Top 5 Ways Dietitians Can Maximize Reimbursement Dollars In Long-Term Care

By Sara Glanz, MS, RD, LD, CNSC

With the implementation of the Patient Driven Payment Model on October 1, 2019, nutrition-related services have officially been monetized (yay!). This is a huge step forward for dietitians working in long-term care (LTC). If that’s you, let’s review how you can help to maximize your facility’s reimbursement dollars and maybe even justify some additional dietitian staffing hours.

5. Complete your nutrition assessments and quick! With the PDPM changes, the reimbursement that LTC facilities receive is based on the 5-day MDS. This streamlines the documentation that is required, but it also raises the importance of adequate dietitian staffing to complete nutrition assessments in this timeframe. If a dietitian’s assessment is yet to be completed, the facility may miss an opportunity to request a higher reimbursement rate.

4. Malnutrition, malnutrition, malnutrition. In recent years, malnutrition has received lots of attention in acute care, and it’s finally coming to a LTC facility near you! In reality, malnutrition is a condition that plagues older adults and has since the beginning of time. It is likely that you have malnourished residents in your LTC facility right at this very moment. The key is identifying them, diagnosing them, and treating them. Then, claim that reimbursement!

3. Brush up on your tube feeding skills. Enteral nutrition is one of 50 non-therapy ancillary comorbidities that can garner higher reimbursement for a LTC facility. As such, you may be seeing more enteral nutrition in your facility.

2. Get familiar with TPN. Parenteral nutrition, when it meets greater than 51 percent of a resident’s nutritional needs, has the second-highest non-therapy ancillary comorbidity point value. What exactly does this mean? TPN = $$$. In the past, parenteral nutrition wasn’t commonplace in LTC facilities because of the expense and level of monitoring required for these residents. But now that TPN is linked with a high level of reimbursement, you may need to dust off that old calculator and laminate your formulary card. If you need a refresher on TPN basics, check out our TPN 101 webinar.

1. Book an NFPE training! Did we mention malnutrition? That’s right — a diagnosis of malnutrition often leans on a dietitian’s nutrition assessment. And it’s downright tough to support a diagnosis of malnutrition if you are not completing a nutrition-focused physical exam. Lucky for you, Dietitians On Demand can send an awesome dietitian to teach you and your friends exactly how to tackle that pesky NFPE. Trust us, it’s a blast!

If you’re a dietitian working in LTC, this is your time to shine! You now have the ability to make a real financial impact on your facility’s bottom line. P.S. If you’d like to request additional dietitian staffing or hours for yourself, start collecting some data, whether it’s the number of residents receiving enteral or parenteral nutrition support, or how many residents you identified as malnourished. When you can point to how much money you are bringing in, that’s when you’ll get the green light for more dietitian staffing. PDPM is here — own it!

Sara Glanz, MS, RD, LD, CNSC worked as a traveling dietitian for Dietitians On Demand for two years before joining the team as the corporate dietitian. In this role, she has championed the continuing education program to empower dietitians everywhere to achieve their professional goals.

Dietitians On Demand is a nationwide staffing and recruiting company for registered dietitians, specializing in short-term, temporary and permanent-hire positions in acute care, long term care and food service positions. We’re dedicated to dietitians and helping them enhance their practice and excel in the workplace. Check out our job openingsrequest your coverage, or visit our store today!

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Who We Are

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