Wisconsin’s Feeding Assistant Training Program Requirements
– Status Update
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BQA 03-016 (PDF, 125 KB)
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DATE: December 29, 2003 DSL-BQA-03-016
TO: Nurse Aide Training Programs NATP - 05, Nursing Homes NH
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FROM: Susan Larsen, Interim Chief, Caregiver Regulation and Investigation Section
Via: Michael J. Steinhauer, Resident Care Review Section,
Bureau of Quality Assurance; Susan Schroeder, Director, Bureau of Quality Assurance
Cross Reference: BQA-01-049, BQA-01-033, BQA-01-022, BQA-00-066
Federal Feeding Assistant Regulations
On September 26, 2003, the Centers for Medicare and Medicaid Services (CMS)
published the final rule for Requirements for Paid Feeding Assistants in Long
Term Care Facilities in the Federal Register. These regulations allow States to
develop program requirements for nursing homes to hire trained feeding
assistants to help residents without complicated feeding problems to eat and
drink. CMS no longer considers the kind of tasks a feeding assistant may perform
as "nursing or nursing-related" duties. Nursing homes have been
required to rely on nurse aides or other health care professionals to assist
residents with eating and drinking. Volunteers and
family members are also allowed
to assist with these tasks. As a result of these new
federal regulations, the Department is no longer required to phase out single
task workers in Wisconsin’s nursing homes.
CMS changed their regulations due to continued reports of nurse aide
recruitment and retention difficulties. Also, the increasing number of assisted
living facilities providing care to individuals with minimal medical needs has
resulted in a more frail nursing home population. This population is more
dependent on nursing staff for basic needs, such as feeding and personal care.
CMS agrees that some nursing home residents only need encouragement or minimal
assistance with feeding, which does not require nurse aide training.
The federal feeding assistant regulations require the successful completion
of a State-approved training course of at least eight hours, and the use of
feeding assistants must be consistent with State law. It is expected the feeding
assistants will relieve some of the pressure on nurses, nurse aides and other
staff, by allowing them more time to provide more complex tasks such as bathing,
toileting and changing dressings.
Wisconsin Feeding Assistant Training Program Development
Wisconsin's "single task worker" model is frequently referenced in
the CMS rule. However, in analyzing the federal feeding assistant requirements,
BQA has determined there are many areas where the federal training and
employment requirements vary from protocols established under Wisconsin's single
task worker program.
As Wisconsin is considered the pioneer on this issue and other states are
watching closely, BQA has reconstituted the previous "Single Task Worker
Workgroup" established several years ago to discuss single task worker,
workforce recruitment and retention issues. This workgroup includes
representatives from BQA, for profit and not-for-profit nursing homes, workforce
associations, the Board on Aging and Long Term Care Ombudsman Program, the
Department of Public Instruction, the Department of Workforce Development and
the Wisconsin Technical College System. The workgroup has reviewed and compared
the previously established single task worker policies and procedures to
determine recommendations for Wisconsin’s feeding assistant program
requirements, such as:
- Minimum training requirements
- Testing requirements
- Instructor qualifications
- Resident population
- Grandparenting of current single task workers
- Training transportability
The workgroup has met several times to review, discuss and provide feedback
to BQA regarding these issues.
Interim Phase
When Wisconsin’s feeding assistant requirements are finalized and approved,
BQA will issue a memo detailing the training and testing requirements; a
formalized program application process; employment requirements; and survey
protocols. It is anticipated this detailed memo will be released in early 2004.
BQA is not yet accepting new applications for feeding assistant training
programs. Nursing homes previously approved by BQA to utilize single task
workers may continue to do so. The Bureau has compiled a list of providers with
such approval. In the course of a routine survey, if a single task issue arises,
surveyors will check with the Regional Field Office Director (RFOD) to determine
whether the facility has been approved. Facilities that are not currently
approved for single task workers should not use such workers for unapproved
duties. In this interim phase, BQA will conduct business as usual including
annual surveys, complaint investigations, verification visits, etc.
If you have further questions at this time, please contact Susan Larsen,
Caregiver Regulation and Investigation Section at (608) 243-2084.
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