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Therapeutic Diet Orders

After more than four years of the Academy of Nutrition and Dietetics working with the Centers for Medicare and Medicaid Services (CMS), RDNs* employed in hospitals may now be allowed to order patient diets without requiring the supervision or approval of a physician or another practitioner.
CMS expects this rule to improve the efficiency and efficacy of nutrition care and save up to $459 million in annual hospital costs.
The Academy supports this new rule that will provide patients with better health care and help hospitals function more efficiently.
Although the final rule became effective July 11, 2014, implementing it in each state in various hospital facilities is a process that will take time.  The Academy has provided resources for implementation.

RDNs’* Role in Implementation:

Since the rule leaves it up to the hospital to make the decision of who can become privileged to independently order diets (in accordance with state law), all RDNs* are encouraged to use the available state analysis and practice tips to initiate the process in hospitals.
  1. Use the grid to analyze the impact of your state’s licensure law and hospital and other regulations on your ability to immediately take advantage of the rule’s opportunities, or whether your state will need to revise laws or regulations to align with the federal rule before obtaining privileges
  2. Work with your state to identify strategies for removing identified statutory or regulatory barriers within your state
  3. Once all barriers are eliminated, review the practice tips to determine next steps for obtaining privileges in your hospital
  4. For additional information, please check out these FAQs.
This is an exciting time for the profession, RDNs* and the health of Americans. CDR is encouraging every RDN* to understand the rule and how it can be applied in their state. 

For more information, visit

*Please note the RDN and RD are two credential designation options for one certification program. Practitioners may choose to use one or the other. For more information, click here