Lack of Full-Time Qualified Supervisor for Dietetic Services
Penalty
Summary
The facility failed to employ sufficient staff with the appropriate competencies and skill sets to manage the food and nutrition service, specifically lacking a full-time qualified position dedicated to supervising and managing the day-to-day operations of the skilled nursing dietetic services. During the survey, it was observed that the Food Manager (FM) was responsible for both the skilled nursing facility (SNF) and a separately licensed residential care facility for the elderly (RCFE), and his position was not dedicated full-time to the SNF. The Dietetics Assistant Director (DAD), a Registered Dietitian, also had responsibilities split between the SNF and RCFE, and her role was not solely dedicated to the SNF. The organizational chart review confirmed that the Director of Dietetics and a Food Service Supervisor (FSS) II positions were vacant, and there was no full-time qualified Food Service Director dedicated to the SNF. Interviews with facility leadership and staff further revealed that the current structure did not provide a full-time qualified supervisor for the SNF dietetic services. The DAD confirmed that all dietetic services leadership positions were shared between the RCFE and SNF, and the Registered Dietitian assigned to the SNF focused on clinical nutrition care rather than day-to-day management of dietetic services. The FM had not completed the necessary training to become a Certified Dietary Manager, and the facility had not attempted to modify position descriptions or minimum qualifications to address the deficiency. Facility policy and regulatory requirements were reviewed, indicating that if a dietitian is not employed full-time, a full-time Food & Nutrition Services supervisor must be responsible for the operation of the food service. The facility's failure to meet these requirements resulted in a lack of dedicated, qualified supervision for the SNF dietetic services, as evidenced by vacant leadership positions and shared responsibilities among existing staff.