Post-Acute and Long-Term Care Management

Post-acute and long-term care can include long-term acute care hospitals, skilled nursing facilities, inpatient rehabilitation facilities, home health agencies, hospice, assisted living facilities, and correctional facilities. Clients/residents in these settings have been hospitalized recently and usually have complex needs, so a person-centered, individualized process to provide care is necessary. With the population age increasing, there is a growing need for food and nutrition professionals' services to ensure that individual dietary needs are met.

The nutrition care process is designed to improve the consistency and quality of individualized care. The Academy connects RDNs and members in practice to resources for providing post-acute and long-term nutrition care.

Standards for RDNs in Post-Acute and Long-Term Care Nutrition
The Academy of Nutrition and Dietetics: Revised 2018 Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists(Competent, Proficient, and Expert) in Post-Acute and Long-Term Care Nutrition provide RDNs with a self-evaluation guide for assuring competence, identifying knowledge and skills to enhance expertise, and advance level of practice in PALTC nutrition.

Nutrition Care Manual
The Academy's NCM includes a section on older adult nutrition which provides guidance and resources on geriatric nutrition, conditions specific to this population as well as end-of-life nutrition.

Joint Commission
The Joint Commission's website houses facts about long-term care accreditation and prepublication standards. Current standards are not available on the Joint Commission's website as they are available in the E-dition that is sent to each accredited organization. Podcasts and free webinars on topics such as nursing care centers are also available.

Centers for Medicare & Medicaid Services
CMS' website includes nursing home Quality Assurance & Performance Improvement, or QAPI, tools including training materials and a QAPI self-assessment tool. Additional resources including the minimum data set, nursing home quality initiative and manuals, policies, regulations and press releases regarding skilled nursing facilities can also be found on CMS' website.

Agency for Healthcare Research and Quality
AHRQ is a U.S. Department of Health and Human Services organization with a mission of producing evidence to increase the safety, quality, accessibility and affordability of health care. AHRQ's website maintains resources on topics such as end-of-life care, falls and injury, multiple chronic conditions, pressure ulcers and quality of life. AHRQ also provides training modules for improving patient safety in long term care facilities.

Pioneer Network
The Pioneer Network started as a group of long-term care professionals advocating for person-directed care. The 2011 New Dining Practice Standards, which were developed by the food and dining clinical standards task force and agreed upon by a number of organizations including the Academy, are housed in a PDF on the Pioneer Network's website. They include standards of practice for diet liberalization, real food first and shifting traditional professional control to individualized support of self-directed living.

Society for Post-Acute and Long-Term Care Medicine
The Society is a medical specialty society of the American Medical Directors Association. Its website contains an allied health professional's center including resources such as webinars, practice management tools and clinical practice guidelines such as altered nutritional status.

Alzheimer's Association
The Alzheimer's Association's website provides information for consumers and professionals regarding Alzheimer's disease and dementia risk factors, diagnosis, stages and treatments. Dementia care practice recommendations for professionals working in a home setting are also housed here and include nutrition services and the role of the RDN.

National Pressure Ulcer Advisory Panel
Clinicians can find educational and clinical resources for pressure ulcers on the NPUAP's website, including pressure injury staging illustrations, pressure injury prevention points and webinars. Treatment and prevention slide sets include nutrition guidelines for pressure ulcer prevention and healing. A full-text white paper discussing the role of nutrition in pressure ulcer management is available.

  • International Dysphagia Diet Standardization Initiative

    The International Dysphagia Diet Standardization Initiative created global standardized terminology and definitions for texture-modified foods and thickened liquids to improve the safety and care for individuals with dysphagia.

  • IMPACT Act of 2014

    The IMPACT Act of 2014 requires standardization of post-acute care assessment data for quality payment, and discharge planning.