Head Dietitian

Department: Clinical/Nutrition Services
Reports To: Administrator / Director of Nursing
Status: Full-Time
FLSA: Exempt/Non-Exempt as applicable
Supervises: Dietetic staff and nutrition-related personnel, as applicable

Position Summary

The Head Dietitian is responsible for providing comprehensive clinical nutrition services to residents of the skilled nursing facility. The Head Dietitian oversees the facility's nutrition program, ensuring that residents receive safe, nutritious, appealing, and individualized meals consistent with their medical conditions, preferences, cultural needs, and goals of care.

The Head Dietitian works collaboratively with nursing, medical providers, rehabilitation, social services, activities, and dietary services to promote optimal nutrition, hydration, quality of life, and resident-centered care. The position is responsible for maintaining compliance with applicable federal, state, and local regulations, including CMS requirements governing nutrition and dietary services in skilled nursing facilities.

Essential Responsibilities

Clinical Nutrition Services

• Complete comprehensive nutritional assessments for new admissions and existing residents according to regulatory and facility requirements.

• Develop individualized nutrition interventions based on diagnoses, nutritional status, weight history, laboratory values, medications, swallowing status, food preferences, and goals of care.

• Monitor residents at nutritional risk, including those experiencing weight loss, poor intake, dehydration risk, pressure injuries, malnutrition, or other nutrition-related concerns.

• Participate in the identification, assessment, and treatment of residents with or at risk for malnutrition.

• Monitor weights and significant weight changes and initiate appropriate interventions.

• Evaluate the effectiveness of nutritional interventions and revise care plans as clinically indicated.

• Provide recommendations regarding therapeutic diets, supplements, fortified foods, snacks, and hydration programs.

• Review and make recommendations regarding enteral nutrition and other specialized nutritional needs in collaboration with the interdisciplinary team and medical provider.

• Ensure appropriate nutrition-related documentation is maintained in the resident's medical record.

Care Planning and Interdisciplinary Collaboration

• Participate in the interdisciplinary team and resident care planning process.

• Attend and contribute to care plan meetings, including discussions related to nutrition, weight changes, wounds, hydration, and food preferences.

• Participate in MDS/CAA processes as appropriate.

• Collaborate with physicians, nurse practitioners, nursing, speech-language pathology, rehabilitation, social services, and other disciplines regarding resident nutritional needs.

• Communicate significant nutritional concerns promptly to the appropriate members of the interdisciplinary team.

• Support resident-centered decision-making and honor resident preferences and choices whenever clinically and safely appropriate.

Dietary Services and Meal Management

• Collaborate with the Director of Food and Nutrition Services/Dietary Manager to ensure meals meet residents' nutritional, therapeutic, cultural, and personal preferences.

• Review menus to ensure nutritional adequacy, variety, appropriate portion sizes, and compliance with prescribed diets.

• Make recommendations for menu modifications and therapeutic diets.

• Participate in meal observations and rounds to evaluate food quality, presentation, temperature, consistency, portioning, and resident satisfaction.

• Monitor the use and effectiveness of nutritional supplements.

• Work with dietary staff to address resident complaints, preferences, allergies, intolerances, and special dietary needs.

• Assist with development and implementation of policies and procedures related to nutrition and dietary services.

Regulatory Compliance and Quality Assurance

• Maintain compliance with CMS, state Department of Health, and other applicable regulatory requirements related to nutrition and dietary services.

• Ensure nutrition documentation is accurate, timely, complete, and clinically appropriate.

• Participate in survey preparation and respond to nutrition-related survey requests and findings.

• Participate in Quality Assurance and Performance Improvement (QAPI) initiatives related to weight loss, malnutrition, hydration, food service, pressure injuries, and resident satisfaction.

• Monitor facility nutrition-related quality indicators and develop corrective action plans when necessary.

• Maintain required professional credentials, licenses, and continuing education.

Staff Education

• Provide nutrition education to nursing, dietary, rehabilitation, and other facility staff.

• Educate staff regarding malnutrition prevention, weight monitoring, hydration, therapeutic diets, food allergies, supplements, feeding assistance, and resident-specific nutritional needs.

• Provide orientation and ongoing education to dietary and clinical staff regarding nutrition policies and procedures.

Resident and Family Engagement

• Meet with residents and families regarding nutritional concerns, dietary preferences, therapeutic diets, supplements, and goals of care.

• Promote resident choice and dignity during meals.

• Participate in resident satisfaction initiatives and address nutrition-related grievances promptly and professionally.

• Educate residents and families regarding appropriate nutrition and hydration strategies when indicated.

Leadership Responsibilities

The Head Dietitian is expected to serve as a clinical leader within the facility and to:

• Establish a proactive nutrition management program.

• Identify trends before they become significant clinical or regulatory concerns.

• Maintain effective communication with the Administrator, Director of Nursing, Medical Director, and Dietary Manager.

• Hold appropriate staff accountable for timely completion of nutrition-related responsibilities.

• Promote a culture of resident-centered care.

• Assist leadership in developing measurable goals for improving nutritional outcomes.

• Participate in interdisciplinary meetings and facility leadership initiatives as requested.

Required Qualifications

• Bachelor's degree in Nutrition/Dietetics or related field from an accredited program.

• Registered Dietitian Nutritionist (RDN) credential preferred/required as applicable by state and facility requirements.

• Current state licensure or certification, when required.

• Experience in long-term care/skilled nursing preferred.

• Knowledge of CMS requirements and regulatory standards governing nutrition and dietary services in nursing facilities.

• Strong clinical assessment, documentation, communication, and organizational skills.

• Ability to work effectively with residents, families, physicians, nursing staff, dietary personnel, and interdisciplinary team members.

Preferred Experience

• Experience with long-term care residents, including geriatric nutrition.

• Experience with MDS/CAA processes.

• Experience managing malnutrition and unintended weight loss.

• Experience with enteral nutrition and therapeutic diets.

• Experience participating in state or federal surveys.

• Experience with QAPI and performance improvement initiatives.

Core Performance Expectations

The Head Dietitian will be evaluated on:

• Resident nutritional outcomes

• Reduction in avoidable weight loss and malnutrition

• Timely and accurate nutrition assessments and documentation

• Appropriate follow-up of nutritional interventions

• Resident satisfaction with meals and dietary services

• Regulatory compliance

• Interdisciplinary collaboration

• Staff education and competency

• Participation in QAPI initiatives

• Commitment to resident-centered care

Physical and Environmental Requirements

The position requires the ability to move throughout the facility, including resident rooms, dining areas, kitchen, rehabilitation areas, and administrative offices. The employee must be able to communicate effectively with residents and staff and perform duties in a skilled nursing environment.

Equal Employment Opportunity

The facility is an equal opportunity employer and considers qualified applicants without regard to legally protected characteristics.