A new educational standard from the Commission on Dietetic Registration is likely to push nursing homes to use consultants and remote work more to meet required registered dietitian needs.
Starting Jan. 1, new dietitians seeking to be registered will have to have at least a master’s degree before they can take the exam. The change will not affect current registered dietitians or dietitians who are eligible to take their exams before the new rule takes effect. But the change is likely to impact the long-term care workforce in the future, experts say.
There is already a shortage of RDs in the LTC workforce, and the new requirement from the commission adds another obstacle for nursing homes, according to Christie Titmuss, vice president of clinical operations at Healthcare Services Group.
“I think the biggest thing is now that the number of dietitians that are going to be available every year is diminishing. Because now after a yearlong internship they can usually take an exam and get a job. [After the new requirement], it’s 18 months to two years before dietitians get into the workforce,” Titmuss told McKnight’s Long-Term Care News. “You’re taking an already small pool of dietitians and now you’re hampering that with a longer time period… before they get into the market.”
More reliance on consultants
The Centers for Medicare & Medicaid Services requires nursing homes to employ RDs to assess residents at least quarterly, but not every facility employs one full-time on-site. Many nursing homes now rely on consultations, sometimes even remotely.
The master’s degree requirement could have a negative impact on RDs’ ability to do their important work assessing resident health and managing nutrition.
“To do a dietitian’s job, you should be in the facilities,” Titmuss said. “It’s not really a remote job, especially in skilled nursing, but I think we’ve seen an increase of that just because you have to have the coverage and there’s not enough people.”
The work shortage could lead to problems in nursing homes, agreed Melinda Manuel, senior manager at Sodexo, a food services and facilities management company.
“To me, you’re not going to receive the same level of care from a consultant visiting once or twice a month versus having somebody in-house who is attending that morning meeting, attending those care conferences, communicating with families,” Manuel told Mcknight’s.
However, while Manuel recognized the shortage of RDs, she remained cautiously optimistic about the future.
“I think [the CDR requirement] scares those young adults going into school… But I think that will parse itself out. A lot of the allied health field is going in that direction,” Manuel explained. “We are just staying on par with the industry.”
But the time and cost of education could remain a barrier going into the future. McKnight’s has covered how other clinicians are facing similar challenges in today’s work environment.
Changes for RDs
Whatever the case, change is on the horizon for RDs and the nursing homes that employ them.
“We’re going to have to be flexible with working arrangements. Whether that’s creating a job share or having some remote or telehealth,” Manuel said. “There’s definitely a growing demand for that flexibility. We hear it when we screen and interview potential candidates all the time. And it’s gone up exponentially since COVID.”
With time-consuming and expensive educational requirements now added to the RD career path, employing them may also require significant pay increases going forward.
“The industry is going to demand it, I can promise you that,” Manuel said.
But higher degrees have not always equated to higher pay in the past.
“I personally don’t think that the degree equates to more pay in the real world,” Titmuss said, explaining that wages have increased over time but she expects there to be a cap to what the market will realistically pay.
If the rewards for pursuing this career path don’t improve, it may drive even more young clinicians into other fields and further stress the market, according to Titmuss.
“We hope we continue to get people to filter in, but the job market is so competitive now, it’s not the first place clinicians are going,” she said. “It was a good stepping stone for clinicians — but now that’s not the case.”
