The Nursing Home Reform Law presently requires that all nursing or “nursing related” services be performed either by licensed personnel (nurses, therapists, etc.) or by certified nurse aides.  But the Center for Medicare/Medicaid Services (CMS) nonetheless is preparing regulations that will authorize unlicensed and uncertified “feeding assistants” to assist residents with eating.

         Many long-term care advocates feel that the regulations, which CMS says it will publish in final form September 26, will be far too weak to ensure safe care by feeding assistants and will be a dramatic step backwards in staffing quality.  The federal nurse assistant training requirements – a minimum of 75 hours of training – help maintain some semblance of quality of care in nursing facilities.  We need more training, not less, to improve the care provided to nursing facility residents.

         The proposed regulations present a false choice, suggesting that an increase in staffing can only be accomplished if training requirements are slashed.

          In fact, there are legal, safer alternatives nursing homes can use now to enable nursing assistants to spend more time with residents during meals; moreover, there is every indication that the proposed regulations would reduce training requirements without increasing staffing.  A facility is likely to use “feeding assistant” regulations as justification for feeding to be done by untrained personnel  (perhaps even office employees or maintenance or housekeeping staff), or simply to replace some certified nursing assistants with feeding assistants. 

        Your help is needed to document the hazards residents face when they are fed by untrained, poorly trained, or poorly supervised workers.  

Are you aware of nursing homes that use feeding assistants?  If so, can you relate any experiences residents have had with them?  If so, please contact Janet Wells at the National Citizens Coalition for Nursing Home Reform  ( [email protected] or 202/332-2275 ) if you are aware of instances in which problems occurred in the feeding of a nursing facility resident, whether the feeding was done by a nurse, a nurse aide, volunteer, or someone else.  It would be helpful if the resident (or the resident’s representative) would be willing to talk to NCCNHR about his or her experiences.

        Your examples can illustrate that feeding is not simply a matter of putting a spoon in a resident’s mouth.  Feeding can be a much more complicated matter, and serious problems arise if feeding is done improperly.