Re-Creative Resources
By Kimberly Grandal, CTRS, ACC, Executive Director
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Ms. Kimberly Grandal,
Founder and Executive
Director of Re-Creative
Resources, Inc., is a
strong advocate for the
field of Therapeutic
Recreation, with over
fifteen years of
experience working with
the elderly in numerous
administrative and
consultant positions. She
is an Activity Consultant
Certified by the National
Certification Council for
Activity Professionals
(NCCAP), and a Certified
Therapeutic Recreation
Specialist by the National
Council of Therapeutic
Recreation Certification.

Ms. Grandal is a recipient
of the Kessler Institute of
Rehabilitation 1997
Triumph of the Human
Spirit Award. She is a
speaker for various state
and local activity
associations, colleges,
and community groups,
and provides educational
workshops and
consultation to long-term
care facilities in
New Jersey.
Providing Internet Resources
for Activity Professionals
in Long Term Care Settings

Copyright 2004-Present
The Activity Director's Office
All Rights Reserved

Activities: Now’s the Time to Advocate and Educate!
By Kimberly Grandal, CTRS, ACC
Executive Director, Re-Creative Resources, Inc

In January, 2007, I had the wonderful opportunity to give a presentation for the New
Jersey Society of Nursing Home Administrators. The session was entitled: “F248
Activities: Conquering the Challenge of the Revised Guidance to Surveyors.” There were
over 60 health-care professionals in attendance, most of which were Administrators.
Other professionals included CEO’s, Activity Directors, Directors of Nursing, and Staff
Educators. The evaluations indicated that the session was well-received, interesting, and
very informative.

It is vital for Activity Professionals to educate others about the revised F248 Activity
Guidance to Surveyors, as well as the role and importance of meaningful activity. The
focus of my session included an overview of the revised interpretive guidelines for F248
as well as a variety of strategies that may be used to offer a well-balanced program of
activities.  Such strategies included: interdisciplinary, staffing, programming, and

I placed a great deal of emphasis on an interdisciplinary approach to quality of life and
the potential Ftags related to activities. Through leisure awareness and team building
activities, the participants learned that all facility staff is responsible for providing
meaningful activities to the residents. Brainstorming offered opportunity for numerous
department-specific quality of life strategies and ways to communicate residents’
interests and needs.

Another area reviewed was staffing. Appropriate staffing in Activity Departments across
the country is often a topic of great concern for Activity Professionals. Unfortunately, not
all states have mandatory staff to resident ratios for resident activities, and even those
that do, may be considered bare minimum. Depending on the needs and acuity levels of
the residents, I recommend that facilities aim to having two full-time activity personnel per
45-60 beds unit. For some of you, this sounds like a dream, but many facilities in NJ have
this type of staffing. I also recommend that facilities hire a separate Volunteer
Coordinator who works with the Activity Director. Volunteers play an instrumental role in
offering a vast array of activities and services, ranging from religious/spiritual needs,
cultural/language considerations, gender, and age-related needs.

In my session, I also discussed various programming strategies and recommendations.
Environmental considerations included benefits of a therapeutic environment and sample
therapeutic environments such as SNOEZELEN or multi-sensory environments,
neighborhoods, Eden Alternative, and reminiscence environments. Other significant
programming strategies included: parallel programming, small group programs, one to
one interventions, Resident Council, adapting activities and adaptive equipment.

Lastly, the session included a variety of documentation strategies. Much discussion
revolved around the importance of activities within the comprehensive care plan. Other
topics covered included: population analysis, calendar analysis, resident satisfaction
surveys, quality of life audits, care planning, assessment, attendance records, progress
notes and the development of a system that communicates residents’ activity needs and

Whether it’s at a state convention, local group, within your facility, etc. get out there and
educate anyone and everyone about the role and benefits of activities. Many health-care
professionals just do not know the full extent of what we do and why we do it. Contact
your local Administrators’ Association, Social Services, Volunteer Ombudsman Programs,
etc. You may even try to incorporate mandatory annual activity in-services at your
facility. So go ahead and take the challenge: Advocate and educate! If you are
interested in speaking on this subject but just don’t have the time to organize the
material, contact Kimberly Grandal.

For those of you in the tri-state area, I will be offering this session again at the New
Jersey Activity Professionals Association Convention on March 30, 2007
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