Section 350.682  Resident Attendants

a)         As used in this Section, "resident attendant" means an individual who assists residents in a facility with the following activities:

1)         eating and drinking; and

2)         personal hygiene limited to washing a resident's hands and face, brushing and combing a resident's hair, oral hygiene, shaving residents with an electric razor, and applying makeup.  (Section 3-206.03(a) of the Act)

b)         The term "resident attendant" does not include an individual who:

1)         is a licensed health professional or a registered dietitian;

2)         volunteers without monetary compensation;

3)         is a nurse assistant or DSP; or

4)         performs any nursing or nursing-related services for residents of a facility. (Section 3-206.03(a) of the Act)

c)         A facility may employ resident attendants to assist the DSPs with the activities authorized under subsection (a).  The resident attendants shall not count in the minimum staffing requirements under this Part. (Section 3-206.03(b) of the Act)

d)         Each person employed by the facility as a resident attendant shall meet the following requirements:

1)         Be at least 16 years of age; and

2)         Be able to speak and understand the English language or a language understood by a substantial percentage of the facility's residents.

e)         Resident attendants shall be supervised by, and shall report to, a nurse.

f)         The facility shall develop and implement policies and procedures concerning the duties of resident attendants in accordance with this Section, and shall document such duties in a written job description.

g)         As part of the comprehensive assessment, each resident shall be evaluated to determine whether the resident may or may not be fed, hydrated or provided personal hygiene by a resident attendant.  The evaluation shall include, but not be limited to, the resident's level of care; the resident's functional status in regard to feeding, hydration, and personal hygiene; the resident's ability to cooperate and communicate with staff.

h)         A facility may not use on a full-time or other paid basis any individual as a resident attendant in the facility unless the individual:

1)         has completed a Department-approved training and competency evaluation program encompassing the tasks the individual provides; and

2)         is competent to provide feeding, hydration, and personal hygiene services. (Section 3-206.03(c) of the Act)  The individual shall be considered to be competent if he/she is able to perform a hands-on return demonstration of the required skills, as determined by a nurse.

i)          The facility shall maintain documentation of completion of the training program and determination of competency for each person employed as a resident attendant.

j)          A facility-based training and competency evaluation program shall be conducted by a nurse and/or dietician and shall include one or more of the following units:

1)         A feeding unit that is a maximum of five hours in length, that is specific to the needs of the residents, and that includes the anatomy of digestion and swallowing; feeding techniques; developing an awareness of eating limitations; potential feeding problems and complications; resident identification; necessary equipment and materials; resident privacy; hand washing; use of disposable gloves; verbal and nonverbal communication skills; behavioral issues and management techniques; signs of choking; signs and symptoms of aspiration; and Heimlich maneuver;

2)         A hydration unit that is a maximum of three hours in length and that includes the anatomy of digestion and swallowing; hydration technique; resident identification; necessary equipment and materials; potential hydration problems and complications; verbal and nonverbal communication skills; behavioral issues and management techniques; use of disposable gloves; signs of choking; signs and symptoms of aspiration; hand washing; and resident privacy;

3)         A personal hygiene unit that is a maximum of five hours in length and includes oral hygiene technique, denture care; potential oral hygiene problems and complications; resident identification; verbal and nonverbal communication skills; behavioral issues and management techniques; resident privacy; hand washing; use of disposable gloves; hair combing and brushing; face and hand washing technique; necessary equipment and materials; shaving technique.  (Section 3-206.03(d) of the Act)

k)         All training shall also include a unit in safety and resident rights that is at least five hours in length and that includes resident rights; fire safety, use of a fire extinguisher, evacuation procedures; emergency and disaster preparedness; infection control; and use of the call system.

l)          Each resident attendant shall be given instruction by a nurse or dietitian concerning the specific feeding, hydration, and/or personal hygiene care needs of the residents whom the attendant will be assigned to assist.

m)        These programs must be reviewed and approved by the Department every two years. (Section 3-206.03(d) of the Act)

n)         Training programs shall not be implemented prior to initial Department approval.

o)         Application for initial approval of facility-based and non-facility-based training programs shall be in writing and shall include:

1)         An outline containing the methodology, content, and objectives for the training program.  The outline shall address the curriculum requirements set forth in subsection (j) for each unit included in the program;

2)         A schedule for the training program;

3)         Resumes describing the education, experience, and qualifications of each program instructor, including a copy of any valid Illinois licenses, as applicable; and

4)         A copy or description of the tools that will be used to evaluate competency.

p)         The Department will evaluate the initial application and proposed program for conformance to the program requirements contained in this Section.  Based on this review, the Department will:

1)         Grant approval of the proposed program for a period of two years;

2)         Grant approval of the proposed program contingent on the receipt of additional materials, or revisions, needed to remedy any minor deficiencies in the application or proposed program, which would not prevent the program from being implemented, such as deficiencies in the number of hours assigned to cover different areas of content, which can be corrected by submitting a revised schedule or outline; or

3)         Deny approval of the proposed program based on major deficiencies in the application or proposed program that would prevent the program from being implemented, such as deficiencies in the qualifications of instructors or missing areas of content.

q)         Programs shall be resubmitted to the Department for review within 60 days prior to expiration of program approval.

r)          If the Department finds that an approved program does not comply with the requirements of this Section, the Department will notify the facility in writing of non-compliance of the program and the reasons for the finding.

s)         If the Department finds that any conditions stated in the written notice of non-compliance issued under subsection (r) have not been corrected within 30 days after the date of issuance of the notice, the Department will revoke its approval of the program.

t)          Any change in program content or objectives shall be submitted to the Department at least 30 days prior to program delivery.  The Department will review the proposed change based on the requirements of this Section and will either approve or disapprove the change.  The Department will notify the facility in writing of the approval or disapproval.

u)         A person seeking employment as a resident attendant is subject to the Health Care Worker Background Check Act (Section 3-206.03(f) of the Act) and Section 350.681, and to Section 3-206.04(a) of the Act and Section 350.670(e).

(Source:  Amended at 46 Ill. Reg. 10519, effective June 2, 2022)