MDS Alert

Use this litmus test to figure out if an activity counts.

Activities programs can count as restorative programs when coding P3 if they meet the RAI user's manual guidelines - and the resident's individualized needs, says Cheryl Field, MSN, RN, a consultant with LTCQ Inc. in Lexington, MA.

Say a resident wants to focus on grooming skills as a restorative goal. "If she participates in a grooming program focused on restorative grooming where staff cue her to participate based on her own plan of care, that would count in P3, Field instructs.

Test: If the resident is in a group where all the interventions are scripted and not resident-specific, it's an activity. "In other words, if a resident is in a group with a restorative plan of care ... the group leaders must know the plan of care and be trained in providing the individual treatment modalities," says Field.

Documentation tip: Grooming programs conducted by activities professionals, including teaching residents to apply makeup, would need to have "goals, objectives and documentation of the resident's progress in the clinical record," according to the RAI user's manual (p. 3-195).

Before involving activities professionals in a restorative program, check your state practice act. Some states don't allow activities professionals to provide any hands-on restorative care, such as range-of-motion type activities.

Remember: You can't count exercise groups with more than four residents per supervising helper or caregiver (RAI user's manual, p. 3-192).