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Ensuring Quality Care: Academy Advocates for Continued Recognition of Malnutrition in Proposed Skilled Nursing Rule

Published June 7, 2024

The Academy opposed the removal of malnutrition and at-risk malnutrition from the Non-Therapy Ancillary (NTA) Classification List in its recent comments to Centers for Medicare and Medicaid Services (CMS) regarding the 2025 Federal Fiscal Year Skilled Nursing Proposed Rule. Given the high prevalence of malnutrition among older adults and its significant health and financial repercussions, maintaining this classification is critical for achieving positive patient outcomes.

The Skilled Nursing proposed rule, issued by CMS, outlines regulatory changes and updates for skilled nursing facilities, covering reimbursement rates, quality measures and policies related to Medicare payments and services in the skilled nursing and long-term care settings. In response to a Request for Information included in the proposed rule, the Academy advocated for continued inclusion of malnutrition and at-risk malnutrition in the NTA Classification List.

This inclusion ensures appropriate reimbursement and resource allocation for quality care, prevention of health deterioration and addressing health equity issues. The comments submitted underscored the vital role of registered dietitian nutritionists in delivering comprehensive care through assessments, personalized interventions and ongoing monitoring of malnutrition, leading to better patient outcomes and advancing health equity.

Additionally, the Academy supported CMS’s efforts to incorporate standardized patient assessment data elements related to food insecurity in the patient intake process. The Academy appreciates CMS's commitment to addressing food insecurity within the Medicare program to enhance health outcomes and reduce health disparities, especially for vulnerable populations. The Academy also appreciates CMS's recognition of the essential role of skilled nursing facility dietitians in transitions of care, where it highlighted the role RDNs play in creating nutrition care plans to support food-insecure residents' medical needs post-discharge.

Read the Academy’s full comments.

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