What Does the Global Malnutrition Composite Score Measure?

December 28, 2025 •

3 min read

According to the Academy of Nutrition and Dietetics, the Global Malnutrition Composite Score (GMCS) is the first nutrition-related electronic clinical quality measure (eCQM) to evaluate the quality of malnutrition care provided to inpatient adults. This critical metric helps standardize care and improve outcomes for a vulnerable patient population.

Quick Summary

The Global Malnutrition Composite Score (GMCS) is an electronic clinical quality measure (eCQM) that assesses the quality of malnutrition care for adult hospital inpatients by evaluating four key components: screening, assessment, diagnosis, and care planning. This tool aims to standardize practices and improve patient outcomes.

Key Points

Four Components: The GMCS measures the quality of care using four steps: malnutrition risk screening, a nutrition assessment for at-risk patients, a malnutrition diagnosis, and a documented nutrition care plan.
Target Population: Initially, the GMCS focused on adults aged 65 and older but has been expanded to include all adults 18 and older for the CY 2026 reporting period.
Standardized Process: The score incentivizes hospitals to follow a standardized, evidence-based workflow for addressing malnutrition, reducing care gaps.
Quality Improvement: A higher GMCS indicates better quality of care, as it reflects a facility's compliance with established nutrition care standards.
Improved Outcomes: By promoting optimal nutrition care, the GMCS helps reduce patient complications, decrease readmissions, and shorten hospital stays.
Electronic Data: The measure relies on electronic clinical quality measure (eCQM) data from electronic health records (EHRs) for collection and reporting.

The Global Malnutrition Composite Score (GMCS) is a critical tool for modern healthcare, measuring and standardizing the quality of nutritional care for hospitalized adults. Introduced as an electronic clinical quality measure (eCQM), it addresses the widespread issue of under-recognized and under-treated malnutrition in clinical settings. By evaluating the entire nutrition care process, the GMCS helps hospitals identify and close gaps in patient care, ultimately leading to better health outcomes and a higher standard of service.

The Four Core Components of the Global Malnutrition Composite Score

The GMCS is an arithmetic average of four component measures, each corresponding to a step in the standardized nutrition care process. A higher composite score indicates better performance in delivering optimal malnutrition care.

1. Malnutrition Risk Screening

The first component assesses the percentage of eligible inpatients who undergo a malnutrition risk screening upon admission. The goal is to promptly identify patients who are malnourished or at risk of becoming so during their hospital stay. Early identification is crucial for triggering the subsequent steps of the care process. This component applies to all eligible patients and serves as the entry point into the comprehensive nutritional evaluation system.

2. Nutrition Assessment

For patients identified as being at-risk during the initial screening, the second component measures the proportion who receive a comprehensive nutrition assessment. This assessment is typically performed by a registered dietitian nutritionist and is vital for providing a more detailed evaluation of the patient's nutritional status. It confirms the risk level and provides the necessary information to determine a diagnosis and plan appropriate interventions.

3. Malnutrition Diagnosis

After a thorough assessment, the third component focuses on whether a formal malnutrition diagnosis is documented in the medical record for patients identified as moderately or severely malnourished. Historically, malnutrition has been underdiagnosed in hospital settings, a critical gap in care that this component seeks to close. A documented diagnosis is essential for proper coding, billing, and ensuring the patient receives the correct level of care.

4. Nutrition Care Plan

Finally, the fourth component measures the percentage of malnourished patients for whom a specific nutrition-focused care plan is documented and implemented. The care plan outlines the interventions and treatments required to address the patient's nutritional needs and is crucial for guiding the recovery process. This step ensures that the patient receives consistent, evidence-based nutrition support throughout their hospitalization and upon discharge.

How GMCS Improves Patient Care and Outcomes

Improving a hospital's GMCS hinges on a multidisciplinary approach that effectively manages the patient's nutrition journey from admission to discharge. By focusing on all four components, facilities can drive significant improvements in patient safety, recovery, and overall well-being. Malnutrition has been linked to a host of adverse outcomes, including longer hospital stays, increased complications, higher readmission rates, and higher mortality. By implementing effective nutritional care processes, hospitals can mitigate these risks and contribute to a healthier population. For more on the clinical impact of malnutrition, the Academy of Nutrition and Dietetics provides a wealth of resources on their website.

Comparison of Inpatient Malnutrition Assessment Approaches


Feature	Global Malnutrition Composite Score (GMCS)	Traditional Inpatient Malnutrition Indicators
Scope	Comprehensive assessment of the entire nutrition care process (4 components).	Focus on individual indicators like weight loss or low BMI, often in isolation.
Standardization	Promotes a standardized, evidence-based nutrition care workflow.	Practices vary widely among facilities and practitioners.
Goal	Evaluate and improve the overall quality of malnutrition care delivered.	Identify malnutrition but without a complete quality assessment of the care process.
Integration	All data are collected and reported electronically via the EHR, streamlining reporting.	Often relies on manual documentation, leading to inconsistencies and underreporting.
Patient Focus	Aims to provide optimal care based on a patient's risk level and severity.	Can fail to capture patients who are malnourished despite having a healthy weight (e.g., specific vitamin deficiencies).

Conclusion

The Global Malnutrition Composite Score offers a holistic and data-driven approach to addressing malnutrition in hospital settings. By focusing on the four critical steps of screening, assessment, diagnosis, and care planning, it provides a structured framework for healthcare facilities to standardize and improve their nutritional care. Ultimately, the GMCS serves as a powerful quality measure, driving better outcomes for patients by ensuring they receive the consistent, optimal nutrition care they need to recover and thrive.

Frequently Asked Questions

The GMCS is intended for hospital systems and healthcare professionals, and it measures the quality of care for adult inpatients who are malnourished or at risk. It was expanded to include all adults aged 18 and older in 2026.

No, the GMCS is a specific electronic clinical quality measure used within hospitals to evaluate inpatient malnutrition care. A global nutrition report typically assesses a country's progress toward international nutrition targets for a broader population, including metrics like stunting and wasting.

The GMCS is calculated as an arithmetic average of four component measures: malnutrition screening, nutrition assessment, malnutrition diagnosis, and care plan documentation. The score reflects the hospital's performance across these four areas for eligible patient encounters.

If a patient screens as not at risk during the initial screening (component one), they do not need to proceed to the other components of the GMCS framework unless a dietitian referral is later made. Their encounter would only be measured for the screening component.

The GMCS promotes a standardized, four-step process for care, whereas traditional methods were often inconsistent and varied between facilities. The composite measure provides a more complete picture of the quality of care rather than just identifying a diagnosis.

A formal malnutrition diagnosis is critical because it ensures proper coding and billing, allows for targeted interventions, and helps track the true prevalence of malnutrition. Without it, malnutrition can be severely under-recognized and under-treated.

The GMCS benefits patients by ensuring they receive timely and appropriate nutritional care throughout their hospital stay. This can lead to a lower risk of complications, shorter hospital stays, and reduced readmissions, ultimately improving their overall recovery.