Many families first notice issues during routine visits—especially when the resident seems “off” compared to prior weeks. Common red flags families report include:
- Weight loss that seems faster than expected for the resident’s condition
- Dry mouth, reduced urination, confusion, or new fatigue
- Pressure injury concerns (skin breakdown, delayed healing, worsening stage)
- Food refusal patterns without a clear escalation plan
- Inconsistent help during meals (encouragement without actual assistance)
- Lab or clinical changes that don’t appear to trigger timely follow-up
In Michigan, nursing homes are expected to follow accepted standards for resident assessments, care planning, and monitoring. When dehydration or malnutrition risk was known—or should have been known—and the facility’s response lagged, that gap can become legally important.


