Re-Creative Resources
By Kimberly Grandal, BA, CTRS, ACC, Executive Director
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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.
Subscribe to Kimberly's Newsletter
See Kim's You-Tube video "Activity Professionals in Action"  (Click Here)
Legislative Updates For Activity Professionals

By Kimberly Grandal BA, CTRS, ACC
Executive Director, Re-Creative Resources Inc.

As the legislative chairperson of the New Jersey Activity Professionals Association, it is
my responsibility to keep abreast of various health-related legislative issues. The
following are a few that I felt were quite pertinent for Activity Professionals in long-term

FTag 309 Quality of Care

The interpretive guidelines for F309 were revised to clarify areas such as assessment,
care planning, and interventions as well as new investigative protocol for pain
management. It is important for Activity Directors to review these changes. Areas of
particular interest to Activity Directors include: assessment, care planning, alternative
interventions for pain management, potential outcomes of ineffective pain management
(decreased activities and quality of life, for example),  and non-pharmacological
interventions (music therapy, soothing distracting verbal communication, reading to the
resident, activities and recreation).

This set of revisions and deletions became effective on March 1, 2009. A final copy of
this new guidance is available at and ultimately
will be  incorporated into Appendix PP of the State Operations Manual on the CMS
Website. You can also download an advanced copy of this FTag, along with training
slides, at:

Star Quality Rating System

On December 18, 2008 CMS issued the Star Quality Rating System for each of the
nation’s 15,800 Nursing Homes that participate in Medicare or Medicaid. Facilities are
assigned star ratings from a low of one star to a high of five stars based on health
inspection surveys, staffing information, and quality of care measures. The ratings are
publicly available on the agency’s Nursing Home Compare Web site at

CMS plans to post updated Nursing Home Compare Five Star data on the third
Thursday of every month. There has been much concern over the accuracy and fairness
of this rating system, therefore the American Health Care Association (AHCA) Research
team is conducting a detailed research analysis to identify the flaws and weak points of
the system. Additional information on the Rating System can be found at
gov/CertificationandComplianc/13_FSQRS.asp#TopOfPage. You can also download a
Questions and Answers manual at

MDS 3.0

Hot off the press news! On Thursday, March 5, 2009 CMS officials announced that they
have postponed the implementation of the MDS 3.0. The new start date is October,
2010 which is one year later than originally planned. To review MDS drafts, timelines,
crosswalks and more visit
gov/NursingHomeQualityInits/25_NHQIMDS30.asp. Activity Professionals really should
review the MDS 3.0 draft and send your comments to CMS!

Re-Creative Resources Inc. can help you can stay abreast of legislative issues. You
may visit for the latest legislative
and regulatory news.
If you’d like to have information sent directly to your email you
may want to join the Re-Creative Resources Group on Facebook or sign up for the Rec-
Room, a free monthly e-newsletter

If you know of any other legislative issues that are of particular concern or interest to
Activity Professionals, please don’t hesitate to contact me at