TIP OF THE WEEK

Dining assistance program – F Tag 373

 

Effective September 28, 2007, surveyors will be using the guidance for F-tag 373 to evaluate paid feed assistance in nursing homes. A final copy of this new guidance will be available at http://www.cms.hhs.gov/Transmittals/. The paid feeding assistant regulation provides the foundational requirements to ensure that the appropriate nursing home residents receive safe care that includes the services of a paid feeding assistant.

 

If a state elects to implement this requirement, it must provide a state-approved training course and an approval program for paid feeding assistant training programs. The federal requirements (§483.160) for training of paid feeding assistants are a minimum of 8 hours of training in the following:

• Feeding techniques.
• Assistance with feeding and hydration.
• Communication and interpersonal skills.
• Appropriate responses to resident behavior.
• Safety and emergency procedures, including the Heimlich maneuver.
• Infection control.
• Resident rights.
• Recognizing changes in residents that are inconsistent with their normal behavior and the importance of reporting those changes to the supervisory nurse.

In order for a facility to participate in this program, they must follow these five aspects:

1. State-approved training course – Training for the paid feeding assistant must be provided through a state-approved training program by qualified professionals as defined by state law, with a minimum of eight hours of training.
2. Resident selection – A facility must ensure that a feeding assistant feeds only residents who have no complicated feeding problems including, but are not limited to, difficulty swallowing, recurrent lung aspirations, and tube or parenteral/IV feedings. The facility must base resident selection on the charge nurse’s assessment and the resident’s latest assessment and plan of care.
3. Supervision by an RN or LPN -- Regardless of where a resident is being assisted to eat or drink, in the case of an emergency, the facility needs to have a means for a paid feeding assistant to obtain timely help of a supervisory nurse. Therefore, for the purposes of this requirement, a “resident call system” includes not only the standard hard-wired or wireless call system, but also additional means for the paid feeding assistant and a supervisory nurse to communicate in an emergency situation.

    

   NOTE: Paid feeding assistants must work under the supervision of a registered nurse (RN) or licensed practical nurse (LPN). Therefore, if a facility has a nursing waiver, the facility cannot use paid feeding assistants when a licensed nurse is not available. Interview the paid feeding assistant who was observed assisting the selected resident to determine whether there are concerns with training, supervision or the selection of the resident.

4. Only assist residents who have no complicated feeding problems – This includes residents who may be at risk for unplanned weight loss and dehydration, have no complicated problems associated with eating or drinking, cannot or do not eat independently due to physical or cognitive disabilities, or need cueing or encouragement to eat. The use of paid feeding assistants is to supplement nursing assistants and not to substitute for licensed nursing staff.
5. Maintenance of records -- The facility must maintain information about how and where the paid feeding assistants received their training and have a list of those who are currently assisting selected residents with eating meals and/or snacks. The requirement does not prescribe specifically how the records should be maintained. However, these records should be available for all paid feeding assistants, both permanent and temporary.

Paid feeding assistants should be able to answer the following questions if asked:

1. What training did you successfully complete in providing feeding assistance?
2. What information did you receive about this resident's needs for assistance (type of assistance needed, any precautions)?
3. In what manner and by whom are you supervised while assisting residents?
4. What issues/problems do you report (such as coughing, choking, changes in the resident’s usual responses, or level of alertness) and to whom do you report?
5. What would you do if an emergency occurred while you were assisting a resident to eat or drink?
6. Who would you contact and how would you contact them if you are not near the resident call system?

These requirements do not apply to family and/or volunteers who may be providing the resident with assistance.

 

The Centers for Medicare & Medicaid Services (CMS) has responded that it is up to each facility to determine whether to require volunteers and family members to complete feeding assistance training. Ultimately, facilities are responsible for the care and safety of residents, even if a relative or friend feeds the resident.

 

More information:

• Download the rule (3701-17-07.2 – Dining assistants)
• Appendix

 

 

 

 

IN THE NEWS

 

NEW MEDICARE CHIEF PROMISES TRANSPARENCY, ACCOUNTABILITY

September 13, 2007 -- The Hill -- Centers for Medicare & Medicaid Services (CMS) acting Administrator Kerry Weems on Wednesday promised higher levels of transparency and accountability at his agency.

 

In a briefing with reporters Wednesday, one week after he took office, Weems vowed to make CMS’ operations and decision-making more public, to improve program management and to evaluate the agency’s relationships with health plans and other private contractors. Read more >>

 

BLACK U.S. RESIDENTS OFTEN RECEIVE POORER QUALITY NURSING HOME CARE THAN WHITES, STUDY FINDS

September 12, 2007 -- Kaiser Network -- Blacks in the U.S. are more likely to receive lower-quality nursing home care than whites, according to a study published in the September/October issue of the journal Health Affairs, CQ HealthBeat reports. Read more >>

 

CMS ANNOUNCES THE START OF PARTICIPANT RECRUITMENT FOR POST ACUTE CARE PAYMENT REFORM DEMONSTRATION

August 21, 2007 -- Rural Assistance Center -- The Centers for Medicare & Medicaid Services (CMS) announced the start of participant recruitment for the Post-Acute Care Payment Reform Demonstration (PAC-PRD). Participating providers include acute care hospitals and four post-acute care (PAC) settings -- Long Term Care Hospitals (LTCHs), Inpatient Rehabilitation Facilities (IRFs), Skilled Nursing Facilities (SNFs), and Home Health Agencies (HHAs). Read more >>

 

ALZHEIMER'S ASSOCIATION RELEASES DEMENTIA CARE PRACTICE RECOMMENDATIONS FOR END-OF-LIFE CARE

August 31, 2007 -- Medical News Today -- The Alzheimer's Association released its third set of Dementia Care Practice Recommendations for Assisted Living Residences and Nursing Homes. The Recommendations focus on improving the end of life experience for people with Alzheimer's disease and other dementias by offering concrete suggestions for addressing issues unique to people with dementia at the end of life. Read more >>

 

 

OHIO KEPRO EVENTS

 

Guidelines and Coding for Restraints Teleconference

Featuring Carla Brumby and Patsy Strouse, Ohio Department of Health

November 8, 2007 1:00 p.m. to 3:00 p.m.

Dial-in: 1.877.339.0018, Conf ID: *4477925*

Download the Flyer (PDF)

 

 

INDUSTRY EVENTS

 

Together We Make a Difference: Solutions for Senior Care 2007
October 5-7, 2007, Columbus Ohio
The conference features plenary sessions and didactic sessions on medical direction, physician-nurse practitioner collaboration, urinary incontinence, atrial fibrillation, appropriate medication prescribing, and the latest diabetic medications (Registration ends Sept 28, 2007). Contact Catherine Austin at (216) 778-8087, Executive Assistant of OMDA, for more details.

 

Medicare Learning Network:
Learning resources and products for the healthcare professional.

 

Alzheimer’s Association Training Events

 

AOPHA Events

 

Case Western Reserve University School of Medicine Courses

 

Ohio Department of Health, Technical Assistance Program – New Programs

 

Ohio Health Care Association Events

 

 

 

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