In late 2016 the Centers for Medicare & Medicaid Services (CMS) released the long-awaited “Medicare and Medicaid Programs; Reform of Requirements for Long-Term Care Facilities”. The new federal regulations became effective on November 28, 2016.
The new regulations indicate that physicians may delegate to a registered licensed dietitian the task of prescribing NH/LTC residents’ diet to the extent allowed by State law. CMS underscored the advantages of expertise and efficiencies contributing to better resident service and care by allowing physicians to delegate therapeutic diet orders to dietitians.
This is a very welcome CMS update for NH/LTC facilities, staff and residents. However the Minnesota Nursing Home License does not currently list dietitians as physician delegates (currently only nurse practitioners and physician assistants are listed). For these situations, a waiver request from the NH/LTC to the Minnesota Department of Health is often used to accommodate revised practices.
Attached here (Waiver Template) is a waiver template developed by MAND that can be used by NH/LTC to secure formal approval to grant registered licensed dietitians diet order responsibility as a physician delegate.
Please share this information with others as appropriate. We want to make sure MAND members working with NH/LTC organizations are aware of this option. For more background information, here is the link (Minnesota Therapeutic Diet Orders for LTC – Overview June 1 2017) to the overview drafted by MAND policy leads.
For additional questions, please contact MAND.