.63 Paid Feeding Assistants.

A. A facility may use a paid feeding assistant who has successfully completed a State-approved training course as described in §E of this regulation.

B. Supervision.

(1) A paid feeding assistant shall work under the supervision of a licensed nurse.

(2) In an emergency, when the resident is fed in the resident's room, a paid feeding assistant shall use the resident call system to call a supervisory nurse for help.

C. A nursing home that uses a paid feeding assistant shall ensure that the paid feeding assistant feeds only residents who do not have complicated feeding conditions including, but not limited to:

(1) Difficulty swallowing;

(2) Choking;

(3) Recurrent lung aspiration; or

(4) Tube or parenteral intravenous feedings.

D. Protocol. The nursing home shall develop a protocol for selecting residents who are appropriate for feeding by a paid feeding assistant. The nursing home shall select eligible residents based on the:

(1) Charge nurse's current assessment of the resident;

(2) The resident's latest Minimum Data Set (MDS) assessment; and

(3) The resident's plan of care.

E. State-Approved Training. A State-approved training course for paid feeding assistants shall consist of at least 8 hours of training that includes:

(1) Feeding techniques;

(2) Assistance with feeding and hydration;

(3) Communication and interpersonal skills;

(4) Appropriate responses to resident behavior;

(5) Safety and emergency procedures, including the Heimlich maneuver;

(6) Infection control;

(7) Resident rights;

(8) Recognizing changes in a resident's behavior that are inconsistent with the resident's normal behavior and the importance of reporting these changes to a supervisory nurse; and

(9) Successful completion of a two-part test that includes a:

(a) Written test with a passing score of 80 percent; and

(b) Demonstration of proper feeding skills performed on a resident while being observed.

F. The feeding assistant training may be taught by a:

(1) Registered nurse and supplementary professional instructors;

(2) Licensed dietitian-nutritionist;

(3) Licensed physical therapist;

(4) Licensed speech therapist; or

(5) Licensed occupational therapist.

G. The facility shall maintain a record of all paid feeding assistants who have successfully completed a feeding assistance course.