173-4-06 Nutrition consultation service.

(A) Definitions:

(1) "Nutrition consultation service" (i.e., "medical nutritional therapy") means a service that provides individualized guidance on appropriate food and nutrient intakes for consumers who require disease management. The service includes nutrition assessment, intervention, education, and counseling.

(2) "Consultant" means a person who performs a nutrition consultation service.

(B) Minimum requirements for a nutrition consultation service:

(1) In general:

(a) Authorization: The consultant shall not provide the service to a consumer unless a physician (or another healthcare professional with prescriptive authority) has authorized it for the consumer.

(b) Face-to-face: The consultant shall provide the service to the consumer or family caregiver (on behalf of the consumer) on a face-to-face basis or by means of a telecommunications system. As used in this paragraph, "telecommunications" means technologies that exchange health information and provide health care services across geographic, time, social, and cultural barriers.

(c) Records: For each service performed, the provider shall document the consumer's name; service date and duration of service; service description, including a description of follow-up plans; consultant's name, consultant's signature; and consumer's signature.

(2) Nutrition assessment:

(a) The consultant shall conduct an initial individualized nutrition assessment of the consumer's nutritional needs and, when necessary, subsequent nutrition assessments by assessing:

(i) Nutrient intake;

(ii) Anthropometic measurements;

(iii) Biochemical values;

(iv) Physical and metabolic parameters;

(v) Socio-economic factors;

(vi) Current medical diagnosis and medications;

(vii) Pathophysiological processes; and,

(viii) Access to food and food-assistance programs.

(b) No later than seven calendar days after the assessment, the consultant shall furnish the results of the assessment to the consumer's case manager, if the consumer has a case manager, and physician (or other healthcare professional with prescriptive authority).

(3) Nutrition intervention plan:

(a) Based upon the results of the nutrition assessment, the consultant shall develop a nutrition intervention plan that includes:

(i) Clinical and behavioral goals and a care plan;

(ii) Intervention planning, including nutrients required, feeding modality, and method of nutrition education and consultation, with expected measurable outcomes;

(iii) Consideration for input from the consumer, physician, case manager, and, when applicable, any family caregiver or relevant service providers; and,

(iv) The scheduling of any follow-up nutrition consultation service.

(b) No later than seven calendar days after the nutrition assessment, the consultant shall furnish the intervention plan to the consumer's case manager and physician (or other healthcare professional with prescriptive authority).

(c) The consultant shall furnish documentation of the plan's implementation and the consumer's outcomes to the case manager and the physician (or other healthcare professional with prescriptive authority).

(d) The consultant shall provide a plan to the consumer.

(4) Consultant qualifications and limitations:

(a) The provider shall furnish evidence to the AAA that the consultant holds a current, valid license to practice as a LD under Chapter 4759. of the Revised Code or a current, valid license to practice another profession in which the license-holder may perform a nutrition consultation service as part of their profession's scope of practice.

(b) The consultant shall not provide a service that exceeds the limitations of the provider agreement with the AAA.

(C) Unit of service: A unit of service is one hour, reported in increments of one-quarter hours.

Effective: 03/05/2009
R.C. 119.032 review dates: 07/31/2013
Promulgated Under: 119.03
Statutory Authority: 173.02 ; 173.392 ; Section 305 (a)(1)(C) of the Older Americans Act of 1965, 79 Stat. 210, 42 U.S.C. 3001 , as amended in 2006; 45 C.F.R. 1321.11
Rule Amplifies: 173.392 ; Sections 214, 336, and 339 of the Older Americans Act of 1965, 79 Stat. 210, 42 U.S.C. 3001 , as amended in 2006