Nutrition problems in nursing homes under CMS scrutiny

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NUTRITION

Malnutrition in nursing homes more common than most people realize

Nutrition problems in nursing homes is drawing increased CMS scrutiny. The National Resource Center on Nutrition, Physical Activity, and Aging has reported that 35% to 85% of long-term care residents suffer from malnutrition, especially those with dementia, swallowing disorders, or chronic illnesses.

CAUSES
Multiple factors contribute to malnutrition, including inadequate staffing, poorly trained staff, failure to account for medical and dietary needs, medication side effects, chronic illnesses, psychological issues (e.g., depression), physical limitations, and sometimes neglect.

DEHYDRATION
Alongside malnutrition, dehydration is a significant risk due to limited mobility, impaired thirst sensation, or insufficient assistance with drinking.

REGULATORY STANDARDS AND OVERSIGHT
Under federal regulations, nursing homes that participate in Medicare or Medicaid must meet minimum standards of nutritional care. These include providing daily meals that meet each resident’s individual nutritional requirements and monitoring for unplanned weight loss. The Centers for Medicare & Medicaid Services (CMS) also require facilities to conduct nutritional assessments upon admission and quarterly thereafter. Despite these regulations, compliance is inconsistent, and enforcement is often lacking.
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At Excelas, LLC, we handle hundreds of post-acute care cases each year—and malnutrition consistently ranks as the third most referenced allegation in claims and lawsuits. The recent spotlight by CMS on nutrition in nursing homes is both timely and necessary.

The insights shared at the 2025 CMS Quality Conference reinforce what we see in our work every day: simple interventions like mealtime monitoring, staff training, and family involvement can make a measurable difference in resident outcomes.

DOCUMENTATION

Excelas’ medical analysts have extensive experience in reviewing medical records and our medical chronologies and associated reports can assist administrators in preparation for surveys or assessing staff training needs and in preparing counsel for the defense of claims and litigation.

KNOWLEDGE

2025 Senior Living and Long-Term Litigation Seminar

Excelas is honored to sponsor the DRI Senior Living and Long-Term Care Litigation for the 16th year—continuing our long-standing commitment to this vital event (with a brief pause during COVID). Join us in Austin, TX, from September 10–12, 2025, at this forward-thinking conference, where legal and healthcare professionals come together to tackle pressing challenges in senior living and long-term care litigation.

This innovative conference offers excellent sessions, including “The Good, the Bad and the Ugly,” a two-part series on preparing and defending administrators, corporate representatives, nurses, CNAs, and other frontline staff.

Max Beach and Sarah Jane Truong will share practical strategies for navigating depositions, while Paul McCartney will discuss how to handle hostile former employees.

This presentation is crucial for legal and healthcare professionals by providing strategies to protect staff during high-stakes legal proceedings.  It addresses challenges like depositions and hostile witnesses, fostering preparedness and resilience in complex litigation.

Preparing for depositions is timely and costly.  Excelas provides the tools and expertise to assist counsel through focused audits, evaluating documentation quality, integrating facility policies and procedures with individual resident medical records, reviewing staffing records, and preparing comprehensive analyses to support your defense strategy.

If you’re attending, plan to meet with Jean Bourgeois, Founder and President of Excelas, to discuss your medical record and document management needs.  Let’s connect in Austin!

Excelas helps organizations respond accurately and quickly to claims and litigation brought against them

Partnering with attorneys, health care organizations, and insurance companies since 1995, Excelas provides medical legal analyses and tools for building winning defense strategies. When expertise, accuracy, reliability, and on-time delivery count, you can count on Excelas.

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