NINETEENTH CONGRESS 
) 
REPUBLIC OF THE PHILIPPINES ) 
Third Regular Session 
) 
HOUSE OF REPRESENTATIVES 
Introduced by Representative Rufus B. Rodriguez 
House Bill No.  10923 
EXPLANATORY NOTE 
The World Health Organization recognizes the critical role of nutrition in health 
outcomes. Nutrition affects health at all ages, strengthens immune systems, reduces mortality 
rates in pregnancy, decreases the risk of lifestyle diseases such as diabetes and 
cardiovascular disease, improves outcomes in education and enhances economic 
productivity. In hospitals, malnutrition is linked to greater risk of complications, longer 
convalescence, and higher mortality. 
However, despite the provisions of Republic Act No. 11223, the Universal Health Care 
Act, which sought to provide an integrated and comprehensive approach to protect Filipinos 
from hazards and risks to their health, a health care model which gives access to a 
comprehensive set of quality and cost-effective, promotive, preventive, curative, rehabilitative 
and palliative health services, a framework that fosters a whole-of-nation approach to the 
development and implementation of health policy, and  for the delivery of health services that 
is centered on people’s needs and well-being, there is no national policy which mandates an 
emphasis on nutrition for hospitalized Filipinos. In addition, while Republic Act No. 10862, or 
the Nutrition and Dietetics Law of 2016, recognizes the important role of nutritionist-dietitians, 
together with the multi-disciplinary team in nutrition, in nation-building and human 
development, it has been silent on the promotion of their role in the hospital setting. 
This bill aims to enhance current laws by mandating the implementation of the Nutrition 
Care Process, an internationally recognized standard approach for practitioners in nutrition 
and dietetics. With this measure, Filipinos will gain access to effective tools for recovering from 
illnesses and significantly improving their quality of life, all in a cost-efficient manner 
In view of the foregoing, the immediate passage of this bill is earnestly sought. 
RUFUS B. RODRIGUEZ 
September 17, 2024
11:03 am


NINETEENTH CONGRESS 
) 
REPUBLIC OF THE PHILIPPINES ) 
Third Regular Session 
) 
HOUSE OF REPRESENTATIVES 
Introduced by Representative Rufus B. Rodriguez 
House Bill No.  10923 
AN ACT 
INSTITUTIONALIZING THE NUTRITION CARE PROCESS AS PART OF MEDICAL CARE 
IN THE PHILIPPINES 
Be it enacted by the Senate and the House of Representatives of the Philippines in Congress 
assembled: 
SECTION 1. Short Title. – This Act shall be referred to as the "Wastong Nutrisyon sa Ospital 
Act.” 
SEC. 2. Declaration of Policy. – The State recognizes the essential role of proper nutrition in 
health and well-being, preventing the spread of disease, strengthening the immune system, 
and improving patient outcomes in cases of hospitalization. To this end, the State shall 
promote and institutionalize the use of the Nutrition Care Process, an internationally developed 
and accepted standard of screening and assessing the nutritional status of patients, nutrition 
intervention, as part of the minimum requirements of in-patient medical care in Philippine 
health facilities, and a means of monitoring patients’ nutritional status after discharge. 
The State further recognizes the critical role of nutritionist-dieticians together with the 
nutrition support team, in administering the Nutrition Care Process. To this end, as provided 
for in Republic Act No. 10862, or the Nutrition and Dietetics Law of 2016, the State shall 
promote their expertise, professionalism, and competence in this field and uphold their status 
as the primary providers of nutrition care in the country. 
SEC. 3. Definition of Terms. – For purposes of this Act, the following terms shall be defined as 
follows:  
(a) Hospital means a place devoted primarily to the maintenance and operation of
facilities for the diagnosis, treatment and care of individuals suffering from
illness, disease, injury or deformity, or in need of obstetrical or other medical
and nursing care. The term “hospital” shall also be construed as any institution,
building or place where there are installed beds, or cribs, or bassinets for
twenty-four-hour use or longer by patients in the treatment of diseases,
diseased-conditions, injuries, deformities, or abnormal physical and mental
states, maternity cases, and all institutions such as those for convalescence,
sanitaria or sanitarial care, infirmities, nurseries, dispensaries and such other
names by which they may designated.
(b) Malnutrition is defined as the deficiencies, excesses, or imbalances in the
intake of energy and/or nutrients of a person. The term malnutrition addresses
three broad groups of conditions:
1) Undernutrition, which includes wasting (low weight-for-height), stunting
(low height-for-age) and underweight (low weight-for-age);
2) Micronutrient-related 
malnutrition, 
which 
includes 
micronutrient
deficiencies (a lack of important vitamins and minerals) or micronutrient
excess; and


