While franchise arrangements can provide solutions and benefits to hospitals, they aren't without potential pitfalls. For one thing, hospitals have to carefully consider whether bringing in fast-food vendors is in keeping with their mission to prevent disease and promote wellness, says Paul Gizara, vice president of product development for Aramark.
“For a while there was some skittishness because of health and wellness concerns with burger joints, but now we partner with brands that have strong health and wellness appeal, like Subway, Quiznos and Einstein Bagels,” Gizara says. “All those brands have menus that speak to consumers' concerns about health and wellness, and have lower fat and calories.”
Still, hospitals acknowledge that given the growing national focus on obesity and chronic illnesses such as diabetes and hypertension, striking a balance between offering healthier franchise food fare and offering the popular brands that drive revenue can be tricky.
Fredericksburg, Va.-based Mary Washington Hospital, which has five franchise food arrangements on its campus, including a Subway sandwich shop that has been on-site for 12 years, has dealt with such concerns by involving key clinical practitioners in a review of any branded food concepts being considered.
“The whole health and wellness piece is a big consideration,” says Penny Nicholas, the Sodexo employee who handles on-site food services operations for 442-bed Mary Washington. “We have a staff of dietitians who are involved with reviewing the concepts we consider.”
Loss of control over food operations and quality can be another problem, say some providers who've had less than stellar experiences with franchise operations.
“You have to sort of demand quality,” says Yesford, who notes that Providence had several problems when their Blimpie franchise was under a previous owner. “We had issues with uniforms, and the service wasn't that good. Some of the workers were coming in in jeans, and that's against hospital policy,” Yesford says.
Both problems have been corrected under the restaurant's new ownership, but the experience taught Yesford to plan for potential problems with a franchise vendor that could affect the hospital. “I wrote into the contract that the franchise will be penalized if we receive a bad review from food inspectors.”
While bringing franchise food operations onboard can relieve hospitals of the burden of subsidizing food-service costs, the higher prices charged by outside vendors don't always sit well with workers, and hospitals can also run the risk that they won't be able to generate enough sales volume among employees and visitors to make a franchise a successful venture.
“In a lot of instances, hospitals are signing contracts, so if the brand fails, they're responsible for all the financial burden that goes with it,” Gizara says.
As a result, Gizara advises hospitals to carefully consider the type of partnership model that will best work for them when looking to bring a branded food concept onto their campus. The arrangements between a branded vendor and a hospital can vary greatly, he says.
“In some cases the hospital will say, ‘Here's the space; pay us rent.' Sometimes they say, ‘Pay us rent and a fee,' ” Gizara says.
Large hospitals that provide food services not only to employees but also to a large number of daily visitors may choose to take a greater risk on their investment for the potential to reap greater revenue.
George Washington University Hospital partnered with Sodexo to purchase and manage its Starbucks franchise. Both organizations provided cash to cover the initial franchise fees, and the ongoing costs are covered by the coffee shop's monthly revenue. Sodexo handles the day-to-day management of the cafe.
Mary Washington, which serves about 3,000 people a day through its food franchise outlets, has adopted a mixed financial-arrangement formula for its varied branded food concepts.
The hospital pays a traditional franchise royalty fee to operate its Subway kiosk inside the food court. But for its three Starbucks kiosks, the provider chose to adopt the coffee company's “We Proudly Brew” concept, which allows the hospital to purchase the coffee products and branded containers and sell those products without paying a franchise fee.
“The ‘We Proudly Brew' arrangement allows you to sell some of your own products along with the Starbucks brand,” says Mary Washington Hospital spokeswoman Kathleen Allenbaugh, who notes the hospital sells breakfast items made by the hospital cafeteria at some of the kiosks but not at others. “We also balance a lot of the franchise offerings with our own soups and vegetables, fruits and salads.”