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F679: What Surveyors Actually Check — and How to Audit Yourself First

Most activity citations aren't about bad programs. They're about paperwork that can't prove a good one. Here's exactly what a surveyor investigates under F-tag 679 — and a free checklist to walk your own files through it first.

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What F679 requires

F679 covers §483.24(c): the facility must provide an ongoing activities program based on the comprehensive assessment, the care plan, and the preferences of each resident — group, individual, and independent activities that support physical, mental, and psychosocial well-being. The load-bearing phrase is "each resident." A full calendar of well-run programs can still be cited if the files can't show it was built from individual assessments and preferences.

The surveyor's worksheet is public

When a survey team investigates an activities concern, they don't improvise — they fill out Form CMS-20065, the Activities Critical Element Pathway. It scripts their record review, their observations, and the interviews they run with activity staff, CNAs, nurses, and the resident. It ends with seven yes-or-no questions, and every "no" maps to a citation:

1. Ongoing program per assessment, interests, and well-being? If no: F679
2. Baseline care plan within 48 hours of admission? If no: F655
3. Comprehensive assessment of needs, risks, and causes? If no: F636
4. Significant-change assessment within 14 days? If no: F637
5. Assessment completed accurately by qualified staff? If no: F641
6. Person-centered care plan with measurable objectives? If no: F656
7. Interventions reassessed and the plan revised with resident input? If no: F657

Notice what that list is: one question about the program, six about the paper trail. That's why the strongest activity department in the building can still walk out of a survey with a deficiency — and why a self-audit is mostly a records exercise.

What the self-audit covers

The checklist walks you through five tests, sampled the way surveyors sample — three residents: one group-active, one room-bound or on one-to-one visits, one recent admission:

• The assessment test — does the record capture the person (lifelong interests, how they prefer to participate, needed adaptations), not just the pastime?
• The care plan test — measurable goals, resident voice, named responsibilities, room-based plans for room-bound residents.
• The calendar test — variety across domains, real evening and weekend programming, group and one-to-one and self-directed options.
• The participation & refusal test — response notes rather than attendance checkmarks, and documented follow-up when a resident says no.
• The interview test — could your activity staff, CNAs, and nurses answer the questions the pathway tells surveyors to ask them?

Every unchecked box is fixable with a better form, a better calendar, or better note language — not more staff hours.

The free companions to the checklist

Three pages on this site answer the audit's most common findings without buying anything: care plan examples for measurable goals and note language, the calendar template for "ongoing and varied," and forty program ideas sorted by group size. If you inherited the department last month, the career guide explains what the surveyor assumes you already know.

And F680?

F680 is the companion tag: the activities program must be directed by a qualified professional (§483.24(c)(2)). It's an absolute tag — cited on qualifications alone, even without any negative outcome for residents. If your program is directed by someone qualifying through the two-years-experience path or a state-approved course, keep the documentation of that qualification where you can produce it on survey day.

Fixing what the audit finds

We're building the Survey-Ready Activity Program Kit — the interest assessment, care-plan goal language, ability-graded calendar system, participation and refusal logs, one-to-one visit kits, and a tabbed survey binder that answers CMS-20065 line by line. Founding members get first access at the founding price.

Sources: Form CMS-20065 (10/2023) and State Operations Manual Appendix PP, F679 (Rev. 211) / F680 (Rev. 173) — public U.S. government documents. This page is an educational summary for activity professionals, not legal or regulatory advice, and is not affiliated with or endorsed by CMS. Facilities remain responsible for their own compliance; always verify against the current Appendix PP.