3) Overweight, obesity and diet-related noncommunicable diseases (such 
as heart disease, stroke, diabetes and some cancers); 
 
(c) Medical Nutrition Therapy (MNT) refers to a nutritional diagnostic, therapy and 
counselling services for the purpose of disease management; services are 
furnished by a registered nutritionist-dietitian. It involves the assessment of the 
nutritional status of patients with a condition, illness or injury that puts them at 
risk.  Based on the nutritional assessment, modalities most appropriate to 
manage the condition or treat the illness or injury are chosen. 
 
(d) Multidisciplinary Team in Nutrition Care or Nutrition Support Team refers to 
attending physicians, registered nutritionist-dietitians, registered nurses, 
registered pharmacists/ clinical pharmacists, registered social workers, and 
other healthcare professions that may deemed necessary in the conduct of 
proper nutrition care; 
 
(e) Nutritionally-at-risk patients is defined as patients who have any of the 
following:  
1) Actual or potential for developing malnutrition (involuntary loss or gain 
greater than ten percent (10%) of usual body weight within 6 months, 
or greater than five percent (5%) of usual body weight in 1 month, a 
weight of twenty percent (20%) over or under ideal body weight); 
presence of chronic disease or increased metabolic requirements. 
2) Altered diets or diet schedules (receiving total parenteral or enteral 
nutrition, recent surgery, illness, or trauma); 
3) Inadequate nutrition intake including those not receiving food or 
nutrition products (impaired ability to ingest or absorb food adequately) 
for greater than seven (7) days; and  
4) Any patient whose condition does not match the criteria above but has 
been determined to be nutritionally-at-risk by the latest standards 
approved by the Department of Health (DOH). 
 
(f) Nutrition Care is defined as an organized group of activities allowing the 
identification of nutritional needs and provision of care to meet those needs. 
 
(g) Nutrition Care Process (NCP) is the systemic problem-solving method that 
dietetics professionals utilize to critically think and make decisions to address 
nutrition-related problems and provide safe and effective quality nutrition care. 
It includes four steps: assessment, diagnosis, intervention, monitoring and 
evaluation; 
 
(h) Nutrition Screening as the prerequisite to the implementation of nutrition care 
process in identifying nutritionally-at-risk patients through certain parameters 
(i.e., anthropometric measures, dietary intake, and clinical condition), is 
accomplished by staff nurses using validated nutrition screening tools for adults 
and pediatric patients. Hospitals using electronic health record (EHR) shall 
create an automatic referral system to the RND when screening criteria are 
met. 
 
(i) Nutrition Assessment as a comprehensive approach to defining nutritional 
status that uses medical, nutrition, and medication histories; physical 
examination; anthropometric measurements; and laboratory data. It provides a 
basis for the development of nutrition care plans. 
 


(j) Registered Nutritionist-Dietitian (RND) is defined as a person who holds a valid 
certificate of registration and a valid professional identification card, which is 
renewed every three years and issued by the Board of Nutrition and Dietetics 
of the Professional Regulation Commission, in accordance with Republic Act 
No. 10862, or the Nutrition and Dietetics Act of 2016. 
 
SEC. 4. Mandatory nutrition screening and assessment. – All patients admitted into hospitals 
shall be screened to identify those who are nutritionally-at-risk using a nutrition screening and 
assessment tool approved by the Department of Health. Identified not-at-risk patients shall 
undergo periodic re-screening to determine as totally not-at-risk or at-risk. Furthermore,  a 
post-assessment and  nutrition care plan will be develop for patients upon discharge. 
 
SEC. 5. Responsibilities of the hospital -The hospital shall have a Nutrition and Dietetics 
Service or Department, headed by an RND, which shall assure the effective delivery of NCP. 
Furthermore, they shall ensure that all necessary support in terms of staff and resources, both 
medical and administrative, is provided for the accomplishment of the NCP and the reporting 
requirements of this Act.  
 
