CIMA BUSINESS PLAN: DESCRIPTION OF SERVICES

The mission of the RDN of CIMA is to offer the highest quality nutrition services possible
by utilizing the most current scientific research in order to help improve dietary habits of
women and their families. The RDN will be devoted to the nutrition-related health of
mothers, their babies, and families. The RDN will provide services tailored towards the
target audience of clients who visit all of CIMAs clinics in the metro Atlanta area by
providing:

Individual nutrition assessments and follow-up consultations to clients who are at

nutrition risk or are seeking nutritional guidance.
Culturally and ethnically sensitive nutritional information, recipes, and meal plans.
Monthly group nutrition classes that discuss nutrition topics, such as diabetes and
gestational diabetes, nutritional concerns, pediatric nutrition, nutrition throughout
pregnancy, lowering nutrition related disease risks during pregnancy, and other nutrition
concerns associated with pregnancy.
Explore additional partnerships with local organizations who can positively impact the
health of clients.
The description of these services will be explained in further detail in the following
pages.

Individual Nutrition Consultations

The RDN will implement nutrition care to CIMA clients who express interest in nutrition
services or are referred to the RDN by the nurse practitioner, pediatrician, and
obstetrician. The RDN will offer the client a primary nutrition assessment which will take
approximately one hour to complete. Individual nutrition follow-up consultations will also
be offered by the RDN and will take approximately 30 minutes to complete. These will
be scheduled on an individual basis. Initial assessments will include anthropometric
screening, calculating energy needs, and dietary analysis. Anthropometric screenings
will include: height, weight, BMI, and if pregnant calculating appropriate weight gain for
the duration of the pregnancy. Medical nutrition therapy (MNT) will be provided to clients
who present with comorbidities such as obesity, gestational diabetes, diabetes,
hypertension, GI problems, and other nutrition related complications. Nutrition education
along with a personalized nutrition treatment plan will be provided to the client. An
electronic medical record (EMR) documentation in the form of an Assessment,

Diagnosis, Intervention, Monitoring, and Evaluation (ADIME) note will be recorded for
each client appointment.

The RDN will bill for individual nutrition consultations and MNT for clients who have
private insurance and/or Medicaid/Medicare. He/she will work with CIMAs billing
department to obtain a National Provider Identifier (NPI) number for the credentialing
process as well as to establish which (MNT) codes will be valid for the services the RDN
provides.
Culturally and Ethnically Sensitive Recipes and Meal Plans
The RDN will provide nutrition information that is culturally and ethnically sensitive to the
clients. The RDN will have knowledge of the different cultures that CIMA works with,
including but not limited to Hispanic, Latino, and Vietnamese. The RDN will work with
the client's food preferences and will remain culturally aware when providing dietary
advice. The RDN will provide suggestions of recipes and cooking methods that can offer
clients a healthy alternative to some of their traditional recipes. The RDN will provide
ideas of foods that are culturally and ethnically appropriate when recommending
sources of foods that provide nutrients that the client may require.
Monthly Group Nutrition Classes
Monthly nutrition classes will be provided to clients of CIMA at each location, both in
Spanish and in English. The class length will be 45 minutes to ensure enough time is
offered to complete the goals and objectives of the class. The topics addressed in each
group session will vary. Examples of educational classes that would be offered include
general nutrition, healthy meal planning, shopping at the grocery store, diabetes,
gestational diabetes, pediatric nutrition, and nutrition throughout pregnancy. A general
nutrition class and a diabetes focused class will each be held at least one time a week
at two locations, and increased up to four times a week based on need. The RDN will
prepare class objectives and lesson plans for each class offered. The RDN will also
provide evaluations at the end of each class session to ensure she is meeting the needs
of the CIMA clients participating in the classes. Each class will consist of no more than
10 participants to ensure a personalized approach, and enough time to answer any
questions that are presented during the session.
Session planning by the RDN will include steps listed below:
A quarterly schedule will be created by the RDN, which will include the topic and time of
each class, along with a brief description of the benefits of participating in the class.
A sign up list with name, phone number, and email will be available in each office to
reserve the clients spot at the session.
Coordinate with the manager of each clinic in order to make reminder email/phone calls
to confirm and increase attendance.

