It’s not news that staffing shortages are rampant at all levels in senior care. Many registered dietitians working in long-term care are spread thin, working at multiple facilities to provide even the minimal services required by law. 

This significant gap in the nutrition workforce is compelling communities to rethink their approach to dietary support for residents. According to the Centers for Medicare & Medicaid Services, if a qualified nutrition professional (i.e., RD) isn’t employed full-time, the facility must designate a person to serve as the director of food and nutrition services. This role can be filled by nutrition and dietetic technicians, registered (NDTRs) or certified dietary managers (CDMs). 

NDTR is a relatively recent credential from the CDR. The number of technicians in the job market compared to RDs and CDMs is very low, but the opportunity for employment is high. 

NDTRs are trained in food and nutrition and are an integral part of healthcare and foodservice management teams. This role requires a minimum of a two-year associate degree with 450 hours of supervised practice experience. They can provide clinical support to a lesser degree than RDs (such as care conferences and weight monitoring) but don’t replace the need for at least a part-time RD on staff in skilled nursing facilities.

Although the CDM designation has officially been around since the mid-1980s, the role is emerging as a complementary profession to oversee operational tasks that some RDs previously undertook. 

The path to obtaining a CDM credential is much less rigorous than that of an RD; no college is required, but passing a nationally recognized CDM Credentialing Exam is. 

Unlike RDs, CDMs don’t provide clinical counseling. Rather, they’re typically responsible for the day-to-day foodservice operations in senior living communities.  For example, they manage menus, working closely with chefs to provide options that meet individual resident needs. 

CDMs also ensure compliance with state, county and local health regulations, schedule and supervise kitchen staff, and maintain high standards of food safety and quality. They are also pivotal in business operations such as budgeting, maintenance, procurement and inventory management.

Most importantly, both NDTRs and CDMs support person-centered care plans when RDs are otherwise engaged. By ensuring meals are nutritionally balanced, flavorful and meet the specific needs of residents, their expertise helps provide the dietary support needed for residents’ well-being. And by backing the long-term development of these roles, employers will undoubtedly help ease the pain of the workforce gap.

Moving the model forward

One pivotal step we’ve taken to promote progress toward an alternative model and support both the roles of RDs and CDMs is a partnership with the Association of Nutrition and Foodservice Professionals (ANFP). 

With more than 15,000 members, the ANFP is one of the nation’s leading organizations focused on foodservice and nutrition operations. It provides numerous educational and networking opportunities, including access to apprentice programs and credentialing for CDMs. By partnering with industry leaders, ANFP can further its mission of providing optimum nutritional care through foodservice management.

Our organization is maximizing its relationship with the ANFP through activities such as

  • Developing and implementing a new youth apprentice program
  • Working together to educate and credential frontline employees
  • New CDM recruitment
  • Supporting retention through ANFP membership and continuing education 

Reducing turnover

Let’s face it: nutrition professionals are in high demand, and with more stringent education requirements on the horizon, it’s not likely to get easier any time soon. RDs have their pick among jobs, and those certainly aren’t limited to senior living. 

Outsourcing services can be the most practical solution for communities looking to elevate programs, gain efficiencies and retain employees because the service provider takes on the responsibility of managing these strategies. 

Below are some tips we’ve found to help reduce turnover and recruit new talent.

  • Cover the basics – salary is important, but competitive benefits, flexibility and work-life balance are becoming non-negotiable. 
  • Go one step further with robust benefits – employers who cover continuing education and specialty certification costs, allow time off for attending conferences, and pay for registration renewal are more likely to win the talent race.
  • Define and employ a career development ladder – one of the primary reasons RDs leave a job is for a “new opportunity.” Document meaningful steps for advancement and review progress on a regular basis.
  • Encourage networking – involvement with trade associations such as the Academy of Nutrition & Dietetics and ANFP promote innovation and professional support. 
  • Give them a voice – as some of the most educated associates on the team, RDs often provide a fresh and intellectual perspective to strategic and clinical concerns.
  • Recognize exemplary work – a kind word is always welcome, and formal recognition in front of other staff or a board can boost morale during long stretches with understaffed teams.

Tracy Blazer is the Regional Vice President, West/Midwest Region, at Sodexo Seniors. She is a registered dietitian with a master’s degree in public health nutrition. Ms. Blazer has been a nutrition professional in the senior living segment for more than 20 years. 

The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.

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