NAC449.544. Nutrition services.

     1. Each facility shall provide nutrition services to each patient of the facility and the provider of care for that patient to maximize the nutritional status of the patient.

     2. The licensed dietitian for a patient of a facility shall:

     (a) Conduct an assessment of the nutrition of the patient;

     (b) Participate in a team review of the progress of the patient in accordance with the provisions of NAC 449.541;

     (c) After consulting with the physician of the patient, recommend a therapeutic diet for the patient based on:

          (1) The cultural preferences of the patient;

          (2) Changes in the treatment of the patient; and

          (3) The nutritional requirements of the patient;

     (d) Except as otherwise provided in subsection 7:

          (1) Counsel the patient and the provider of care for that patient, if required, concerning any diet prescribed for the patient at the facility; and

          (2) Monitor the patient’s adherence and response to that diet;

     (e) Refer the patient for assistance with any resources that are available to the patient, including, without limitation, financial assistance, community resources or assistance at the residence of the patient;

     (f) Participate in activities conducted at the facility to ensure the quality of the facility; and

     (g) Monitor the nutritional status of the patient to determine the need for intervention and follow-up by the facility. In making that determination, the licensed dietitian shall consider:

          (1) Changes in the weight of the patient;

          (2) The chemistry of the blood of the patient;

          (3) The adequacy of the dialysis treatment provided to the patient; and

          (4) Changes in the medication prescribed for the patient.

     3. Each facility shall collect data to assess the nutritional status of a patient of the facility not later than 2 weeks after the patient is admitted to the facility or immediately after the patient receives seven treatments at the facility, whichever occurs later. A comprehensive assessment of the nutritional status of the patient must be completed within 30 days after the patient is admitted to the facility or immediately after the patient receives 13 treatments at the facility, whichever occurs later. Such an assessment must include a determination by the dietitian of the degree to which the patient understands the diet prescribed for him or her by the facility.

     4. Each facility shall, annually or more often if required by the circumstances concerning the treatment of the patient, revise the comprehensive assessment of the nutritional status of each patient specified in subsection 3.

     5. Each facility shall employ or contract with a licensed dietitian to provide nutrition services for each patient of the facility. If a facility provides treatment for 100 or more patients, the facility shall ensure that one full-time equivalent licensed dietitian is available at the facility.

     6. Nutrition services must be available at each facility during scheduled periods for treatment. The facility may require a patient to obtain an appointment with a licensed dietitian before receiving those services.

     7. The provisions of paragraph (d) of subsection 2 do not apply to a correctional institution.

     (Added to NAC by Bd. of Health by R130-99, eff. 8-1-2001; A by R090-12, 12-20-2012)