Nursing Home Complaint Regarding Malnutrition or Dehydration

One thing that often shocks family members is to learn that their loved one has been suffering from malnutrition or dehydration while living in a nursing home. After all, isn't one of the reasons that they went to a nursing home was to make sure that they were being taken care of properly?

There are federal regulations which address the issue of the resident's hydration and nutritional condition:

(g) Assisted nutrition and hydration. (Includes naso-gastric and gastrostomy tubes, both percutaneous endoscopic gastrostomy and percutaneous endoscopic jejunostomy, and enteral fluids). Based on a resident's comprehensive assessment, the facility must ensure that a resident -
     (1) Maintains acceptable parameters of nutritional status, such as usual body weight or desirable body weight range and electrolyte balance, unless the resident's clinical condition demonstrates that this is not possible or resident preferences indicate otherwise;
     (2) Is offered sufficient fluid intake to maintain proper hydration and health; and
     (3) Is offered a therapeutic diet when there is a nutritional problem and the health care provider orders a therapeutic diet.
     (4) A resident who has been able to eat enough alone or with assistance is not fed by enteral methods unless the resident's clinical condition demonstrates that enteral feeding was clinically indicated and consented to by the resident; and
     (5) A resident who is fed by enteral means receives the appropriate treatment and services to restore, if possible, oral eating skills and to prevent complications of enteral feeding including but not limited to aspiration pneumonia, diarrhea, vomiting, dehydration, metabolic abnormalities, and nasal-pharyngeal ulcers.

42 CFR, Part 483.25(g)

Nursing home residents are evaluated on a regular basis by a dietician and if the dietician is doing a proper job with the right data, absent some serious illness, there should be no reason that a resident should suffer from dehydration or malnutrition in a nursing home, provided that the staff is providing the care needed.

Poor nutritional and hydration can have several adverse health effects on the resident:

• Predisposing the resident to developing bed sores or pressure ulcers;
• Causing or aggravating osteoporosis, or brittle bone disease, which leaves the resident susceptible to serious fractures and poor healing when there is a fall;
• Impeding the body's ability to resist and recover from infection.

If there is a diagnosis of malnutrition or dehydration made by a doctor or during a hospital admission, there is a legitimate basis for filing a nursing home complaint with the Illinois Department of Public Health.