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Nearly four years after the Centers for Medicare & Medicaid Services first published a final rule allowing nursing homes to use paid feeding assistants, the agency is adding to it.

The new surveyor guidance on paid feeding assistants, F-Tag 373, highlights areas that inspectors should focus on during surveys, including whether assistants have completed state-approved training and whether the facility has record of it. Surveyors also are instructed to investigate whether feeding assistants are being properly supervised, and whether appropriate residents have been chosen to receive their help.

The new guidance is expected to be published Sept. 28, according to a memo sent to state survey agency directors by Thomas Hamilton, the director of CMS’s Survey and Certification Group.