For HEN eligibility, the patient must require tube feeding to maintain weight and strength and adequate nutrition must not be possible by dietary adjustment and/or oral supplements. Which statement is true?

• A. Both criteria must be met
• B. Only one criterion is needed
• C. They are optional
• D. They are not required

Answer: (D)

The key idea is that Home Enteral Nutrition (HEN) eligibility requires two things to be true at the same time: the patient needs tube feeding to maintain weight and strength, and adequate nutrition cannot be achieved with dietary adjustments or oral supplements alone. The first condition ensures that oral intake, even when optimized, isn’t enough to meet energy and protein needs, so a reliable, controlled delivery via tube feeding is necessary to preserve body mass and functional status. The second condition confirms that less invasive options have been inadequate, so there is a clear medical justification for enteral access instead of relying on diet changes or oral supplements alone.

If a patient could meet their nutritional requirements with diet tweaks or high-dose oral supplements, enteral feeding would not be indicated. Both criteria being satisfied ensures that HEN is truly medically necessary and appropriate.