On-Time Quality Improvement Manual for Long-Term Care Facilities

Table 3.1. Sample Nutrition Report: High Risk

Resident Name	Resident ID	Decreased Intake: First Date	Avg Meal Intake % Week 03/05/07	Avg Meal Intake % Week 03/12/07	Avg Meal Intake % Week 03/19/07	Avg Meal Intake % Week 03/26/07	TF	Weight Change Lb
A	001	03/26/2007	50	41	36	29	X	-1.5
B	002	03/27/2007	94	92	97	85	-	-3.3
C	003	03/29/2007	54	52	48	52	-	-1.5
D	004	03/31/2007	86	89	71	59	-	-10.5

* High risk = decreased meal intake and weight loss during the report week.

Decreased intake: first date = Date of the current week the resident first had meal intake of 50 percent or less for two meals in one day.

Average weekly meal intake = Average percentage of meals consumed for one full week, including breakfast, lunch, and dinner; takes into account missed meals, refusals, and NPO (nothing by mouth) status.

TF = Tube feeding. If resident is taking tube feedings, X will display.

Weight change in lb = Any weight loss during the report week. Determined by subtracting current week's weight from most recent weight.

Return to Document

Current as of January 2011

Internet Citation: On-Time Quality Improvement Manual for Long-Term Care Facilities: Table 3.1. Sample Nutrition Report: High Risk. January 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/systems/long-term-care/resources/ontime/ontimeqimanual/qimanltab3-1.html