Lack of Qualified Dietary Leadership and Absence of Registered Dietitian
Penalty
Summary
The facility failed to employ sufficient qualified staff to manage food and nutrition services for a census of 62 residents. The Dietary Manager (DM) had been in the role for approximately four weeks, had no prior LTC dietary experience, and held only a Food Safety Manager Certification, not a Dietary Manager Certification. Review of her resume showed no certification or degree in dietary management and prior work limited to a grocery store bakery and a hotel. The facility’s own job description for the Dietary Manager required certification or specific education/experience in food service management, including LTC experience or equivalent qualifications, which the current DM did not meet. The Nursing Home Administrator acknowledged that the DM was only taking classes to become certified and that, in the past, she had required LTC experience for this role. The facility also failed to employ a Registered Dietitian (RD) to oversee residents’ nutritional needs. The DM did not know if the facility currently had an RD and reported that she relied on the food vendor for menu questions. She stated that nursing staff were responsible for notifying the kitchen about residents needing high-calorie supplements or therapeutic diets and was unaware of any role she had in addressing weight loss. The former RD reported she had not been employed since approximately October/November of the prior year, with only one day in the building in December, and that when employed she worked 20 hours per week and was responsible for monitoring resident weights, therapeutic diets, menu adequacy, menu adjustments, education, and generating a weight change report for QAPI. In a follow-up interview, the DM believed the RD was responsible for assessing residents’ nutritional needs and thought nurses were responsible for developing and evaluating regular and therapeutic diets, including food and liquid textures, while she assumed she might be responsible for staff education programs. The NHA reported she had been told the facility had an RD on staff but that this person had not been seen recently and that they were trying to find a full-time RD.
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