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F248/249 standards for activities directors applicable to ALL senior residences or just nursing homes?


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I have heard two interpretations of this:  my first understanding was that EVERY type of facility that houses a group of seniors that are not family members must abide by all the rules - one being that the activity director must qualify by meeting the stated standards.  A member of one certain facility corrected me and said that only nursing homes need to follow ANY of the 248/249 rules.  The person later corrected herself regarding activities and said that as long as one person in the facility had a four-year degree in gerontology and was available to the activity director, that the activity director need meet no state standards.  Can you please clarify?

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CMS (Center for Medicare and Medicaid) requires a qualified activity director in all facilities that accept Medicaid. (FTag 249). If a facility does accept Medicaid then it is inspected by the state and or federal regulators. This regulation was developed in 1976 for all skilled nursing facilities. Each state, at that time, decided other regulations for the activities department. For example, in NY it is required that a calendar for the month be posted in an area accessible to all of the residents. There are many states that did not accept that particular part of the regulation. So in a Skilled Nursing Facility they must have a qualified activity director.In Assisted Living Facilities, each state has its regulation for what a qualified activity director is. As each state has developed its own regulations it is difficult to answer your question. You would have to look up the Assisted Living Facility regulations for your state. An example would be that in NY the activity director has to have an associate’s degree and it can be in anything. So looking up the Assisted Living Facility regulations will assist you. Here is a link to assist you: http://www.alfa.org/alfa/State_Regulations_and_Licensing_Informat.aspThere is no regulation in either setting that requires a four-year degree in gerontology for an activity director. Perhaps this person is thinking about a consultant, which there are no regulations currently that state what or who can consult a qualified activity director.

Couple of Links

Surveyor Guide for CMS

State by State Regs for Activity Directors

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