In many Paramount cases, the issue isn’t that dehydration or poor nutrition is “mysterious.” It’s that the facility had warning signs and still didn’t escalate in a way that would typically prevent the decline.
Common red flags families report include:
- A sudden change in alertness after medication changes or illness
- Weight loss over a short period without corresponding dietitian updates
- Dry mouth, reduced urination, constipation, or recurring infections
- Pressure injuries that appear or worsen while the resident is weak
- Notes showing fluids or meals were “offered” but not showing meaningful assistance, monitoring, or follow-up
A key legal question in these cases is whether the facility responded with appropriate assessment, feeding/fluid support, and clinician escalation once risk became apparent.


