As part of a larger study that investigated the social, cultural, clinical, and environmental factors that influenced nutritional intake in two proprietary nursing homes, 82 of 100 residents who were not eating well received a bedside dysphagia screening evaluation by a speech pathologist. This article reports on the dysphagia evaluation results and the consequences of swallowing disorders for nursing home residents. Forty-five of the 82 residents (55%) had some degree of dysphagia, ranging from mild to profound, but only 10 of these 45 residents (22%) had been referred for a dysphagia evaluation. Unrecognized and unmanaged dysphagia may lead to dehydration, malnutrition, aspiration pneumonia, and asphyxiation. Assessment and management of dysphagia also are discussed.