucky and Tennessee represented approximately 50% of the total number of these facilities. Little attention has been given in the professional literature to health care facilities of this size. Many small facilities have not employed persons with specialized education and training to manage the foodservice; thus food quality control methods may not be used. Research is needed to identify existing areas of quality control in order for needed improvements and changes to be made. The purposes of this study were to identify and compare current quality control measures employed in dietary departments of small hospitals and nursing homes and to develop a feasible evaluation form that would facilitate the time spent by a consultant dietitian in these facilities.

Chi square and t-tests performed on the responses of hospitals and nursing homes indicated few significant differences in food quality control methods. Differences were indicated between hospitals and nursing homes for group purchasing practices, the use of issue and requisition forms, qualifications of persons responsible for planning menus and for several of the types of employee and guest foodservices. All of the responding hospitals reported that they employed a dietitian while only 83% of the nursing homes did so. A difference (p < 0.01) occurred between facilities for the employment status, full-time, part-time or consultant, of the dietitian. Patients from a random sample of the facilities rated the food and service "Fair" to "Good." No differences in patient opinions occurred between types of facilities.

Nutrient means obtained by analysis of one day's menu from the facilities met or exceeded the Recommended Dietary Allowances (RDA) for adult males and females, ages 23-50, and 51+. An exception to this was the iron RDA for females and calories for men, ages 23-50.

To facilitate the continuous control process, a check sheet was developed to evaluate small health care foodservices. The form was critiqued by 20 practicing dietitians and appropriate revisions made in the form.

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