How does Resthome identify a resident at risk of undernutrition?

Resthome applies the AViQ/ESPEN screening rules and updates a status: a weight loss of more than 5% in 1 month or more than 10% in 6 months, a BMI below 23 in a resident over 70, or an MNA overdue by more than 6 months move the resident to Re-screen (MNA). A latest MNA of “undernourished” places the resident directly in Undernutrition. The status is recalculated on every weight change and once a day.

Does the undernutrition category change the dependency allowance?

No. The dependency allowance depends on the resident’s Katz category, not on their nutritional status. Undernutrition monitoring is a clinical tool: it triggers assessments (MNA) and alerts, but has no effect on billing. The Katz category and the allowance are managed elsewhere (see the Katz page).

Where do the energy, protein and fluid targets come from?

The ESPEN coefficients (30 kcal/kg, 1 g/kg of protein, 1.6 L for women and 2.0 L for men) are facility-wide settings. Resthome then computes each resident’s own target from their weight and sex. The energy band rises to 35 kcal/kg for an underweight resident (BMI less than or equal to 21).

Who receives the undernutrition or deficit alerts?

A daily cron creates a “to do” activity. The undernutrition alert goes to the head nurse (then the manager); nutritional deficit or hydration deficit alerts go first to the Kitchen role (dietitian), then to the head nurse, then to the manager. Each alert is capped at once every 30 days per resident to avoid duplicates.

Is nutritional monitoring mandatory to use Resthome?

No. It is an optional screening feature, designed as a differentiator for MR/MRS. It assists the team but does not replace the judgment of a dietitian or a physician. You can use it as much or as little as you like: it activates as soon as you enter weight, MNA, meals and drinks.

Nutritional monitoring and undernutrition¶

Q: How is actual intake calculated?

From the meal services: for each meal served, you record the amount eaten (Amount Eaten: none, 25%, 50%, 75%, fully). Resthome multiplies the per-portion nutritional value of the dishes served by this percentage, adds the logged hydration, then compares the 3-day average with the targets. Dishes must therefore carry their portions and their per-portion values.

Resthome screens for undernutrition and tracks each resident’s intake, drawing on the geriatric ESPEN recommendations and the AViQ screening rules. Everything is read in the resident record’s Nutrition tab and driven from the Meals dashboard.

The principle is simple: you enter the weight, the meals served and the drinks; Resthome derives an undernutrition risk status, targets for energy, protein and fluids, a coverage of intake, and raises alerts when a resident falls behind.

A screening tool, not a diagnosis

Nutritional monitoring helps the team spot frail residents early. It does not replace the assessment of a dietitian or a physician: the status and alerts are signals to be interpreted, not decisions.

The resident’s Nutrition tab¶

Open a resident (the Residents or Meals app), then the Nutrition tab. The tab only appears for residents. It brings together the undernutrition status, the latest MNA, the ESPEN targets, the intake, the diets and the food preferences.

The undernutrition risk status¶

The Undernutrition Status block is read-only: Resthome computes it, you do not edit it by hand. It shows a colored badge and the measurements that explain it.

Displayed status	Meaning	Badge color
No concern	No concern	Green
To monitor	To monitor (last MNA “at risk”)	Blue
Re-screen (MNA)	An AViQ signal is active: redo or renew the MNA	Orange
Undernutrition	Confirmed undernutrition (last MNA “undernourished”)	Red

Below the badge, the tab shows the weight, the BMI, a Low BMI indicator (age-adjusted low BMI) and the weight loss over 1 month and over 6 months.

        flowchart TD
    A[Weight, height and BMI up to date] --> B{Last MNA = undernourished?}
    B -- Yes --> C[Undernutrition]
    B -- No --> D{AViQ signal active?}
    D -- Yes --> E[Re-screen MNA]
    D -- No --> F{Last MNA = at risk?}
    F -- Yes --> G[To monitor]
    F -- No --> H[No concern]

What triggers “Re-screen (MNA)”

An AViQ signal is active as soon as one of these conditions is true:

weight loss of more than 5% over about 1 month;
weight loss of more than 10% over about 6 months;
BMI below 23 in a resident over 70 (age-adjusted threshold);
overdue MNA: no MNA, or a last MNA more than 6 months old.

The thresholds match the default values of the AViQ/PWNS-be-A screening.

Weigh regularly to get the weight loss

The weight loss over 1 and 6 months is computed from the weights logged in the vital signs (nursing notes). Without regular weigh-ins, Resthome cannot compare and these percentages stay at zero. The height is required for the BMI.

The latest MNA¶

The Latest MNA block summarizes the resident’s most recent MNA (Mini Nutritional Assessment) assessment: date, score and interpretation (normal, at risk, undernourished).

Two buttons give access to it:

New MNA opens a new MNA assessment pre-filled for this resident, with the BMI band already selected based on their known BMI.
MNA History opens the list of their previous MNAs.

