New CMS Guidelines for Hospital Diet Orders

摘要

On August 18, 2005, the CMS released a memo to state survey agency directors that described revisions to the CMS interpretive guidelines for hospitals participating in Medicare Part A. This memo was meant to provide clarification to issues related toseveral CMS standards. One of these standards, §482.28 (b)(l), states, "Therapeutic diets must be prescribed by the practitioner or practitioners responsible for the care of patients." No change in the actual standard occurred, but the interpretive guidelines have been altered as shown on the bottom of this page. The effective date for this change was September 19, 2005. Dietitians consider themselves to be the "nutrition experts." Many feel they are more capable than other members of the health careteam to determine the best possible diet for a patient. They say that physicians only receive a minimal amount of nutrition education so dietitians should determine the most appropriate diet for a patient. These dietitians often point out examples of diet orders they have seen written by physicians that were not appropriate (e.g., regular diets for diabetics, inappropriate tube feedings, regular-consistency diets for edentulous patients, and orders for diets that have not been approved for use in theirparticular facility).