02-2023 

Malnutrition Screening 

Practices for OAA 

Nutrition Programs: 

The Who, What, Why, and How 

What is Malnutrition?

Malnutrition occurs when we don’t get enough 

of the nutrients our body needs. Not feeling 

hungry, strict diets, problems chewing and 

swallowing, and chronic illnesses can often lead 

to malnutrition. Those who are unable to purchase 

or prepare healthy food may also be at risk for 

malnutrition. Malnutrition can cause older adults 

to have problems with: 

◊ Weakness and being tired

◊ Problem healing wounds 

◊ Loss of muscle and strength

◊ More falls and fractures

◊ More infections

◊ Having to be admitted to a hospital 

◊ More medical cost 

◊ Being unable to stay in the home (Hogan, 

2019) 

Who May Benefit from Malnutrition 

Screening?

Participants in the Older Americans Act (OAA) 

Senior Nutrition Programs (SNP), such as 

congregate meals and home-delivered meals, 

will benefit from the addition of malnutrition 

screenings. 

Why Does Malnutrition Matter to SNPs?

In the 2020 reauthorization of the OAA: 

“Reduce malnutrition” was added as an additional 

purpose of the SNP and malnutrition screening 

was added to the OAA nutrition screening 

requirements (Whitmire, 2022). Additionally, 

individuals aged 60+ are at a higher risk for 

malnutrition and SNPs are able to effectively 

identify, prevent, and address malnutrition. Area 

Agencies on Aging (AAAs) can refer participants 

to additional community and medical resources.

How Can Malnutrition be Addressed by 

SNPs?

1. Perform malnutrition screenings.

There are no federal requirements about how 

screenings should be performed, providing lots of 

flexibility (Whitmire, 2022).

◊ The Malnutrition Screening Tool (MST) is the 

chosen tool of the Academy of Nutrition and 

Dietetics and can be performed by nutrition 

program staff. The MST consists of the 

following questions:

1. Have you lost weight recently without trying?

2. If so, how much?

◊ The participants who are identified as high risk 

by the required nutrition screening questions 

should be assessed for malnutrition and 

referred to appropriate intervention services.

◊ Risk for malnutrition can also be assessed by 

screening for social determinants of health.

◊ Additionally, AAA staff and volunteers can 

identify risk factors and potential signs of 

malnutrition in participants they serve. Inform 

staff and volunteers of these risk factors and 

potential signs for malnutrition, including:

• Poor appetite 

• Chronic disease 

• Side effects from medications

• Poor dental health 

• Trouble with chewing or swallowing 

• Social isolation 

• Dementia 

• Low income 

• Changes in participants’ behavior 

• Changes in living situation 

• Medical changes 

• Other changes in conditions 

◊ Screening can occur as part of the registration 

process for congregate meals or homedelivered meals. 
How Can Malnutrition be Addressed by 

SNPs? Continued

2.Identify the root cause and create a 

community care plan including goals and 

steps to achieve those goals (Hogan et al., 

2019). 

Provide and document referrals to services that 

address root causes. Appropriate referrals might 

include: 

◊ Congregate and home-delivered meal 

services 

◊ Nutrition education and counseling 

◊ Falls prevention resources 

◊ Assisted living services 

◊ Transportation services 

◊ Help with federal assistance applications 

(SNAP, Medicaid, etc.) 

◊ Personal care 

◊ Case management 

◊ Social supports 

◊ Food pantries 

3.Establish a process for notifying a 

participant’s medical provider in the event of 

a positive screening. 

The medical provider can then offer services such 

as: 

◊ Further testing 

◊ Specialist referrals

◊ Physical therapy

◊ Medical nutrition therapy

4.Monitor the participant’s progress.

◊ Establish regular contact with the participant. 

◊ Follow up on a regular basis to check progress, 

provide encouragement and support, and 

provide additional referrals if necessary.

*For more information, details, and examples of 

topics discussed in this resource, see Addressing 

Malnutrition in Community Living Older Adults 

A Toolkit for Area Agencies on Aging. 

References

Hogan, L., Rutherford B.K., & Kramer, R. (2019). Addressing Malnutrition in Community 

Living Older Adults: A Toolkit for Area Agencies on Aging. Maryland Department on Aging.

Whitmire, M. (2022). Connecting Science to Practice: The OAA Nutrition Program as 

Malnutrition Prevention [Webinar]. Defeat Malnutrition Today. https://defeatmalnutrition.today/sites/ 

default/files/documents/CPSTF%20%26%20DMT%20webinar%20slides%20-%20full.pdf

This project was supported in part by grant number 90PPNU0002 from the U.S. Administration for Community Living, Department of 

Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects with government sponsorship are encouraged to 

express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official ACL policy.