Last updated on June 15th, 2023
Having a skilled and experienced nutrition team is invaluable for the health of senior living community residents and for remaining in compliance with federal regulations. According to changes in the §483.60 guidelines from the Centers for Medicare and Medicaid Services (CMS), long-term care facilities should have one of the following two combinations of professionals on staff:
- Option 1: A full-time Registered Dietitian Nutritionist (RD, RDN)
- Option 2: A part-time Registered Dietitian Nutritionist (RD, RDN) and another nutrition professional that is a certified food service manager, certified dietary manager, or has an equivalent national certification or education from an accredited university
These certifications help ensure that nutrition staff in long-term care facilities have adequate knowledge to provide older adults with balanced meals appropriate to their health or cultural needs.
Even though it’s been several years since these updated regulations were released, some directors are still trying to figure out which option is best. But what’s the best way to determine what type of staff will benefit your community most? Here are a few important questions to help you make your decision.
What’s the difference in licensing requirements between an RD and a CDM/CFPP?
RDs, CDMs, CFPPs, and other nutrition professionals have the same goal: to optimize people’s nutritional well-being. However, there are some differences in the type of training they must complete.
A registered dietitian is someone who has a bachelor’s degree in nutrition and has completed at least 1000 hours of supervised practice hours. While advanced degrees are something most RDs pursue, having a master’s degree will be required in 2024 for anyone wanting to take the RD licensure exam.
On the other hand, certified dietary managers and certified food protection professionals are evaluated by the Association of Nutrition and Foodservice Professionals (ANFP). There are several pathways CDMs or CFPPs can take toward certification, but most include some sort of professional nutrition experience or a degree in nutrition or a related field.
Each state differs on how licenses are recognized, but all nutrition professionals working in long-term care have to hold some sort of degree or certification from a national certifying body like the Commission on Dietetic Registration (CDR).
Next, it’s important to understand what role each could play in your community.
What responsibilities do RDs and CDM/CFPPs have?
Because RDs and CDM/CFPPs have different requirements, they aren’t trained or qualified to perform the same tasks. Here’s a brief summary of what each can do.
Registered Dietitians
RDs focus on nutrition as a whole and are involved in the assessment, diagnosis, intervention, and evaluation of a resident’s dietary plan. This license requires the most training out of any nutrition professional. Because of this extensive training, they’re able to provide Medical Nutrition Therapy (MNT), which includes:
- Conducting a thorough nutrition-focused physical exam and nutrition assessment that covers a resident’s entire dietary history and needs.
- Identifying nutritional deficits, and providing residents with an accurate diagnosis based on symptoms and other comorbid disorders.
- Creating a nutrition treatment plan that incorporates goals, diet modifications, and therapies to improve dietary health.
- Regularly evaluating a resident’s treatment plan (nutrition intervention), adjusting it as needed to best fit their needs.
Certified Dietary Manager/Certified Food Protection Professional
CDMs and CFPPs handle different tasks than RDs and are more limited in what they’re qualified to do. However, that doesn’t downplay the important role they play as nutritional health professionals. They aren’t qualified to perform MNT, which includes diagnosing a patient with a nutritional problem. Here are some of the duties they are trained for:
- Conduct structured interviews with residents to identify nutritional needs, preferences, and problems.
- Generate an accurate picture of a resident’s nutritional intake and history of compliance.
- Implement and modify a treatment plan, using evidence-based principles to alter it as needed.
- Converse with a resident’s support system to maintain updated nutritional health information in their medical record.
What is the role of food service director in a senior living community?
Being a food service director means taking responsibility for overall day-to-day nutrition operations in a long-term care facility. Whether your community has a few dozen or a few hundred residents, this job involves constantly evaluating how well a current food service management team is operating and identifying areas for improvement. They handle food service, personal management and communications, sanitation and safety, and general business operations. Because of food service directors’ diverse role, the more experienced they are, the better.
With this in mind, it’s important to think about other factors that could influence your decision besides training. For example, having a full-time RD may not be a cost-effective choice for smaller long-term care facilities — making a part-time RD and CDM/CFPP combo a more feasible. However, a full-time RD may bring insight into a community where a large portion of the resident population is of higher acuity and has dietary concerns or requires special accommodations.
So, one option isn’t necessarily “better” than the other. Every senior living community is unique; their food service management should reflect that.
Ready to make the best decision for your community?
We understand that making staffing decisions for your long-term care facility can be challenging. That’s why we created this guide on clinical nutrition staffing. It includes details about the role of a food service director, factors to consider when choosing, and more.
If you still need a bit more assistance, the Culinary Services Group team can assess your needs and help you determine exactly what type of nutrition leadership staff you need. Contact us today to schedule a consultation and to learn more about our food service management programs.
