Civil Money Penalty Reinvestment Program

About the Civil Money Penalty Reinvestment Program (CMPRP)


Civil Money Penalty (CMP) Funds

About Civil Money Penalty (CMP) Funds

A CMP is a monetary penalty the Centers for Medicare & Medicaid Services (CMS) may impose against nursing homes for either the number of days or for each instance a nursing home 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 nursing homes are returned to the states in which CMPs are imposed. State CMP funds may be reinvested to support activities that benefit nursing home residents and that protect or improve their quality of care or quality of life.

What CMP Funds Can Be Used For

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
  • Facility improvement initiatives, such as joint training of facility staff and surveyors, or technical assistance for facilities implementing quality assurance and performance improvement programs.

As part of its 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) to improve quality of life by equipping nursing home staff, administrators and stakeholders with technical tools and assistance to enhance resident care. CMPRP is one of several initiatives CMS has underway to strengthen safety and health outcomes for nursing home residents

How to Apply for CMP Funds

  • The application process for CMP funds is determined by the state in which the nursing home is located. The process for each state may differ, and some states have their own applications for CMP funds. Applicants should use their state-specific application and instructions, if applicable. Please use the “CMP Contacts by States” link  in the “Downloads” section to find specific state contacts
  • A CMP Frequently Asked Questions (FAQ) is also available in the “Downloads” section below.

How to Find Information about Previously Funded Projects

CMS publishes and updates information about CMP funded projects annually. To view a list of funded projects, please download the “State CMP Reinvestment Projects Funded by Calendar Year” zip file in the “Downloads” section below.


Toolkit Resources are available under the downloads section below to aid nursing home teams in reducing adverse events, improving staffing quality, and improving dementia care. Use of these tools is not mandated by CMS and their use does not ensure compliance with Federal requirements.

INSTRUCTIONS FOR DOWNLOADS: Save documents to your Desktop in order to use all functions of the documents. Make sure you have Adobe Acrobat installed on your computer. If you do not have Adobe Acrobat, download it for free on the Adobe website (

Reducing Adverse Events and Improving Dementia Care Toolkits

CMS developed optional toolkits to aid nursing home teams with reducing adverse events and improving dementia care. These toolkits were the result of CMS work with nursing home Breakthrough Communities—a learning collaborative design where a subset of nursing homes joined learning sessions and team calls to learn about quality improvement concepts.

Head to Toe Infection Prevention (H2T) Toolkit

Infections comprise a large share of adverse events in nursing homes. The Head to Toe Infection Prevention Toolkit contains educational materials and practical tools to support the clinical team in providing person-centered care that helps prevent and control common infections like pneumonia, skin infections, and urinary tract infections. The Toolkit aims to educate licensed nurses and nurse aides on infection prevention practices and provide tools that can be integrated into their daily work.

The H2T Toolkit consists of the following components:

1) Implementation Guide

2) Infection Prevention Handbook

3) Staff Presentation

4) Resource for Residents and Loved Ones

5) Observation Guide

6) Customizing Care Tool

7) Suspected Infection Investigation Tool

Developing a Restful Environment Action Manual (DREAM) Toolkit

As many as 70% of adults with dementia experience sleep disturbances, which are associated with various negative health outcomes. High quality sleep is necessary for optimal cognitive and physical functioning, especially for residents who already experience cognitive decline due to dementia. The DREAM Toolkit provides educational material and practical tools for nursing home staff to help all residents living with dementia improve sleep quality. Nursing homes can choose from a variety of strategies in the DREAM Toolkit to help improve quality of life and quality of care, especially for residents living with dementia.

The DREAM Toolkit consists of the following components:

1) Implementation Guide

2) Handbook

3) Sleep Matters Video:  

4) Pocket Guide for Clinical Teams

5) Sleep Environment Improvement Tool

6) Resident Preferences Tool

Improving Staff Competency and Employee Satisfaction Toolkits

CMS developed optional toolkits to aid nursing home teams with improving staff competency and employee satisfaction. There are three toolkits in this series.

Toolkit 1: Nursing Home Staff Competency Assessment

Quality care is complex. That’s why the CMPRP competency assessment helps nursing homes break down and self-examine some of the most important building blocks of quality care. Use the competency assessment to identify areas where your nursing home is doing well, versus where your facility might need support.

Three competency assessments are available in print and electronic formats:

1) Certified Nursing Assistants (CNA)/Certified Medication Technicians (CMT)

2) Licensed Practical/Vocational Nurses (LVN/LPN) and Registered Nurses (RN)

3) Assistant directors of nursing (ADON), directors of nursing (DON) and administrators.

The assessments pose questions about behavioral, technical and resident-based competencies to support your nursing home’s existing learning and development standards of practice. The toolkit includes an Instruction Manual, videos and other materials to support managers in implementing the assessment.

Toolkit 2:  Nursing Home Employee Satisfaction Survey

The employee satisfaction survey can help your nursing home to recruit, motivate and retain staff that are critical to better resident health and quality of life. This free, anonymous survey offers employees an opportunity to share their perceptions about the nursing home workplace. Survey topics include: employee engagement and team building, job satisfaction, management and leadership, scheduling and staffing and training.

An Implementation Guide and a Data Analysis Tool are available to support managers in implementing the survey, as well as aggregating and interpreting survey results. Watch these two videos to get started:

Toolkit 3:  Guide to Improving Nursing Home Employee Satisfaction

There are many resources out there to help nursing facilities improve quality, but it can be overwhelming to identify which are most relevant to your facility’s specific needs and to stay up-to-date on the latest guidance. This employee satisfaction guide helps nursing homes determine the most appropriate and helpful resources to address challenges.

Once your facility completes the employee satisfaction survey, you will be ready to address the identified improvement opportunities. The employee satisfaction guide is a repository of evidence-based approaches, solutions and interventions to address challenging areas discovered through the survey.

If you have CMPRP questions, comments or page content feedback, email the CMPRP Team at

August 2021- New and updated CMP resources added to the Downloads section.

September 2021- New and updated State CMP funded projects located in the State CMP Reinvestment Projects Funded by Calendar year Zip folder in the Downloads section.

October 2022- New and updated CMP resources added to the Downloads section.

Page Last Modified:
10/20/2022 09:24 AM