Nutrition Services Delivery and Payment

Policy and Advocacy

FNCE 2018

234. Who Is Prescribing Nutrition Support Orders and How Can RDNs Do More?

Monday, October 22
8:00 AM - 9:30 AM
CE: 1.5

Session Level 2 - Intermediate

In May 2014, the Centers for Medicare and Medicaid Services published their final ruling, which became effective in July 2014, permitting registered dietitian nutritionists (RDNs) to to order patient diets under the hospital conditions of participation. A follow-up ruling has applied this regulation to the long term care setting. Individual institutions determine who has privileges to independently order therapeutic diets, including enteral and parenteral nutrition (EN/PN), and is variable by state. Some states face barriers from State Boards of Pharmacy. This session will reveal collaborative data between the American Society for Parenteral and Enteral Nutrition (ASPEN) and the Dietitians in Nutrition Support Dietetic Practice Group (DNS) on current practices of RDN EN/PN prescription across the United States; demonstrate value for this RDN role; and assist those not yet able to write EN/PN orders in elevating their practice.

Learning Objectives:

Learning Need Codes:

  • 5440 - Enteral and parenteral nutrition support (nutritional care)
  • 9050 - Publication, communications of research outcomes
  • 7180 - Strategic planning

Yimin Chen, PhD, RD, CNSC

Dr. Yimin Chen has been a practicing nutrition support dietitian for 15 years and has recently transitioned to a translational human milk researcher. She started her research career primarily in adult nutrition support clinical studies before switching gear to neonatology and human milk research during her PhD work in basic science research. Dr. Chen is a research collaborator with the Rush NICU Human Milk Research Program. Her research interest focuses on specific human milk components and how manipulations of human milk feedings affect cellular and intestinal response in premature infants.


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Wendy Phillips, MS, RD, CNSC, CLE, FAND

As a Division Director of Clinical Support at Morrison Healthcare, Wendy Phillips directs the development and implementation clinical nutrition programs according to regulatory requirements and market place demand. She provides regulatory oversight for clinical nutrition at ~160 hospitals from California to Ohio in the Western Division. Wendy has worked with Morrison’s corporate operations and wellness/nutrition teams to lead a productivity analysis program and outcomes measurement studies for registered dietitians to ensure efficient and effective use of resources, and leads program development for ambulatory nutrition programs.

Wendy is also Public Policy Chair of the Utah Academy, Chair of the Academy’s Consumer Protection and Licensure Committee, Chair-Elect for the CNM DPG, and Director of Communication and Marketing for the DNS DPG. She has championed legislative updates to Virginia and Utah regulations to allow greater flexibility for order writing privileges for dietitians in hospitals and long term care facilities. She has authored several articles related to malnutrition identification and treatment.

Wendy’s previous experience includes public health nutrition, nutrition support for neonatal, pediatric, and adult populations in multiple care settings, insulin pump trainer, and adjunct university professor positions. She has worked for Morrison Healthcare in Clinical and Patient Service Manager roles in California and Virginia. Her most recent position was the Clinical Nutrition Director at the University of Virginia Health System, where she managed 48 RDs in inpatient, ambulatory, and dialysis settings.

She is a Certified Nutrition Support Clinician, a Certified Lactation Educator, and a Fellow of the Academy of Nutrition and Dietetics.


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Stephanie Dobak, MS, RD, LDN, CNSC


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Peggi Guenter, PhD, RN, FAAN, FASPEN

Peggi Guenter, PhD, RN, FAAN, FASPEN is the Senior Director of Clinical Practice, Quality, and Advocacy for the American Society for Parenteral and Enteral Nutrition (ASPEN). She is well known in the field of nutrition support as a clinical nurse specialist, researcher, author of over 150 peer-reviewed publications, and was a former Editor-in-Chief of Nutrition in Clinical Practice. Dr. Guenter won the Cheers Award from the Institute of Safe Medication Practices, and was recently elected as an ASPEN Fellow. In her current position, she leads ASPEN efforts on clinical practice, quality, and advocacy issues such as malnutrition, enteral and parenteral safety and efficacy.


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234. Who Is Prescribing Nutrition Support Orders and How Can RDNs Do More?

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