New Requirements for Feeding Assistants in Nursing Homes
Federal, state, and local laws heavily regulate nursing homes to ensure the best quality of life for our aged population. The Nursing Home Reform Act of 1987 sets forth specific requirements for the amount of time qualified professionals must devote to each resident, but recent staff shortages can potentially lead to improper care/endangerment of residents.
As is stands, direct-care employees are required to be licensed health professionals, or to complete 75 hours of training before undergoing a competency test. This training is supposed to help staff care for elders in the best way possible, but with a shortage of these professionals, it is harder and harder to provide that care. These shortages led to malnutrition and dehydration in some locations.
One proposed solution is to relax training requirements for assistants, allowing them to perform tasks such as feeding. The Centers for Medicare and Medicaid Service (CMS) passed new regulations that relax the training for certain employees — such as allowing homes to employ “feeding assistants” to lighten the workload for other staff members. These assistants are typically part-time workers — including students and retirees — and are paid minimum wage. They are required to meet these minimal requirements to work in nursing homes:
- Completion of an eight-hour state-approved training course
- Selection of residents to be fed must be conducted by a professional nursing staff
- Feeding assistants must work under the supervision of a registered nurse/licensed practical nurse
- Feeding assistants are not authorized to feed residents who have difficulty swallowing/other feeding issues
But the use of feeding assistants has sparked criticism among some elder law advocate groups, such as AARP. They feel the relaxed requirements will not solve the problem, and could even cause adverse effects. For some, it isn’t just putting a spoon in a resident’s mouth — they could still choke or experience aspiration, so it is important to know how to position the resident. Despite a few lawsuits, the court of appeals ruled in favor of the government, stating that “health care professionals” is an ambiguous enough term to allow the DHHS to authorize feeding assistants.
