Civil Money Penalty Reinvestment Program (CMPRP) Funds Grants

CMP REINVESTMENT FUNDS GRANT BACKGROUND

The Healthcare Facility Regulation Division (HFRD) is responsible for the oversight and administration of the Civil Money Penalty Reinvestment Program (CMPRP).

Nursing homes are inspected by state surveyors for compliance with federal requirements for participation with Medicare and/or Medicaid (42 CFR 483 Subpart B). When noncompliance is identified, the Centers for Medicare and Medicaid Services (CMS) may impose a civil money penalty (CMP) to incentivize swift correction and to deter future noncompliance to protect the health and safety of residents. CMPs collected from nursing homes can be reinvested to improve the quality of care and quality of life of nursing home residents (per 42 CFR 488.433). CMS revised the Civil Money Penalty Reinvestment Program with the goal of more equitable distribution of funds across all long-term care facilities. 

The newly revised structure of the CMPRP will provide:

• A detailed listing of allowable uses of CMP funding, so all applicants have a clear understanding of what types of projects will be approved.
• Funding of projects to benefit residents that can be implemented in all nursing homes by a variety of different organizations.
• A plan to equip all nursing homes to have access to similar, basic capabilities, reflective of those typically found in a traditional household (e.g., wireless internet access).

CMP grants are only available for quality improvement initiatives that are outside the scope of normal facility operations. Funds may be used for (but not limited to) the following:

• Assistance to support and protect residents of a facility that closes or is decertified
• Time-limited expenses incurred in the process of relocating residents to home and community-based settings or another facility when a facility is closed or downsized pursuant to an agreement with the state Medicaid agency
• Projects that support resident and family councils and other consumer involvement in assuring quality care in facilities
• Facility improvement initiatives, such as joint training of facility staff surveyors, or technical assistance for facilities implementing quality assurance and performance improvement programs

Additionally, CMP funds grants can be used to support any one of the following project categories:

• Direct improvement to quality of care
• Resident or family councils
• Culture change/quality of life
• Consumer information
• Transition preparation
• Training
• Resident transition due to facility closure or downsizing
• Other projects aimed to benefit nursing facility residents directly or indirectly

CMP funds cannot be used for goods or services that the applicant already offers or is required to provide by state or federal law or regulation. Further, CMP funds may not be used to:

• Pay for capital improvements to a nursing facility or to build a nursing facility.
• Assist the facility with achieving compliance for approval of a plan of correction for cited deficiencies or investigate and work to resolve complaints.
• Pay the salaries of temporary managers who are actively managing a nursing facility.
• Recruit or provide Long-Term Care Ombudsman certification training for staff or volunteers.

CMP REINVESTMENT FUNDS GRANT 

Federal law, Sections 1819(h)(2)(B)(ii)(IV)(ff) and 1919(h)(3)(C)(ii)(IV)(ff) of the Social Security Act (the Act) incorporate specific provisions of the Patient Protection and Affordable Care Act, (the Affordable Care Act, ACA) (Pub. L. 111-148), provides for the collection and use of CMP funds imposed by CMS when nursing facilities do not meet the Medicare requirements for participation. The Act provides that a portion of CMP funds could be used to support activities that benefit nursing facility residents, including projects that assure quality care within a nursing facility.

In accordance with Survey & Certification transmittal 12-13-NH dated December 16, 2011, States must obtain approval from CMS for the use of federally imposed civil money penalty (CMP) funds. A copy of this transmittal is available on the CMS website, www.cms.hhs.gov, as well as an attachment below. Effective January 1, 2012, CMS has established a process for reviewing applications that seek funding to improve resident outcomes in certified nursing facilities. Only CMP funds applications that meet the statutory intent of the regulations, federal law and policy will be considered.

CMP REINVESTMENT FUNDS GRANT GUIDELINES

Requests to use CMP funds may be made by various organizations and entities. Applications may be submitted by:

• Certified nursing facilities
• Academic or research institutions
• State, local, or tribal governments
• Profit or not-for-profit
• Other types of organizations that are interested in promoting quality of care and/or quality of life for residents of nursing facilities

Nursing facility providers, stakeholders, and other organizations are encouraged to submit CMP funds grant applications for the development and implementation of quality improvement initiatives that directly or indirectly benefit nursing facility residents. Project proposals should demonstrate current and sound evidence-based practices that promote quality of care and quality of life for nursing facility residents.

Entities from which CMP grant requests originate shall submit the request to the Healthcare Facility Regulation Division, as the State Survey Agency (SSA) for Georgia, for an initial review and recommendation. All requests must be submitted electronically to [email protected] utilizing the CMP Funds Grant Application, State Request for Approval of Use of the Civil Money Penalty Funds for Certified Nursing Homes. Receipt of a fully completed application is necessary before the HFRD review process begins.

All stakeholders interested in applying for CMP funds should review the revised application information and documentation available on the CMPRP website.  All fields on the application must be complete (or state “not applicable”), and the application must be signed and dated before submission. During the CMPRP review process, applicants will have two (2) attempts to provide all required corrections and information. Failure to provide the requested information will result in the application not being considered for approval.