The MNA-SF is a 14-point scale: 12–14 = normal status, 8–11 = at risk of undernutrition, 0–7 = undernourished. It is the MNA that switches the status to Undernutrition or To monitor. The assessments are clinical registers: see Clinical registers.

The ESPEN targets¶

The Nutritional Needs (ESPEN) block shows the target specific to the resident, derived from their weight and sex:

Target	How it is computed
Energy Target (kcal/day) — energy	Weight × 30 kcal/kg (or 35 if BMI less than or equal to 21)
Protein Target (g/day) — protein	Weight × 1 g/kg
Fluid Target (ml/day) — fluids	1600 ml (women) / 2000 ml (men)

The coefficients (30/35 kcal, 1 g, 1.6/2.0 L) are set once for the whole facility in Meal and nutrition settings. Resthome then derives each resident’s individual target.

Intake vs needs (3-day average)¶

The Intake vs Needs block compares what the resident actually consumed with their targets.

The Today row shows the day’s intake: kcal, protein (g) and fluids (ml).
Three coverage bars — Energy Coverage, Protein Coverage and Fluid Coverage — give the 3-day average as a percentage of the target.
Two indicators, Nutrition Deficit and Hydration Deficit, become true when coverage falls below the configured threshold (75% by default).

Two buttons round out the block:

Log Drink quickly records a drink for this resident.
Hydration History opens their drinks log.

For coverage to fill in

Food intake comes from the meal services: at each meal, record the amount eaten (see below). The dishes must carry their portions and their per-portion values (kcal, protein), otherwise the intake stays at zero. Hydration comes from the logged drinks.

Logging food intake¶

Energy and protein intake is derived from the meal services. On a service, the Amount Eaten field offers: Not Eaten, 25%, 50%, 75% and Fully Eaten.

Resthome multiplies the per-portion nutritional value of the dishes served by this percentage to obtain the meal’s actual intake, then takes the 3-day average. Meal-by-meal entry is done in Meals → Operations (Meal services, Distribution) — see Menus, diets and hydration.

Recording hydration¶

Drinks are logged throughout the day in Meals → Operations → Hydration, a directly editable list (quick entry). Each line records the resident, the time, the quantity in milliliters and the drink type: water, coffee/tea, juice/soda, milk/dairy, soup/broth, oral supplement, other.

You can also log a drink in one click from the Nutrition tab, with the Log Drink button. Resthome adds up the day’s drinks, computes the fluid coverage over 3 days and raises an alert if intake is insufficient.

The nutrition dashboard¶

Open Meals → Statistics: below the general cards (Residents, Menus, Alerts), the page brings together three nutritional banners that only appear if they concern at least one resident.

Banner	Residents concerned	Button
Undernutrition risk (red)	Re-screen (MNA) or Undernutrition status	Review opens the list of these residents
Nutritional deficit (orange)	Intake below the ESPEN target	Review opens the list of these residents
Hydration deficit (blue)	Fluid intake below the target	Review opens the list of these residents

Each Review button opens the filtered list of residents, on their full record (Nutrition tab included) to act directly.

The automatic alerts¶

A daily cron refreshes the screening and creates activities for residents who fall behind. Activities are capped at once every 30 days per resident to avoid duplicates.

Alert	Condition	Recipient
Undernutrition — redo/renew the MNA	Re-screen (MNA) or Undernutrition status	Head nurse, otherwise manager
Nutritional deficit — intake below target	Energy or protein coverage below the threshold	Kitchen (dietitian), otherwise head nurse, otherwise manager
Hydration deficit — fluid intake below target	Fluid coverage below the threshold	Kitchen (dietitian), otherwise head nurse, otherwise manager

In addition to the activities, the Nutrition tab shows a warning banner at the top as soon as the status is Re-screen (MNA) or Undernutrition, recalling the weight loss and prompting to redo the MNA.

Set the deficit threshold

The 75% coverage threshold that triggers the deficit alerts is changed in Meal and nutrition settings. Lower it to be alerted later, raise it to be alerted earlier.

Key takeaways¶

The resident’s Nutrition tab brings together the undernutrition status, latest MNA, ESPEN targets and intake coverage — read-only for the computed measurements.
The undernutrition status follows the AViQ/ESPEN rules: weight loss, age-adjusted BMI, overdue MNA or “undernourished” MNA.
The targets (energy, protein, fluids) are specific to each resident, computed from their weight and sex using the configurable ESPEN coefficients.
The intake is derived from the amount eaten at meals and the logged drinks; coverage is a 3-day average.
The Meals dashboard (Statistics) and the daily alerts surface at-risk residents; this monitoring does not change the allowance, which depends on the Katz category.

Nutritional monitoring and undernutrition¶

The resident’s Nutrition tab¶

The undernutrition risk status¶

The latest MNA¶

The ESPEN targets¶

Intake vs needs (3-day average)¶

Logging food intake¶

Recording hydration¶

The nutrition dashboard¶

The automatic alerts¶

Key takeaways¶

Further reading¶