Swallowing difficulties, or dysphagia, are among the most common and dangerous conditions in skilled nursing facilities. Without proper assessment, residents may face choking, aspiration pneumonia, malnutrition, and frequent hospitalizations. For administrators and care teams, the stakes extend beyond resident health to include cost, compliance, and reputation.
Research makes the urgency clear. One study published in PMC found that when instrumental evaluations such as Fiberoptic Endoscopic Evaluation of Swallowing (FEES) were not readily available, residents often ended up with unnecessarily restricted diets and poorer outcomes. Another article on implementing instrumental assessments emphasized that timely, accurate testing prevents aspiration-related complications and reduces costly hospital transfers. In other words, SNFs that prioritize early evaluation improve safety and outcomes while avoiding preventable expenses.
Testing Methods, Costs, and Building a Program
Most facilities use a mix of bedside swallow evaluations, Modified Barium Swallow Studies (MBSS), and FEES. Bedside assessments are inexpensive and quick but prone to missed diagnoses, especially with silent aspiration. MBSS, sometimes referred to as videofluoroscopic swallow studies, provides detailed imaging but requires transporting residents to a hospital, exposing them to radiation and creating logistical challenges. FEES can be completed at the bedside, avoiding transport and radiation while delivering accurate, real-time results. FEES is often the most practical option for nursing facilities, and a guide for providers reinforces that while both MBSS and FEES have strengths, FEES is more accessible for residents in SNFs.
Costs are another important consideration. A study on post-stroke dysphagia shows the long-term financial burden of untreated swallowing disorders, highlighting why timely testing is ultimately less expensive than dealing with complications. On-site FEES, in particular, reduces hospital transfer costs and lowers the risk of rehospitalization. For many facilities, it is a cost-effective and clinically safer choice.
Forward-thinking SNFs are going beyond occasional testing and creating structured dysphagia management programs. These programs not only improve resident safety and quality of care but can also positively affect reimbursement. Facilities that establish these programs often begin by partnering with mobile FEES providers or investing in staff training, while also developing clear referral pathways and outcome-tracking systems. Over time, the benefits extend from safer residents and smoother workflows to stronger compliance and financial stability.
Ultimately, dysphagia will always be a concern in long-term care, but complications do not need to be inevitable. By investing in on-site FEES testing, and building structured dysphagia management into their operations, skilled nursing facilities can create safer environments, reduce avoidable costs, and deliver care that truly protects their residents.
Take the Next Step in Improving Care
If your facility is exploring ways to strengthen care with on-site dysphagia testing, our team at DiagnosTech can help. Contact us today to learn how we support skilled nursing facilities in implementing accurate, cost-effective testing and building programs that improve outcomes for every resident.
