Pennsylvania's Long Term Care Grant Program​

Overview

A Civil Money Penalty (CMP) is the monetary penalty the Centers for Medicare & Medicaid Services (CMS) may impose against Medical Assistance Nursing Facilities (MA NFs), nursing facilities (NFs) and dually certified Skilled Nursing Facilities (SNF)/NFs for either the number of days or for each instance a facility is not in substantial compliance with one or more Medicare and/or Medicaid participation requirements for Long-Term Care Facilities.

Please note CMS released updated guidance for  the Civil Money Penalty Reinvestment Program (CMPRP) process on September 25, 2023 regarding  allowable and non-allowable uses, can be found at the following: Civil Money Penalty Reinvestment Program

Goal

The goal of the Pennsylvania Civil Money Penalty Grant Program is to facilitate the use of federally imposed civil money penalty funds to support activities that support, protect and benefit residents living in nursing facilities.

The objectives are to review and make recommendations regarding CMP grant applications that are submitted for the development and implementation of quality improvement initiatives that directly or indirectly benefit nursing facility residents. These initiatives should showcase a variety of enhancement or educational philosophies through current and sound evidence-based practices that promote quality of care and quality of life for nursing facility residents.

Applications

The CMP grant program will accept applications from any entity as long as the proper use of Centers for Medicare & Medicaid Services (CMS) approved CMP projects are to protect or improve the quality of life or quality of care for long-term care (LTC) facility residents. Provided the receiving entity is:

• Qualified and capable of carrying out the intended project or use,
• Not in any conflict-of-interest relationship (or the appearance of conflict-of-interest) with the entity or entities that will benefit from the intended project or use.
• Not paid by a state or federal source to perform the same function as the CMP project or use. CMP funds may not be used to enlarge or enhance an existing appropriation or statutory purpose.

Examples of eligible organizations, included but not limited to:

• Consumer advocacy organizations
• Resident or family councils
• Professional or state nursing home associations
• CMS-certified long-rerm care facilities [skilled nursing facility (SNF), nursing facility (NF)]
• Vendors
• State agencies
  
• Academic institutions
• Quality Innovation Network – Quality Improvement Organization (QIN-QIO)
  

As noted in the QSO-23-23-NH Memorandum, to ensure that funding parameters outlined are followed, CMS will be tracking CMP funding through CMS Certification Numbers (CCNs) and letters of support (LOS). CCNs should be provided on each corresponding letter of support for all participating nursing homes. In the instance of a corporation submitted a letter of support on behalf of its nursing homes, a list of corresponding CCNs should also be provided.​

Project Award Categories

Resident or Family Councils: Maximum project funding per nursing home per year: $5,000. CMP funds may be used for projects by not-for-profit resident advocacy organizations that;

• Assist in the development of new independent family councils;
• Assist resident and family councils in effective advocacy on their family member's behalf; and/or
• Develop materials and training sessions for resident and family councils on state implementation of new federal or state legislation.

Consumer Information: Maximum project funding per nursing home per year: $5,000. CMP funds may be used to develop and disseminate information that is directly useful to nursing home residents and their families in becoming knowledgeable about their rights, nursing home care processes, and other information useful to a resident.

Training to Improve Quality of Care: Maximum project funding per nursing home per year: $5,000. CMP Funds may be considered for training in facility improvement initiatives that are open to multiple nursing homes, including joint training of facility staff and surveyors, technical assistance for facilities implementing quality assurance programs, training for resident and/or family councils, LTC ombudsman or advocacy organizations and other activities approved by CMS.

Activities to Improve Quality of Care: Maximum project funding per nursing home per year: $5,000. CMP funds can be used for projects to foster social interaction, movement, and minimize loneliness. Projects include, but are not limited to:

• Horticulture/gardening
• Music therapy
  
• Animal therapy including robotic pets
• Activities for games fostering movement and function
• Reading and memory interventions
• Crafting

Grant Application Process

Effective immediately LTC applications will be accepted anytime throughout the year. Applications must be submitted electronically to: ra-pwcmpgrants@pa.gov

What is the application process and where can I apply?

Completed applications may be submitted to the Office of Long-Term Living at RA-PWCMPGrants@pa.gov for recommendation to CMS.

All applications must receive approval through the CMS location. The location will respond to the state agency (SA) with either approval, denial, or a request for more information. After a determination by the SA and CMS Location, the applicant will be notified of the funding determination by the State.

Applicants may contact the applicable SA with questions regarding their CMP application. CMP applications that are denied may not be resubmitted at a later date. A list of state CMP contacts is available on the CMS CMPRP webpage under the downloads section.

Collaboratively, representatives from Pennsylvania's Departments of Health, Human Services, and Aging shall assess the merit of each proposed project and the ability of the project to improve resident outcomes and advance the care and services provided in certified long-term care facilities.  

Following this collaborative review, the selected CMP application/s will be forwarded to CMS for final approval.

Availability of Funds

At the beginning of each state fiscal year, the Department of Human Services (DHS) shall determine the total amount of money to be allocated for the civil money penalty fund to be awarded in the form of grants to eligible entities.
 
There is no entitlement to any funds available for grants awarded through this initiative. DHS may award grants to the extent funds are available and, within its discretion, to the extent that applications are approved.  

