Proposed rules would create a new classification of paid nursing home workers who would be permitted to feed residents even though they had not completed 75 hours of training to become certified nurse assistants. 61 Federal Register 15,149 (Mar. 29, 2002). While acknowledging that residents have "more acute clinical conditions than in the past" and "need higher levels of medical care," the Centers for Medicare & Medicaid Services nevertheless concludes that the new category of "paid feeding assistants" could help some residents to eat.

The proposed rules would require states to approve training courses, but would not require competency evaluation of feeding assistants. They include no federal guidelines on the duration of training. The proposed rules also expressly exempt paid feeding assistants from federal rules requiring that states maintain registries of certified nurse assistants who are found to have abused or neglected a resident or misappropriated a resident’s property.

The states of Wisconsin and North Dakota have been using single task workers to feed residents for some years. Both states signed agreements with the Health Care Financing Administration in December 2000 stating that they would either require single task workers to get nurse aide training or require facilities to discontinue their employment. Those agreements are now in abeyance and single task workers are continuing to work in Wisconsin and North Dakota during the rulemaking process.

As a policy alternative, CMS considered requiring facilities to hire more nursing staff, including nurse aides. It rejected this alternative because of the higher cost and the continuing shortage of certified nurse assistants. 61 Fed. Reg., at 15,153.

Comments on the proposed rules must be submitted by May 28, 2002. For further information, please contact Toby S. Edelman in the Washington, DC office at tedelman@centerproject.org or (202) 293-5760.

© Center for Medicare Advocacy, Inc. 04/04/2008