New York, NY: NYC Health + Hospitals/Carter announced it will offer Flexible Endoscopic Evaluation of Swallowing (FEES) to diagnose dysphagia, a swallowing disorder affecting 1 in 25 adults in the United States, according to the American Speech-Language-Hearing Association. In 2025, over 300 patients in Carter’s Long-Term Acute Care Hospital and another 100 patients across the system’s Post-Acute Care facilities had a dysphagia diagnosis. Dysphagia can be a symptom of several conditions, including amyotrophic lateral sclerosis (ALS), Parkinson’s disease, stroke, head and neck cancer, traumatic brain injury, and respiratory failure. For patients who require a tracheostomy and a ventilator, safe initiation of an oral diet is not possible without a swallowing test given the high risk for silent aspiration, when food or drink enters the airway without triggering any symptoms such as a cough. Access to in-house FEES testing in the Skilled Nursing Facility and Long-Term Acute Care Hospital settings is important for resident and patient quality of life, safety, and improving clinical outcomes. Carter administers the test onsite at the patient’s bedside which allows the assessment of swallowing without the use X-rays making it more convenient and efficient. The bedside evaluation also avoids unnecessary transport to the hospital and reduces the risk of infection.
A speech language pathologist performs the FEES test by inserting a small flexible endoscope through the patient’s nose and into the throat. The patient or resident consumes food or drink that has been colored green to improve visibility. Compared to other diagnostic tests for dysphagia, FEES is a more sensitive tool that provides a high-definition color video of swallowing function. If diagnosed, the patient receives an individualized care plan to manage dysphagia and decrease the risk of aspiration pneumonia, a serious infection caused by inhaling something other than air into one’s lungs.
“We are proud to be the first post-acute care facility in our health system to offer this important diagnostic test with dedicated in-house staff and equipment,” said NYC Health + Hospitals/Carter Chief Executive Officer Floyd R. Long, LNHA, MBA. “FEES empowers speech language pathologists to perform bedside evaluations independently, reducing the amount of staff needed to transport patients and residents to Radiology, and ensuring timely evaluations and faster transitions to oral diets, which positively impact the patient experience.”
“I’m passionate about helping patients swallow their favorite foods and drinks. Approximately 78% of LTACH patients with tracheostomy or ventilator support advanced to an oral diet after a swallow test and therapy in the last quarter of 2025,” said NYC Health + Hospitals/Carter Speech-Language Pathology Supervisor Lindsey Hall, MEd, CCC-SLP. “With FEES, we can make that number even greater! Special thanks to our Post-Acute Care leadership, Carter’s interdisciplinary team, and the health system’s Speech Language Pathology Council who made this new rehabilitative service possible for our patients and residents.”
