Residents with weight loss may still be considered as having avoidable, preventable weight loss in a survey even if the resident stated a desire for weight loss. This does not absolve the facility of responsibility to assure that residents maintain acceptable parameters of nutritional status. F325 has been cited in several surveys for residents with weight loss and surveyors are scrutinizing RD's documentation.
Things the surveyors will review to determine if a weight loss is planned include:

•  Check the MDS section A and /or B for resident's responsible party status and mentation/cognition.
• Check the physician orders for resident's ability to make health care decisions.
• Has the responsible party (if resident is not their own responsible party) been consulted and is in agreement with a weight change plan, and is it documented?
• Has the MD been consulted and is in agreement with a weight change plan, and is it documented?
• Is there a good IDT note/conference note indicating the resident, responsible party and MD concur on the weight change plan?
• Has the MD addressed the weight plan in his/her progress notes?
• Has the Nutrition Care Plan been updated timely with progress of the weight change, and goals that are measurable and achievable?
• Are the interventions and approaches on the Nutrition Care Plan individualized for the resident's weight change plan and with appropriate physician diet orders?
• Is the acceptance of the diet, meal consumption and appetite being monitored to rule out other contributing factors for the weight change?
  OR......
• Is the statement that "resident is happy about the weight loss" putting up a roadblock to ruling out other causative factors?
  
  In summary, a care-planned weight change goal and weight change plan that is documented on MDS section "K" cannot be implemented without the previous steps in place to assure continuity of the resident's care in maintaining acceptable parameters of nutritional status.