The short answer
Nursing homes generally treat as significant a weight loss of 5 percent in 30 days, 7.5 percent in 90 days or 10 percent in 180 days. Significant loss should trigger reweighing to confirm, a dietitian and physician review, a look for causes such as dental problems, swallowing difficulty, depression or lack of feeding help, and changes to the care plan. Facilities must help each resident keep acceptable body weight and stay hydrated unless the resident's condition makes that impossible.
Warning signs
- Loose clothing or dentures, sunken cheeks
- Meal trays left untouched or set out of reach
- Dry mouth, cracked lips, dark urine, new confusion or repeated urinary infections (signs of dehydration)
- A resident who needs help eating but is not being helped
What should happen
- Regular weights (weekly after admission or a significant change, then usually monthly)
- Recording the percentage of each meal eaten
- A dietitian assessment, supplements, and help or cueing at meals
- A speech therapy swallowing evaluation for coughing or choking at meals
- Notice to the physician and family
Questions to ask
- What is the current weight, and what was it one, three and six months ago?
- Who helps the resident eat at each meal?
- When did the dietitian last see the resident, and what changed?
The rules behind this
- 42 C.F.R. § 483.25(g) (nutrition and hydration)
- 42 C.F.R. § 483.60 (food and nutrition services)
Related questions
This guide provides general information, not medical or legal advice. Rules change; confirm current requirements with the facility, the New York State Department of Health or a professional. Attorney Advertising.