Subchapter G. DIETITIAN-NUTRITIONISTS
GENERAL PROVISIONS Sec.
21.701. Definitions.
21.702. Scope.
21.703. Applicability of general rules.
21.704. Matters related to allegations of sexual impropriety or violation.
21.705. Fees.
RESPONSIBILITIES OF THE LICENSED DIETITIAN-NUTRITIONIST
21.711. Professional conduct.
LICENSURE REQUIREMENTS
21.721. Qualifications for licensure.
21.722. Education, examination and re-examination of applicants.
21.723. License renewal.
21.723a. Reporting of crimes and disciplinary action.
21.723b. Reporting of address changes.
21.724. Continuing education.
21.725. Inactive status.
Authority The provisions of this Subchapter G issued under sections 2.1(k) and 11(c) of The Professional Nursing Law (63 P.S. § § 212.1(k) and 221(c)), unless otherwise noted.
Source The provisions of this Subchapter G adopted May 19, 2006, effective May 20, 2006, 36 Pa.B. 2396, unless otherwise noted.
GENERAL PROVISIONS
§ 21.701. Definitions.
The following words and terms, when used in this subchapter, have the following meanings, unless the content clearly indicates otherwise:
ACEND—Accreditation Council for Education in Nutrition and Dietetics— The organization recognized by the Council on Higher Education Accreditation and the United States Department of Education as the accrediting agency for education programs that prepare individuals for the practice of dietetics-nutrition.
ACN—American College of Nutrition.
AND—Academy of Nutrition and Dietetics.
Act—The Professional Nursing Law (63 P.S. § § 211—225.5), which provides for the licensing of Licensed Dietitian-Nutritionists.
Approved—Approved by the Board.
Approved program—Those educational programs accredited by ACEND or the American Council on Education for dietetics-nutrition education.
Board—The State Board of Nursing of the Commonwealth.
CBNS—Certification Board for Nutrition Specialists—The certification body of the ACN.
CDR—Commission on Dietetic Registration—The credentialing agency for the AND.
CNS—Certified Nutrition Specialist—The title given to individuals who meet the requirements of the CBNS.
CPE—Continuing professional education, required by the act for biennial license renewal.
Deviate sexual intercourse—The term as defined in 18 Pa.C.S. § 3101 (relating to definitions).
Indecent contact—The term as defined in 18 Pa.C.S. § 3101.
LDN—Licensed dietitian-nutritionist—A person holding a current license under this subchapter to practice dietetics-nutrition in this Commonwealth.
Patient—A person upon whom or with whom an LDN is practicing dietetics-nutrition, including a client. For purposes of § 21.704 (relating to matters related to allegations of sexual impropriety or violation), any conduct prohibited with a patient is also prohibited with an immediate family member or spouse of a patient.
Professional relationship—The relationship through which a licensed dietitian-nutritionist provides professional food and nutrition services to a patient. The relationship continues, for purposes of § 21.704, for 30 days after termination of professional services by either the licensed dietitian-nutritionist or the patient.
RD—Registered Dietitian—The title given to an individual who meets the requirements set forth by the CDR.
Registration Examination for Registered Dietitians—A written academic examination developed, prepared, administered and scored by the CDR.
Sexual impropriety—The term includes the following offenses:(i) Making sexually demeaning or sexually suggestive comments about or to a patient, including comments about a patient’s body or undergarments.
(ii) Exposing a patient’s body or watching a patient dress or undress, unless the patient specifically requests assistance.
(iii) Examining or touching the body of a patient except in the appropriate performance of the LDN’s practice.
(iv) Discussing or commenting on a patient’s sexual history, preference or performance during consultation, except when the consultation is pertinent to the issue of sexual function or dysfunction or reproductive healthcare.
(v) Soliciting or accepting a date from a patient.
(vi) Discussing information about one’s sexual problems, preferences or fantasies.
Sexual intercourse—The term as defined in 18 Pa.C.S. § 3101.
Sexual violation—The term includes the following offenses:(i) Engaging in sexual intercourse, indecent contact or deviate sexual intercourse with a patient during the professional relationship.
(ii) Encouraging the patient to masturbate in the presence of the dietitian-nutritionist or masturbating while a patient is present.
(iii) Providing or offering to provide drugs, herbs, nutritional supplements or treatment in exchange for indecent contact, sexual intercourse or deviate sexual intercourse.
(iv) Using or causing the use of any herb, nutritional supplement or drug affecting consciousness for the purpose of engaging in conduct that would constitute a sexual impropriety or sexual violation.
Authority The provisions of this § 21.701 amended under section 2.1(k) of The Professional Nursing Law (63 P.S. § 212.1(k)).
