We carried out a questionnaire survey of the cooking systems and food services in nursing homes for the elderly in 210 institutions in the Chugoku region and 55 institutions in large urban areas (Osaka, Kyoto, and Kobe). The cook-chill system had been introduced in 8.3% of the institutions, the vacuum cooking system in 3.0%, and the steam convection oven in 58.5%. The cooking process was significantly more frequently standardized in the institutions with a cook-chill system than in those without this system. Since the cook-chill system is introduced for improvement in the efficiency of the food production system, there may be a relationship between improvement in the efficiency of the production system and the standardization of the cooking process. Preprocessed vegetables and precooked foods were more frequently used in institutions with a cook-chill system, which suggested improvement in efficiency in the production system in terms of both the introduction of new cooking systems and the purchase forms of food ingredients. In contrast, Japanese soup powder was less frequently used in institutions with a cook-chill system than in those without a cook-chill system. Refreshment service is offered every day in 32.8% of the institutions. As food-associated support for independence, residents themselves peeled vegetables, cooked rice, and set and cleared tables in 17.0% of the institutions. Both refreshment service and food-associates support for independence were significantly more frequently provided in institutions with a cook-chill system.