Civil Monetary Penalty (CMP) funds provide Massachusetts with money to support activities to protect, improve the quality of care or improve the quality of life of nursing home residents. In order to promote transparency and ensure fairness, the Department will solicit proposals for the use of CMP funds using the state’s procurement process.
According to guidance from the Centers for Medicare and Medicaid Services (CMS), states may direct collected CMP funds to a variety of capable organizations as long as funds are used in accordance with statutory intent, the use is consistent with Federal law and policy, and the use is approved by the CMS.
Federal regulations at 42 CFR 488.433 authorize the use of CMP funds to support activities that benefit residents, including assistance to support and protect residents of a facility that closes; projects that support resident and family councils and other consumer involvement in assuring quality care in facilities; and facility improvement initiatives approved by the Secretary (including joint training of facility staff and surveyors, technical assistance for facilities implementing quality assurance programs, the appointment of temporary management firms, and other activities approved by the Secretary).
CMP funds are released by CMS to the state as a result of sanctions imposed on nursing homes for violation of the federal conditions of participation in the Medicare and Medicaid programs. As a result, the money made available to the state from CMP funds varies year to year.
A. Solicitation of Proposals: The Department will solicit proposals from capable parties for the use of CMP funds on a calendar year basis using the “Request for Proposals” (RFP) process.
CMP funding for a project will not exceed three years. Applicants may propose projects which can be completed or sustained in less than three years.
The Department will solicit proposals for projects to begin in 2017 that either pilot innovative approaches, or seek to implement proven methods to protect nursing home residents, or improve the quality of care or quality of life of nursing home residents through a variety of ways, examples of which may include, but are not limited to the following areas:
- The development and implementation of methods, tools and techniques to assist and support Resident Councils and Family Councils in the promotion of meaningful engagement by residents and families in the care planning process.
- The development and implementation of methods, tools and techniques to promote family teaching to reduce re-admission and hospitalizations following discharge from a nursing home.
- The analysis of state agency deficiencies, and development and implementation of educational, quality assurance and performance improvement training, methods, tools and techniques for facility staff, state agency surveyors, and students and teachers in nursing programs based on survey and complaint findings.
Specific details concerning the amount of funding available for projects and selection criteria will be released through the RFP process. RFPs will be posted on the state’s COMMBUYS website, and include detailed instructions on the process for submitting proposals.
B. Evaluation and Acceptance of Proposals: The Department will accept applications from capable parties through the RFP process only. In order to be considered, a proposal for the use of CMP funds must be:
- Consistent with the federal requirements for CMP fund usage at 42 USC 488.433.
- From an applicant that is:
- Qualified and capable of carrying out the intended project(s) or use(s);
- Not in any conflict of interest relationship with the entity(ies) who will benefit from the intended project(s) or use(s);
- Not a recipient of a contract or grant or other payment from Federal or State sources for the same project(s) or use(s);
- Not paid by a State or Federal source to perform the same function as the CMP project(s) or use(s). CMP funds may not be used to enlarge or enhance an existing appropriation or statutory purpose that is substantially the same as the intended project(s) or use(s).
- Submitted in a timely manner in the format specified in the RFP.
For planning purposes, interested capable parties should anticipate that they will be required to include as a part of their application:
- Purpose and Summary: Project title, purpose, and project summary;
- Expected Outcomes: Short description of the intended outcomes, deliverables, and sustainability;
- Results Measurement: A description of the methods by which the project results will be assessed (including specific measures);
- Benefits to Nursing Home Residents: A brief description of the manner in which the project will benefit nursing home residents;
- Non-Supplanting: A description of the manner in which the project will not supplant existing responsibilities of the nursing home to meet existing Medicare/Medicaid requirements or other statutory and regulatory requirements;
- Consumer and other Stakeholder Involvement: A brief description of how the nursing home community (including resident and/or family councils and direct care staff) will be involved in the development and implementation of the project;
- Funding: The specific amount of CMP funds to be used for this project, the time period of such use, and an estimate of any non-CMP funds that the State or other entity expects to be contributed to the project;
- Involved Organizations: List all organizations that will receive funds through this project (to the extent known), and organizations that the State expects to carry out and be responsible for the project;
Note that all proposals for the use of CMP funds must be approved by CMS before funding can be awarded, in accordance with CMS guidance in CMS Survey and Certification Memo 12-13-NH.
C. Monitoring and Tracking of Proposals: The Department will monitor and track all funded proposals in accordance with state procurement requirements and to ensure funds are utilized in a manner consistent with federal requirements. Award information, progress reports and final reports will be made publically available through this website, including information on the dollar amount awarded, grantee or contract recipient, the results of projects and other key information.
Current and Past CMP Funded Projects in Massachusetts
Since the inception of the CMP fund program, Massachusetts has funded a variety of projects to protect or improve the quality of care or quality of life of nursing home residents. Current and prior CMP funded projects include but are not limited to:
- Resident and Family Council Engagement Initiative: The Resident and Family Council Engagement Initiative works with skilled nursing home staff, residents, and family members to develop, enhance, and sustain resident and family councils in their facilities. Resident and family councils are essential to foster meaningful engagement between nursing home residents, their families, and facility leadership to improve person-centered care and the quality of resident life.
- Supportive Planning and Operations Team (SPOT): The SPOT initiative developed a framework where experts with long term care experience provided technical assistance to nursing homes based upon their individualized needs. These slides share the assessment, interventions and outcomes from the first year of this initiative. Supportive Planning and Operations Team (SPOT) Initiative Stakeholder Presentation
- Massachusetts Falls Prevention Coalition: The Massachusetts Falls Prevention Coalition was founded in 2006 to raise awareness among senior care providers and the public of the harmful impact of falls and the availability of successful prevention strategies. CMP funding was used to support the activities of the Coalition, including joint training for facility staff and surveyors from the Department on ways to reduce falls among nursing home residents. The work of the Coalition subsequently led in part to the establishment of the Massachusetts Commission on Falls Prevention and their 2013 Phase 1 Report file size 1MB .
- OASIS: With support from CMP funding, 363 Massachusetts nursing facilities enrolled in the initiative receive training and support to implement the innovative, non-pharmacologic focused OASIS curriculum, designed to help staff meet the needs of residents with dementia. This resident-centered approach to reducing antipsychotic medications focused on helping all nursing facility staff develop and refine behavioral strategies to improve quality of life for residents and job satisfaction for staff members. Additional information about the project is available on the OASIS website.
- Massachusetts Long Term Care Mutual Aide Plan (MassMAP): CMP funding provided support to nursing homes for participation in this program. MassMAP creates a system of support that provides participating facilities with resources and technical assistance in the event of a disaster; and conducts annual exercises to better prepare nursing homes to respond to a disaster and protect their resident. Additional information on the MassMAP system is available on the MassMAP website.
This information is provided by the Division of Health Care Facility Licensure and Certification within the Department of Public Health.