Beyond Bingo & Board Games: Tailor Nursing Home Activities to Meet Residents’ Real Needs

CMS Nursing Home Residents

“It’s not the years in your life that count, but the life in your years,” goes the saying, one that could very well be the motto for the Centers for Medicare & Medicaid Services (CMS) in their new survey process instituted last November. Using “f-tags” as performance metrics to evaluate your facility’s Medicare and Medicaid reimbursement options (and ultimately your star ratings), CMS is looking to you to provide high-quality activities and programs for your residents.

The key to complying with CMS’s updated list of f-tags is being proactive, says healthcare compliance consultant Carmen Bowman in her live webinar with ProfEdOnDemand. During her presentation on providing purposeful and engaging programs for your residents, Bowman walks you through regulatory text, interpretive guidelines and survey tools so you can spot and respond to deficiencies in your facility before they become CMS violations.

Residents Need Individualized Care

The fact that several elements go into caring for nursing home residents – meeting physical, emotional and social needs– can make it easy to overlook an under-stimulated resident. When a resident doesn’t respond well to a certain activity, it’s easy to blame that attitude on general aging or disease.

And then there are the behavioral problems – rather common in dementia and Alzheimer patients, who make up approximately half of nursing home residents as of 2014. Sadly, there is a tendency to overlook the social and emotional needs of these residents, who usually present highly erratic behavior. Although such behavior can be hard to deal with, these residents still need as much stimulation as they did when younger and employed. Withdrawn behavior, often interpreted as an anti-social behavior, can at times be instead a plea for other, more interesting activities.

Feeling Forgotten: What is interesting to one resident won’t be to another. Having only the options of a few cookie-cutter activities to choose from can make residents feel like their interests and preferences do not matter, causing them to feel invisible and withdraw even further.

Focus on F-tag 679

In attempts to tackle this problem of under-stimulated residents, CMS’s new survey process is in aligned with what studies have said for years – quality of life does not mean just that residents are properly fed and bathed; their minds and emotions must also be engaged on a level that affirms their value as a member of society.

To create programs that comply with CMS requirements and meet the needs of your residents, you’ll need to focus on f-tag 679, which states that each “facility must provide, based on … the preferences of each resident, an ongoing program to support residents in their choice of activities … designed to meet the interests of and support the physical, mental, and psychosocial well-being of each resident.”

Be Creative: Gone are the days of just bingo, board games, and birthday parties. While it’s fine to have these activities if your residents actually enjoy them, you’ll need to offer so much more to be in alignment with CMS requirements.

Personalized Activities Create Engagement

When planning activities and programs in compliance with CMS tag 679, try out these tips for creating engagement among your residents:

  • Get input from each resident: By finding out what each resident likes and dislikes, you’ll make it easy on yourself to create enjoyable and meaningful activities.
  • Watch residents during each activity: Check and see – are they smiling? Do they seem engaged in what’s going on? For more reserved residents, can you sense their contentment?
  • After each activity, get feedback: As with any learning process, interests and preferences can change. Leave room for modifications as needed. Too rigid and you risk falling into the bingo and board games rut, where all too late you discover residents are not enjoying the activities.


Be Proactive: Researchers have identified the three plagues of nursing homes as loneliness, helplessness, and boredom. Don’t let these plague your facility – take action today to improve activities for your residents. You’ll not only see them more active and engaged, says Bowman, but you’ll be checking off all the boxes for CMS, too. After all, happy, fulfilled residents and CMS compliance go hand in hand.

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