Source The provisions of this § 21.701 amended December 16, 2016, effective December 17, 2016, 46 Pa.B. 7822. Immediately preceding text appears at serial pages (378862) and (346621) to (346622).
§ 21.702. Scope.
In this subchapter the Board:
(1) Provides for licensure of dietitian-nutritionists who meet the qualifications set forth in the act.
(2) Administers the act by providing rules and regulations for the practice of dietetics-nutrition.
(3) Provides rules and regulations for the conduct of licensees.
(4) Regulates the practice of LDNs.
§ 21.703. Applicability of general rules.
The provisions of 1 Pa. Code Part II (relating to the General Rules of Administrative Practice and Procedure) apply to the activities of and proceedings before the Board.
§ 21.704. Matters related to allegations of sexual impropriety or violation.
(a) A licensee may not engage in conduct constituting a sexual violation or sexual impropriety.
(b) Engaging in conduct constituting a sexual violation or sexual impropriety is unprofessional conduct and will subject the licensee to disciplinary action under section 14 of the act (63 P.S. § 224).
(c) The consent of the patient to any sexual impropriety or sexual violation is not a defense to any disciplinary charge for violation of the act or this subchapter.
(d) Evidence of specific instances with individuals other than the licensee, opinion evidence or reputation evidence of a patient’s past sexual conduct is not admissible in proceedings brought under § 21.711 (relating to professional conduct). The Board may consider sexual relationships between the dietitian-nutritionist and the patient occurring prior to the professional relationship.
(e) A dietitian-nutritionist who attempts to raise as a defense an argument that conduct prohibited as a sexual violation or sexual impropriety was necessary or appropriate to the treatment of a patient shall be required to demonstrate competency in practice which relates directly to the treatment of sexual function or dysfunction. This competence may be demonstrated through educational training and supervised clinical experience.
Cross References This section cited in 49 Pa. Code § 21.701 (relating to definitions).
§ 21.705. Fees.
(a) The following application fees are charged by the Board for services to licensees and applicants:
Application for licensure… $95
Reactivation of inactive or lapsed license (after 5 years or longer) … $50
Verification of licensure… $45
Verification of licensure with history… $50
Restoration after suspension or revocation … $60
Approval of each hour of LDN continuing education activity by sources not listed in § 21.724(b) (relating to continuing education)… $115
Renewal of approval of LDN continuing education activity by sources not listed in § 21.724(b) … $35
(b) The following renewal fees are charged by the Board to support its operations:
Biennial renewal of license… $71
(c) In addition to the application fee prescribed in subsection (a), which is payable directly to the Board, a candidate shall also pay an additional examination fee to the Commission on Dietetic Registration or to the Board for Certification of Nutrition Specialists for the examinations set forth in § 21.722(b) (relating to education, examination and re-examination of applicants).
Authority The provisions of this § 21.705 amended under section 11.2 of The Professional Nursing Law (63 P.S. § 221.2); amended under section 11.2(a) and (b) of The Professional Nursing Law (63 P.S. § 221.2(a) and (b)), section 17.5(a) and (b) of the Practical Nurse Law (63 P.S. § 667.5(a) and (b)) and section 810(a)(3) and (7) of The Administrative Code of 1929 (71 P.S. § 279.1(a)(3) and (7)).
Source The provisions of this § 21.705 amended August 20, 2010, effective August 21, 2010, 40 Pa.B. 4755; amended July 26, 2019, effective July 27, 2019, 49 Pa.B. 3895. Immediately preceding text appears at serial page (385252).
Cross References This section cited in 49 Pa. Code § 21.721 (relating to qualifications for licensure); and 49 Pa. Code § 21.723 (relating to license renewal).
RESPONSIBILITIES OF THE LICENSED DIETITIAN-NUTRITIONIST
§ 21.711. Professional conduct.
(a) Licensed dietitian-nutritionists shall:
(1) Conduct themselves with honesty, integrity and fairness.
(2) Practice dietetics based on scientific principles and current information.
(3) Present substantiated information and interpret controversial information without personal bias, recognizing that legitimate differences of opinion exist.
(4) Provide information which will enable patients to make their own informed decisions regarding nutrition and dietetic therapy, including:
(i) The purpose and nature of any evaluation, treatment, educational or training procedure.
(ii) The estimated cost of each stage of a procedure or of the entire treatment.
(iii) The reasonable expectations of the professional relationship.
(iv) The right to withdraw from treatment at any time.
