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Civil Money Penalty (CMP) Fund Grants

CMP Fund Grant Background

The Alabama Department of Public Health (ADPH), Bureau of Health Provider Standards (BHPS), is responsible for the oversight and administration of the Long Term Care Program and seeks innovative projects that support, protect and benefit nursing facility residents.

Civil money penalties are imposed by the federal Centers for Medicare and Medicaid Services (CMS) when the department finds long term care facilities to be in violation of CMS conditions of participation. Alabama receives a portion of the collected funds to be used to support projects that improve the overall quality of life and/or care of nursing facility residents.

CMP fund grants are only available for quality improvement initiatives that are outside the scope of normal facility operations and cannot be used to fund goods or services that the applicant already offers or is required to provide by state or federal law or regulation. Further, CMP fund grants may not be used to:

  • pay for capital improvements to a nursing facility or to build a nursing facility;
  • assist the facility with achieving compliance for approval of a plan of correction for cited deficiencies or investigate and work to resolve complaints;
  • pay the salaries of temporary managers who are actively managing a nursing facility; or
  • recruit or provide Long Term Care Ombudsman certification training for staff or volunteers.

Additionally, CMS will not approve projects for which a conflict of interest exists or the appearance of a conflict of interest. However, CMP fund grants can be used to support any one of the following project categories:

  • Direct Improvement to Quality of Care
  • Resident or Family Councils
  • Culture Change/Quality of Life
  • Consumer Information
  • Transition Preparation
  • Training
  • Resident Transition due to Facility Closure or Downsizing
  • Other projects aimed to directly or indirectly benefit nursing facility residents

CMP Fund Grant Authorization

Federal law, Sections 1819(h)(2)(B)(ii)(IV)(ff) and 1919(h)(3)(C)(ii)(IV)(ff) of the Social Security Act (the Act) incorporate specific provisions of the Patient Protection and Affordable Care Act, (the Affordable Care Act, ACA) (Pub. L. 111-148), provides for the collection and use of CMP funds imposed by CMS when nursing facilities do not meet the Medicare requirements for participation. The Act provides that a portion of CMP funds could be used to support activities that benefit nursing facility residents, including projects that assure quality care within a nursing facility.

In accordance with Survey & Certification transmittal 12-13-NH dated December 16, 2011, States must obtain approval from CMS for the use of federally imposed civil money penalty (CMP) funds. A copy of this transmittal is available on the CMS website at as well as an attachment below. Effective January 1, 2012, CMS has established a process for reviewing applications that seek funding to improve resident outcomes in certified nursing facilities. Only CMP fund applications that meet the statutory intent of the regulations, federal law and policy will be considered.

CMP Fund Grant Guidelines

Requests to use CMP funds may be made by various organizations and entities. Applications may be submitted by:

  • certified nursing facilities,
  • academic or research institutions,
  • state, local or tribal governments,
  • profit or not-for-profit, or
  • other types of organizations that are interested in promoting quality of care and/or quality of life for residents of nursing facilities.

Nursing facility providers, stakeholders and other organizations are encouraged to submit CMP fund grant applications for the development and implementation of quality improvement initiatives that directly or indirectly benefit nursing facility residents. Project proposals should demonstrate current and sound evidence-based practices that promote quality of care and quality of life for nursing facility residents.

Entities from which CMP fund grant requests originate shall submit the request to the Alabama Department of Public Health, Bureau of Health Provider Standards, as the State Survey Agency (SSA) for Alabama, for an initial review and recommendation.

All CMP Fund Grant Requests must be submitted electronically to [email protected] utilizing the CMP Fund Grant Application, State Request for Approval of Use of the Civil Money Penalty Funds for Certified Nursing Homes. Receipt of a fully completed application is necessary before the BHPS review process begins.

CMP Fund Grant Application Process

1. Submit completed application electronically to [email protected].

    A. Submitted applications for projects that are planned over a continuous time period should not exceed thirty-six (36) months.

    B. All sections of the CMP Grant application shall be completed or the CMP Fund Grant request may be denied. The application* shall include:

               a)  Cover Letter Addressed to the Director of the Bureau of Health Provider Standards

               b)  Purpose and Summary

               c)  Expected Outcomes

               d)  Results Measurement

               e)  Benefits to the Nursing Home Residents

               f)  Consumer and Other Stakeholder Involvement

               g)  Funding

               h)  Involved Organization

*Refer to the CMP Application for a detailed list of requirements for each of the referenced areas.

    C. The font for all CMP fund grant requests is Times New Roman, twelve (12) point, and shall include the entity name and page numbers on all documents.

    D. Requests should be limited to no more than twenty (20) pages, including appendices and the actual CMP request form.

    E. When CMP funds are requested for educational purposes, the organization involved must also include the following: anticipated number of attendees; target audience; accrediting authorities; timeline for implementation and plan for sustainability; and letters of support. Representatives from any group requesting funding, or representatives who are in situations where a conflict of interest exists, must disqualify themselves from making recommendations.

2. BHPS shall review the completed submitted application for approval or disapproval and recommendation to CMS. The BHPS review process should not exceed forty-five (45) calendar days. However, please allow at least 14 business days for the preliminary review and initial feedback.

3. Upon approval or disapproval of an application, BHPS shall notify the applicant of any action taken on the application via written correspondence. Some applications may require additional information before a final determination regarding approval can be made. When an application is returned to the applicant with recommendation(s) for a revision, the applicant will have fifteen (15) calendar days (unless otherwise indicated) to complete revision(s) and re-submit to BHPS.

4. Following notification that an application has been approved by BHPS, the application will then be forwarded to CMS for approval. CMS approval should not exceed forty-five (45) calendar days. However, some applications may require additional information before CMS makes a determination regarding approval. When an application is returned to the applicant for recommendation(s) for a revision, the applicant will have a specified time frame to complete the revision(s) and return to both CMS and BHPS.

5. Any cost associated with the completion of the application is the responsibility of the applicant.

6. When BHPS receives notice from CMS that the approval may proceed, BHPS will notify the applicant with instructions about the process for entering into an agreement with Alabama Medicaid to allow for the release of CMP funds.

Should you have any questions concerning the CMP Fund Grant Application Process, please contact the CMP Grant Coordinator at (334) 206-5210, or [email protected].

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Page last updated: November 21, 2022