Medical Nutrition Therapy Service Standards

Approved January 2020

Prepared by

Priorities, Services Standards, Comprehensive Care Plan Committee
Middlesex-Hunterdon-Somerset HIV/AIDS Health Services Planning Council

Medical Nutrition Therapy definition:
Medical Nutrition Therapy includes:
• Nutrition assessment and screening
• Dietary/nutritional evaluation
• Food and/or nutritional supplements per medical provider’s recommendation
• Nutrition education and/or counseling
These activities can be provided in individual and/or group settings and outside of HIV
Outpatient/Ambulatory Health Services.
Program Guidance:
All activities performed under this service category must be pursuant to a medical provider’s referral
and based on a nutritional plan developed by the registered dietitian or other licensed nutrition
professional. Activities not provided by a registered/licensed dietician should be considered
Psychosocial Support Services under the HRSA RWHAP.

Source: HIV/AIDS Bureau Policy Clarification Notice (PCN) #16-02 (2018)

Staff Service Standards

(Medical Nutrition Therapy)

Policy
Number
Activity/IssueMinimum Acceptable Threshold of Service

Accountability Mechanism
1.1Staff Hiring

All staff have necessary skills and experience determined by:
*Written application
*Resume
*References
*Personal interview
100% of staff have an application, resume, and communication with personal references documented in personnel files.

1.2 (a)Staff QualificationsParticipating dieticians and other licensed nutrition professionals possess appropriate licenses, registration, credentials and expertise as required by the State of New Jersey.

100% of dieticians and other licensed nutrition professionals have current degrees, licensing, registration, certificates and resumes on file.
1.2 (b)Staff Qualifications
Peer Navigator
A member of the peer community living with HIV with a high school diploma or GED, plus two years of social service experience. Peer must demonstrate understanding of HIV services and healthcare service navigation.

100% of staff possess a diploma/GED with the required experience documented in the personnel file.
1.3Staff Job Descriptions

All staff have a written job description.

100% of staff have job descriptions documented in personnel files.
1.4Staff Continuing EducationAll participating dieticians and other licensed nutrition professionals must have HIV-specific continuing education on a yearly basis.

100% of personnel files document training.
1.5Policies and Procedures

Signed form is documented in the personnel file.

100% of staff agree to follow agency policies and procedures (See 1.10).

1.6 (a)Staff SupervisionAll supervisors are knowledgeable about RW HIV procedures including fiscal and program.
100% of supervisors are knowledgeable about the Ryan White program.

Supervision is documented in personnel files.

1.6(b)Staff Supervision
Peer Navigator

All peer navigators receive (at minimum) one hour supervision per week to include patient case conference, peer navigator job performance, and skill development.Supervision is documented in personnel files.
1.7Staff EvaluationStaff evaluations are documented in personnel files100% of staff are evaluated on their performance annually.

Client Service Standards

(Medical Nutrition Therapy)

Policy NumberActivity/IssueMinimum Acceptable Threshold of Service

Accountability
Mechanism
2.1Service eligibilityA physician’s recommendation is documented prior to initiation of service.
A physician’s recommendation is documented prior to initiation of service.
2.2Initial nutrition assessmentAn initial nutrition assessment must be completed prior to the initiation of the nutritional plan.
80% of clients have documentation of nutritional assessment in their file.

2.3Initial nutritional plan

Within 30 days of the initial assessment, a nutritional plan is developed for each eligible patient and signed by the dietitian rendering the services.

The plan should address:
a) recommended services and course of medical nutrition therapy to be provided, including types and amounts of nutritional supplements and food;

b) date service to be initiated;

c) planned number and frequency of sessions; and

d) education regarding nutritionally appropriate and safe food.



80% of clients’ files have a completed nutritional plan which is signed and dated by both the client and the dietician.



80% of clients have documentation of the recommended services, including types and amounts of nutritional supplements and food, in their file.


80% of clients have documentation of the date services start in their file.

80% of clients have documentation of the planned number and frequency of MNT sessions in their file.

80% of clients have documentation of education regarding nutritionally appropriate and safe food in their file.
2.4Updating nutritional plan

The Nutrition plan is updated at least every 6 months.
80% of clients have documentation of their nutritional plan being reviewed and updated, as appropriate, in their file.

80% of updated nutritional plans are signed and dated by clients and kept in their file.
2.5Coordination of Care

As appropriate, recommend medical evaluation by the medical provider to address nutrition-specific issues, i.e. loss of muscle, loss of appetite.80% of clients for whom medical evaluation is indicated have documentation of recommendation and referral for medical evaluation in their file.
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