Nursing homes and other healthcare facilities must adhere to the requirements outlined in 42 CFR §483.60(h), which states that paid feeding assistants must complete a State-approved training course and work under the supervision of an RN or LPN. The training must include 8 hours of instruction in feeding techniques, assistance with feeding and hydration, communication and interpersonal skills, appropriate responses to resident behavior, safety and emergency procedures, infection control, resident rights, and recognizing changes in residents. Facilities must also maintain records of all individuals used as feeding assistants who have completed the training course. When determining whether a resident may be assisted by a paid feeding assistant, the interdisciplinary team must base their selection on the resident's latest assessment and plan of care. Complicated feeding problems, such as difficulty swallowing, recurrent lung aspirations, and tube or parenteral/IV feedings, are not permitted. Supervisory nurses must monitor the provision of assistance provided by paid feeding assistants and be available to respond in the case of an emergency. Existing staff, such as licensed nurses, certified nursing assistants, and other employees must also complete the State-approved training course if they are to be used as paid feeding assistants. To ensure compliance, nursing homes and other healthcare facilities must provide adequate supervision, maintain records of individuals who have completed training, and ensure that only eligible residents are assisted by paid feeding assistants.

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