Nursing Home Malnutrition Problems Raise Concerns Among Regulators, Consumer Advocates

Federal panel reports that more than 50% of nursing homes across the U.S. spent less than $12 for three meals a day per resident.

Health experts warn that residents in long-term care facilities are frequently underfed and malnourished, often due to persistent problems like inadequate staffing and poor living conditions.

During a panel at the 2025 CMS Quality Conference, speakers emphasized that conditions in nursing homes appear to be deteriorating, with many of the challenges becoming more severe in recent years. 

The panel indicated nursing home malnutrition and inadequate food intake are common issues for residents in facilities nationwide. Experts on the panel said many factors contribute to malnutrition and dehydration among residents, including chronic conditions, medication complications, psychological issues like depression, and economic or environmental factors. Those risks often lead to a downward spiral among residents, the panelists warned.

A recent survey conducted on food complaints noted a lack of variety in food, not enough fruit and vegetables, poor tasting food, overcooked or undercooked food, and small servings, the panel reported.

The conference was largely focused on physical and mental conditions that play a role in nursing home resident malnutrition. However, a NJ.com report found that nutritional food and cleanliness failures by nursing homes were a major contributor.

Malnutrition Resulting from Nursing Home Neglect

The investigative report by NJ.com put much of the blame on the facilities themselves, warning that one-third of nursing homes spend less than $10 per day to feed residents. Investigators found that the food is often spoiled or prepared in dirty conditions.

Journalists from NJ.com and researchers from Rutgers University reviewed thousands of federal reports filed with the CMS to compile the data for the investigation. They found that more than 50% of nursing homes across the U.S. spent less than $12 for three meals a day per resident.

The number of nursing home neglect complaints increased by 50% from 2020 to 2023, according to the report. Meanwhile, the number of complaints filed against nursing homes for food-related issues more than tripled from 2021 to 2024.

While nursing homes care cost families and the government roughly $104,000 per resident per year on average, most of the facilities are skimping on meals, the investigators concluded.

According to the report, some nursing homes limit residents to 4 ounces of milk per day. One nursing home reportedly served a single ravioli to residents for dinner one day.

There were also many reports of rotten food, spoiled vegetables, moldy fruit and meals prepped in dirty kitchens, with reports calling meals “below average” and “not edible food.” One resident who previously spent time in jail said there was better food in prison.

Nursing Home Food Problems Increase Risk of Complications

Data from the U.S. Centers for Disease Control and Prevention (CDC) indicate outbreaks from foodborne illnesses linked to nursing home food are also increasing. At the same time, food-related deficiencies among residents increased from roughly 3,000 cases in 2019 to more than 9,000 by 2024.

While there are no clear guidelines for how much money should be spent on food in nursing homes, the recent CMS Quality Conference outlined strategies to help encourage residents to eat more food, such as conducting regular mealtime rounds, encouraging frequent meals, giving residents oral supplements and encouraging families to visit during meals.

However, the strategies did not address poor food conditions in many CMS-funded nursing homes or ways to ensure enough money is spent daily on meals per resident.

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