What does it mean to serve “real” food? For some it’s about what you avoid, like preservatives, processed items and food dyes. For others it means what you emphasize, such as whole foods, ancient grains and nutrient-dense ingredients.
At Community Health System in California, the Thomas Cuisine dining team defines it as R.E.A.L.: Robust flavor, Exceptional ingredients, Avoiding additives, Loaded with nutrients. The foodservice provider rolled out the REAL program back in 2015—before this conversation was quite as mainstream—and has continued to evolve it to better serve its clients including Community Health System.
“Thomas Cuisine is part of a food revolution, and we are committed to promoting real food,” says Christie Tayar, a registered dietitian and Clinical Nutrition Manager at Community’s Clovis campus. “To us, real food means we know where it comes from and we know it’s going to have health benefits for our bodies.”
That’s particularly important for Thomas Cuisine’s clients like Community Health System, where food is both medicine and a balm for what may be a difficult time in someone’s life. Community Health System spans eight campuses of hospitals, skilled nursing facilities and outpatient centers.
The partnership has fueled an 80% increase in café and retail revenue over its three years, consistently strong patient satisfaction, and unusually low annual turnover of 24% in 2025.
Craveable items at affordable prices
It’s increased participation—not pricing—that fueled the sales surge, says Amanda Kephard, Food Service Director at Clovis Community Medical Center. That means the team must make dishes delicious and craveable, while keeping ingredients nutrition-focused.
Part of that challenge is avoiding ingredients on Thomas Cuisine’s “scrap list,” says Tayar, “which are ingredients that we want to remove from our kitchens because they have been shown to not provide health benefits to our bodies.”
This scrap list includes food dyes, preservatives, additives and artificial sweeteners. So far, Thomas Cuisine has removed red and green dyes #3, potassium bromate (a dough strengthener identified as a possible carcinogen), and propylparaben (an antimicrobial ingredient that may be an endocrine disruptor). They’re working to remove blue dyes #1 and #2 as well as azodicarbonamide (a dough conditioner that may also be a carcinogen).
These guidelines influence how the team plans menus, and they often must get creative: For Valentine’s Day, the bakery sold heart-shaped chocolate chip cookies topped with beetroot-colored frosting instead of red dye. More than 350 of them flew off shelves, and people were amazed that the frosting was just as delicious as the traditional—with zero beet taste.
It’s just one example of how the team aims for every offering to reinforce the message that health and flavor can coexist. Guests’ favorite entrees include a butter chicken that “gets hammered for the whole week,” panko-crusted trout that’s “nutritious, but also really delicious,” charbroiled salmon with tropical salsa, and beet and burrata salad, Kephard says.
“That extends even to grab-and-go,” she adds. “We have an overnight oats that people go crazy for, and it’s one of the most simple, real-food things you can make. Sometimes people think healthy means not good, and we’re trying to show them that it can really be both.”
Menus are also shaped in large part by café satisfaction surveys, which Kephard says leadership “really takes to heart.” That feedback directly fuels changes like recently updated menus for Community Health System’s food trailers.
Kephard also credits consistently low pricing for keeping guests on campus rather than venturing out in Clovis, which offers plenty of local eateries. A typical hot plate that includes a protein, a starch and a vegetable runs only about $7 after an employee discount.
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A Thomas Cuisine staff member prepares Korean Chicken Thighs at Community Health System.
Making scratch work in a hospital setting
The Clovis foodservice team supports patient meals, multiple retail outlets, a bistro, a food trailer and catering. To keep scratch cooking feasible in a fast-paced hospital setting, the team relies heavily on optimization-centered systems and smart menu design.
They standardize recipes through an online database that the entire culinary team has access to, which helps keep taste and preparation consistent. On the menu side they repackage shared ingredients across locations: the café may use a protein in a sandwich, and the food trailer can use the same protein in a grain bowl or a salad.
“You can do a lot by menu-ing differently, so the production in the back of house is the same but the menus are still exciting for guests,” Kephard says.
Scheduling is another lever in a relatively small kitchen. For example, house-made soups and items that require the blast chiller are often prepared on the evening shift when service demands are often lower and staffers have more space to move around.
That said, systems and scheduling can’t make everything run smoothly all the time, Kephard says.
“We are definitely in a trying time in healthcare right now across the United States, so it’s important not to get discouraged and to stay flexible,” Kephard says. “The CEO of Community has told me that’s his favorite thing about our team: If he calls us with an urgent need, we are pivoting two minutes later. If you’re not adaptable to change, I think people will find themselves really struggling in this space.”
Get to know Thomas Cuisine at Community Health System’s Amanda Kephard
See what’s in store for Kephard’s operation, which was named FSD’s April Foodservice Operation of the Month.
Q: What is it that makes your operation excel?
Our team truly has a passion for cooking real foods. They care about the product they produce, and they care about helping each other with that mission. I love seeing our culinary team grabbing tasting spoons to try what they’re making, and they ask each other to taste it. They ask me to taste it. They really want to be proud of what they’re serving.
Our team even volunteers to help with extra things like high-end catering events. Like, who does that these days? But they want to be part of it. [Similarly,] I have patient services chefs who want to contribute ideas to our menus and help our sous chef develop new seasonal items. You see it all in their actions: what they’re producing every day, but also how they take care of our guests and each other.
Amanda Kephart
Q: What are your goals for the operation in the coming year?
Within about the next eight months, we’re planning to roll out an IDDSI program (International Dysphagia Diet Standardization Initiative). We’ve been working on this for a while, and it’s because we’re really trying to do it the right way: We are creating new recipes, vetting recipes, testing and tweaking menus, the whole thing, so that’s definitely one of our largest projects for the coming year.
We’re also making changes to some of our physical spaces and planning on more training and development. The leaders below me all want to be directors, and I want to see them and everyone on our team continue to develop. Whether it’s our leadership or anyone else on the team, helping them continue to grow is really important.