Home parenteral nutrition (HPN) patients need periodic reassessment for compliance, appropriateness of parenteral formulation, infusion regimen, bowel adaptation, and effective oral nutrient intake. Additionally, new technological advances need to be considered for potential use in the home parenteral nutrition population. Since costs for home parenteral nutrition therapy are substantial, cost-effective options should be exercised whenever reasonable. The following case illustrates our approach to the reassessment process, subsequent modifications, and resultant impact on the lifestyle, adequacy, and cost of home parenteral nutrition therapy.