(5) Safeguard the patient’s dignity, the right to privacy and the confidentiality of patient information and make full disclosure about any limitations on the LDN’s abilities to guarantee full confidentiality. This standard does not prohibit or affect reporting responsibilities under 23 Pa.C.S. Chapter 63 (relating to Child Protective Services Law), the Older Adults Protective Services Act (35 P.S. § § 10211—10224) and other statutes which may mandate reporting of this information.
(6) Provide professional services with objectivity and with respect for the unique needs and values of individuals.
(7) Be alert to situations that might cause a conflict of interest or have the appearance of a conflict. The LDN shall provide full disclosure when a real or potential conflict of interest arises.
(8) Permit the use of their names for the purpose of certifying that dietetic services have been rendered only if they provided or supervised the provision of those services.
(9) Accurately present professional qualifications and credentials.
(i) Dietitian-nutritionists may use the title ‘‘Licensed Dietitian-Nutritionist’’ or abbreviation LDN only when they hold a current license issued by the Board.
(ii) LDNs are subject to disciplinary action for aiding another person in violating any Board requirement or aiding another person in representing himself as an LDN when that person is not currently licensed.
(10) Document and maintain accurate records in accordance with the acceptable and prevailing standard of recordkeeping. Discussion of a patient’s sexual practices, preferences and performance shall be fully documented in the patient’s chart, when applicable.
(b) The licensed dietitian-nutritionist may not:
(1) Knowingly aid, abet or assist another person to violate or circumvent a law or Board regulation.
(2) Discriminate, while providing dietitian-nutritionist services, on the basis of age, marital status, gender, sexual preferences, race, ethnicity, religion, diagnosis, socioeconomic status or disability.
(3) Knowingly permit another individual to use his license for any purpose.
(4) Misappropriate equipment, materials, property, drugs or money from an employer or patient.
(5) Solicit, borrow or misappropriate money, materials or property from a patient.
(6) Leave an assignment prior to the proper reporting and notification to the appropriate department head or personnel.
(7) Falsify or knowingly make incorrect entries into the patient’s record or other related documents.
(8) Engage in conduct defined as a sexual violation or sexual impropriety in the course of a professional relationship.
(9) Advertise in a false or misleading manner. Statements which qualify as false or misleading include the following:
(i) Statements containing a misrepresentation of facts.
(ii) Statements likely to mislead or deceive because in context the statements make only a partial disclosure of the relevant facts.
(iii) Statements intended to, or likely to, create false or unjustified expectations of favorable results.
(iv) Statements relating to fees without reasonable disclosure of all relevant variables so that the statements would be misunderstood by or would be deceptive to a layperson.
(v) Statements conveying the impression that the LDN could influence improperly any public body, official, corporation or person on behalf of the patient.
(vi) Statements containing a representation or implication that is likely to cause a reasonable person to misunderstand or to be deceived, or fail to contain reasonable warnings or disclaimers necessary to make a representation or implication not deceptive.
(vii) Statements containing representations that the LDN is willing to perform any procedure that is illegal under the laws or regulations of the Commonwealth or the United States.
(10) Practice when:
(i) The LDN has engaged in any substance abuse that could affect the LDN’s practice.
(ii) The LDN has been adjudged by a court to be mentally incompetent.
(iii) The LDN has an emotional or mental disability that affects his practice in a manner that could harm the patient.
(11) Accept a client or patient for treatment or continue treatment unnecessarily, if benefit cannot reasonably be expected to accrue.
(12) Accept or receive, or both, remuneration for making or accepting referrals.
Cross References This section cited in 49 Pa. Code § 21.704 (relating to matters related to allegations of impropriety or violation).
LICENSURE REQUIREMENTS
§ 21.721. Qualifications for licensure.
(a) An individual may apply for licensure as a dietitian-nutritionist by submitting a written application on forms provided by the Board and remitting the application fee set forth in § 21.705 (relating to fees).
(b) To obtain licensure, an applicant must meet the qualifications set forth in section 6(b)(1)—(4) of the act (63 P.S. § 216(b)(1)—(4)), which include:
(1) Evidencing good moral character.
(2) Receipt of a baccalaureate or higher degree from a Board-approved program or equivalent program as set forth in section 5(b) and (c) of the act (63 P.S. § 215(b) and (c)).
(3) Completion of a planned continuous preprofessional experience of at least 900 hours under appropriate supervision.
(4) Successful completion of one of the examinations specified in § 21.722 (relating to education and examination of applicants).
(c) To obtain licensure, an applicant shall complete at least 3 hours of training in child abuse recognition and reporting in accordance with § 21.508(a) (relating to child abuse recognition and reporting—mandatory training requirement).