Guideline for Applicants:

Eligible entities wishing to apply for CMP grants must meet the following requirements:

1. Grants are available for quality improvement initiatives that are outside the scope of normal operations for the nursing facility or other applicant. Grants cannot be used as replacement funding for goods or services that the applicant already offers.
2. 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 of sustainability; and letters of support.
3. An applicant previously awarded a CMP grant that failed to achieve that initiative's intended goals or outcomes shall be ineligible to apply for a period of 3 years following that grant award. However, a grant may be considered if the applicant's inability to complete the initiative was due to circumstances beyond the applicant's control.
4. Representatives from any facility requesting funding, or representatives who are in situations where a conflict of interest exists, must disqualify themselves from making recommendations.
5. CMP applications shall be accepted from dually certified providers (SNF/NF) and MA NFs or Chain NFs.
6. Applications will not be accepted via fax or hardcopy.
7. Applications shall include a cover letter addressed to the CMP grant committee.
8. The font for all applications is Times New Roman, 12 point, and shall include the entity name and page number on all documents.
9. Applications shall be limited to no more than 20 pages, including appendices and the actual CMP application form.
10. All sections of the application form shall be completed in its entirety with all required information, or the application will be denied.
11. Demonstrate the capacity to carry out the initiative for which the grant is requested.

GRANT AWARDS ARE NOT AVAILABLE FOR THE FOLLOWING:
a) Conflict of interest: projects will not be approved for which a conflict of interest exists or the appearance of a conflict of interest;
b) General operations or administrative salaries;
c) Capital improvements to a nursing home, or to build a nursing home;
d) Facility maintenance activities intended to meet the minimum standards for nursing facilities set forth in 42 CFR Part 483;
e) Goods or services for which the applicant or others are already obligated to pay;
f) Vendor payments and payroll obligations for a facility's normal operations or for fulfillment of state or federal requirements;
g) Salaries of temporary managers who are actively managing a nursing home;
h) Costs related to travel, bonuses or other direct employee benefits;
i) Costs that are not specifically outlined in the applicant's grant proposal or are already included in the facility's cost report;
j) Projects, programs, goods or services unrelated to improving the quality of life or quality of care of NF residents; and
k) Recruitment or providing Long-Term Care Ombudsman certification training for staff or volunteers, or investigation and work to resolve complaints.

Instructions for Downloading and Submitting the Application:

• Review instructions, Pennsylvania Long-Term Care Grant Application​, and FAQs​ from the Department of Health website.
• Submit completed application including all attachments to ra-pwcmpgrants@pa.gov.  
• CMP checklist:
  • Cover sheet
  • Application completed in its entirety
    
  • Letters of Support​ (LOS) - Starting October 1, 2024, all applications submitted to State Agencies (SAs) must include LOS with an acknowledgement that the proposed project funding will count against the nursing home’s allocated budget for that project category.
  • Letters of support​
    
  • Itemized Excel budget sheet
    
  • Proposal if not within application

Review of Grant Applications

The CMP Grant Committee shall collaboratively conduct an initial review and evaluate all components of the completed grant application. Reviewed applications and the state's recommendation for approval will be forwarded to CMS.
 
All grant awards are subject to final approval by the CMS regional office.

Expectations for Application Categories:

• Purpose and Summary – Describe the project purpose and project summary.
• Expected Outcomes – A description of the intended outcomes, deliverables and sustainability beyond the scope of the grant.
• Results Measurements – A description of the methods by which the project result will be assessed, including specific measures.
• Benefits to Nursing Home Residents – A description of the manner in which the project will benefit nursing home residents.
• Consumer/Staff/Stakeholder Involvement – A description of how the nursing home community (including the residents and/or family councils and direct care staff) will be involved in the development and implementation of the project.
• Involved Organizations – List all organizations or sub-contractors that are expected to carry out and be responsible for components of the project. Indicate whether or not deliverables shall receive funding.
• Funding/Project Time-line – Provide a specific itemized budget of CMP funds to be used for this project.  Itemize all other funds that will contribute to the project.  Provide a detailed project timeline including the expected project completion timeframe.
• Non-Supplanting - A description of the way the project will not supplant existing responsibilities of a nursing facility and that CMP funds will not be used to pay entities to perform functions for which they are already paid by state or federal sources.

Grant Awards

Grants for approved proposals shall be awarded through a contract entered into by DHS and the applicant. Grant funds shall be distributed pursuant to contractual obligations.

Quarterly Progress Reports

Following the date of the award and continuing until completion, the grantee shall submit quarterly reports on the status of the project to the CMP grant committee at ra-pwcmpgrants@pa.gov.  Awardees will receive additional instructions at the time the grant agreement is signed.  A grantee that fails to submit a quarterly progress report shall forfeit any future grant award distributions. 

Quarterly Reports

Quarterly reports must be submitted within 15 calendar days at the conclusion of the quarter for each three-month period throughout the identified project timeline. Please note the entity must complete the quarterly reports for the length of the project even if the funds have been fully dispersed.  Quarterly reports must be submitted to the following: ra-pwcmpgrants@pa.gov

Please note: The first report will be due at the conclusion of the first quarter that the project began. The partial report must still be submitted and follow the quarterly report schedule going forward.

Quarter 1: January, February, March. Due by April 15.

Quarter 2: April, May, June. Due by July 15.

Quarter 3: July, August, September. Due by October 15.

Quarter 4: October, November, December. Due by January 15 of the following year.

Final Report

A final report of the project shall be submitted within 30 calendar days at the conclusion of the project.

The Grant award final report must provide evidence of successful completion of the project or quality improvement initiative and address the following:

• The purpose of the grant
• The expected outcomes
• The actual outcomes
• The number of residents that benefited from the project or initiative
• The action plan for sustainability if the project or initiative will continue beyond the grant funding

All reports should be submitted to ra-pwcmpgrants@pa.gov.