Philadelphia Mobile FEES, LLC

Fiberoptic Endoscopic Evaluation of
Swallowing Directly On-Site


Fiberoptic Endoscopic Evaluation of Swallowing

FEES is a safe instrumental swallow evaluation performed by a highly specialized speech-language pathologist.

Philadelphia Mobile FEES, LLC

Our Service

We provide Fiberoptic Endoscopic Evaluation of Swallowing (FEES) studies for dysphagia patients. This is a cost-effective alternative to Modified Barium Swallow Studies (MBS).

We Travel to You

Philadelphia Mobile FEES, LLC will travel to your skilled nursing facility, nursing home/long term care facility, subacute facility, LTACH, acute care or ENT offices to perform the FEES procedure, for one simple flat rate. We provide services in Philadelphia, and the surrounding areas.

Contact Us

Contact us today for additional information or to schedule a clinical in-service.

(215) 806-2481 |

What is dysphagia?

Swallowing has 3 phases, oral, pharyngeal and esophageal. Problems or difficulties in any or all of these phases is known as dysphagia.

1. Oral Phase

The oral phase involves acceptance of food or liquids, chewing and how a person moves the food or liquid into the throat.

2. Pharyngeal phase

The pharyngeal phase involves starting the swallowing reflex, squeezing food down the throat, and closing off the airway to prevent food or liquid from entering the airway (aspiration) or to prevent choking.

3. Esophageal Phase

The esophageal phase relaxing and tightening the openings at the top and bottom of the feeding tube in the throat (esophagus) and squeezing food through the esophagus into the stomach.


Aspiration is when food or liquid passes below the vocal folds and into the airway. Silent aspiration is the lack of sensory response (cough, throat clear, etc.) to aspiration. This can lead to pneumonia and respiratory complications.

  • 25-57% of aspiration occurs before the swallow
  • 7-9% aspiration occurs during the swallow
  • 44-65% aspiration occurs after the swallow
Silent Aspiration
  • 2,000 patients evaluated in study, 51% found to be aspirating on objective MBS study. 55% of those who aspirated had no cough reflex.
    • (Silent aspiration: results of 2,000 video fluoroscopic evaluations., Garon, Sierzant, Ormiston., 2009)
  • 67% of stroke patients of SLP caseload silently aspirate
    • (Daniels et al.,1998)
  • 2-25% of acute stroke patients silently aspirate
    • (Silent Aspiration : what do we know? Ramsey, Smithard, Karla. ,2005).
Prevalence of Dysphagia

Research varies

  • 22% in adults over 50
    • (Lindgren & Janzon, 1991; National Foundation of Swallowing disorders, n.d.; Tibbling & Gustafsson, 1991)(Lindgren & Janzon, 1991; National Foundation of Swallowing disorders, n.d.; Tibbling & Gustafsson, 1991)
  • 30% in elderly adults receiving inpatient medical treatment
    • (Layne, Losinski, Zenner, & Ament, 1989)
  • 68% of adults living in long-term care settings
    • (National institute on Deafness and Other Communication Disorders [NIDCD], n.d.; Steele, Greenwood, Ens, Robertson, and Seidman-Carlson, 1997)
  • 29-64% of stroke patients
    • (Barer, 1989; Flowers, Silver, Fang, Rochon, & Martino, 2013; Gordon, Hewer, & Wade, 1987; Mann, Hankey, & Cameron, 1999)
  • 13-57% in patients with dementia
    • (Alagiakrishnan, Bhanji, and Kurian, 2013)
  • 90% of patients with Parkinson’s or amyotrophic lateral sclerosis (ALS)
    • (Coates and Bakheit 1997)

What is FEES?

  • Developed by Susan Langmore, PhD, CCC-SLP in 1986.
  • Fiberoptic Endoscopic Evaluation of Swallowing (FEES) is an instrumental swallow evaluation completed by a specially trained speech-language pathologist (SLP). This study allows us to objectively evaluate swallowing physiology and detect penetration or aspiration that is commonly missed during bedside evaluations.
  • A flexible endoscope is introduced transnasally and advanced to view the pharyngeal and laryngeal structures and their functions. A small amount of food coloring is added to various food consistencies. The SLP evaluates swallowing function and presence or absence of penetration/aspiration. Compensatory strategies can be assessed in during the study without time constraints, since there is no exposure to radiation. Upon completion of the FEES the SLP can provide recommendations for safest diet level, compensatory strategies, and treatment plan.
A little more info about this photo
A little more info about this photo

