LTC Ordering Writing Toolkit

The CMS Rule Change of 2016 was the first update to the rules governing Long Term Care since 1991. The rule change applies to Skilled Nursing Facilities and Nursing Facilities as well.

The rule allows for a resident’s attending physician to delegate the task of writing dietary orders to a qualified dietitian. With the 2018 passage of a Missouri bill that now allows for following of CMS guidelines, we feel confident that LTC dietitians are covered by Missouri licensure rules when ordering therapeutic diets in LTC when under the delegation and direction of the attending physician.

LTC dietitians need to discuss this change with leadership in each facility to create a policy and procedure for implementation. This should be signed by administration and physicians of each facility.

Your MOAND Public Policy team has put together a toolkit to help you with this process. It includes references and guidelines with sample letters and policies for your use. To Download the tooklit click on the Toolkit link below. 

Questions? Contact Anita Marlay, RD/LD, Consumer Protection Coordinator at


Download the LTC Ordering Writing TOOLKIT Here.