Attention Long Term Care Dietitians

If you have not implemented the CMS ruling regarding delegated diet ordering in your LTC community, we must alert you that there are some issues that may occur with the implementation and you should hold off for now.

If you have implemented the LTC delegated diet order writing in your community we suggest that you speak with your administration and medical staff to assure you have 100% support. Please contact us at if you have implemented so we can assure direct communication with you and your facility as more information becomes available.

PAND was informed that the issues relate to interpretation of the CMS rule and have a potential to create issues during annual inspections. As of now, no community has been cited.

Please be assured we are working diligently to solve the issues. We will keep you informed.

This communication applies only to Long Term Care Communities and does not apply to Acute Care Facilities.


CMS Long-Term Care Rule Change

The PA Academy of Nutrition and Dietetics is pleased to announce that the CMS Long Term Rule Change regarding delegated dietitian diet order writing has been approved for implementation in LTC facilities in Pennsylvania.  Our partners, The Pennsylvania Board of Nursing, PA Medical Society, Hospital and Healthsystem Association of Pennsylvania, and the Department of Health, Division of Nursing Care Facilities are in support of the rule change. You can learn the specifics of the rule change by reading our Newsletter, or by downloading the FAQ: CMS-LTC-Rule-Change-FAQ-November-2017.pdf

Implementation Toolkit

The Pennsylvania Academy of Nutrition and Dietetics and the CMS Long Term Care Task Force developed a rule change implementation tool kit to assist LTC facilities with implementing the new rule.  The toolkit is free to PA Academy Members or $25 for non-members.  Non-members may order the toolkit using the form below.  If you have any questions or difficulties with the form for purchasing the toolkit, please contact us at

Thank you to the CMS Long-Term Care Task Force for their hard work on this valuable resource for Pennsylvania RDNs.

If you have specific questions about the CMS Long-Term Care rule change or implementation process, please contact:
Meg Rowe, MS, RD, LDN, FAND
CMS Long-Term Care Task Force Chair & Delegate of the Pennsylvania Academy of Nutrition & Dietetics

This tool kit and the information regarding the CMS LTC rule change of 2016 on the PAND website are specific to Pennsylvania. Other states may have different regulations.
[Due to the message above, the link to purchase the toolkit has been removed – 12/19/18]