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Nutrition Care Manual
Nutrition Care ManualSubscribe

The Academy's Nutrition Care Manual is a comprehensive online resource that covers all aspects of nutrition management. NCM’s user-friendly resources include:

  • Disease-specific nutrition assessment, diagnosis, intervention, monitoring and evaluation recommendations.
  • Printable client handouts in English and Spanish.
  • Formulary database.
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...from the publication: Eat Right Weekly - June 8

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CMS Division Adopts ADA's Therapeutic Diet Recommendations

The Center for Medicare & Medicaid Services recently released revisions that adopt ADA's recommended definitions and interpretations related to therapeutic diets, mechanically altered diets and nutritional supplements to its Resident Assessment Instrument Minimum Data Set (MDS) 3.0, which affect quality of care to residents in long-term care and is directly tied to reimbursement of services provided.

ADA members and staff drafted a letter to CMS in April defining a therapeutic diet as "a diet intervention ordered by a health care practitioner as part of the treatment for a disease or clinical condition manifesting an altered nutritional status, to eliminate, decrease, or increase certain substances in the diet (e.g., sodium, potassium)." CMS not only adopted this definition for the MDS 3.0, it additionally included ADA's interpretive recommendations for clarifying a "supplement" and mechanically altered diets for coding purposes on the MDS:

  • Therapeutic diets are not defined by the content of what is provided or when it is served, but why the diet is required. Therapeutic diets provide the corresponding treatment that addresses a particular disease or clinical condition, which is manifesting an altered nutritional status by providing the specific nutritional requirements to remedy the alteration.
  • A nutritional supplement (house supplement or packaged) given as part of the treatment for a disease or clinical condition manifesting an altered nutrition status, does not constitute a therapeutic diet, but may be part of a therapeutic diet. Therefore, supplements (whether given with, between or instead of meals) are only coded in K0500D, Therapeutic Diet, when they are being administered as part of a therapeutic diet to manage problematic health conditions (e.g. supplement for protein-calorie malnutrition).
  • A mechanically altered diet should not automatically be considered a therapeutic diet.

ADA's next step will be working with CMS for the agency to adopt the MDS 3.0 definition (with consistent interpretive guidelines) applicable across the lifecycle in hospitals, long-term care facilities, and elsewhere. ADA will continue to keep members aware of developments and impact on dietetic practice.

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