Thank you for your inquiry regarding CMS986, the Global Malnutrition Composite Score (GMCS). Current measure logic does not specify which clinical professional may complete each measure observation. However, the header specifies that the RD/RDN is uniquely qualified to complete the nutrition assessment. The current DTR/NDTR scope and standards ( www.cdrnet.org/scope ) states that “Per RDN request or standard procedure, [DTR/NDTR may] obtain and document specified data to contribute elements of the nutrition assessment or re-assessment for completion by the RDN.” The RDN is responsible for supervising or providing oversight of any patient/client/population nutrition care activities assigned to professional, technical, and support staff, including the NDTR, and is held accountable to the patients/clients/populations and others for services rendered. Delineating scope-appropriate tasks, such as screening and data collection for the assessment, may be useful to easing workload burden; however, as always, the measure steward recommends deferring to national, state, and/or local guidance to ensure compliance with guidelines and statutes. For additional information about the scope and standards of the DTR/NDTR and the RD/RDN including specific guidance in clinical situations, please contact the CDR Practice Competence team at quality@eatright.org .

As we implement the screening for malnutrition on patients age 65+ we are expecting an increase in referrals to our Nutrition team for Assessment. When this expands to 18 Plus age we are concerned about the increase in patients will overwhelm our RD group.