NURSING HOME
WEST VIRGINIA CMP GRANT FUND PROJECT
Purpose
The purpose of the West Virginia Civil Money Penalty Fund Project is to provide a pool of funds each year to assist eligible nursing facilities to prevent continued noncompliance, help improve performance, and/or develop new and innovative approaches to improve the quality of life and/or care of residents in nursing facilities.
Background and Rationale
The purpose of the West Virginia Civil Money Penalty Fund Project is to provide a pool of funds each year to assist eligible nursing facilities to prevent continued noncompliance, help improve performance, and/or develop new and innovative approaches to improve the quality of life and/or care of residents in nursing facilities.
Section 1919(h)(2)(A)(ii) of the Social Security Act (the Act) provides that CMP funds collected by a state as a result of certain actions by nursing facilities or individuals must be applied to the protection of the health or property of residents of nursing facilities that the state or the Secretary of the West Virginia Department of Health and Human Resources finds deficient. These actions include CMPs assessed against:
- A nursing facility that is not in compliance with federal requirements in Sections 1919(b), (c) and (d) of the Act;
- An individual who willfully and knowingly certifies a material and false statement in a resident assessment [Section 1919(b)(3)(B)(ii)(I) of the Act];
- An individual who willfully and knowingly causes another individual to certify a material and false statement in a resident assessment [Section 1919(b)(3)(B)(ii)(II) of the Act];
- An individual who notifies (or causes to be notified) a nursing facility of the time or date on which a standard survey is scheduled to be conducted [Section 1919(g)(2)(A)(i) of the Act].
Because CMP funds collected by a state are state funds, the state may use the money for any project that directly benefits facility residents, in accordance with Section 1919(h)(2)(A)(ii) of the Act.
The Act requires that the use of CMP funds be focused on nursing facilities that have been found to not be in substantial compliance with federal requirements in Sections 1919(b), (c), and (d) of the Act. For this reason, CMP funds shall be used to assist nursing facilities with histories of recurring non-compliance with these requirements (i.e., deficiencies cited at a scope and severity greater than level C).
CMP FUND COMMITTEE
Purpose
The purpose of the West Virginia Civil Money Penalty Fund Project is to provide a pool of funds each year to assist eligible nursing facilities to prevent continued noncompliance, help improve performance, and/or develop new and innovative approaches to improve the quality of life and/or care of residents in nursing facilities.
Committee Functions
- The CMP Committee shall meet quarterly or more frequently as needed.
- The Office of Health Facility Licensure and Certification (OHFLAC) shall receive all grant applications.
- For an application received from a facility, OHFLAC shall verify that the facility meets eligibility requirements before forwarding the application to the CMP Committee for review.
- The CMP Committee shall review applications for awarding grants and recommend to the director of OHFLAC for approval. The director of OHFLAC or OHFLAC designee will forward the application to the CMS for approval.
- The CMP Committee shall maintain minutes of meetings.
Clerical Support
- OHFLAC shall provide support staff to the CMP Committee.
- OHFLAC’s fiscal staff shall maintain records of accounting.
- OHFLAC’s fiscal staff shall give an accounting of records to the CMP Committee on a quarterly basis or as requested by the committee.
USE OF CMP FUNDS & ELIGIBILITY REQUIREMENTS
Intent
A nursing facility applies directly for CMP grant funds to train its staff and/or residents to help "improve their own performance or to develop new and/or innovative approaches to improve the quality of life or care for residents."
- Only nursing facilities that participate in Medicaid (whether certified for participation in Medicaid only or dually certified to participate in both Medicaid and Medicare) shall be eligible for receiving grant funds.
- Grant funds shall be limited to a range of $1,000 - $5,000. If two (2) or more nursing facilities would like to apply jointly for funding of education and/or training, the dollar amount will be limited to a range of $1,000 - $25,000. To be eligible, a nursing facility must have a history of recurring deficient practice on two (2) or more surveys within a twenty-four (24) month time frame. The nursing facility must not be in an enforcement cycle at the time of application nor have any outstanding CMPs. An enforcement cycle begins when a survey event finds a facility to not be in substantial compliance with the federal Medicare and/or Medicaid certification requirements. The cycle ends when the nursing facility either achieves substantial compliance (as verified through submission of an acceptable plan of correction and/or onsite revisit) or has its Medicare and/or Medicaid provider agreement terminated due to continuing non-compliance. Substantial compliance means a level of compliance with the requirements of participation such that any identified deficiencies pose no greater risk to resident health or safety than the potential for causing minimal harm (i.e., no deficiencies cited at a scope and severity greater than level C).
- No matching funds are required.
- Receiving grant funds in one (1) quarterly period does not preclude the nursing facility from receiving additional funds, either to continue training on the same topic or to provide training in a different area of knowledge.
- The nursing facility may use the grant funds for training and/or education directed towards the facility’s residents and/or responsible parties or for a program intended to improve the residents’ quality of life.
- The nursing facility shall not use the grant funds for payroll, operational expenses, or capital expenditures.
- The nursing facility shall not include expenses related to the grant-funded project on its cost report.
- The CMP Committee shall give priority consideration to nursing facilities applying for grant funds for training and/or educational opportunities focused on direct care staff
Intent
An outside agency applies for funds to offer training and/or educational programs (at no cost) to multiple nursing facilities on specific topics that would improve the quality of life and/or quality of care of residents.
Example: The Alzheimer’s Association may apply for funding, allowing the organization to offer seminars (free of charge to nursing facilities) on topics that would improve the quality of life and/or quality of care of residents with dementia.
- The grant funds shall be limited to a range of $1,000 - $50,000 for any one (1) quarterly period (with the stipulation that the outside agency shall not use the CMP funds as its main source of income).
- The CMP Committee shall give priority consideration to nursing facilities applying for grant funds for training and/or educational opportunities focused on direct care staff
Intent
The CMP Committee, through its diverse membership, having identified broad concerns related to quality of life and/or quality of care in nursing homes, recommends to the state survey agency an outside agency to develop and/or implement a program to address the area(s) of concern statewide.
Examples:
- The CMP Committee recommends funds to be granted to an agency to develop and/or implement web-based training for infection control practitioners that would then be made available to all nursing facilities at no charge
- The CMP Committee recommends funds to be granted to an outside agency to develop and administer a questionnaire or survey to assess the training needs of staff in all nursing facilities in West Virginia.
The dollar amount for such a grant would be considered on a case-by-case basis.
CMP APPLICATION PROCESS
- Submit completed application to the CMP Committee via mail or email.
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Applications or Projects submitted that are planned over a continuous time period shall not
exceed thirty-six (36) months.
The application shall include:
- Purpose and Summary
- Expected Outcomes
- Result Measurement
- Benefits to the NH Residents
- Non-Supplanting
- Consumer and other Stakeholder Involvement
- Funding
- Involved Organizations
- Contacts
- The CMP Committee shall review the application and recommend approval or disapproval to the director of OHFLAC.
- Upon approval or disapproval of an application, OHFLAC 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 thirty (30) calendar days to complete revision(s) and re-submit to the CMP Committee.
- Following notification that an application has been approved by the CMP Committee and the Director of OHFLAC, the OHFLAC office will forward the application to CMS for approval (not to exceed forty-five (45) calendar days). 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 thirty (30) calendar days to complete the revision(s) and return to OHFLAC for resubmissions to CMS.
- Any cost associated with the completion of the application is the responsibility of the applicant.
- When OHFLAC receives notice from CMS that the approval may proceed, OHFLAC will notify the applicant with instructions about the process for entering into an agreement with OHFLAC to allow for the release of CMP funds.