Some aged care homes are spending as little as just over $6 a day on food per person as experts warn malnourished residents are "starving to death".
Malnutrition has been labelled the "silent faceless abuser" in Australia's aged care sector, with celebrity chef Maggie Beer among those who argue there is not enough focus on providing food full of flavour, goodness and pleasure.
The best and worst of food has been discussed at the aged care royal commission, from filet mignon and salt-and-pepper squid at one facility to food returned to the kitchen being served up again.
Chefs spoke about being stuck with food budgets of $7-a-day per resident, compared to $17 at the other end of the scale.
An Australian study put the average at $6.08, which nutritionist Dr Sandra Iuliano noted fell short of the $8.25 spent in prisons.
It was almost impossible to meet someone's nutritional needs with $6 a day, the University of Melbourne academic told the commission's Cairns hearing on Tuesday.
Dr Iuliano said new aged care quality standards failed to focus on the resident, their needs and wants, or on giving them the best quality of life.
"Unless there is an incentive to actually get those systems in place, I think we're going to maintain the status quo which to me at the moment is not appropriate.
"It's inadequate because basically these residents are malnourished and they're starving to death."
Dr Iuliano said it was sad many residents had to rely on family members bringing in food to get foods and nutrition they wanted.
Dietitians Association of Australia CEO Robert Hunt said there was an epidemic in nutrition that must be elevated to the top of health prevention strategy.
"It has been tragic around what we've seen in terms of the safety of residents," he said.
"But for years and years and years this silent, faceless abuser called malnutrition has been around."
Chef Nicholas Hall said some aged care providers and third-party caterers talked about food satisfaction but were really focused on saving money.
"They're just racing to the bottom to see who can feed for the lowest amount of cost," he said.
Mr Hall recalled seeing a resident with dementia eating old food from the previous night off trolleys left outside a facility's kitchen, after food service attendants' hours were cut back.
"For an 80-bed residence when they are paying half a million dollars each to move in, they've got $40 million. And yet they're saving 50 bucks a shift and they've got $40 million of their money in the bank. It's just not right."
Mr Hall described having to cut corners by using frozen and processed foods at one facility with a $7.20 daily budget per resident.
"At the end of the meal if the resident was still hungry and they wanted more food, there was no more food to give them."
Beer, whose foundation runs masterclasses for aged care chefs, said a $7 budget was absolutely inadequate and $10.50 would be the minimum.
"Without the right budget for the right ingredients - you cannot make good food with bad ingredients," she said.
Beer said she felt terrible when she read letters from aged care residents and relatives detailing a litany of complaints about the food.
"It just breaks your heart because it doesn't have to be like that. It should never be like that."
Australian Associated Press