SECTION 554.1102. Staffing

The facility must employ sufficient staff with the appropriate competencies and skill sets to carry out the functions of the food and nutrition services, taking into consideration resident assessments, individual plans of care, and the number, acuity, and diagnoses of the facility's resident population in accordance with the facility assessment required at §19.1931 of this chapter (relating to Facility Assessment). This includes:

(1) a qualified dietitian, either full-time, part-time, or on a consultant basis. A qualified dietitian:

(A) holds a bachelors' or higher degree granted by a regionally accredited college or university in the United States, or an equivalent foreign degree, with completion of the academic requirements of a program in nutrition or dietetics accredited by an appropriate national accreditation organization recognized for this purpose;

(B) has completed at least 900 hours of supervised dietetics practice under the supervision of a registered dietitian or nutrition professional; and

(C) is licensed as a dietitian by the state of Texas;

(2) a dietitian hired or contracted with before November 28, 2016, that does not meet the requirements in paragraph (1)(A) - (C) of this section must:

(A) be either:

(i) registered by the Commission on Dietetic Registration or;

(ii) licensed, or provisionally licensed, by the Texas Department of Licensing and Regulation with at least one year of supervisory experience in dietetic service of a health care facility; and

(B) meet the requirements in paragraph (1)(A) - (C) of this section by November 28, 2021;

(3) if a qualified dietitian is not employed full-time, the facility must designate a person to serve as the director of food and nutrition services who receives frequent scheduled consultations from a qualified dietitian and who:

(A) is a certified dietary manager;

(B) is a certified food service manager;

(C) has similar national certification for food service management and safety from a national certifying body; or

(D) has an associate's or higher degree in food service management or in hospitality, if the course study includes food service or restaurant management, from an accredited institution of higher learning;

(4) a director of food and nutrition services who is not a qualified dietitian and does not meet the requirements in paragraph (3)(A) - (D) of this section, and who was designated before November 28, 2016, must:

(A) be at least:

(i) an associate-in-arts graduate in nutrition and food service management;

(ii) a graduate of a dietetic technician or dietetic assistant training program approved by the Academy of Nutrition and Dietetics or the Association of Nutrition & Foodservice Professionals;

(iii) a person who has completed a state-agency-approved 90-hour course in food service supervision; or

(iv) a person who has training and experience in food service supervision and management in a military service equivalent in content to the programs in paragraph (3) of this section or clauses (i) - (iii) of this subparagraph and has had the person's training credentials evaluated and approved by the nutrition program specialist of the HHSC Regulatory Services Division; and

(B) meet one of the requirements in paragraph (3)(A) - (D) of this subsection by November 28, 2021.

(5) Support staff. The facility must provide sufficient support personnel to carry out the functions of the food and nutrition service.

Source Note: The provisions of this §554.1102 adopted to be effective March 24, 2020, 45 TexReg 2025; transferred effective January 15, 2021, as published in the Texas Register December 11, 2020, 45 TexReg 8871