Across skilled nursing facilities (SNFs), residents with dysphagia are routinely placed on restrictive diets—pureed foods, thickened liquids, or non-oral feeding—often based on outdated assessments or incomplete clinical data. But two recent retrospective studies reveal a stark truth: many of these restrictions may be unnecessary, and potentially harmful.
Why Imaging Matters
- Accurate diagnosis leads to appropriate care—with imaging-based tools like DIGEST, clinicians can match diet recommendations to actual swallow safety and efficiency.
- Quality of life improves when restrictions are lifted unnecessarily. Patients can eat what they enjoy, socialize at meals, and avoid complications like dehydration or malnutrition.
- Healthcare costs drop when feeding tubes and specialized diets are avoided.
As a leader in mobile diagnostics, Patheous Health delivers FEES and MBSS assessments directly to SNFs—removing access barriers and restoring dignity to care. We advocate for evidence-based, imaging-led swallowing evaluations whenever medical status changes, especially after acute hospitalization.
Rethinking Dysphagia Care: Why Timing and Imaging Matter in SNFs
Dysphagia management in skilled nursing facilities (SNFs) is often driven by habit rather than data. Many residents arrive post-acute care on restrictive diets—thickened liquids, pureed foods, or NPO orders—based on clinical exams or outdated assessments. But what if those restrictions aren’t medically necessary anymore?
The Data Tells the Story
Recent studies show that more than 60% of SNF residents receiving modified diets do not have active dysphagia when evaluated with imaging. These individuals often continue with unnecessary diet restrictions, swallowing therapy, and even feeding tubes—interventions that don’t match their current medical status.
One large-scale review found:
- 76% of NPO patients were cleared for oral intake after FEES re-evaluation
- Diets improved from mechanical soft or puree to regular texture in 43% of cases
- Recommendations for thin liquids more than doubled post-imaging
These aren’t just numbers. They reflect real improvements in quality of life—and lower risk of complications like dehydration, malnutrition, and social isolation.
The Cost of Delay
When evaluations are ordered late—after a resident returns to the hospital, is discharged, or declines medically—facilities miss the opportunity to:
- Lift unnecessary restrictions
- Prevent rehospitalizations
- Capture reimbursement for swallowing therapy
- Offer dignified, evidence-based care
Imaging Changes the Game
FEES and MBSS assessments provide objective, accurate insights into swallow physiology, and tools like the DIGEST scale ensure that diet modifications match actual safety and efficiency—not just guesswork from a bedside screen.
Medical status evolves, especially after acute hospital stays. Yet dysphagia management too often relies on clinical swallow exams alone—subjective, non-visual assessments that fail to capture true swallow physiology. In fact, there’s a 70% false positive rate on these clinical swallow evaluations. The result? Over-treatment, unnecessary diet changes, and lower quality of life.
In fact, a recent study published in the Journal of Clinical Medicine found that:
- Even when patients had dysphagia imaging while they were in the hospital, their outcome will improve if imaging is performed again within the first five days of returning to the SNF.
- Imaging performed at the SNF, within five days of hospital discharge, led to significant diet restriction changes plus lower rates of pneumonia.
Final Thought
Dysphagia doesn’t have to mean indefinite diet restrictions. Patients require timely reassessment using trusted technology—especially after a hospital stay. Let’s rethink how we care for residents—and restore the joy of a shared meal.
