Clinical Assistance Program

Clinical Team

The clinical team at Pentec Health specializes in the management of malnutrition within the ESRD population. IDPN and IPN are the only therapies dispensed from the renal pharmacy which allows Pentec Health’s clinical team to provide unparalleled expertise.

Dedicated experts to help Nephrologists and clinicians improve their patient’s nutritional status and overall quality of life.

Pentec Health offers a Clinical Assistance Program to support clinicians with the treatment of malnourished dialysis patients. Pentec Health’s Clinical Case Manager specializes in Renal Nutrition and Nutrition Support and strives to maximize a patient’s response to IDPN and IPN therapy.

Key components of the clinical assistance program:

Nutrition Experts
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Renal Pharmacists
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Onboarding Process

  • The Clinical Case Manager (CCM) confirms patient qualification criteria for therapy is met prior to initiation of IDPN or IPN therapy.
  • The CCM can provide guidance regarding patients who may benefit from these therapies and answer therapy related questions.

Monitoring Functions

  • The goal of the Clinical Assistance program is to ensure that all patients meet nutritional goals while receiving IDPN or IPN therapy.
  • The CCM will review nutrition outcomes of the IDPN and IPN patients quarterly and as needed to assure the patient's nutritional goals are met. Suggestions are offered as indicated throughout the course of treatment, based on a patient’s response to therapy.
  • Pentec Health's Albumin Drop System uses a proactive approach to track and trend albumin data received. The albumin drop system identifies patients who have had declines in the albumin which trigger the CCM to review the patient’s status.
  • The Clinical Case Manager will offer interventions for patients who are experiencing side effects in an attempt to allow patients to remain on therapy until goals are met.
  • Albumin graphs can be provided to illustrate serum albumin trends.

Clinical Support

The Clinical Case Manager is an extension of the clinic healthcare team and serves as a resource for all clinical questions or concerns. They provide guidance regarding existing patients on therapy as well as potential patients who may benefit from these therapies.

Referral and Therapy Process

  • Reimbursement

    Pentec Health has existing contracts with both government and private insurers.

    Pentec Health’s Insurance Coordinators are familiar with all requirements for reimbursement and provide the patient with optimal opportunities for therapy coverage.

    All insurance verification and prior authorizations from insurance carriers are handled by Pentec Health’s experienced reimbursement team

  • Delivery of Product

    All IDPN and IPN solutions are delivered via shipping courier using a validated shipping procedure to ensure proper temperature controls are maintained throughout the shipping process.

Download our Quick Guide to IDPN

Pharmacy Support

The pharmacy team also offers many services, including:

  • Resolving any discrepancies found during the initial review of medication profile including dosing errors, duplications, and interactions
  • Contacting the patient prior to the start of care to review new therapy (IPN or home IDPN) and answer any questions the patient may have including, but not limited to: administration, goals of therapy, storage and delivery schedule.
  • Establishing Care Plans for all the home patients as a way to monitor therapy and ensure patients are progressing towards their goals.
  • Routinely reviewing and updating medication profile and Care Plans.
  • Mailing medication profile to the patient’s home upon discharge to ensure a smooth transition of care.

Electrolyte Management

If additional additives are required, Pentec Health’s pharmacists will assist in the management of electrolyte disorders, including refeeding syndrome. After assisting with the initial order, routine follow-up is performed to monitor therapy and provide suggestions for dosing adjustments. Oral supplementation and dietary recommendations are also provided.

Quality Assurance

Pentec Health maintains established protocols and quality control measures which ensure the safe and accurate compounding of every sterile preparation dispensed to the patients entrusted to our care. Our Pharmacy Quality team performs environmental monitoring, which meets and exceeds the requirements of USP 797 guidelines for sterile compounding. This includes daily non-viable particle testing, daily final product testing, monthly air viable and surface sampling, and personnel monitoring within the clean room to ensure the sterility and quality of the nutritional solutions dispensed by Pentec Health.

Nutrition Experts

Renal Pharmacists

Anna Marie-Rodriguez
AnnaMarie Rodriguez, RDN, LD

Renal Clinical Case Manager

AnnaMarie has more than 20 years of experience in renal dietetics and has held a wide variety of leadership and volunteer positions in Texas and Wisconsin. She is currently the Renal Practice Group (RPG) Chair and Wisconsin Council on Renal Nutrition (CRN) Chair. By working with health care practitioners, AnnaMarie helps patients achieve optimum nutritional health and a better quality of life.

Cynthia Ray, RD, CD, CSR

Renal Clinical Case Manager

Cynthia has 21 years of experience and assists healthcare professionals treating malnourished dialysis patients. As an RD, she feels great satisfaction knowing that she is helping to make a difference in the treatment of malnutrition and improving the lives and well-being of dialysis patients.

Danielle Impriano, MA, RDN, LDN

Renal Clinical Case Manager

Danielle has been working in the nutrition/dietetics field for 13 years and as a Licensed Dietitian for nine of those years. Her favorite part about being an RD is helping people improve their nutritional status and overall quality of life.

Deborah Degree BSN, RN


Deborah is a Registered Nurse with a BSN degree and has been actively serving the renal community since 1990. Working at Pentec Health enables her to interact with the dialysis patients and clinical staff through live, one-on-one or webinar IPN/IDPN training.

Elizabeth Seeley, RD, LDN, CDR Weight Management

Renal Clinical Case Manager

Elizabeth has worked as an RD for the past 10 years. Elizabeth enjoys her job because she loves helping people. She also loves math and science and enjoys using these skills to help providers personalize prescriptions based on patients’ needs.

Jane Marshall, RD, LDN

manager of clinical case operations

Jane has many years of renal care experience, from working in a dialysis center supporting patients using IDPN therapy to serving in various roles at Pentec Health since 2010. In Jane’s current role, she strives to enhance clinical support and advance the growth and development of our Renal Clinical Case Managers.

