A mail questionnaire surveyed Arizona hospital dietary departments to reveal the most frequently initiated changes in dietary practice since the implementation of Diagnostic Related Groups (DRGs). The most frequently initiated change was remodeling the service/cafeteria areas to increase consumer appeal and subsequent sales. Fee-for-service nutrition was the tenth most frequently initiated change. Non-subsidized employee feeding was the second least frequently initiated change since DRGs. Hospital size was found to correlate significantly (alpha ≥ 05) with innovative management, development of DRG avenues of recovery, purchase of computers, development of clearly defined treatment plans, utilization of time studies and staffing, and the implementation of corporate wellness programs. Only a few hospitals have determined costs for DRG dietary treatments, or know standard length of stay for each DRG. The number of dietitians documenting services and patient outcome must increase or their cost effectiveness may never be known.