353. Where Are the Walls? Nutrition When Long-Term Care Isn’t Confined to a Building

Tuesday, October 29
9:45 AM – 11:15 AM
Location: 121-ABC
CE: 1.5
Level 2 – Intermediate
Activity Code: 149619

Nationally, 300 nursing homes are closing each year, despite the rising number of older adults. As a result, care providers are delivering nutrition care in less contained settings. The Center for Medicare and Medicaid Services has emphasized a shift to care in the least restrictive setting, and home- and community-based services waivers with expanded income levels have led to new models of care. Speakers will introduce several of these models of care in this session. They will also review the varying types of nutrition services in these waivers and describe alternative sites for individuals to receive nutrition care. Learn about the role of state Medicaid programs in the design of waiver programs and discover how to identify critical times for waiver review and renewal. The need for dietitians to advocate for nutrition care in the waivers will be clarified. Speakers will present the most developed alternative model of care, PACE (Program of All Inclusive Care), which serves as a case study for an excellent model for the inclusion of nutrition services.

Award Presentation: Excellence in Practice – Community Dietetics Award – Kay Craven, MPH, RDN, LDN, CDE

Planned with the Healthy Aging DPG

Learning Objectives:

  • Describe the variety of home- and community-based long term care options available in lieu of facility placement.
  • Detail the positive and challenging aspects of providing nutrition care to older adults and people with disabilities in non-traditional settings.
  • Identify the home- and community-based waivers and waiver authority in their states, explain how waivers are amended and describe how to advocate for nutrition services.

Learning Need Codes:

  • 4020 Community program development
  • 1080 Legislation, public policy
  • 5040 Long-term, intermediate, assisted living (care sites)

Performance Indicator:

  • 12.1.4 Influences legislation, regulation, and policy changes to impact nutrition in the community.
  • 12.3.3 Takes into consideration any population and environmental disparities (health, availability, finances, access) when developing programs.
  • 8.3.6 Keeps abreast of current nutrition and dietetics knowledge and trends.


  • Margery Gann, MS, MBA, RDN, LDN, FAND

    Chief Operating Officer


  • Speaker(s)

  • Royletta Romain, M.ED, RD, LDN


    The Mentor Network

  • Emily Schilling, RD, LDN, CDE

    Nutrition Manager

    Upham’s Elder Service Plan