Washington, D.C. — Federal regulators are pushing healthcare facilities to clean up what they serve patients — and nursing home operators say the new guidance is headed their way too.
The Centers for Medicare & Medicaid Services sent a memo to hospitals in late March directing them to overhaul their menus in line with the updated 2025–2030 Dietary Guidelines for Americans. The guidance, championed by HHS Secretary Robert F. Kennedy Jr. and CMS Administrator Mehmet Oz, calls for eliminating ultra-processed foods, sugary drinks, and refined carbohydrates — replacing them with whole grains, lean proteins, vegetables, and minimally processed ingredients.
“For too long, we have treated the food served in hospitals as an afterthought,” Oz said during a press conference in Florida. “The food is bland, it’s poorly prepared, and it’s lacking nutrients of the nature that you actually need for a full recovery.”
What the guidelines require
The CMS memo lays out specific expectations: meals with less than 10 grams of added sugar per serving (unless clinically appropriate), no deep-fried options, no processed deli meats, and no sugary beverages. Sample swaps include trading sugary cereal for steel-cut oats with berries and flavored yogurt for plain, unsweetened varieties.
The agency framed the change as a reinforcement of existing Medicare Conditions of Participation — not new mandates. But facilities that don’t meet current standards can still face enforcement action under existing rules, according to the Michigan Health & Hospital Association.
Nursing homes operate under their own CMS dietary regulations, and industry reports say the administration’s MAHA-driven nutrition push is expected to ripple into long-term care settings. Like hospitals, nursing homes rely heavily on Medicare and Medicaid funding and are subject to federal dietary compliance standards under Section 483.60.
Operators are paying attention
For many skilled nursing facilities, the shift won’t be simple. Nursing home residents often have complex dietary needs — dysphagia, diabetes, renal disease, and other conditions that require tailored menus. Dietitians and food service directors say the spirit of the new guidelines aligns with good clinical nutrition, but implementation will take planning and, in some cases, vendor changes.
The cost concern is real too. Rural facilities and those already squeezed by Medicaid underfunding may struggle to absorb the transition. Oz argued the cost increase is “about 5% — a trivial rounding error” — but operators say that math doesn’t always hold at scale.
The federal dietary push adds another layer to an already complex compliance environment. Nursing home administrators who’ve been navigating CMS’s evolving inspection and oversight strategy say they’re bracing for further guidance on how the new food standards will apply specifically to long-term care.
Public comments on how the dietary guidelines should apply beyond hospitals are expected to come through later this year.