Authority The provisions of this § 21.721 amended under section 2.1(k) of The Professional Nursing Law (63 P.S. § 222.1(k)); section 17.6 of the Practical Nurse Law (63 P.S. § 667.6); and 23 Pa.C.S. § 6383(b)(2).
Source The provisions of this § 21.721 amended March 25, 2022, effective March 26, 2022, 52 Pa.B. 1916. Immediately preceding text appears at serial page (396909).
§ 21.722. Education, examination and re-examination of applicants.
(a) Education. The Board approves educational programs that meet the requirements of section 6(b)(2) of the act (63 P.S. § 216(b)(2)) that are approved by ACEND or the ACN.
(b) Examination.
(1) The Board approves the Registration Examination for Registered Dietitians and Examination of the Certification Board for Nutrition Specialists as the examinations which an applicant may complete to satisfy section 6(b)(4) of the act.
(2) A candidate shall take the examination for the first time within 1 year of completing the dietetics-nutrition education program unless prevented by emergency, illness, military service or other good cause shown, or the candidate holds a license to practice as a dietitian-nutritionist in another state or country.
(c) Re-examination.
(1) A candidate may take the licensing examination as many times as necessary to pass the licensure examination.
(2) Candidates who apply for re-examination 2 years or more after initial examination shall satisfy the administrative and education requirements prevailing at the time of reapplication.
Authority The provisions of this § 21.722 amended under section 2.1(k) of The Professional Nursing Law (63 P.S. § 212.1(k)).
Source The provisions of this § 21.722 amended December 16, 2016, effective December 17, 2016, 46 Pa.B. 7822. Immediately preceding text appears at serial page (378866).
Cross References This section cited in 49 Pa. Code § 21.705 (relating to fees); 49 Pa. Code § 21.721 (relating to qualifications for licensure); and 49 Pa. Code § 21.724 (relating to continuing education).
§ 21.723. License renewal.
(a) A license issued under section 5(e) of the act (63 P.S. § 215(e)) or under this subchapter will be valid from the date of issuance through September 30, 2006, following the issuance of the license. Each subsequent license renewal will be valid for 2 years from October 1 through September 30.
(b) When applying for renewal of licensure, an LDN shall:
(1) Complete the renewal application, including disclosing a license to practice dietetics-nutrition in any other state, territory, possession or country.
(2) Pay the required fee as set forth in § 21.705 (relating to fees).
(3) Submit, or cause to be submitted, proof to the Board that the LDN has satisfactorily completed a minimum of 30 hours of CPE approved by the Board in accordance with § 21.724 (relating to continuing education) during the 2 calendar years immediately preceding the application for renewal. At least 2 of the required 30 hours shall be completed in approved training in child abuse recognition and reporting in accordance with § 21.508(b) (relating to child abuse recognition and reporting—mandatory training requirement).
(4) Disclose any discipline imposed by a state licensing board in the previous biennial period or any criminal charges pending or criminal conviction, plea of guilty or nolo contendere, or admission into a probation without verdict or accelerated rehabilitative disposition program during the previous biennial period unless prior notification has been made under § 21.723a (relating to reporting of crimes and disciplinary action).
Authority The provisions of this § 21.723 amended under sections 2.1(k) and 12.1(a) of The Professional Nursing Law (63 P.S. § § 212.1(k) and 222(a)); section 17.6 of the Practical Nurse Law (63 P.S. § 667.6); and 23 Pa.C.S. § 6383(b)(2).
Source The provisions of this § 21.723 amended October 16, 2015, effective October 17, 2015, 45 Pa.B. 6196; amended March 25, 2022, effective March 26, 2022, 52 Pa.B. 1916. Immediately preceding text appears at serial page (396910).
Cross References This section cited in 49 Pa. Code § 21.723a (relating to reporting of crimes and disciplinary action).
§ 21.723a. Reporting of crimes and disciplinary action.
(a) An LDN shall notify the Board of pending criminal charges within 30 days of the filing of the criminal charges or on the biennial renewal application under § 21.723 (relating to license renewal), whichever is sooner.
(b) An LDN shall notify the Board of a criminal conviction, plea of guilty or nolo contendere, or admission into a probation without verdict or accelerated rehabilitative disposition program within 30 days of the disposition or on the biennial renewal application under § 21.723, whichever is sooner.
(c) An LDN shall notify the Board of disciplinary action in the nature of a final order taken against the LDN’s license by the licensing authority of another state, territory or country within 90 days of receiving notice of the disciplinary action or on the biennial renewal application under § 21.723, whichever is sooner.
Authority The provisions of this § 21.723a issued under sections 2.1(k) and 12.1(a) of The Professional Nursing Law (63 P.S. § § 212.1(k) and 222(a)).