Benefits of mobile FEES

  • View of pharyngeal and laryngeal structures in color. View of secretion management, vocal fold mobility and evidence of edema/erythema (redness and swelling).
  • Continuous recording with no limit on length of study which allows SLP to assess for fatigue factor.
  • Report with impressions, recommendations and treatment plan provided same day.
  • Efficacy of swallowing compensatory strategies trialed and assessed.
  • Improved quality of life
  • Reduced hospital readmissions!
  • Objective study allows for more confident diet initiation which will save money on:
    • Modified diets (pureeing/chopping foods, etc.)
    • Pre-thickened liquids and thickened liquid packets
    • Enteral feeds
    • Transport and readmissions to the hospital


MBS-Modified Barium Swallow Study

MBS or Videofluoroscopic Swallow Study is a radiologic examination of oral, pharyngeal, and esophageal phases of swallowing that uses x-ray. This test must be performed in a video-fluoroscopy suite of a hospital with a radiologist, radiology tech, and speech-language pathologist. The patient must be seated upright for the study and is given barium impregnated foods. The study is typically time limited to reduce the patient’s exposure to radiation. Recommendations for safest diet level can be made following the study.

Study is completed in patient’s own environment, allowing for natural positioning Study completed in radiology dept of hospital in upright chair
No size or position restrictions Width/weight restrictions depending on equipment.
Real food with food coloring Food mixed with barium- high toxicity rate if aspirated.
No time constraints or breaks in study allows for assessment of effects of fatigue on swallowing function Limited assessment time due to radiation exposure.
Save $ on transportation/escort costs. No radiology fee $500-$1000 for transportation cost, in addition to an escort, if needed.
Study can be scheduled quickly

Wait times of a week or more to coordinate scheduling

No lost therapy time while patient is out of the facility Patient out of facility for prolonged period.
Primary SLP able to be present for evaluation and contribute Unfamiliar therapist completing the study with limited information.

About the owner

April Cerogino, MS, CCC-SLP, is the founding owner and operator of Philadelphia Mobile FEES, LLC.

April attended LaSalle University - where she was able to build her framework and began to cultivate meaningful knowledge, deepen her understanding of working with and for others, and developed an extensive network within the Philadelphia speech pathology community. She participated in an intensive accelerated five year program for Speech, Language, and Hearing Science - successfully receiving her Bachelor's degree and ultimately her Master's degree in 2012. April holds a Certificate of Clinical Competence from the American Speech and Hearing Association (ASHA), and is licensed to practice in both Pennsylvania and New Jersey. April possesses dynamic experience in various clinical settings, including: outpatient, skilled nursing facilities, long term care, long term acute care hospitals/transitional care and acute care hospitals. April also has a diverse background in the patient populations she works with, inclusive of: tracheostomy/ventilator, dementia, neuro, trauma, etc. While working in the LTACH setting, she began to show a strong interest in the Fiberoptic Endoscopic Evaluation of Swallowing (FEES), and decided to pursue special training which would enable her to perform FEES in a clinical setting as well. In order to ensure the best possible service is being provided to the patient, April has collaborated with SEC Medical Speech Pathology Consulting & Training, who have over twenty years of experience, to enhance and develop Philadelphia Mobile FEES, LLC.

April's passion for helping others coupled with her knowledge of dysphagia is not only the foundation for Philadelphia Mobile FEES, LLC, but also what sets it apart from the rest. Prior to being trained in FEES, April experienced the obstacles of coordinating Modified Barium Swallow Studies in the skilled nursing facilities and LTACH settings. FEES provided a needed convenience for the patients and facilities, and quickly became the preferred method for dysphagia diagnostics. April's determination and commitment to simplify the delivery of dysphagia diagnostics to patients in need is what led to the establishment of Philadelphia Mobile FEES, LLC.

Schedule a FEES

You can schedule a FEES in just a few short steps.

  1. Once a contract is established between your facility and Philadelphia Mobile FEES, LLC, the SLP will recommend a FEES.
  2. A physician’s order must be obtained for the procedure.
  3. Obtain a consent form from the patient or POA (review an explanation of the FEES)
  4. Complete an intake form to provide us with as much information about your patient as possible
  5. Send an email to request an appointment, attach these documents in the email.

**If your facility does not have a contract with Philadelphia Mobile FEES, LLC please contact (215) 806-2481 or to set up a meeting or schedule a free inservice!