Code of Federal Regulations 483.160 allows for paid feeding assistants in certified facilities in Missouri. The paid feeding assistant does not have to be a certified nurse assistant.

Federal regulations requires the feeding assistant to be taught certain topics. A State-approved training course for paid feeding assistants must include, at a minimum, 8 hours of training in the following:

  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 residents that are inconsistent with their normal behavior and the importance of reporting those changes to the supervisory nurse.

A facility must maintain a record of all individuals used by the facility as feeding assistants, who have successfully completed the training course for paid feeding assistants.

The following requirements may be met by utilizing the manual created by CMS or by using the identified unit and lesson plans from the current Nurse Assistant in Long Term Care Facility Manual, 2001 Revision. The classroom and On-the Job time requirements are recommended in the Nurse assistant in Long Term Care Facility Instructor Manual, 2001 Revision.

  • Federal Regulation Requirement-Feeding Techniques, Assistance with Feeding and Hydration and Safety and emergency procedures, including the Heimlich maneuver.

Unit IV: Food Service

Lesson Plan Classroom Instruction On-The-Job Training/Laboratory
1-Nutrition 60 min 0
2-Serving, Feeding, and Monitoring 45 min 105 min
3 Observing, Measure, and Record Fluid Intake and Output > 45 min 60 min
  • Federal Regulation Requirement-Communication and Interpersonal Skills

Unit I: The Nurse Assistant

Lesson Plan Classroom Instruction On-The-Job Training/Laboratory
11-Communication Skills 45 min 0
  • Federal regulation requirement-Appropriate Responses to Resident Behavior

Unit II: Understanding the Elderly

Lesson Plan Classroom Instruction On-The-Job Training/Laboratory
1 and 2-Needs and Behaviors of Residents 120 min 0
  • Federal Regulation Requirement-Infection Control

Unit III: Safety-Infection Control

Lesson Plan Classroom Instruction On-The-Job Training/Laboratory
3-Infection Control 60 minutes 60 minutes
4-Trasmission-based Precautions 60 minutes 120 minutes
  • Federal Regulation Requirement-Resident Rights

Unit 1: The Nurse Assistant

Lesson Plan Classroom Instruction On-the-Job Training/laboratory
4-Ethical and Legal Responsibilities-Resident Rights 90 0
  • Federal Regulation Requirement-Recognizing changes in residents that are inconsistent with their normal behavior and the importance of reporting those changes to the supervisory nurse.
Unit 1: The Nurse Assistant
Lesson Plan Classroom Instruction On-The-Job Training/laboratory
5-Human Anatomy and Physiology 90-120 minutes 0
6-Observing and Reporting 60 minutes 0

This training is broken into two aspects, part classroom and part on-the-job training or a laboratory setting, use whichever is most advantageous for you and your residents. You may adjust the on-the-job training hours according to class size. In other words, if you are training only one (1) or two (2) individuals, your practicum hours may be less than shown in the tables above. The entire training must be a minimum of eight (8) hours regardless of class size.

The facility must maintain a record of all employees used by the facility as paid feeding assistants. The record should include verification that they have successfully completed a State-approved training course for paid feeding assistants.

This regulation became effective September 28. 2007 and pertains only to certified facilities.

A licensed registered nurse must teach this short course. Also, keep in mind other relevant regulations are to be followed.