Dietitian Blog, Long-Term Care | Jul 6 2023

Help! My long-term care facility is out of compliance

It’s your first day on the job at long-term care facility and you are met with overdue assessments, outdated policies, and a rapidly approaching survey window. This situation can be an intimidating and overwhelming place to start. When you are faced with a mountain to climb, how do you scale it? 

Remind yourself of your responsibilities

An important detail to note in this scenario is that, legally, you are only liable and responsible for the nutrition care that goes on after your date of hire. You do not need to be concerned about your license being liable for any inadequate care prior to your time with the facility. Of course, you still want to get things in order and catch up on nutrition assessments to make sure your department is back in compliance. 

Where to start

To get started, there are three key players within your facility that you should be collaborating with to best prioritize the efficiency and quality of patient care.  

  1. MDS Coordinator: The MDS coordinator can help you to determine which assessments are more time-sensitive and need to be tackled first to comply with being survey-ready. 
  2. Director of Nursing (DON): The DON can alert you to the residents requiring urgent nutrition care, even if they are outside of the MDS schedule. Whether its declining nutrition status, drastic changes in weight, and/or new-onset wounds, these residents may need to be placed at the top of your list.
  3. Food Service Director: The Food Service Director can provide insight into any current food service-related concerns that may be affecting the resident’s nutrition intake. They may also know of policies or menus that need a dietitian’s approval, in-services that need to be completed, or other food service tasks that need your attention. 

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Now that you have established a relationship with these key players of your facility, it is time to get to work! Providing the best care to your patients is the main objective. Aim to address several items from each of the above contacts’ “wish list.”

It may take a couple of weeks of diligent work to get caught up but with these three people in your court, you will be set up for success. Keep in mind, you are only responsible for addressing the current care of your residents. Take each day one at a time – you can do this!  


Dietitians On Demand is a nationwide staffing and recruiting company for registered dietitians, specializing in short-term, temporary and permanent-hire positions in acute care, long term care and food service positions. We’re dedicated to dietitians and helping them enhance their practice and excel in the workplace. Check out our job openingsrequest your coverage, or visit our store today!

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About Courtney Lee

Courtney Lee, MS, RDN, CLT, CFCS has a virtual private practice specializing in personalized nutrition and anti-inflammatory diets. She loves helping people use nutrition to change their lives and enjoys empowering other RDNs to do the same!

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