Civil Monetary Penalties

Civil Monetary Penalties (CMPs) are fines imposed against nursing facilities that do not meet federal health and safety requirements. CMPs are collected by the federal Centers for Medicare & Medicaid Services (CMS). A portion of the penalty funds collected by CMS are released to the State of Rhode Island to reinvest in projects that improve quality of care and/or quality of life for nursing home residents.

The Executive Office of Health and Human Services (EOHHS) administers the Rhode Island CMP reinvestment grant program in partnership with CMS. This grant opportunity allows certified nursing facilities, non-profit organizations, consumer advocacy organizations, resident or family councils, professional or state nursing home associations, academic institutions, state agencies, and more to apply for funding to improve the lives of nursing facility residents in Rhode Island.

Federal rules limit the use of CMP funds to projects that directly benefit nursing facility residents.

Funds may be used for (but are not limited to):

  • Direct improvements to quality of care
  • Culture change initiatives focused on person-centered values and practices
  • Projects that support resident and family councils and other consumer involvement in assuring quality care in facilities, including consumer information
  • Support and protection of residents of a nursing facility that closes (voluntarily or involuntarily), downsizes, or is decertified, including offsetting time-limited expenses incurred in the process of planning transitions and relocating residents
  • Facility improvement initiatives, such as joint training of facility staff and surveyors or technical assistance for facilities implementing quality assurance and performance improvement programs
  • Development and maintenance of temporary management or receivership capability

Funds may not be used for:

  • Capital improvements
  • Enlarging or enhancing an existing appropriation or statutory purpose that is substantially the same as the intended project or use
  • Long-term projects (greater than three (3) years)
  • Funding for services or supplies that the nursing home is already responsible
  • Staff salaries or incentives
  • Projects where Rhode Island nursing home residents or nursing home settings are not the focus of the project
  • Projects, items, or services that are not directly relating to improving quality of life and care of nursing home residents
  • Projects for which a conflict of interest or the appearance of a conflict of interest exists
  • Projects disapproved by CMS

Pursuant to Survey and Certification Memo 12-13-NH and 42 C.F.R. § 488.433, CMS must review and approve all applications before EOHHS can award funding.

Please visit CMS’ CMP Reinvestment Program website for more information regarding eligibility, allowable uses, restrictions, and examples of projects that have been approved in other states.

EOHHS is not currently accepting applications for Civil Monetary Penalty (CMP) grant funding. Please contact OHHS.CMP@ohhs.ri.gov if you would like to be added to the email list to be notified when applications are open in the future.

 

For applications submitted during the April 2023 application round, the process for reviewing applications and determining awards will consist of the following steps:

Step 1: EOHHS Internal Review

  • EOHHS is required to follow CMS guidelines when accepting applications. As applications are received, EOHHS will complete an initial assessment for compliance with CMS criteria. Applications that do not satisfy CMS criteria cannot be awarded funding. Depending on the nature of any identified errors, EOHHS may request revisions to correct the errors.
  • EOHHS will not complete further review of applications that do not satisfy CMS criteria.
  • A team of EOHHS staff will begin a detailed review of qualified applications after the application period closes at 5 p.m. on April 28, 2023.
  • For general proposals, EOHHS will score the pool of qualified applications based on alignment with EOHHS values, mission, and strategic goals using the uniform EOHHS review criteria. EOHHS may request revisions from applicants at this stage. Applications for CMS pre-approved projects (air filters and communicative technology) do not need to be scored.
  • The EOHHS internal review team will complete review and advance applications to Step 2 by May 26, 2023.

Step 2: EOHHS Leadership

  • Within 2-3 weeks, EOHHS leadership will review and determine which applications will advance to CMS review.
  • Depending on the volume and types of proposals submitted, EOHHS may not be able to advance all applications. In the event that the total funding requested exceeds the amount available, EOHHS will allocate funding as follows:
    • Priority will be given to applications for CMS pre-approved air filter and communicative technology projects
    • The remaining funds will be allocated to the highest scoring applications
  • Applications for CMS pre-approved projects (air filters and communicative technology) will be awarded funding upon approval from EOHHS leadership.
  • General proposals approved by leadership will advance to Step 3.

Step 3: CMS Review

  • EOHHS will submit leadership-approved general proposals to the CMS Regional Office for final approval.
  • CMS may request changes, corrections, or additional information. EOHHS will coordinate with the applicant if revisions are requested. CMS does not communicate with applicants directly.
  • CMS will make a final decision to approve or reject within approximately 40-60 days.
  • Once CMS makes a final decision, EOHHS will communicate next steps directly with applicants.

EOHHS will track and monitor all approved projects by requesting invoices and receipts and conducting progress check-ins with the project lead(s) at regular frequencies.

EOHHS is required to post information about active CMP projects, including the dollar amount awarded, grantee, project highlights, results, and other key information.

There are currently no active CMP projects in Rhode Island. Please see CMS’ CMP Reinvestment Program website for historical project details.

Please email OHHS.CMP@ohhs.ri.gov.

For more information on Rhode Island Medicaid nursing facility providers, please see here.