 The price of the classes for prenatal clients will be included in the bulk fee that the client
pays at her initial CIMA visit.
If clients cannot attend their scheduled class, they must call within 24 hours to
reschedule or cancel. Otherwise, CIMAs current no-show policy will take place.
Each lesson plan will incorporate:
Information on specific nutrition topics. The client will be able to express an
understanding of the material through a short pretest and posttest. Both will be available
in English and Spanish.
Specific goals that are anticipated to be met by the participants by the end of the class
session.
Nutrition information that is ethnically specific to the various cultures represented at
CIMA.
Activities related to each class topic to promote application and further
understanding.
Exploration of Additional Partnerships with Local Organizations

The RDN will facilitate and build connections with appropriate organizations to assess
willingness and ability to donate free or low-cost food or services to clients. On a
regular basis the RDN will make efforts to reach out to local organizations and form
implemental plans to impact CIMA clients.
Efforts to build partnerships will include actions such as:
Contacting organizations such as Georgia Organics, Atlanta Community Food Bank,
Community Gardens, Community Farmers Markets to obtain food donations for the
clients and/or donations of educational materials.
Joining networking groups to make connections with local businesses to obtain
donations and/or to receive discounts for CIMA clients.
Actively participate in local, state, and national levels of the Academy of Nutrition and
Dietetics (AND) to increase the knowledge base and reliability of the program.
Partnering with local churches for additional class and workshop space.
Referring eligible CIMA clients to other services such as WIC, Cooking Matters and
Shopping Matters through Open Hand, and the Supplemental Nutrition Assistance
Program (S.N.A.P.)
Working with organizations related to the health of mother and baby, such as Healthy
Mothers, Healthy Babies of GA, and exploring opportunities to mimic ideas found in
Healthy Mothers, Healthy Kids.
Additional Detailed Information
Location

The location of the RDN will vary among the five CIMA clinics- Norcross, Indian Trail,
Sandy Springs, Chamblee, and Doraville. Each location will be equipped with a scale
and stadiometer to obtain anthropometrics of each client. The RDN will utilize food
models, provide handouts, and any other tools needed for individual and group
meetings. The RDN will have a laptop with access to the EMR software that he/she is
able to bring with her to each clinic location in order to chart on each client.
Health Fairs
Along with the RDN working inside the CIMA offices, he/she will actively participate in all
the CIMA sponsored Health Fairs, having a table set up with activities such as Build
Your Healthy Plate and Sugar Shock demos to increase awareness about health and
nutrition.
Tools
The RDN will create and use a variety of tools once hired. An assortment of nutrition
assessment forms will need to be developed to remain specific to the different clients
seen at CIMA such as pregnant and non-pregnant women as well as children. These
assessment forms will gauge current dietary habits of the client, nutrition knowledge,
areas of concern, and nutrition goals the client may have. Educational materials will
need to be developed and translated in various languages. Handouts will be created
from evidence based materials. Lastly, evaluations will be created by the RDN. These
evaluations will assess the participants experience of both the individual and group
nutrition meetings, what they found helpful, and any other services or information
needed. Evaluation data will be used to improve services offered by the RDN on a
continual basis. Evaluations that assess the impact the RDN has had on CIMA clients
will also be done. These evaluations can be based on outcomes such as decreasing the
number of newborns admitted to the neonatal intensive care unit (NICU), and
appropriate weight gain of mothers throughout pregnancy.
Resources
The RDN will remain up to date with nutrition standards by remaining an active member
of the AND, completing Continuing Education hours in the areas relevant to the CIMA
population, and by using The Nutrition Care Manual when providing nutrition
recommendations to the clients of CIMA.

Possible Sources of Revenue

Opportunities to generate revenue could include general nutrition group classes and
grocery shopping tours held for clients not currently receiving prenatal care. In addition,
reimbursement from Medicaid for billable items such individual and group MNT provided
to CIMA patients.