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Civil Money Penalty Reinvestment Resource

Survey & Certification- Long Term Care Facility Civil Money Penalty Reinvestment Resource


A civil money penalty (CMP) is a monetary penalty the Centers for Medicare & Medicaid Services (CMS) may impose against skilled nursing facilities (SNFs), nursing facilities (NFs), and dually-certified SNF/NF for either the number of days or for each instance a facility is not in substantial compliance with one or more Medicare and Medicaid participation requirements for Long Term Care Facilities. A portion of CMPs collected from facilities are returned to the States in which the CMPs are imposed. State CMP funds may be reinvested to support activities that benefit nursing facility residents, and that protect or improve their quality of care or quality of life. CMP 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; and
  • Facility improvement initiatives such as joint training of facility staff and surveyors or technical assistance for facilities implementing quality assurance and performance improvement programs.

Entities interested in applying for State CMP funds, must apply according to the process determined by the State in which they are located, and each State process may differ. In addition, States have their own application to apply for CMP funds, and entities should use their States’ application and instructions. A list of CMP contacts and applicable CMP State websites is available in the Downloads section below for use in determining how entities can apply for State CMP funds. Furthermore, a CMP Frequently Asked Questions document is available in the Downloads section that provides further details on who can apply and what types of projects are allowable.

CMP Projects and States

States are responsible for soliciting projects utilizing CMP funds. After solicitation, States first review submitted CMP project applications for appropriateness before forwarding to CMS for approval. After CMS approval, States must monitor and track projects’ progress and metrics or deliverables. Further information on State requirements pertaining to CMP uses can be found at 42 CFR Part 488.433. An example of a CMP fund application is provided in the Downloads section. This example is for States to consider when looking for a sample application, although States should first contact their CMS Regional Office to inquire whether a standard application is already in use. Likewise, potential applicants should reach out to their States, using the CMP Contacts by State document below to determine the process and appropriate application to use.

What's New

CMP Reinvestment State Plans

By October 31, 2018, and annually thereafter, States must submit their CMP Reinvestment State Plans to their CMS Regional Office for approval in accordance with 42 CFR 488.433(e). The CMP Reinvestment State Plan must include how the State will:

  • Solicit, accept, and monitor CMP projects (including funding for State administration);
  • Make CMP project information publicly available (i.e., amount awarded for each approved project, what entities received project funding, results of projects, and other key information);
  • Ensure a certain amount of CMP funds are held in reserve for emergencies; and
  • Ensure a reasonable amount of CMP funds are awarded as specified in §488.433(a)-(d).

CMS Launches Nationwide Effort to Improve Quality of Care in Nursing Homes

As part of our continued commitment to the nation’s most vulnerable populations, The Centers for Medicare & Medicaid Services (CMS) has launched the Civil Money Penalty Reinvestment Program (CMPRP), a three-year effort to drive improvements in quality of care for nursing home residents. A contract was awarded to a team led by Deloitte Consulting, LLP in September 2017, and project start up activities have begun. 

This effort is funded by the Federal portion of CMPs to conduct activities that support and protect nursing home residents. The goals of the CMPRP are to reduce adverse events, improve staff quality, and improve dementia care. This program will build on other CMS initiatives, such as the National Nursing Home Quality Campaign and the National Partnership to Improve Dementia Care. These efforts also support the revised Requirements of Participation for Long Term Care Facilities, which were finalized in October 2016 and represent the biggest reform to the industry since 1991.

Through this program, CMS and its contractor will develop and implement evidence-based interventions, activities tools, and resources help to improve dementia care, reduce adverse events, and improve staffing quality. Staffing quality includes areas such as reducing turnover, improving tenure, and enhancing general staff performance. Additionally, the CMPRP will support projects for resident and family councils, develop and maintain the ability to provide temporary management of a nursing home, and support activities to protect residents during facility closures. Lastly, this program will support efforts to administer, monitor, and evaluate the effectiveness of CMP projects implemented throughout the country.

Due to the breadth of activities this program will engage in, we also anticipate partnering with many organizations to accomplish the goals of the program. These partnerships will be managed by the Deloitte consulting team. CMS understands the difficult challenges that nursing facilities and their residents face each day. This program demonstrates our dedication to improving the quality of life and quality of care for nursing home residents nationwide.

We are very excited to move forward with this program.