By Brooke DeNisco, Lead Content Writer at Activity Connection, Recreation Therapist
Survey Survival: 7 Ways Activity Directors Can Stay Survey Ready
Written by: Brooke DeNisco, BA, BS, Recreation Therapist, Lead Content Writer, Activity Connection
As the dust from COVID-19 continues to settle, CMS surveys and state inspections have returned to a more familiar rhythm. Survey readiness shouldn’t begin when surveyors walk through the door. For activity and life enrichment professionals, this is a good time to look closely at both the big picture and the small details.
What Is F679?
For federally regulated nursing homes, CMS F679 focuses on ensuring each resident has access to an ongoing program of activities designed around their assessed interests, abilities, preferences, and care plan.
Assisted living requirements vary by state, but many of the same fundamentals, including individualized programming, documentation, safety, accessibility, and resident choice, are important considerations for activity departments.
What Do Surveyors Look for in an Activity Department?
Before looking at larger programming concerns, we should make sure the everyday details of your department are in order.
- Store potentially hazardous supplies, such as scissors, chemicals, or small objects, where they cannot be accessed by someone who could be harmed by them.
- Protect participant information and keep personal records private.
- Follow facility and fire-code requirements for storage. Avoid placing supplies on top of refrigerators or storing boxes too close to ceilings or sprinkler systems. This goes for decorations, too.
- Keep calendars and other important information visible, accessible, current, and easy to read.
- Label and date food and other perishable activity supplies.
These may seem like minor details, but they are also among the easiest things to address before they become problems.
When looking at the bigger picture, there are several areas that can create survey concerns for activity departments. Here are seven areas to consider, along with practical suggestions for keeping your department prepared.
7 Areas That Can Create Survey Concerns for Activity Departments
1. Inappropriate or Unsafe Activities
Potential concerns may include:
- Games that require motor skills a participant no longer has
- Physical activities that create an unnecessary fall risk
- Loud or highly stimulating programs that upset someone with sensory sensitivities
- Activities offered without considering a participant’s current physical or cognitive abilities
Suggestions
- The best protection is preparation. Know participants well, assess potential risks, adapt activities when necessary, and document important changes in abilities or needs.
- An activity does not have to be difficult to be worthwhile. Sometimes the best adaptation is simply changing the rules, slowing the pace, offering larger materials, or providing extra assistance.
- Make sure participants have adaptive equipment, glasses, hearing aids, or other supports they need to participate safely and comfortably.
2. Failure to Encourage Participation
Having a full calendar does not necessarily mean participants are being given a meaningful opportunity to attend.
Surveyors may notice when people are not reminded about activities or when those with mobility or cognitive challenges are routinely left out because they need additional assistance.
Suggestions
- This is one area where the entire team can help. Encourage nursing, care, dietary, housekeeping, and other team members to mention upcoming activities, help someone get to a program when appropriate, or simply offer a friendly reminder.
- Look for barriers that may prevent someone from participating and work with the interdisciplinary team to identify possible solutions.
- Advertise activities with signs in public places in addition to including them on the calendar.
3. Repetitive or Poorly Matched Programming
Even a reliable activity can become stale when it appears too often.
Programming may raise concerns when activities rarely change, do not reflect participant interests, are consistently too easy or too difficult, or rely heavily on television and other passive entertainment.
Suggestions
- Add several new activities, games, or special events each month.
- Include outdoor programs when weather and safety allow.
- Ask participants what they would like to do and document their suggestions.
- Keep copies of calendars and note new or novel activities.
- Adjust activities when attendance or participant response suggests something is not working.
4. Too Few Evening and Weekend Activities
People do not stop wanting things to do at 5 p.m. on Friday.
A calendar that is heavily concentrated Monday through Friday during traditional business hours may not reflect the needs and preferences of everyone in the community.
Suggestions
- Consider preparing simple programs that care staff, volunteers, or other team members can lead during evenings and weekends. Leave clear instructions and everything needed in one place.
- Activity professionals might also consider occasionally adjusting their own schedules when staffing and community needs allow. Working Sunday through Thursday, for example, can provide weekend programming and offer a chance to meet family members who often visit on Sundays.
