Aside from meeting one of the two HEN criteria, which of the following is NOT one of the three additional criteria?

• A. Test of permanence
• B. Beneficiary must require tube feeding to maintain weight and strength
• C. Adequate nutrition must not be possible by dietary adjustment and/or oral supplements
• D. The patient must have no history of GI disease

Answer: (D)

Eligibility for home enteral nutrition beyond the initial two criteria centers on three requirements that confirm the need is long-term and essential. The test of permanence ensures the tube feeding is expected to be a lasting solution rather than a temporary measure. The criterion that the beneficiary must require tube feeding to maintain weight and strength highlights that the nutrition support is necessary to prevent malnutrition and functional decline, not just to supplement minimal intake. The third criterion, that adequate nutrition must not be possible by dietary adjustment and/or oral supplements, ensures there isn’t a feasible non-enteral option to meet the patient’s needs. The statement about having no history of GI disease is not part of these criteria; a history of GI disease does not determine eligibility in the same way, and many patients needing HEN have GI conditions or other etiologies.