Yves here. It says a lot about the US that this toothless HHS measure is controversial. Hospital and nursing home meals are often abortions. Jello. Turkey in a white stripe with mayo. Spaghetti in red sauce. Iceberg lettuce often with orange dressing (not the sweet Japanese kind). The poor quality of hospital food is a great incentive to get healthy again.
It doesn’t have to be like that. The Hospital for Special Surgery had amazing food (and gave patients lots of options) and a friend who spent a month in the hospital here had excellent grub.
In my experience, US hospitals strongly encourage “nutrition shakes” Confirm. Ingredients label from Original Confirm:
And on the specific line about sugary drinks…what about fruit juices? They are actually very high in sugar but at least they have some nutrients.
Written by Stephanie Armour. Originally published on KFF Health News
Complaints about hospital food are certainly not new, and Jell-O and fruit juice are often the targets of related jokes. But the Trump administration recently upped the ante.
It urges the public to report hospitals and nursing homes that serve sugary drinks, nutrition shakes, or food it says does not meet dietary guidelines established last year by the US Department of Agriculture, with officials vowing to withhold millions of dollars in federal funding if violations occur.
An initiative by Health and Human Services Secretary Robert F. Kennedy Jr. sparking backlash from some doctors and medical providers who say we fail to account for the unique dietary needs of patients and are an embarrassment to Republicans who have long embraced an anti-regulatory stance.
It’s also unclear whether HHS has the regulatory authority to enforce its threat without going through a formal decision-making process, advocates and nutritionists say.
“A lot of this is a political arena. HHS doesn’t have the power to do much,” said Kevin Klatt, a nutritionist and research scientist who is an assistant professor at the University of Toronto. “Also, when it gets to the point where you’re trying to control people’s choices, you look a little authoritarian.”
The agency has sent notices to hospitals asking them to align their food purchases with the administration’s 2025-30 nutrition guidelines to ensure continued eligibility for Medicaid and Medicare payments, Kennedy said at a March 30 press conference.
“We will bring all the hospitals in the country to comply with good food,” he said, explaining these orders as “actually a mandate of the organization.”
“If a hospital is offering sugary drinks to patients, they are not in compliance with government standards and are jeopardizing their reimbursements,” Kennedy’s senior adviser Calley Means told X. “If you see patients being given sugary drinks, please post details below or notify CMS.”
The comment includes a link to an HHS webpage with a toll-free number to report complaints typically used for medical bills. Withholding federal funding from hospitals is one of the most powerful enforcement tools available to regulators, one the Centers for Medicare & Medicaid Services often uses.
Even providing liquid food products as a guarantee to patients can put hospitals at risk, it warns. “They have to change or lose their refund. Please report them if you see it,” he told X user.
Medicare and Medicaid, together, pay the most for hospital costs.
The notice came in the form of an update to “Conditions of Participation” issued by CMS to ensure that hospital patients’ meals comply with dietary guidelines, said HHS spokesman Andrew Nixon. “We commend the many hospitals that have committed to improving their food, and we expect all hospital systems to do so,” he said.
Means did not directly respond to requests for comment by KFF Health News, instead tweeting to X shortly after being contacted: “‘Trump Derangement Syndrome’ has led Democrats to defend the medical value of mass-feeding soda and junk food to America’s patients.” In a text with KFF Health News, he said, “That’s a quote if you want. I have no comment.”
Still, some administration officials have made it clear they won’t rule out suspending federal funding, a rare move that could jeopardize a hospital’s ability to stay open.
Carrot and Stick
HHS can withhold or threaten federal funding if hospitals violate basic health and safety standards set by the agency. The standards say hospitals must protect patient privacy, for example, and participate in infection control.
The standards address hospital nutrition, but do not explicitly refer to the 2025-30 dietary guidelines established by the USDA.
Instead, the standards require that “the dietary needs of each patient be met in accordance with recognized dietary practices,” and list other requirements for hospitals, such as access to a trained dietitian.
“CMS has never interpreted this requirement as mandating adherence to any set of dietary guidelines,” according to an April 13 brief from law firm Akin Gump Strauss Hauer & Feld.
The CMS memo indicates the agency is taking a “significant step” to incorporate dietary guidelines “into the hospital’s regulatory framework without creating new regulations,” according to the brief.
Hospitals are likely to comply because they don’t want to run afoul of the federal government and want to avoid a legal battle or Kennedy’s enforcement action, some lawyers said.
“He doesn’t have a legal basis to do this, but hospitals and nursing homes can’t ignore it completely because of what it indicates about possible enforcement actions,” said Nicholas Bagley, a law professor at the University of Michigan.
If federal funding was denied, hospitals could always sue to try to challenge HHS’s authority.
“If the agency goes to the hospital and says, We will forfeit your money for thisthe hospital can sue and say, Look, there’s no need to fry our fries with beef whatever,” Bagley said.
For hospitals seeking to comply, the agency’s memo provides examples of what should and should not be given to patients.
Food as Medicine
What the guideline calls “don’ts”: sugary drinks or juice. And “must dos”: water, unsweetened tea, milk, or coffee. Foods suggested in the memo include grilled salmon with quinoa or a bean-based meal with leafy greens.
Some dietitians have welcomed the focus on hospital nutrition for patients. Marion Nestle, a public health advocate and molecular biologist, praised the initiative, saying, “This sounds great!” in an April 8 post on his blog, Food Politics.
Some health leaders and doctors pushed back, noting that hospitalized patients often have individual nutritional needs that may not meet government dietary recommendations.
“For a patient who struggles to swallow just because of a stroke, salmon and quinoa are the worst thing for them.
Hospitals that neglect to provide certain standards of care, such as protein shakes to treat malnutrition or unhealthy weight loss, can open themselves up to potential legal action. Eighty percent of malnourished elderly patients gain weight and improve muscle mass on nutritional supplements such as Qinisekisa, according to clinical trial results published in Nutrición Hospitalaria, a peer-reviewed scientific journal.
Abbott, which makes Ensure, makes a variety of products including shakes for people “who may be malnourished due to treatment, such as chemotherapy, and not getting the calories they need because they don’t have a lot of food,” company spokesman John Koval said in a statement.
“It’s always a struggle to get people to eat. Hospital weight loss raises the risk of death,” said Mary Talley Bowden, a sleep medicine specialist, who often sides with Make America Healthy Again causes but criticized management’s failure to report X violations, writing: “Give me a break Calley. A hospital sewing line for soda?”
“It’s brutal,” he said in an interview.
The focus on hospital nutrition came in late March as part of Kennedy’s MAHA program, where he outlined changes to the organization’s dietary guidelines that emphasize protein and healthy fats while avoiding processed foods.
Kennedy is heavily dependent on his work to change eating habits, matching the MAHA gestalt and polling with both Democratic and Republican voters. Eighty-six percent of registered voters surveyed say it should be easy for every American family to get fresh fruits and vegetables, according to a survey released in September by Navigator Research.
