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 pleased to announce $600,000* in Civil Monetary Penalty (CMP) grant funding available to improve quality in nursing facilities. 

Projects are not limited to in-state entities but must benefit Rhode Island nursing home residents. The deadline for submitting applications is 5 p.m. on Monday, September 30, 2024.  

All applications must be submitted via email to OHHS.CMP@ohhs.ri.gov.  

Please include all requested materials and any necessary supporting information in your email submission. Incomplete or late applications will not be accepted. Please also review the “Application Review Process” section below for information about the process and timeline for determining awards, including the criteria EOHHS will use to review applications. 

CMS pre-approved projects related to COVID-19  

CMS offers two (2) pre-approved projects to facilitate visitation in nursing facilities. These projects have their own applications and must use the specific CMS templates provided below.  

  1. Visitation Aids (Air Filters): Certified nursing facilities may apply for the use of CMP funds to reimburse for the purchase of portable fans and portable air room cleaners with high efficiency particulate air (HEPA H-13 or -14) filters to facilitate safer in-person visitation. Corporations may apply on behalf of several facilities but must include each facility on the application. 

Details: 

  • Projects must directly address the need to facilitate in-person visits for residents. 
  • Maximum allowance of $3,000 per facility (requests for exceptions may be considered in limited circumstances, such as requests involving facilities with a large number of residents). 
  • Costs may include installation, installation materials, and shipping costs. 
  • Facilities should ensure that funds are only used to purchase the types of visitation aids described within the application. 
  • Facilities that were previously awarded funding for this project cannot reapply. 

Required application materials: 

  1. Communicative Technology: Certified nursing facilities may apply for the use of CMP funds to reimburse for the purchase of smart devices and related accessories that help residents virtually connect with family and friends and access preventative care, such as telehealth services. Corporations may apply on behalf of several facilities but must include each facility on the application. 

Details: 

  • Limited to a maximum of $3,000 per facility (requests for exceptions may be considered in limited circumstances, such as requests involving facilities with a large number of residents). 
  • Devices may be shared among residents with a ratio of one device per 7-10 residents.  
  • Facilities should ensure that funds are only used to purchase the types of devices described in the application, including that devices are able to support both virtual and telehealth visits. 
  • Facilities must ensure appropriate infection prevention and control practices, including cleaning and disinfecting devices between residents. 
  • Facilities that were previously awarded funding for this project cannot reapply. 

Required application materials: 

Statewide Conference 

State agencies may apply to sponsor a statewide training conference for nursing facilities. State-sponsored trainings may be offered through in-person trainings, virtual trainings, and webinars. Please note that CMS limits this application opportunity to state agencies only.  

Details: 

  • Limited to a maximum of $300 per participating nursing home (requests for additional funding may be considered in limited circumstances). 
  • Requests for funding may not include any of the prohibited items listed on the application, such as refreshments, decorations, and travel costs for nursing home staff. 
  • Statewide conference applications must be submitted to EOHHS at least four (4) months before the conference date to facilitate submission to CMS at least ninety (90) days before the conference date. 
  • Conferences can be approved for up to three (3) years. 

Required application materials: 

Application resources: 

General Application (all other submissions) 

Applicants interested in submitting proposals for all other projects must use the following application process. Please note that the general application form cannot be used to apply for visitation aids, communicative technology, or statewide conferences.  

Details: 

  • Certain project requests may have a funding limit. Please see the application template and CMS guidance for additional information.  
  • Projects are limited to a maximum of three (3) years 
  • Applicants should ensure that they satisfy the CMS review criteria and EOHHS review criteria as described in the “Application Review Process” section below. 

Required application materials: 

  • General Application Form 
  • Cover letter containing the following information: 
    • A brief overview of the proposal, participating nursing homes, funding requested, and expected outcomes. 
    • An acknowledgement that the applicant, if approved, will be required to register with the Ocean State Procures system (if not already registered) in order to receive payment. Registration information is available at https://ridop.ri.gov/ocean-state-procures-osp/osp-vendor-registration
  • General Application Budget Template 
  • Letters of support and indication of commitment from all nursing homes that will participate in the project (if applying on behalf of multiple nursing homes) 

Application resources: 

 

*NOTE: Please note that this is the total amount available for all projects at this time. The total amount actually awarded by EOHHS may vary, depending on the volume of requests received. EOHHS may ask applicants to revise their request and will not accept requests for more than $600,000. 

 

The process for reviewing applications and determining awards consists of the following steps:

Step 1: EOHHS Internal Review

  • EOHHS is required to follow CMS guidelines when accepting applications. As applications are received, EOHHS completes 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 any applications that do not satisfy CMS criteria.
  • A team of EOHHS staff begins a detailed review of qualified applications after the application period closes.
  • EOHHS scores 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.
  • The EOHHS internal review team completes review and advances applications to Step 2 no later than 30 days after the application period closes.

Step 2: EOHHS Leadership

  • Within 2-3 weeks, EOHHS leadership reviews and determines 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 based on project scores (highest to lowest).
  • Proposals approved by leadership advance to Step 3.

Step 3: CMS Review

  • EOHHS submits leadership-approved 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 makes 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 tracks and monitors 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.

Year Amount Awarded Grantee Project Highlights Results
2023 $3,000.00 Eastgate Nursing & Rehabilitation Center Air filters Purchased and installed
2023 $2,719.15 Tockwotton on the Waterfront Communicative technology Purchased and installed
2024 $2,726.77 Eastgate Nursing & Rehabilitation Center Resident garden Garden installed and survey completed

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.