The ability of the clinical dysphagia examination to identify patients who aspirate and to determine specialized diet management has been suspect. In long-term care, however, the clinical examination can be the only assessment procedure available to clinicians. Cervical auscultation with stethoscope was incorporated into the clinical examination for dysphagia in an attempt to enhance the clinical examination's ability to detect aspiration and to determine specialized diet management in long-term care. Comparison of the clinical examination's results with results from videofluoroscopy revealed significant agreement in both areas. Results support the use of cervical auscultation as a highly sensitive and specific method of dysphagia assessment in long-term care.