“Pointing out cost savings may help convince administrators at post-acute care settings of the value of instrumental swallow studies.” -

Barnes, George. “The Case for Instrumental Assessments.” The ASHA Leader, 9 July 2023.

“These studies, which allow SLPs to observe the internal mechanisms of a patient’s swallow, are critical to accurate diagnosis—and thus treatment—of swallowing difficulties. Payers, however, often assume that bedside assessments provide the same level of clinical information and may not pay for instrumental studies.” -

Nanof, Tim, and Monica Sampson. “Instrumental Assessments: Importance, Value, and Payment.” The ASHA Leader, 8 Mar. 2022,

“The best available evidence suggests lack of efficacy of percutaneous endoscopic gastrostomy (PEG) feeding tubes in prolonging survival or preventing aspiration pneumonia among persons with advanced dementia.” -

Hwang, D. et al “Feeding Tubes and Health Costs Post Insertion in Nursing Home Residents with Advanced Dementia”. J Pain Symptom Manage. 2014 Jun; 47(6): 1116-1120.

“Patients that are not properly hydrated are at an increased risk for dehydration, malnutrition, electrolyte imbalance, sepsis, and/or a UTI. All 5 of those conditions equate for 78% of all 30 day re-hospitalizations.” -

Richard , T. (2018). Overcoming Objections in Ordering Instrumentals for the Assessment and Treatment of Dysphagia [Keynote Presentation]. Georgia Speech-Language Hearing Association Annual Convention.

“No bedside screening protocol has been shown to provide adequate predictive value for presence of aspiration.” -

O'Horo JC, Rogus-Pulia N, Garcia-Arguello L, Robbins J, Safdar N. Bedside diagnosis of dysphagia: a systematic review. J Hosp Med. 2015 Apr;10(4):256-65.

“Patients who aspirate have three times higher mortality than patients who do not aspirate.” -

Oh E, Weintraub N, Dhanani S. Can we prevent aspiration pneumonia in the nursing home? J Am Med Dir Assoc. 2004 May-Jun;5(3):174-9.