- Another option is to occasionally work a later shift to better understand what the community feels like in the evening and identify opportunities for additional engagement.
5. Lack of Coverage or Backup Planning
Many activity departments operate with limited staff, making backup planning especially important.
Problems can arise when only one person knows how to run a program, no one is prepared to cover vacations or sick days, or other staff members have little training or confidence in leading activities.
Suggestions
- Develop a dependable volunteer program.
- Prepare ready-to-use programs that other team members can confidently facilitate. Activity Connection members can use printable and digital activities to help build this type of backup programming.
- Match staff members with programs that fit their interests or talents.
- Ask administration about recognizing employees who regularly help support activities.
- Build relationships with schools, clubs, churches, musicians, theater groups, and other local organizations that may be interested in visiting or performing.
6. Documentation Gaps
Good programming and good documentation should go hand in hand.
Surveyors may look for evidence that participant interests, preferences, abilities, and changes in condition are being considered.
Make sure information about participants’ life histories and interests is gathered soon after move-in and updated as needs, abilities, or preferences change.
Suggestions
- One practical approach is to spend a few minutes each day jotting down observations. Who attended? Who declined? Did someone unexpectedly enjoy a new activity? Did a participant have difficulty with something that was previously easy?
- Those small observations can become valuable information when care plans are reviewed and updated.
- It can also be helpful to review relevant nursing and care notes when appropriate. A physical or cognitive change documented by another department may affect someone’s ability to participate comfortably or safely.
7. One-on-One Visits and Individualized Engagement
Not everyone enjoys group activities, and some participants may be unable to attend them regularly. It is important that these individuals still have opportunities for meaningful engagement.
One-on-one programming should be more than simply stopping by a room to say hello. Whenever possible, visits should reflect something the individual enjoys.
For one person, that might mean looking through gardening magazines. For another, it could be listening to jazz, working on a puzzle, discussing baseball, or sorting photographs.
Suggestions
- Consider creating an individual one-on-one calendar and documenting visits as appropriate for your community. Activity Connection’s calendar builder makes it easy to create multiple personalized calendars and can help make individualized programming more visible and intentional.
- When a full visit is not possible, provide something the person can enjoy independently, such as books, craft supplies, music, audiobooks, puzzles, or other familiar materials based on their interests and abilities.
- Don’t forget people who remain in their rooms during special events. Bringing them a dessert, party favor, or drink from the celebration is a small gesture that can help them feel included.
Stay Survey Ready Every Day
Preparing for an inspection should not mean scrambling to fix everything the week before surveyors arrive.
The better approach is to build good habits into everyday routines: keep supplies organized, get to know your participants, document what matters, offer variety, and make sure people who need additional support or individualized engagement are not forgotten.
Most of all, remember that compliance and good programming usually point in the same direction. When activities are safe, varied, accessible, individualized, and appropriate for the people taking part, you’re not simply preparing for survey. You’re creating a stronger engagement program every day.
One Last Survey Survival Tip: Keep Calm and Pack Snacks
Even if you are confident in your program, being watched can make anyone nervous.
Try to stay calm and continue running your activity schedule as usual. If you’re interviewed directly, answer honestly. Sometimes the appropriate answer really is, “I don’t know, but I’ll find out.”
Consider taking notes during conversations when appropriate. It can help you remember questions or follow-up items and give those fidgety hands something productive to do.
And finally, pack snacks.
It may feel harder to take breaks during an inspection, and no activity professional needs to add “hangry” to the list of things they’re managing during survey week.
We also invite you to share your own survey experiences and tips in the comments to help fellow activity professionals navigate the survey process.
Looking for resources to help keep your activity program organized, varied, and individualized? Activity Connection gives you ready-to-use programming and planning tools to support your team every day.
Explore the Discovery Pass for a free look at Activity Connection and the resources available to support your activity programs.
About the Author: Brooke DeNisco, Lead Content Writer for Activity Connection, was a journalist for seven years before working as an activity director for 12 years, primarily in PACE communities. She is also a certified yoga and fall prevention instructor.
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