Implementing a screening protocol for food insecure patients within a long-term acute care hospital (LTACH): A community health needs assessment (CHNS)

Food insecurity is a prevalent yet overlooked issue within the inpatient setting. Despite food insecurity being predictive of poor health outcomes and increased hospital readmission rates, the development of efficient screening protocols remains a gap in care for high-risk, hospitalized patients. As part of a community health needs assessment (CHNA), a screening protocol for food insecurity has been implemented within a long-term acute care hospital (LTACH). This is a multistep protocol in which each newly admitted patient is asked pertinent questions related to food insecurity during the initial nutrition consult, led by a registered dietitian, followed by dissemination of a nutrition-resource packet upon positive screening. The packet includes a registry of county-based community nutrition resources and samples of recommended oral nutrition supplements. Additionally, the interdisciplinary team is informed of positive food insecurity status during weekly rounding to facilitate appropriate coordination of care in preparation for patient discharge. During the first year of implementation, 2022-2023, an average 95% of identified food insecure LTACH patients per the CHNA screening protocol were provided the appropriate nutrition-related resources during admission. This was improved upon from 2023-2024 as 100% of LTACH patients identified as food insecure received appropriate CHNA nutrition resources. Further, 93% of food insecure patients captured from 2023-2024 reported living within geographical proximity, or within the same county as this healthcare facility. As this protocol continues to be refined, future considerations include embedding a brief, validated food insecurity questionnaire within the initial nutrition consult as well as tracking metrics related to protocol effectiveness.