Medical Nutrition Therapy (MNT)

Referral by Licensed Medical Provider: Activities performed under this service category must be pursuant to a medical provider’s referral.

1. Percentage of clients with documentation of the medical provider’s referral to MNT.

Medical Nutrition Therapy Assessment: An initial MNT assessment will be conducted by an RD pursuant to a medical provider’s referral.

A comprehensive nutritional assessment includes the following components: clinical examination (history and physical examination), anthropometric measurements, diagnostic tests, and functional and dietary assessments.

2. Percentage of clients with documentation of a completed assessment conducted by an RD that includes the following components at a minimum: (Pilot Measure)
    
   1. Clinical history
   2. Physical examination
   3. Anthropometric measurements
   4. Diagnostic tests as applicable
   5. Functional assessment
   6. Dietary assessment

Nutrition Plan: A nutritional plan will be developed that is appropriate for the client’s health status, financial status, and individual preference. 

A Nutritional Plan is completed within 10 business days of Nutrition Assessment and includes, but is not limited to:

• Nutritional diagnosis
• Client-centered nutrition education
• Measurable goal(s)
• Date service is to be initiated
• Recommended services and course of medical nutrition therapy to be provided to include the planned number and frequency of sessions
• Types and amounts of nutritional supplements and food provisions
• Signature of RD who developed the plan.

The Nutrition Plan will be updated as necessary, but no less than twice per year, and will be shared with the client, the client’s primary care provider, and other authorized personnel involved in the client’s care.

3. Percentage of clients with a documented nutrition plan that includes the following components: (Pilot Measure)
    
   1. Nutritional diagnosis
   2. Client-centered nutrition education
   3. Measurable goal(s)
   4. Date service is to be initiated
   5. Recommended services to be provided
   6. Planned number and frequency of sessions
   7. Type, frequency, and amount of food or
   8. nutritional supplements to be provided if this
   9. service is part of the plan
   10. RD signature
        
4. Percentage of clients with documentation of a nutrition plan updated at least twice per year if the client has been receiving services for over 12 months.

Provision of Nutritional Supplements and Food Provisions: Nutritional supplements and food provisions deemed medically necessary may be provided per written orders from a prescribing provider.

5. Percentage of clients that are prescribed nutritional supplements and/or food provisions in accordance with the nutritional plan developed by the RD have documentation corresponding to written orders from the referring prescribing provider.

Discharge: An individual may be discharged from services for but not limited to the following:

• The clients’ medical condition changes and services are no longer necessary
• Client no longer wishes to continue services
• Client moves out of the service area

The date of discharge, reason, and any recommendations for follow-up shall be documented in the client’s record and provided to the prescribing provider and other multidisciplinary team members as applicable.

Note: Staff should not inactivate clients in Take Charge Texas (TCT) at the time of discharge, unless the case is being closed due to a deceased client.

6. Percentage of clients discharged from services during the measurement period with the following documentation components: (Pilot Measure)
    
   1. Date of discharge
   2. Reason for discharge
   3. Recommendations for follow-up
   4. Prescribing provider notified of discharge
   5. Other multidisciplinary team members notified of the discharge, as applicable