New York State: Recommendations for Use of CMP Funds

In 2004, New York State passed a law, long advocated for by LTCCC, creating a nursing home quality of care improvement fund, a segregated account for monies collected from federal civil money penalties. As a result, the state could collect and use funds from civil monetary penalties and state fines to fund projects to improve nursing home care.  With funding from the New York Community Trust, LTCCC brought together a broad based group of consumers, consumer representatives and ombudsmen in a CMP Stakeholder Summit to develop criteria to implement recommendations made in our national study (see report on the right) in New York State.

Visit our page on NY State developments.

National Report: How Federal Civil Monetary Penalties and State CMPs/Fines Can Support Good Care for Nursing Home Residents 

Project Background: Federal Civil Monetary Penalties (CMPs) and State CMPs/fines are imposed by the regulatory agencies that license nursing homes if a nursing home does not comply with regulatory standards. We believe that CMPs and state CMPs/fines present an additional valuable resource for fiscally constrained states to improve the quality of nursing home life and care. The collected funds can be used to support innovative care; however, little is known about which states levy these fines, whether or not the fines that are levied are actually collected or whether and how they are used to improve care. Although many states impose CMPs and state fines and do use these funds to improve resident care and life, the use of this option is highly variable from state to state. 

Project Goals: The project’s central purpose is to encourage states to use CMP funds to support innovative, resident directed practices either as specific practices or more fundamental changes in organizational culture by (1) informing the public, consumer groups, state leaders, ombudsmen and the industry about the practices and experiences of states’ use of CMPs and state fines; (2) encouraging appropriate state use of CMPs by identifying and publicizing states’ experiences with CMPs; (3) encouraging the use of CMPs funds and state fines to improve nursing home resident care and/or quality of life by identifying innovative uses that are related to improving long term care; and (4) identifying ways to make the public aware of the levying of CMPs and state fines and the uses of the collected funds.

Project Products: In order to reach these goals, the project has produced a number of materials which can be downloaded for free from this Webpage. These materials include the full report, Funding for Innovation: A Review of State Practices with Civil Monetary Penalties, which includes details of projects in six states and findings of a survey with long term care ombudsmen and consumers. In addition, the following specific components of that report can be downloaded separately:  

· Case Studies – examining a number of state activities and identifying “best practices.”

· Resource Brief – describing a survey of ombudsmen and advocates including information on their knowledge and perceptions of the use of fines, public information issues, and recommendations for changes in policies and practices. The brief also discusses current methods for informing the public about CMPs and state fines and identifies “real life” successful practices in consumer education on CMPs and state fines.

· Action Plan – relates the findings of all of the above products to help stakeholders use the information in their states to advocate for use of the monies collected to improve resident quality of life. 

These findings have been published in the December, 2006 of The Gerontologist. 

Project Benefits: The project provides a comprehensive compilation of information about states’ practices related to CMPs and state CMPs/fines as well as an action plan stakeholders can use to make changes in their state to encourage the appropriate levying and use of CMPs to improve nursing home care.  

Project Support: Funding for this project was provided by The Commonwealth Fund.

Project Staff: The Long Term Care Community Coalition (www.ltccc.org) and Dr. Charlene Harrington of University of California, San Francisco, (nurseweb.ucsf.edu/www/ffharrc.htm) with the assistance of the National Citizens’ Coalition for Nursing Home Reform (www.nursinghomeaction.org).  

Advisory Committee: The authors wish to thank the following individuals for their valuable participation and input as member of our Advisory Committee: Carol Benner, Association of Health Facility Survey Agencies; Rose Marie Fagan, Pioneer Network; Donna Folkemer, National Conference of State Legislators; Alice Hedt, National Coalition for Nursing Home Reform; Barbara Manard, American Association of Homes and Services for the Aging; Sally Petrone, National Association of State Ombudsman Programs; Brian R. Purtell, Wisconsin Health Care Association (Representing the American Health Care Association); and Jacquie Woodruff, National Association of Local Long Term Care Ombudsmen.