1 - Activity Director Today



Activity Director Today Questionnaire

The Impact of LTC Activities upon Census Building

A Research Project of the Activity Director Today Website at

The information you submit will remain strictly confidential. All answers given will be used to establish a group average. No third party is involved in this research. It is an independent research project of Activity Director Today. If you would rather not answer a specific question, skip it and go on to the next question.

You may continue to write answers on page 3.

ANSWER THE QUESTIONS WITH A WRITTEN ANSWER OR AN “X”.

1. What is you total bed capacity?

2. What is your current facility census?

3. What is your position in the facility?

4. If you are certified, what is level?

5. Do you have other staffing within your department? [ ] yes [ ] no

6. If yes, what staffing do you have?

7. How many volunteers does your department have?

8. Have any volunteers admitted family members or friends into your facility? [ ] yes [ ] no

9. If yes, did the activity program have any impact on their decision? [ ] yes [ ] no [ ] don’t know

10. Are you responsible for facility marketing? [ ] yes [ ] no

11. Do you post want ads in local paper and church bulletins in order to recruit volunteers? [ ] yes [ ] no

12. Do you submit resident pictures to local newspapers? [ ] yes [ ] no

13. Do you submit your activity calendar to local papers? [ ] yes [ ] no

14. How many residents are capable of attending group activities?

15. Do you bring in outside talent for your activities? [ ] yes [ ] no

16. Do you pay for people to come in for activities? [ ] yes [ ] no

17. Are non-residents invited to your large group activities? [ ] yes [ ] no

18. If yes, which non-residents come to large group activities? [ ] families [ ] community [ ] staff [ ] friends [ ] volunteers

19. Who assists with inside Activities? [ ] nursing [ ] families [ ] AD staff [ ] administration [ ] visitors [ ] social services [ ] Volunteers

20. Do you have outings? [ ] yes [ ] no

21. If yes, who assists with outings? [ ] volunteers [ ] AD staff [ ] nursing [ ] social services [ ] administration [ ] visitors [ ] families

22. Have you had any admissions as a result of out-of-facility activities? [ ] yes [ ] no [ ] don’t know

23. Do you have a facility vehicle to use? [ ] yes [ ] no

24. Where do you go on outings?

25. Who donates items for activities? [ ] AD staff [ ] visitors [ ] families [ ] businesses [ ] churches [ ] volunteers [ ] other:

26. How many one-to-one residents do you have?

27. Who assists with one-to-one activities? [ ] you only [ ] AD staff [ ] volunteers [ ] others:

28. What do visitors and families say about the affect of your activities upon the resident?

29. Do you have an active Resident Council? [ ] yes [ ] no

30. Do you do fundraisers? [ ] yes [ ] no

31. If yes, what kind of fundraisers do you do?

32. Which activities get the most attention from the community?

33. Do you or your residents participate in local community groups? [ ] yes [ ] no

34. If yes, which groups are they?

35. Do you publish a monthly newsletter? [ ] yes [ ] no

36. If yes, who receives your newsletter? (check all that apply)

[ ] All responsible parties

[ ] Visitors

[ ] Seniors at home

[ ] Banks

[ ] Hospital discharge planners

[ ] Nursing homes

[ ] Adult day care centers

[ ] Churches

[ ] Home health agencies

[ ] Social service agencies

[ ] Social organizations and clubs

[ ] Business organizations

[ ] Corporate headquarters

[ ] Area schools

[ ] Area radio stations

[ ] Area television stations

[ ] Area newspapers

[ ] Area businesses

[ ] Volunteers

37. If you publish a monthly newsletter, how do you rate your activities’ impact on building census? (Check only one) [ ] High [ ] Moderate [ ] Some [ ] Very little [ ] None [ ] Don’t know

38. Does your administrator support activities? [ ] yes [ ] no

39. Do you have a consultant? [ ] yes [ ] no

40. Does your consultant ever stress the impact of activities on the facility census? [ ] yes [ ] no

41. If yes, what does your consultant suggest you do?

42. Do you attend regional activity director association meetings (i.e. not NAAP)? [ ] yes [ ] no

43. If yes has the topic of how activities impact census ever been addressed? [ ] yes [ ] no

44. To whom does your facility market? (check all that apply)

[ ] All responsible parties

[ ] Visitors

[ ] Seniors at home

[ ] Banks

[ ] Hospital discharge planners

[ ] Nursing homes

[ ] Adult day care centers

[ ] Churches

[ ] Home health agencies

[ ] Social service agencies

[ ] Social organizations and clubs

[ ] Business organizations

[ ] Corporate headquarters

[ ] Area schools

[ ] Area radio stations

[ ] Area television stations

[ ] Area newspapers

[ ] Area businesses

[ ] Volunteers

45. Do your residents ever suggest possible friends or relatives who need LTC care? [ ] yes [ ] no

END OF QUESTIONS

Thank you for taking part in our research. Please feel free to forward a questionnaire to your consultant, your sister facilities and any organizations to which you belong. The participants we have the better the research results will be. You will be informed of the results of our research at a later date. Please return the questionnaire by e-mail to admin@

COMMENTS:

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download