SEC. 6. Responsibilities of the Multidisciplinary Team in Nutrition Care or Nutrition Support 
Team – The members of the team shall ensure the timely and effective delivery of NCP based 
on sound and updated evidence, as approved by the Department of Health: 
 
1. Attending Physician - shall (i) refer all cases of MNT to RNDs, (ii) conform and duly 
sign the NCP recommendations developed by the RND, (iii) lead in the 
administration of care plan provided by the RNDs, nurses, pharmacists, and other 
allied health professionals, (iv) conduct nutrition support access, and (v) actively 
convene interdisciplinary conferences to present results of managed cases; 
 
2. Registered Nutritionist-Dietitian - shall (i) develop nutrition care plan for 
nutritionally-at-risk and critically-ill patients, (ii) implement the nutrition care plan, 
(iii) monitor, evaluate, and document the nutrition care plan to determine progress 
and nutrition outcome of the interventions, (iv) prepare bi-annual accomplishment 
report and submit such report to the hospital health information management 
worker and to DOH through the Health Facility Development Bureau, and (v) 
actively participate in case conferences, e.g. ward rounds and interdisciplinary 
health care planning; 
 
3. Registered Nurse - shall (i) complete nutrition screening upon admission, (ii) carry-
out the prescribed medications, diet and fluid requirements, and diagnostic tests 
related to nutrition care, (iii) prepare and update diet list for submission to the 
Nutrition and Dietetics Service/Department, and (iv) document changes in 
eating/drinking patterns in the patient’s chart and tolerance/intolerance to certain 
foods, and discuss such matters with the RND; 
 
4. Registered Pharmacist or Registered Clinical Pharmacist - shall (i) discuss with 
RND for food/nutrient and drug interaction, and (ii) participate in case conferences 
and interdisciplinary planning of healthcare team; 
 
5. Registered Social Worker - shall (i) provide psychosocial interventions to patients 
and families, and (ii) facilitate referral of patients needing financial assistance 
relative to health and nutrition care needs; 
 
6. Other healthcare professionals that will be identified as necessary shall coordinate 
with the team in the conduct of proper nutrition care of patients. 
 


SEC. 8. Development of NCP Guidelines. – The DOH shall be responsible for approving the 
NCP guidelines to be complied with by all the relevant stakeholders based on the latest 
internationally-approved standards. The DOH shall also be responsible for updating these 
guidelines whenever necessary to ensure that the NCP provided to patients are consistent 
with internationally accepted standards.  
 
SEC. 9. Seal of Nutrition Care Compliance. The Seal is an award, incentive, honor, and 
recognition-based program to ensure and motivate effective delivery of the NCP. The DOH 
shall award a “Seal” to hospitals that will very satisfactorily comply with the NCP consistent 
with monitoring guidelines that the DOH is hereby mandated to develop.  
 
SEC. 10. NCP Incentive Fund. There is hereby created a special account under the General 
Appropriations Act (GAA) lodged with the DOH called the "NCP Fund". The Fund shall be 
utilized only to pay out the incentives granted to hospitals which qualify for the Seal of NCP 
Compliance. 
The DOH team tasked to ensure compliance to the NCP shall have the authority to 
determine the monetary incentives for hospitals based on the number of awardees. It shall 
also have the authority to re-evaluate and increase the amount of the incentive to be awarded: 
Provided, That, the increase shall be subject to the sufficiency of the Fund at the time the 
increment is implemented. 
 
SEC. 11. Implementing Rules and Regulations. – The DOH, in cooperation and consultation 
with relevant government agencies and stakeholders, shall promulgate the rules and 
regulations for the proper implementation of this Act within ninety (90) days from its effectivity. 
 
SEC. 12. Separability Clause. – If any provision of this Act shall be deemed unconstitutional 
or invalid, the other provisions not affected there shall remain in force and effect.  
  
SEC. 13. Repealing Clause. – All Acts, Presidential Decrees, Executive Orders and 
Administrative Orders, Rules and Regulations and other such issuances or parts thereof which 
are inconsistent with the provisions of this Act are hereby repealed or modified accordingly. 
 
Approved,