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 videos (Click Here)
Progress Notes CQI Sample
By Kimberly Grandal, CTRS, ACC/EDU

Participating in a Quality Assurance (QA) or Continuous Quality Improvement (CQI)
program is an important responsibility of the Activity or Recreation Director. QA and CQI
require preparation, data collection, evaluation and extensive follow-up. There are a
variety of methods that may be utilized but please be sure to utilize your facility’s CQI/QA
format when performing a study. The following progress note CQI study serves as an
example to help guide you through the process.

Indicator (issue)
Document the provision of and residents’ response to the recreation program at least
quarterly, in the medical record.

Criteria (how you measure performance)
•        Recreation progress notes are to be written in conjunction with the MDS schedule
on a quarterly basis.  
•        Quarterly progress notes must be completed prior to the MDS completion date as
set by the MDS Coordinator.
•        Progress notes should also be written episodically for changes in residents’
needs and interests.
•        Progress notes are to reflect the residents’ current status.
•        Outcomes/responses to recreation interventions are identified.

Performance Standard (expectation/desired outcome)
100% compliance

Sample Size (number in study)
One hundred medical records were audited (5 closed)

Methodology (interviews, chart audit, satisfaction survey, etc.)
All statistical data was retrieved from the residents’ medical records.  The audit
included a review of quarterly and episodic recreation progress notes.

Findings (include specific data-numbers, percentages, etc.)
The Recreation department demonstrated 82% (82 out of 100) compliance in this area.
The medical record was deemed out of compliance even if one quarterly progress note
was missing from the one-year cycle.   

Recommendations/Action Plan (who, what, where, when, how)
1.        All missing documentation shall be reported to the Recreation

2.        If a medical record is missing a quarterly note from the last quarter, a current
progress note shall be completed.

3.        The Director and Assistant Director of Recreation will perform weekly medical
record audits to ensure timeliness and accuracy of recreation progress notes.

4.        Over the next quarter, the Director and Assistant Director of Recreation will meet
with Recreation Therapists/Assistants on a weekly basis to review residents who are
scheduled for care plan meetings to ensure timeliness and accuracy of recreation
progress notes.

5.        To increase episodic notes, the Recreation Director will develop and implement
the “Progress Note Alert Board” to communicate changes in residents’ interests and
needs. All recreation staff will be in-serviced on the purpose and procedure for using
the board. The date of implementation is ____________.

6.        Recreation Therapists and Assistants will monitor Attendance Records for
residents with activity, behavioral or psychosocial concerns.

To learn more about QA and CQI, read the article, Quality Assured Activity Programming
by Kimberly Grandal.

Re-Creative Resources Inc. offers the Recreation Department Review Manual which
consists of thirteen audit tools that are great for evaluating the Activity Department. Visit for more information.