Landmark Federal Ruling Expands Nutrition Services in Hospitals
By Judith Riddle

The Center for Nutrition Advocacy (CNA) has announced what it’s calling a “watershed victory” for the dietetics profession. The Centers for Medicare & Medicaid Services (CMS) has issued a final rule stating that a variety of nutrition professionals, including certified nutrition specialists, independently can order therapeutic diets in hospitals, serve on hospital medical staffs, and provide telehealth nutrition services.

Initially, the CMS proposed giving only RDs (not nutritionists) the right to order therapeutic diets in hospitals independent of a physician order and permitted appointment to hospital medical staff, according to the CNA. 

The CMS ruled that “all patient diets, including therapeutic diets, must be ordered by a practitioner responsible for the care of the patient, or by a qualified dietitian or qualified nutrition professional as authorized by the medical staff and in accordance with State law,” according to a CNA press release.

The ruling adopts the Board for Certification of Nutrition Specialists’ formal recommendation to the CMS that qualified nutrition professionals obtain any privileges granted to RDs, the CNA notes.

The ruling goes on to say that “we agree with commenters that the regulatory language for § 482.28 should be inclusive of all qualified nutrition professionals. We do not agree with commenters who requested that we use the term ‘registered dietitian’ or define ‘qualified dietitian’ as an individual specifically registered with the Commission on Dietetic Registration. We agree that a more flexible approach would be the best way to ensure that patients benefit from the improved quality of care that these professionals can bring to hospital food and dietetic services,” the press release notes.

The CNA states that the ruling may have far-reaching effects on the nutrition profession over the next 10 years and beyond, such as removing a long-standing barrier to hospital employment of other clinically qualified nutrition professionals, leveling the nutrition regulatory playing field in states and at the federal level, and increasing insurance reimbursement opportunities for all clinically qualified nutrition professionals.

To learn more about this latest ruling, visit

— Judith Riddle is editor of Today’s Dietitian.