Federal requirements to be a qualified long-term care facility director of food and nutrition services are changing Saturday (Oct. 1) in order to ease training and staffing obstacles while keeping standards high, according to the Centers for Medicare & Medicaid Services.
The move has not come without controversy.
Would-be dining directors will need to have had two or more years of experience in the position come Saturday. Those who don’t have it need to complete “a minimum course of study in food safety that includes topics integral to managing dietary operations, such as, but not limited to: foodborne illness, sanitation procedures, food purchasing/receiving, etc,” according to the final rule in the Federal Register. CMS published the updated regulations Aug. 3, 2022.
The updated rule “will help address concerns related to costs associated with training for existing staff and the potential need to hire new staff.”
The previous requirements for the job stated that a director of food and nutrition services was required to be a certified dietary manager, a certified food manager, have a similar certification in food service management and safety, or have an associate’s degree or higher in food service management or hospitality.
In 2019, CMS proposed changing those standards to allow a director of food and nutrition services to either have two years of experience working in that position or have completed a minimum course of study in food safety.
The National Consumer Voice for Quality Long-Term Care, a consumer advocacy group, complained that the changes would endanger residents’ health by lowering the bar for the job.
“Two years of experience as a director of food and nutrition services does not mean a person is adequately equipped for this position,” said the organization. “The proposed alternative qualification, a ‘course of study,’ is extremely vague.”
Eases some hiring concerns
The new rule will ease staffing pressure, said Emily Fear, a Sodexo senior area manager in clinical support and a registered dietitian who works with long-term care communities across the country.
“Staffing has been an unprecedented challenge over these past months, which has made the job of finding current Certified Dietary Managers and/or completing your CDM (training) while working in a position that much more difficult,” Fear said.
“Depending on your work and education experience, the coursework to become a CDM can take a year or more to complete and the cost for some can be a barrier. The change in the regulation will open the door for some individuals and may help organizations fill positions that are desperately needed and hard to fill.”
Fear said providers will have to pay attention to what their respective states require for the role because many have specific requirements for the position and communities may have to follow regulations that are more strict. She said Sodexo supports managers who want to become CDMs through tuition reimbursement and other financial assistance options. The company has been working on systems to support its current CDMs by providing free continuing education that is a requirement to maintain their credential.
“The role of the food service director varies greatly from community to community and there may be instances where you don’t get all of the clinical experiences that you need to best support the clinical and nutrition needs of the residents,” she explained. “It will be critical for directors without their CDM to work closely with and learn from the registered dietitian that supports their community to ensure that residents’ clinical nutrition needs are met. The CDM certification ensures that directors have this necessary training and is the best practice when possible.”