On November 20, 2018, the Centers for Medicare and Medicaid Services (CMS) announced a new program designed to improve nursing home residents’ safety and quality. CMS is now offering funding for certain resident-centered projects through a three-year initiative called the “Civil Money Penalty Reinvestment Program (CMPRP).”
According to CMS Administrator Seema Verma, “CMS is committed to ensuring nursing home residents are safe and receive quality care.” In order to meet the stated goals of the CMPRP, CMS will “offer nursing home staff practical tools and assistance to improve resident care and positively impact the lives of individuals in our nation’s nursing homes,” added Administrator Verma.
Arif Nazir, MD, FACP, CMD, AGSE notes that “I am delighted that CMS is seeking ways to reinvest the penalty funds in supporting training and education in facilities.” Dr. Nazir, who is the President-Elect of the American Medical Directors Association, the Society for Post-Acute and Long-Term Care Medicine (AMDA) and the Chief Medical Officer, Signature HealthCARE, adds, “Based on what we know about human behaviors, a supportive and engaging approach will always outperform a simplistic carrot and stick approach.”
Civil Money Penalty Reinvestment Program Overview
The origins of the CMPRP are found in the Social Security Act (the Act) which incorporated certain aspects of the Patient Protection and Affordable Care Act, (the Affordable Care Act) (Pub. L. 111-148) regarding the use of CMPs. The Act and the implementing regulations require that a portion of CMP funds must be used to promote residents’ quality of care and quality of life. Such initiatives may include:
- Programs that support resident and family councils and other activities that foster quality care for residents;
- Joint training initiatives, such as training of staff and surveyors or technical assistance for facilities implementing quality assurance and performance improvement (QAPI) programs;
- Activities that provide support and protection for residents of a facility that is closing (voluntarily or involuntarily);
- Expenses related to relocating residents to home and community-based settings or other facilities when a facility closes; and
- The development and maintenance of temporary management or receivership capability, including recruitment, training, retention or other system infrastructure expenses (not including a temporary manager’s salary).
We previously reported on the Act’s mandate that CMS use CMP funds for various programs that promote resident care.
CMS just released the first toolkit in the CMPRP, the Nursing Home Staff Competency Assessment, along with supporting information. That toolkit is focused on assisting nursing home management personnel to assess staff knowledge regarding behavioral, technical and resident-based capabilities. CMS plans to produce additional toolkits in that series titled, “Building on a Culture of Quality: Your Guide to Resident-Centered Care.”
Examples of CMP Reinvestment Projects Already Funded
- Partnership to Improve Dementia Care and Reduce the Use of Antipsychotics;
- Improving the Quality of Care for Deaf and Deaf-Blind Residents;
- Managing Challenging Behaviors; We All Hold the Keys;
- Music and Memory, Technology to improve the quality of life for residents in rural communities with the use of digital music and photos.
How to Apply for CMP Funds
The application process for CMP funds begins at the state level and varies somewhat from state to state. After a state initially approves an application, the CMS Regional Office must then give its approval. A list of CMPRP contacts by state along with the application forms are available at: https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Downloads/CMP-Contacts-State.pdf.
CMS also provides Frequently Asked Questions (FAQ) regarding the CMPRP which is available at: https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Downloads/CMP-FAQs.pdf. Additional information about the potential use of CMP funds by nursing facilities is found in the above-referenced articles and the CMS Survey and Certification Memo (S & C Memo) 12-13-NH.