For the ninth straight year, October is Dining Month on OnMilwaukee, presented by the restaurants of Potawatomi Hotel & Casino. All month, we're stuffed with restaurant reviews, dining guides, delectable features, chef profiles and unique articles on everything food, as well as voting for your "Best of Dining 2015."

Head out to just about any independently owned restaurant in Milwaukee and you’ll find dishes made with locally sourced, fresh ingredients. But, until more recently, the move to fresh, farm-to-table fare was largely absent from healthcare facilities, including hospitals and elder care facilities.

But, all of that is changing, as chefs like Justin Johnson take the reigns in assisting healthcare facilities in revamping the way they look at food service.

Watertown Regional Medical Center

Johnson, whose experience includes positions at Hotel Metro and Harwood Place retirement community, was hired by the Watertown Regional Medical Center in 2012 to lead its new food service program. During his tenure, he spear-headed a redesign of the hospital’s cafeteria, re-training food service staff and revamping meal service to include all scratch-made fare. He also helped to implement the development of an 11,000-square foot garden that supported most of the kitchen's vegetable needs during the growing season, a move that earned him a nomination for the Operator Innovations in Sustainability Award from the National Restaurant Association in 2013.

Johnson, who left the Watertown Center earlier this year, now runs a consulting business called Sustainable Kitchens, which aims to help restaurants and food service facilities make similar changes.

And the Watertown facility is not the only place where change is taking place. Area elder care facilities – including The Lutheran Home and Harwood Place – are also joining a trend that's spreading among senior living facilities across the U.S. – moving toward the use of more fresh ingredients and elevated cooking techniques in service to their residents.

The Lutheran Home

"Nationally, there is this movement that emphasizes farm to table, local and organic," notes Matthew Ricketts, Director of Dining & Hospitality at the Lutheran Home in Wauwatosa. "And now more and more aspects of the industry are starting to move that way together. In the healthcare industry, it only makes sense that we would follow so that we can accommodate the needs of our seniors as they grow older."

Despite statistics showing that baby boomers are turning 65 at a rate of 8,000 per day, increasing the number of residents at senior living facilities overall,  the movement has taken some time to evolve. Ricketts notes that changes can take time to implement, in part due to regulations which have traditionally limited the venues from which produce for elder care facilities can be sourced.

"We’d love to go to the farmer’s markets and pick up our produce," he says. "But, we need to be accountable for every piece of produce that comes into the facility, and that’s just not possible if we’re buying directly from farmers."

But, thanks to partnerships between large-scale distributors like Sysco with farms like Growing Power, making the transition to locally sourced food products for facilities like the Lutheran Home is becoming easier.

Ricketts, who started with the Lutheran home three years ago, says it’s been rewarding to take a fresh look at the way they provide nourishing meals for their residents.

In the past, everything was fiscally driven," he says. "But, in the past few years, we made the decision to increase our budgets to accommodate an overall increase in quality. And it’s worth it. We’re now investing in our seniors, and helping them to live better quality lives."^{Matthew Ricketts (far right) with his kitchen staff at The Lutheran Home}

Ricketts' colleague, Executive Chef Ashley Wolf agrees.

"Prior to my arrival three years ago, our potatoes au gratin came out of a box," she notes. "We now slice fresh potatoes and make our own homemade cheese sauce.  The only fresh fruit we were receiving were bananas. Now we have a huge walk-in cooler full of fresh fruits and vegetables, which we cut fresh daily for our residents."

But, Rome wasn’t built in a day, and the process is a constant evolution.

"It’s been an ongoing progression, really bringing passion and integrity to the table in terms of how we serve our residents," he says. "We’ve gone from beginning to eliminate canned goods and introducing fresh fruits and vegetables. And now we’re looking at how to source more locally. From there, we’re just chipping away at the process of sourcing and serving better food."

Ricketts, who serves 300 residents – including children who participate in the Lutheran Home’s Childcare program – oversees six different dining areas, as well as room tray delivery for residents in the home. And, bit by bit, every menu has been revamped with an eye for wellness and nutrition.

"We’ve updated all of the menu’s to make them more nutritious and fresh with higher quality ingredients," explains Wolf. "We want to use more whole foods to guarantee the residents are getting the nutrients they need while still giving them the comfort foods they grew up with and love."

"We’re making changes everywhere," Ricketts goes on. "From serving turkey sausage for breakfast to making our own housemade cranberry sauce instead of serving jellied canned sauce. In our rehab program, we’re shifting over to menus with ingredients that specifically promote healing. And we’ve found ways to revamp our daycare menu to include more fresh fruits and vegetables while still providing options that kids will eat."

The changes, Ricketts adds, aren’t limited to food; it’s also about offering better hospitality for both residents and guests through programs like a daily happy hour cart, which is wheeled around the facility at 2 p.m. daily, offering residents the opportunity to sip a drink while socializing with other residents and guests.

Harwood Place

Similar changes have been enacted at Harwood Place, the Lutheran Home’s retirement living facility which offers both independent and assisted living options for over 200 residents.

Executive Chef Tonya Garrido – who manages operations at both The Terrace, Harwood’s fine dining facility and a new pub and lounge, which offers options for breakfast, lunch and dinner -- says that in the past ten years there’s been a sea change in the way they approach dining options for residents.

"This is a retirement community where residents have their own kitchens and cars.They can cook at home or they can choose to dine elsewhere," she says. "So, for us, the food has to be able to compete with the other options out there."

For Garrido, that means taking good, quality ingredients and really showcasing them in classic dishes that appeal to residents.

"We’ve made a huge shift away from using frozen products," she says. "We’re now using 90 percent fresh produce and spending between $200 and $500 per day on produce."

^{Left to right: Chefs Ashley Wolf, Matthew Ricketts and Tonya Garrido}

Seasonal produce from Growing Power, including kale, green beans, pea shoots, microgreens, lettuce mix, yellow squash and zucchini, is incorporated into dishes alongside options like beef tenderloin medallions and seared salmon.  Food is cooked to order – an effort which reduces overall food waste.

A resident council helps to drive decision-making, in terms of food offerings at the residential venues.

"If items aren’t well received," says Garrida, "We make changes to accommodate. And we’re always listening to what residents want and need. They get excited when we tell them we’re using products from companies like Belgioso, Miller Bakery and Cedar Crest. So, we showcase those things on our menus."

And many residents take a pro-active role in supporting Garrida’s work. Take Sharon and Warren Braun who too the initiative to plant an herb garden on the Harwood premises for use by the kitchen staff.

"Every day we’re in that garden," says Garrida. "And we use the fresh herbs in our cooking. Residents here are so proud of our program, and of where they live. There are some residents who invite guests to dine with them here, and some have been known to bring up to twenty people to our restaurants for the holidays."

Programming at Harwood also reinforces the emphasis on fresh, local produce with annual visits to Windy Hills Farm, a dairy farm managed by the family of Jesse Rammel, Harwood’s wellness coordinator.

"It’s the second year she’s taken residents to tour the farm," says Garrido, "The trip always includes a tour and a meal made with fresh ingredients at the farm, and residents love it. For many, it brings them back to a life they grew up with."

And that life – that world in which fresh food is part of everyday life – is one Garrida says she works every single day to recreate.

"With seniors, they’re not necessarily into the trends," notes Garrido. "We are, but they aren’t so much. So, we’re taking things back to the basics. Fresh, delicious food. And that’s, ultimately, what they want… in so many ways, it’s what we all want."