CMP REINVESTMENT FUNDS APPLICATION PROCESS

1. Submit completed application electronically to [email protected]
   1. Submitted applications for projects that are planned over a continuous time period should not exceed 3 years (36) months.
   2. All sections of the CMP grant application shall be completed, or the CMP Funds Grant request may be denied. 
2. HFRD shall review the completed submitted application for approval or denial and recommendation to CMS. HFRD reviews will include a preliminary, expert substantive evaluation, and leadership review and recommendations. The HFRD review process should not exceed forty-five (45) calendar days. Please allow at least 14 business days for the preliminary review and initial feedback.
3. Upon approval or disapproval of an application, HFRD shall notify the applicant of any action taken on the application via written correspondence. Some applications may require additional information before a final determination regarding approval can be made. When an application is returned to the applicant with recommendation(s) for a revision, the applicant will have fifteen (15) calendar days (unless otherwise indicated) to complete revision(s) and re-submit to HFRD.
4. Following notification that an application has been approved by HFRD, the application will then be forwarded to CMS for approval. CMS approval should not exceed forty-five (45) calendar days. However, some applications may require additional information before CMS determines approval. When an application is returned to the applicant for recommendation(s) for a revision, the applicant will have a specified time frame to complete the revision(s) and return to HFRD. HFRD will then resubmit the revision to CMS.
5. Any cost associated with the completion of the application is the responsibility of the applicant.
6. When HFRD receives notice from CMS that the approval may proceed, HFRD will notify the applicant with instructions about the process for entering into an agreement with HFRD to allow for the release of CMP funds.

Should you have any questions concerning the CMP Funds Grant Application Process, please contact us at [email protected].

All stakeholders interested in applying for CMP funds should review the information in this memorandum, all attachments, and the CMPRP website. All fields on the application must be complete (or state “not applicable”), and the application must be signed and dated before submission. During the CMPRP review process, applicants will have two (2) attempts to provide all required corrections and information. Failure to provide the requested information will result in the application not being considered for approval.

CMS encourages applicants to review all application documentation (links provided below), including the Frequently Ask Questions Documents on the CMP Reinvestment Resources file weblink:

https://www.cms.gov/medicare/provider-enrollment-and­certification/surveycertificationgeninfo/downloads/cmp-reinvestment-application-resources.zip prior to submitting an application.

CMP REINVESTMENT FUND APPLICATION SUBMISSION SCHEDULE 

All CMP grant applications and proposals must be submitted within the following schedule: 

CMP REINVESTMENT FUNDS APPLICATION RE-SUBMISSION CRITERIA

Upon approval or disapproval of an application, HFRD shall notify the applicant of any action taken on the application via written correspondence. Some applications may require additional information before a final determination regarding approval can be made. When an application is returned to the applicant with recommendation(s) for a revision, the applicant will have 15 calendar days (unless otherwise indicated) to complete revision(s) and re-submit to HFRD.

Applicants will have two attempts to resubmit the application. After the second attempt, the application will be closed, and applicants will be required to submit a new application.

State use of civil money penalty fund requests is not subject to an appeal. If the CMP Funds Application and Proposal is denied, then the applicant will have one attempt to submit a new application concerning the proposed project. 

CMP REINVESTMENT FUNDS GRANT, EMERGENCY RESPONSE GUIDELINES

Nursing facility providers are encouraged to submit CMP Fund Grant, Emergency Response applications to assist residents that may reside in homes that are involuntarily terminated; or homes that have been involved in an emergent event, or for other unknown events impacting resident care, treatment, and services.

Entities from which CMP fund grant requests originate shall submit the request to the HFRD as the SSA for Georgia, for an initial review and recommendation.

All CMP Fund Grant Requests must be submitted electronically to [email protected] utilizing the CMP Reinvestment Fund Grant Application. Receipt of a fully completed application is necessary before the HFRD review process begins.

CMP REINVESTMENT FUNDS GRANT, EMERGENCY RESPONSE APPLICATION PROCESS

1. Submit completed application electronically to [email protected]. Submitted applications must include:
   1. Detailed description of the emergency event and its impact on residents and facility operations. Additionally, applicants must provide evidence of expenditures directly related to the emergent event, including legible receipts or other documentation and explain how the expenditures related to the emergent event if that is not obvious from the documentation. 
   2. Signed attestation statement.
2. HFRD shall review the completed submitted application for approval or disapproval and recommendation to CMS. The HFRD review process should not exceed forty-five (45) calendar days. However, please allow at least 14 business days for the preliminary review and initial feedback. 
3. Upon approval or disapproval of an application, HFRD shall notify the applicant of any action taken on the application via written correspondence. Some applications may require additional information before a final determination regarding approval can be made. When an application is returned to the applicant with recommendation(s) for a revision, the applicant will have fifteen (15) calendar days (unless otherwise indicated) to complete revision(s) and re-submit to HFRD. 
4. Following notification that an application has been approved by HFRD, the application will then be forwarded to CMS for approval. CMS will review applications in a timely manner. However, some applications may require additional information before CMS determines approval. When an application is returned to the applicant for recommendation(s) for a revision, the applicant will have a specified time frame to complete the revision(s) and return HFRD. HFRD will then resubmit the revision to CMS. 
5. Any cost associated with the completion of the application is the responsibility of the applicant.
6. When HFRD receives notice from CMS that the approval may proceed, HFRD will notify the applicant with instructions about the process for the release of CMP funds.

Should you have any questions concerning the CMP Funds Grant Application Process, please contact us at [email protected].  

CMP REINVESTMENT FUNDS GRANT, NEW PROPOSAL REQUESTS

Based on the current needs of Georgia, we are specifically interested in projects related to the topics below. Please note this list will be updated as our needs change and evolve.

Tele-health Innovations Focusing on Rural Nursing Facilities Promoting Access to Care

Refer to the CMP Funds Grant Background, Guidelines, Application Process and Submission Schedule before applications and proposals are submitted.

Should you have any questions concerning the CMP Funds Grant application process, please contact us at [email protected].