Federal Guidelines for Activities in a Nursing Home

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The federal government establishes the minimum guidelines for nursing home activities and shares this responsibility with state governments. Title 42 § 483.15 of the U.S. Code of Federal Regulations (CFR) addresses the Quality of life for nursing home residents. The basic law requires nursing facilities, also referred to as skilled nursing facilities, to provide a certain level of care for its residents.


The laws mandate nursing home owners, administrators and staff treat residents as individuals. Residents deserve dignified and respectful care that recognizes their uniqueness and allow them to intermingle with their environment. Activities, delivered in a manner and setting that facilitate the physical, mental, psychological and social well-being of residents enhances an individual's quality of life. Specific events also give residents outlets to continue to shape their lives and to discover fresh, vibrant and rewarding relationships.

Self Determination

Nursing home facilities must allow residents to exercise their rights to determine the activities they want to indulge in as well as participate. The rules state the activities have to correlate with the resident's interest, evaluation and the plans of care as determined for the person. These activities may range from self-directed informal events developed by the residents or to formally organized actions headed by staff or volunteers.


In order to meet the letter and spirit of the law, nursing home activities have to take into consideration the interest and the health needs of the residents. People have different medical and physical challenges, such as disorientation or those wheelchair bound. Administrators and staff must consider these matters when planning activities. Therefore, scheduling a wide range of activities may become necessary in order to appeal and include as many people as possible.

Professional Supervision

CFR rules state that a nursing home must have a "qualified professional" to oversee nursing home activities. Regulations require the person to hold a state license as an activity professional or a qualified therapeutic recreation specialist. The person must also have the credentials necessary for certification in his respective field or two-years experience accumulated within the previous five years. The individual may also be a qualified occupational therapist or occupational therapy assistant. The regulations also allow activities directors who have completed state-approved training programs.

This individual has the basic charge of coordinating and implementing activities for its residents. Along with the residents, staff, volunteers and family members may request activities. Usually, the activities coordinator creates a calendar of events in large type and makes it available to residents. The coordinator should place the calendar where wheelchair-bounded residents may view it with ease.