MDS 3.0 looks at "abnormal" BMI as a possible nutrition risk for triggering Care Area Assessments. If residents are overweight or obese, we should be documenting why we did or did not choose to address and care plan the issue. Our documentation should include statements from the resident on their usual weight, the stability of their weight, and the additional nutrition risk factors the resident may have that would contraindicate a weight loss plan. Overweight and obese residents should not be automatically placed on weight control plans. If a physician orders an RD consult for weight loss on a resident, make sure the resident and responsible party agree to the plan, and request an order for a physician-prescribed weight loss diet including the weight goal. See HMC Policy and Procedure Manual, Nutritional Care Management, guideline no. 492 on page 241 for surveyor guidance on resident weight status: "...the resident's usual body weight prior to decline or admission is the most relevant basis for weight-related interventions...weight stability, rather than weight gain, may sometimes be the most pertinent short-term or long-term objective for the nutritionally at-risk or compromised resident."