105 CMR 150.012 - Activities and Recreation

(A) All facilities shall provide an ongoing program of activities and recreation suited to meet the interests of and support the physical, mental and psychosocial well-being of each resident, including residents with disabilities. The program shall also be suited to meet the needs of residents for whom English is not their primary spoken language.
(1) The activities program shall provide a broad assortment of both facility-sponsored group and individual activities, as well as independent activities, that accommodate residents of various needs and backgrounds.
(2) The activities program shall utilize all possible community, social, recreational, public and voluntary resources to encourage independence and interaction in the community.
(3) In a SNCFC, therapeutic recreation/rehabilitation programming shall be incorporated within the rehabilitation services.
(B) All facilities shall provide an activity director who is responsible for developing and implementing the activity program.
(1) The activity director shall possess a high school diploma or its equivalent; have the interest and ability to work with elderly persons and person with physical, developmental and behavioral disorders; and have at least one year's experience or training in directing group activity.
(2) In total, all facilities shall provide at least 20 hours of activity per week, per unit.
(3) In a SNCFC, activity programs shall be developed by the supervisor of therapeutic recreation services.
(4) The activity director of the CSF shall in addition to possessing a high school diploma; have an ability to work with the elderly; have at least one year of experience or training in directing group activities; and possess documented experience and training in the planning and providing of special activities and programs for the elderly mentally ill which are geared toward enhancing resocialization and community integration of residents.
(C) Functions of the Activity Director.
(1) The activity director plans, schedules and posts in advance a monthly activity program including group activities, special activities on holidays, religious days, birthdays, and other special occasions; supervises and conducts activities; arranges for religious services; supervises the work of volunteers; and participates in resident reviews, staff meetings and in-service educational programs.
(2) The activity director and other staff shall encourage, but not force, residents to participate in each day's activities and, where appropriate, in program planning; shall seek ways to motivate and interest residents in activities; and shall provide suitable activities for residents unable to leave their rooms.
(3) The activity director shall prepare activity records, which shall include: a monthly activity schedule posted in a conspicuous place in each unit and an activity participation record indicating resident participation in and reaction to activities.

In a SNCFC, the resident's care plan must include:

(a) periodic surveys of the resident's interests; and
(b) the extent and level of resident's participation in the recreation program.
(D) Residents who are able shall be encouraged to pursue activities outside of the facility.

In a SNCFC, field trips into the community shall be an integral part of each resident's programming.

(E) Visiting hours shall be flexible and shall be conspicuously posted.
(1) Provisions shall be made for privacy during telephone conversations, during visits with clergymen, relatives or other such visitors.
(2) Facilities shall have a list of the clergymen of the major faiths readily available, and requests to see clergymen shall be honored at all times.
(F) Facilities shall provide, maintain and store, without charge to the residents, the following basic supplies and equipment: books, current magazines and newspapers, games, crafts, and radio and television (in appropriate areas). Residents who use their personal radio, television or other such equipment shall not be billed for electricity.
(G) Recreation rooms, living rooms, sitting rooms, dining areas and residents' rooms shall ordinarily be sufficient for activities and recreational programs. Additional activity unit or space are not required.
(1) In a SNCFC, indoor play areas shall be provided with a space of at least 12-square feet per bed. Additional outdoor play area shall also be provided.
(2) In a SNCFC, therapeutic recreational/rehabilitation areas shall be designed and constructed so all residents regardless of their disabilities, have access to them. Recreation equipment and supplies shall be provided in a quantity and variety is sufficient to carry out the facility's activities programs.
(H) Special Activities and Services.
(1) Facilities may provide or contract for certain special personal services for residents such as hairdresser or barber services. These services shall not substitute for routine personal care services the facility is required to provide regularly for all residents. These special personal services shall be available only to residents within the facility.
(2) Facilities may provide a snack shop or small gift shop (with total retail value of the salable items not to exceed $150) as an adjunct to recreational, diversional and therapeutic services for residents. Snack shops and gift shops shall be conveniently located and accessible to residents' living and recreational areas and shall be open only to residents and their immediate visitors. Such shops shall be open to facility staff only if this does not interfere with or inconvenience the use by residents.
(a) Snack shops shall not be open to residents during the servicing of regular meals required for all residents.
(b) Snack shops shall serve only: hot and cold beverages, desserts, cookies, crackers and other pre-packaged snacks.
(c) Snack shops shall conform to all regulations relating to sanitation, refrigeration and food quality, and other rules and regulations relative to general dietary and kitchen services. (105 CMR 150.009 and 150.016) .
(d) Food purchase, storage, preparation and service, and the staff for the snack shop shall be completely separate from the facility's general dietary service.
(e) Gift shops may contain greeting cards, newspapers, magazines, articles made by residents, a modest assortment of gift items and toiletries. Gift shops shall be staffed by volunteers (including residents if they so desire) and operated under the direction of the activity director.
(f) If articles made by the residents are sold in the gift shop, the money shall be given or credited to the residents.
(3) Bazaars, fairs and other recreational fund-raising activities shall be solely for the benefit of the residents and shall not be of financial benefit to the facility.
(4) All special services described in 105 CMR 150.012(H) shall be provided as a service to residents, and there shall be no profit or financial benefit to the facility. Accounts for all such services shall be kept entirely separate from other financial records and accounts (including separate purchase of food and supplies), and these accounts shall be available on the premises for inspection and evaluation by the Department. Facilities shall submit, at their own expense, to the Department an annual audit by a Certified Public Accountant of the financial records and accounts of such special services.
(5) The regular staff of the facility shall not be used to provide any of the above special services.
(6) No special services shall be available to the general public.
(I) All Resident Care Facilities, multi-level facilities with Level IV units with Community Support Residents and Community Support Facilities shall develop in-house activities and programs specific to the mental health needs of Community Support Residents and shall encourage the involvement of Community Support Residents. The activities director shall develop such activities and programs with the input of the resident's Support Services Coordinator and social worker.

Notes

105 CMR 150.012
Amended by Mass Register Issue 1361, eff. 3/23/2018.

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