This week’s “Ftag of the Week” on the CMSCG Blog is F811 Feeding Assistant training, supervision and resident suitability to be assisted with eating by a paid feeding assistant. Our last Ftag of the Week was F948 Training for Feeding Assistants, so this week we will look more in-depth at this associated Ftag. F811 is part of the Food and Nutrition Services regulatory group, while F948 is part of the Training Requirements Regulatory Group, and there are additional requirements at F811.
Facilities are permitted to use paid feeding assistants under certain circumstances. First, feeding assistants must have completed a State-approved training course that includes certain topics, such as feeding techniques, communication and interpersonal skills, how to respond to resident behaviors, and safety and emergency procedures. Existing facility employees, such as administrative or housekeeping staff, may be feeding assistants, but they are still required to complete the training course. The facility is responsible for maintaining a record of all individuals who have successfully completed the training course.
Paid feeding assistants can only provide dining assistance to residents who do not have complicated feeding problems, as documented in the resident’s most recent assessment and care plan. A facility is responsible for following resident selection criteria included in the regulation. Feeding assistants must be supervised by a Registered Nurse (RN) or Licensed Practical Nurse (LPN), who needs to be available when the assistants are working and able to assist in the event of an emergency. Feeding assistants are responsible for calling the supervisory nurse in an emergency situation. The Interpretive Guidance (IG) clearly states that facilities with a waiver in place and do not have an RN or LPN available in the building may not use paid feeding assistants during that time. The supervisory staff, per the IG, needs to be located close enough to the resident to assist if the paid feeding assistant notifies them of an emergency. The licensed nurses supervising the paid feeding assistants are to monitor for use of appropriate feeding techniques, if the resident’s eating and drinking needs are being followed, if the assistant is maintaining resident rights and dignity, as well as ensuring safety and infection control practices are maintained.
Surveyors can use observation and record review to identify issues related to training, supervision and appropriate assessment and selection of residents. They will couple those with resident and family interviews, if needed. Issues identified with supervision and appropriateness of residents for feeding assistance can be cited under this tag, but training requirements will be cited at F948, as we mentioned under that blog post. You also need to remember that while the facility is responsible for ensuring the safety and care of all residents, this regulation does not apply to family members or volunteers. While this regulation does not address family members or volunteers, it is a recommended practice to provide them with some training so that assisting the resident with eating is a safe and enjoyable time for all involved.