Jenny Vyduna, MS, RDN, CNSC

Renal Clinical Case Manager

Jenny has been an RD for nine years. She has worked in renal care for nearly eight years and at Pentec Health for four of them. She has a Bachelor’s degree in Dietetics from Purdue University, a Master’s degree in Dietetics from the University of Kansas and completed a dietetic internship at Yale. As a Renal Clinical Case Manager, Jenny also earned her CNSC credential.

Kayla Merritt, MPH, RD, LD

Renal Clinical Case Manager

Kayla has worked as a Registered Dietitian for eight years and has been at Pentec Health for four years. She loves her job because she has a passion for nutrition and helping dialysis patients. Kayla is dedicated to improving her patients’ nutrition because it improves their quality of life.

Kelli McEntire, MS, RD, LD

Renal Clinical Case Manager

Kelli has been a Registered Dietitian for 10 years and possesses a Master’s of Science in Nutrition and Dietetics. She has worked at Pentec Health for more than four years and supports clinicians in improving their patients’ quality of life.

Kristen Hackey, RDN, LD, CSR, FNKF

Renal Clinical Case Manager

Kristen has been an RD for 10 years. Her passion for renal/ESRD patients grew when her late cousin passed away from complications of ESRD and a failed transplant. She feels privileged to be able to live out her cousin’s legacy everyday by helping other ESRD patients with their nutritional needs.

Leah Courtnage, RD

Renal Clinical Case Manager

Leah has worked as a Registered Dietitian in various states for many years. As a unit RD, Leah managed patient outcomes and patient IDPN/IPN therapies. She loves being able to help people and educate them on a daily basis.

Toni Devane, MS, RDN, LDN, CSR, CNSC

Renal Clinical Case Manager

Toni has 10 years of experience in renal care and has worked at Pentec Health for nearly two years. Her job combines her two favorite fields: Renal care and nutrition support. She enjoys being able to provide nutrition to malnourished patients and improve their quality of life.

Valinda Baldwin, RD, CSR, LDN

Renal Clinical Case Manager

Valinda has been working as a Registered Dietitian for 23 years and has worked in the dialysis setting for over 20 years. She has been a Board Certified Renal Nutrition Specialist for 15 years. She enjoys working in the renal field because of the progress she is able to witness in patient’s lives through adequate nutrition.

Wai Yin Ho, MSEd, MS, RDN

Clinical Learning and Development Specialist

Wai Yin has 10 years of dialysis experience as a Registered Dietitian and a Master’s degree in Learning Design and Technology. Pentec Health’s motto, “Large enough to serve, small enough to care,” is exactly why she has worked here for three years.

Anthony Ruggear, PharmD

Lead Renal Pharmacist

Tony has been working with Pentec Health for 4 years. He is responsible for day-to-day operations in the cleanroom, as well as taking care of our newly acquired FMC patients. He enjoys making sure every patient’s prescription is compounded with the utmost quality and integrity.

Arun Mohanan, PharmD

Team Pharmacist

The most recent addition to the team, Arun, started with Pentec Health in late 2017 and is a graduate of Temple University. He hopes to use his clinical skills and passion to provide quality care to our patients.

Brendan Klar, PharmD

Team Pharmacist

Brendan has been working with Pentec Health since 2012. He joined the team in 2016 as a pharmacist after graduating from Temple University School of Pharmacy and now helps to take care of the midwest to west coast dialysis patients. He also works as a pharmacist for the specialty infusion side of Pentec Health and enjoys being able to compound for those patients.

Darren Leatherman, PharmD, BCNSP, CNSC

Manager- Renal Pharmacy

Darren is a Board Certified Nutrition Support Pharmacist with Pentec Health. After graduating from University of the Sciences, he began his career as a home infusion pharmacist, caring for a diverse patient population that requires intravenous medications at home. He has been with Pentec Health for 6 years and serves as the Renal Pharmacy Manager, overseeing the provision of specialized nutrition products for patients with ESRD.

David Bak, PharmD

Team Pharmacist

David has been with Pentec since 2015 and is the pharmacist for the southeast/northeast territory. He is a graduate of University of the Sciences and enjoys presenting on clinical topics such as “Metabolic Acidosis in CKD Patients” in addition to his daily responsibilities.

David Keammerer, PharmD

Team Pharmacist

David has spent four decades in pharmacy practice as a department head, clinical pharmacist, managing consultant, pharmacist and resident primarily in the hospital and home infusion settings. His primary role in the last 3 years at Pentec Health is to back up the pharmacist team leaders.

Dominick Bulone, PharmD

Team Pharmacist

Dominick has been with Pentec Health since 2014 and is the pharmacist for the central renal team. He received his Black Belt Certification in Lean Six Sigma in early 2018 and has been involved in several time and cost savings projects for Pentec Health.

Jamie Ksiazek, PharmD

Team Pharmacist

Jamie has been with Pentec Health for 6 years. He oversees pharmacy production and cleanroom operations. He is currently working on his Six Sigma black belt certification and enjoys compounding nutritional therapy that enhances patients’ quality of life.

Joseph Coughlan, PharmD

Team Pharmacist

Joseph started with Pentec Health as a student-intern in 2013 and now acts as the lead pharmacist for much of the Central and West renal teams. He has represented Pentec Health across the country to present clinical information, including some of his own research on intraperitoneal nutrition.

William L. Briganti, PharmD

Team Pharmacist

William has been working at Pentec Health since 2015 and is currently the East territory pharmacist. He is a Temple University graduate and, in addition to his other roles, serves as the preceptor to Temple University pharmacy students on their Advanced Practice Pharmacy Experience rotations.