Source The provisions of this § 21.723a adopted October 16, 2015, effective October 17, 2015, 45 Pa.B. 6196.
Cross References This section cited in 49 Pa. Code § 21.723 (relating to license renewal).
§ 21.723b. Reporting of address changes.
An LDN shall notify the Board within 14 days of a change of address.
Authority The provisions of this § 21.723b issued under section 2.1(k) of The Professional Nursing Law (63 P.S. § 212.1(k)).
Source The provisions of this § 21.723b adopted December 16, 2016, effective December 17, 2016, 46 Pa.B. 7822.
§ 21.724. Continuing education.
(a) Prior to renewal. One hour of CPE credit will be given for each 50-minute clock hour of CPE activity. Each LDN shall complete 30 CPE credits during the 2 calendar years immediately preceding the application for license renewal. At least 2 of the 30 hours shall be completed in approved training in child abuse recognition and reporting in accordance with § 21.508(b) (relating to child abuse recognition and reporting—mandatory training requirement). If any activity overlaps two renewal periods, the date of completion of the activity determines the date in which the activity can be reported.
(b) Board-approved continuing professional education. The Board will accept for completion of the CPE requirement substantive learning experiences, subject to the limitations in paragraph (2) relating to the field of nutrition and dietetics which are not designed for the public and which are sponsored by the AND, the ACN, by individual state dietetic associations, if the association is a member of the AND or ACN, by approved college or dietetic programs under § 21.722 (relating to education, examination and re-examination of applicants) when a certificate of attendance is issued, and courses related to the practice of dietetics-nutrition offered by the Accreditation Council for Continuing Medical Education, the Accreditation Council on Pharmaceutical Education, the American Osteopathic Association and the American Medical Association.
(1) In addition to lecture-based CPE courses, LDNs may apply to the Board for approval of CPE credit and the Board may, upon review by the LDN Committee, grant credit for the following:
(i) Case presentations, such as grand rounds or patient case studies.
(ii) Academic coursework and research studies approved by an institutional review board.
(iii) Interactive workshops.
(iv) Lecturers and seminars.
(v) Residency and Fellowship programs which are at the post baccalaureate level, and are sponsored by a United States regionally accredited college or university, or an institution accredited/approved by the Joint Committee on Accreditation of Healthcare Organizations or the National Committee for Quality Assurance.
(2) The Board will not accept for completion of the CPE requirement the following:
(i) Academic coursework or programs on office management skills, or entrepreneurship, strategic business planning, computer skills, except courses directly related to the practice of dietetics-nutrition such as accessing nutrient analysis databases.
(ii) Attendance at exhibits manned by detail personnel.
(iii) Journal clubs.
(iv) Professional leadership, such as holding an elective office in a dietetics or dietetics-related organization.
(v) Professional reading for which there is no evaluative test submitted and no certificate of completion or CPE unit awarded.
(c) Documentation. The licensee shall retain documentation of completion of Board-approved continuing education (as set forth in subsection (b)) for at least 5 years and shall submit this documentation upon request of the Board.
(d) Waiver. An LDN who can demonstrate to the Board a verified hardship may request a waiver of CPE requirements for a single biennial period. It shall be the duty of each licensee seeking waiver to notify the Board in writing and request the waiver, at least 60 days prior to the end of the biennial renewal period, which will be granted, denied, or granted in part.
Authority The provisions of this § 21.724 amended under section 2.1(k) of The Professional Nursing Law (63 P.S. § 212.1(k)); section 17.6 of the Practical Nurse Law (63 P.S. § 667.6); and 23 Pa.C.S. § 6383(b)(2).
Source The provisions of this § 21.724 amended December 16, 2016, effective December 17, 2016, 46 Pa.B. 7822; amended March 25, 2022, effective March 26, 2022, 52 Pa.B. 1916. Immediately preceding text appears at serial pages (385257) to (385258).
Cross References This section cited in 49 Pa. Code § 21.705 (relating to fees); and 49 Pa. Code § 21.723 (relating to license renewal).
§ 21.725. Inactive status.
An LDN may request that his license be placed on inactive status. The licensee will not be required to remit the biennial renewal fee during the period when the license is on inactive status. In order to return to active status, the licensee shall submit proof of completion of a minimum of 30 hours of approved CPE in the biennial period preceding the request for reactivation and pay applicable fees. A person who requests an active status license who has been on inactive status for 5 consecutive years shall satisfy the requirements of section 6(b)(4) of the act (63 P.S. § 216(b)(4)), unless the person demonstrates that he has an active license to practice in another state or has had an RD registration or a CNS certification for at least 2 out of the last 5 years.
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