[Congressional Record (Bound Edition), Volume 147 (2001), Part 4]
[Extensions of Remarks]
[Page 5826]
[From the U.S. Government Publishing Office, www.gpo.gov]



 THE MEDICARE AND MEDICAID NURSING SERVICES QUALITY IMPROVEMENT ACT of 
                                  2001

                                 ______
                                 

                           HON. EARL POMEROY

                            of north dakota

                    in the house of representatives

                        Wednesday, April 4, 2001

  Mr. POMEROY. Mr. Speaker, today I join my colleague from Wisconsin, 
Representative Paul Ryan, in introducing legislation to allow certain 
non-certified resident assistants to continue to be employed by nursing 
facilities in North Dakota, Wisconsin, and up to 8 other states under a 
3-year demonstration project.
  For several years, nursing facilities in these and other states have 
relied upon single-task employees, specifically assistants who help 
their residents dine, to supplement professional nurse staffing levels 
and increase patient care. Unfortunately, the Health Care Financing 
Administration (HCFA) has given our states' facilities until August 31, 
2001 to discontinue the employment of feeding assistants. With the 
current national shortage in nursing facility employees, the loss of 
these valuable workers will further strain our nursing homes. 
Particularly as our elderly population increases in future years, we 
must ensure that nursing homes do not lose existing staff. Unless 
Congress acts, significantly fewer trained professionals will be 
available to ensure that nursing home residents can comfortably and 
safely enjoy their meals.
  In North Dakota alone, 40 percent, or two out of five, of the state's 
nursing facilities have had to deny new admissions in the past 12 
months due to staffing shortages. The state currently has 600 open 
positions for Certified Nursing Assistants (CNAs). While the North 
Dakota Long Term Care Association encourages all feeding assistants to 
become CNAs, many assistants are members of a contingent workforce and 
are not able to become CNAs due to physical or other limitations.
  I understand that certain consumer groups, patient advocates, and 
labor organizations have concerns regarding the continued employment of 
feeding assistants in long-term care facilities. I also believe, as do 
these organizations, that we must act during this Congress to address 
the nursing shortage in our nation, increase wages for certified and 
licensed nurse professionals, and improve the work conditions of these 
individuals. At the same time, I believe that moderate steps can be 
taken to address the reservations regarding feeding assistants without 
compromising the ability of nursing facilities to care for our nation's 
seniors.
  Specifically, I support efforts to allow only feeding assistants to 
continue to be employed by nursing facilities in a few states through a 
pilot project administered by the Department of Health and Human 
Services. Under such a program, these assistants augment staffing 
levels in a facility--they do not supplant professional nurses and are 
not counted toward any minimum staffing levels. Furthermore, these 
feeding assistants would have to complete a state-reviewed training and 
competency evaluation, and would only complete a limited number of 
tasks under onsite supervision by a licensed health professional. I 
believe that these safeguards, among others, would ensure the quality 
of care without obviating the need for CNAs and other nurse 
professionals in long-term care facilities.
  Mr. Speaker, I look forward to working with my colleagues this year 
to ensure that our nursing facilities have the staff and resources 
necessary to care for our families and friends in the years to come.

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