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Malnutrition Criteria

Posted on: August 29, 2017

What criteria do Mercy dietitians use to assess for malnutrition?

These guidelines recommend that the diagnosis of adult malnutrition be based on the presence of two or more of the following characteristics:

  • Insufficient energy intake
  • Weight loss
  • Loss of subcutaneous muscle
  • Loss of subcutaneous fat
  • Localized or generalized fluid accumulation
  • Diminished functional status as measured by hand grip strength

Some indicators (low albumin or pre albumin) previously thought to be useful in a malnutrition diagnosis have not proven to be sensitive or specific and should be interpreted with restraint.

What are the levels of malnutrition?

Mild, moderate, severe or unspecified if not known

Where can you find the dietary assessment?

Follow these steps:

  1. Physician desktop
  2. Search for patient under patient list
  3. Assessment forms
  4. MNT (Med Nutrition Therapy) Assessment
  5. Choose your date of service

Malnutrition can have many impacts–Relative weight, Severity of Illness (SOI), Risk of Morality (ROM) and length of stay (LOS)

Example:

Patient admitted with a diagnosis of Pneumonia and has malnutrition documented

DRG 194

Relative weight 0.9469

SOI 2

ROM 1

Average LOS 4.3

Patient admitted with a diagnosis of pneumonia with severe protein calorie malnutrition

DRG 193

Relative weight 1.386

SOI 3

ROM 2

Average LOS 5.7

The CMS assigns a unique weight to each DRG. The weight reflects the average level of resources for an average Medicare patient in the DRG, relative to the average level of resources for all Medicare patients. The weights are intended to account for cost variations between different types of treatments. More costly conditions are assigned higher DRG weights.

References

For the record July 2014 Vol 26 Number 7, Pg 26

ASPEN criteria guidelines

Medicare PPS system guidelines

 

 

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