Re-Creative Resources
By Kimberly Grandal, BA, CTRS, ACC, Executive Director
Join our Activity Director
Community message
board and network with
Activity Professionals
across the country. This
is a free service.
Be sure to subscribe to
Activity Director Today
E-magazine for the
latest news and more
about your profession.
Only $24.00/year
Providing Internet Resources
for Activity Professionals
in Long Term Care Settings

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

At Resident Shopping &
More you will find
clothing and more for
your residents.  
Also, you
will  find Activity
Department supplies
Activity Director
Novelties features
promotional materials
and gifts for you, your
residents, your facility
and your Department.
Be sure to visit.
Get promotional and gift
items customized.  Bob
creates your design and
makes it available for
you on
Activity Director
Novelties.  Buy as much
or little as you want.
(Design Fee $10.00)
Contact Bob
Activity Director
Excellent Resources for
Activity Professionals
Featuring supplies for
parties, holiday
celebrations  and
special events
Click Here
Executive Director
Re-Creative Resources
About Kim

Kimberly Grandal, Founder
and Executive Director of Re-
Creative Resources, Inc., is a
strong advocate for the field of
Therapeutic Recreation and
Activities, with over fifteen
years of experience working
with the elderly in numerous
management and consultant
positions.  She is an Activity
Consultant Certified and a
Certified Therapeutic
Recreation Specialist. Kim is a
member of the New Jersey
Activity Professionals
Association and the New
Jersey/Eastern Pennsylvania
Therapeutic Recreation

In 1990, Kim graduated from
William Paterson University
with a BA in Sociology and
later studied gerontology
courses at Union County
College and Therapeutic
Recreation courses at Kean
University. Throughout her
career, Kim has been the
Director of Therapeutic
Recreation for several long-
term care facilities, including
one of NJ’s largest.

In 2006, Kim founded Re-
Creative Resources Inc. She is
a speaker for various state and
local activity associations such
as NJAPA, MOCAP, and
NJACA, as well as the Society
of Licensed Nursing Home
Administrators of NJ. She also
offers lectures for Re-Creative
Resources Inc., local colleges,
and community groups, and
provides consultation and
support to numerous facilities
in the state.

Kim is the editor and writer for
the “The Rec-Room", a
monthly newsletter published
by her company. In addition,
she writes monthly articles for
the Activity Directors Office
newsletter, and has contributed
articles to Creative Forecasting
Magazine, and The
Continuing Care Insite

Kim is a recipient of the
Kessler Institute of
Rehabilitation 1997 Triumph
of the Human Spirit Award.  
Her passion is to promote the
field of Therapeutic
Recreation and Activities and
to unite Recreation Therapists
and Activity Professionals. Kim
currently serves on the NJAPA
board as the Chairperson for
the Legislation Committee.
Resources Inc.

Re-Creative Resources, Inc. is
committed to enhancing the
lives of long-term care
residents through the use of
Therapeutic Recreation. We
provide a variety of services
such as Therapeutic
Recreation seminars,
in-services, resources, form
development, program analysis
and development,
consultation, and support for
activity professionals and
recreational therapists. A
selection of downloadable
training materials and forms
are available for your
convenience as well as a free
job posting site.
An MDS 3.0 Overview for
and Recreation Therapists
By Kimberly Grandal BA, CTRS, ACC
Executive Director, Re-Creative Resources, Inc

The Centers for Medicare & Medicaid Services (CMS) held an Open Door Forum (ODF)
regarding the Minimum Data Set, Version 3.0 (MDS 3.0) in Baltimore, Maryland on
January 24, 2008 from 1:00 pm to 3:00 pm EST and reported on the findings of a 5-year
CMS Nursing Home MDS 3.0 Validation Study.

There are many advantages to the MDS 3.0 such as:

  • Increased  resident’s voice
  • Increased clinical relevance for assessment
  • Increased accuracy, both validity and reliability
  • Increased clarity and efficiency
  • 45% reduction in the average time for completion
  • Supports the movement of items toward future electronic formats

A section with significant revisions is the “Customary Routine and Activity Section”. The
customary routine staff assessment is replaced by the MDS 3.0 Preference
Assessment Tool. Residents are to be interviewed for their activity interests and routine
preferences. The residents are to rate the level of importance by using the following

  • Very important
  • Somewhat important
  • Not very important
  • Not important at all
  • Important, but can’t do or no choice
  • No response or non-responsive

Some of the questions to ask the residents include:

  • How important is it to you to have books, newspapers, and magazines to read?
  • How important is it to you to listen to music you like?
  • How important is it to you to be around animals such as pets?
  • How important is it to you to keep up with the news?
  • How important is it to you to do things with groups of people?
  • How important is it to you to do your favorite activities?
  • How important is it to you to do things away from the nursing home?
  • How important is it to you to go outside to get fresh air when the weather is
  • How important is it to you to participate in religious services or practices?
  • If your doctor approves, would you like to be offered alcohol on occasion at
    meals or social events?  (No, Yes, Yes but can’t or no choice, No response or
    non-responsive answer.)

For residents who cannot answer the questions, a staff assessment of activities and
daily preferences is available. Staff is also instructed to observe the resident’s
response during activity programs.  A variety of routine and activity preferences are
listed and staff is to check off each item as it applies. Some of the recreational items

  • Reading books, newspapers, or magazines
  • Listening to music
  • Being around animals such as pets
  • Keeping up with the news
  • Doing things with groups of people
  • Participating in favorite activities
  • Spending time away from the nursing home
  • Spending time outdoors
  • Participating in religious activities or practices
  • None of the above

In a sample of individuals that completed the revised Customary Routine and Activity
Section, findings indicated that:

81% rated the interview items as more useful for care planning
80% found that the interview changed their impression of resident’s wants
1% felt that some residents who responded didn’t really understand the items
More likely to report that post-acute residents appreciated being asked

Another section of special interest to Activity Professionals and Recreation Therapists
is that of “Special Treatments and Therapies”. Recreational Therapy is included as a
therapeutic service, beyond the general activity program, as it is currently in the MDS
2.0. Under the section of Recreation Therapy, however, it is indicated that Music
Therapy is included as well.

Although this is a still a “draft” it is important for Activity Professionals and Recreation
Therapists to keep abreast of these changes. Please take a moment to visit CMS’s
website to read further about the MDS 3.0. CMS plans to implement MDS 3.0 changes
nationally on October 1, 2009. To download the transcript, audio files, power point
presentation, word presentation and the timeline, visit