# COMAR Title 10 — Maryland Department of Health

## Subtitle 07 — Hospitals

### Chapter 02 — Nursing Homes

#### Regulation .63 Paid Feeding Assistants.

*COMAR 10.07.02.63*

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.