New Guidelines PDF Form Packet

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New Guidelines PDF Form Packet
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New Guidelines PDF Form Packet

Downloadable PDF Documents (.zip File)

Specifically, the new guidelines advise surveyors "to determine if the facility has provided an ongoing program of activities designed to accommodate the individual resident's interests and help enhance her/his physical, mental, and psychosocial well-being, according to her/his comprehensive resident assessment."

Activity Directors Network has put together this packet to help the AD/TR keep better records of the responses received from the residents while participating in activities being conducted and whether or not these activities are specifically tailored to meet the needs of each resident. Documentation also should be recorded even when the resident is not participating in activities. This documentation is not only required under the new guidelines, but should also help create a better quality of life for everyone in the facility.


  • Resident Activity Assessment Form
  • Resident Activity Assessment Extended Summary Form
  • Extended Participation Summary Form
  • Multi-Departmental Participation Summary Form

Resident Activity Assessment

Initial assessment form must be filled out upon admission of a new resident. This form should constantly be updated on the resident including , new interests, self set goals, etc.

Resident Activity Assessment Extended Summary

Can be used to add information or update any existing Resident Activity Assessment .

Extended Participation Summary Form

Activity leader/conductor should use this form to record any responses, concerns, etc. from residents participating in activities.

Multi-Departmental Participation Summary Form

This form should be kept in an area available to all staff members of the facility in order to document any emotions, interests, opinions, etc. expressed by a resident overheard by any staff member.

**Upon purchase of this PDF form packet, an e-mail will be sent to the e-mail address used for your ADN Store Account. The e-mail will contain a link to download the .zip file containing the PDF documents.

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