June 8th, 2021
Under the general direction of the Clinical Nutrition Manager, the Registered Dietitian (RD) implements the Nutrition Care Process (NCP) through the completion of comprehensive nutrition assessments, determination of the nutrition diagnosis, development and implementation of evidence-based nutrition intervention(s), and evaluation of participant progress. The nutrition assessment can include, but is not limited to, identification and documentation of malnutrition and morbid obesity, evaluation for food insecurity, motivation for changing behaviors, and development of individualized goals and interventions for participants with complex medical conditions. The RD is responsible for providing evidence-based medical nutrition therapy to participants and caregivers with varying levels of nutrition risk. The RD is a required and integral member of the Interdisciplinary Team (IDT) and demonstrates ability to collaborate with all members of the IDT.
- Conducts a comprehensive nutrition assessment at the time of enrollment and semi-annually thereafter according to CMS guidelines.
- Utilizes screening tools and applies tools in effective ways.
- Utilizes medical history, laboratory data, medications, anthropometric measurements, and diet history to assess nutritional status.
- Performs nutrition focused physical exam (NFPE) during assessments on participants to determine risk and/or degree of malnutrition when indicated.
- Evaluates psychosocial, functional, and behavioral factors related to food access, selection, preparation; physical activity; and understanding of health condition.
- Evaluates participant and family’s knowledge, readiness to make changes towards positive outcomes, and motivation for changing behaviors.
- Collaborates with other IDT members or other healthcare professional when indicated.
- Finds patterns and possible causes for the nutrition problem.
- Documents the nutrition diagnostic statement in PES (problem, etiology, and signs/symptoms) and provides supporting evidence within the documentation.
- Formulates and determines individualized interventions focused on the etiology of the problem.
- Assesses educational needs and provides individualized nutrition education and counseling based on the individual, including nutrient requirements, knowledge and abilities, and medical, economic, and social situation.
- Coordinates nutrition plan of care with the IDT team and other healthcare professionals when indicated.
Nutrition Monitoring and Evaluation
- Utilizes monitoring and evaluation techniques that consider participants nutrition needs as well as cultural, religious, and ethnic concerns.
- Evaluates the effectiveness and measures progress toward outcomes of nutrition interventions.
- Monitors participants to be identified at high nutritional risk and provides timely follow up based on department criteria and clinical judgement.
Documentation, Coordination of Care, and Compliance
- The RD is responsible for completing documentation that is relevant, accurate, and timely in the participant’s electronic medical record in accordance with standards set forth by CMS, PACE SEMI, and the department leader.
Coordination of Care and Compliance
- The RD participates in Care Plan meetings as a required member of the interdisciplinary team.
- The RD is responsible for effectively communicating the plan of care with the interdisciplinary team as well as other healthcare providers as warranted.
- The RD understands, complies with, and promotes the Participant Bill of Rights and works to achieve high levels of participant satisfaction.
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