Home health care: the dietitian's role.

Nutritional services are an important part of the home care program. Medicare, Medicaid, and other third-party mechanisms do not reimburse providers for such services, even though the cost for home care is lower than for institutional care. Recognizing the need for nutritional services, the Veterans Administration has included the dietitian as a member of the home care team. Skills and guidelines developed by The American Dietetic Association for home and ambulatory care were adapted and utilized in developing a dietetic home care procedure which helps to avoid institutional care and provides a better quality of life at home. Nutritional services should be an integral part of all home health care programs. Because most home care programs do not have funds for a dietitian's service, legislative and/or regulatory action is needed to provide reimbursement for nutritional home care services.