Did you know that Long Term Care Facilities may qualify for up to $3,000 in care improvements?

CMP: Civil Monetary Penalties

A CMP is a sanction imposed against long term care facilities for committing fraud or an Immediate Jeopardy situation. The Centers for Medicare & Medicaid Services (CMS) study the case and decide if the SNF requires civil monetary penalties or its exclusion from the Medicare and Medicaid program.

Here are the references on how the penalties are calculated depending on the infraction.

A CMP is an efficient measure to regulate long term care facilities from harmful behaviors, but it can also turn into a productive, indirect tool to improve their provided services.

The collected capital accumulates in an interest-bearing account the state reinvests in supporting skilled nursing facilities when meeting specific requirements.

CMPs Before and After Covid-19

In the past, the Civil Monetary Penalties Funds were sometimes challenging to access. Facilities could apply for a CMP grant, but the grant proposal needed to have enough documentation to be approved. If the application could not prove its evidence-based outcomes, the facilities would have fewer chances to obtain the claimed resources.

Since Covid-19 overwhelmed the country’s long term care health systems, the funds are more easily available for skilled nursing facilities. 

Laura Cartwright says in the interview above:

“All you had to do was fill out this form. It asks what technology is wanted, how much it costs, and we got up to $3,000.” 

How Laura Cartwright From Nazareth Home Earned the CMP Grant

Laura Cartwright is an RN and specialist in quality and education at the Highlands Campus for the Nazareth Home in Kentucky. Before getting her RN license, Laura studied and worked in fine arts, and it was still before even working as a nurse when she learned about the CMP grants and all the funds the states were concentrating out of Civil Monetary Penalties.

CMP Funds Application Process

In April 2020, the CMS put out the emergency grants to help facilities face the difficulties of Covid-19.

As soon as Laura learned about it, she sent the state’s application for a $3,000 technology grant designated to the residents’ communication and councils’ improvement.

They found the Kentucky grant representative’s contact to apply for the CMP grant and got informed about every application process step.

You can find your state contact for CMP reinvestment at the bottom of this article.

To be considered for the funding, each application must include the following information:

  • Facility’s name
  • Number of residents
  • Devices information
  • Cost per device 
  • The total number of devices requested. 
  • Total funds requested 

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Communicative Technology CMP Grant

Because of the situation’s urgency, Nazareth Home went ahead and financed the equipment they needed on their own before the reimburse would be approved. 

Their proposal required communicative devices to connect residents with their families and loved ones during the pandemic’s isolation in the long term care facility.

The purchase consisted of eight iPads for each one of their campuses, along with their corresponding cases. The acquisition cost $2,950, right on the cusp of the available $3,000.

The major hitch the SNF had to face was being able to buy all the tablets at once. Laura explains how they needed iPads for too many people, but there was a limit of iPads they could get at a time. They had to go through a vendor they had a partnership with to get all the products they needed soon.

In the end, Laura managed to get 16 iPads for both Nazareth Home campuses, and by the middle of May, the reimbursing check arrived.

Long Term Care Facilities Need for Communicative Equipment

Communicative devices help long term care facilities connect with their families, turning into a helpful tool to combat social isolation’s adverse outcomes.

Combating the Covid-19 pandemic has required the skilled nursing facilities to self-isolate for long periods and follow other crucial recommendations to stop the spread of the virus within their communities.

How does Cantata Long Term Care Software help SNFs face Covid-19? 

A Guide Through COVID-19 for Long Term Care Facilities

Learn about the CMS and CDC recommendations to slow the spread of the Covid-19 in SNFs in the following ABILITY INFECTIONWATCH webinar

The WHO  (World Health Organization) and governments worldwide agree on the crucial importance of social isolation in fighting the virus spread.

The problem is that social isolation may carry severe health issues. Research  has linked confinement and loneliness to a variety of physical and mental conditions: 

  • High blood pressure 
  • Heart disease
  • Obesity
  • Immune system weakening
  • Anxiety 
  • Depression 
  • Cognitive decline 
  • Alzheimer’s disease
  • Death

Skilled nursing and senior care facilities have isolated their residents from the community, family, and friends to protect them. In many cases, they have been isolated even from the rest of the residents. Strict measures of this sort have led to a significant decline in the residents’ health.

For more detailed information about the social isolation outcomes and solutions, take a look at our interview with Kevin McCormick:

Combating Depression and Social Isolation in Long Term Care

Technology to Connect People

From the different possibilities the CMS offers to help long term care facilities, the Communicative Technology Grant is the most common among the applications. The CMS and facilities understand the power of communication to overcome social isolation, and the CMP fund has already financed a significant amount of these projects across the country.

The Act and regulation provides that CMP funds may be used to support activities that protect or improve the quality of care or quality of life for residents

Centers For Medicare And Medicaid Services

Facilities may use CMP funds for (among others) the following reasons: 

  • Projects that support resident and family councils and other consumer involvement in assuring quality care in facilities
  • Assistance to support and protect residents of a facility that closes
  • Residents relocation expenses when a facility is closed
  • Facility improvement initiatives. 

Laura Cartwright found the opportunity to provide residents a mental health and life improvement in the Communicative Technology Grant.

The grant served to purchase iPads the residents could use to FaceTime with their families. The money covered the iPads, their cases, and cleaning solutions. The funds could be used for any kind of adaptive equipment they could prove destined for their residents’ telecommunication, like, for example, cameras for video calls.

Laura noted, some iPads were dedicated only to the Covid-19 unit. Nobody else could use them, and they were regularly cleaned. The facility always kept all devices safely cleaned with the proper antiviral, alcohol wipes. The tablets became the only way residents could contact their families and friends during uncertain times of isolation and loneliness. In some cases, the iPads became some residents’ entire social lives.

CMP Grants For Telehealth

As another communicative implementation for the residents’ care, the staff also used the iPads for telehealth.

While one nurse practitioner had to quarantine at home for caution, she continued assisting residents by working from home. 

Thanks to the CMP Grant, we could keep direct communication between her and the patients she would need to interview and check on. Even if we can do a more integrated assessment in person, we had nurses at both ends of the call coordinating to share all the needed assessments, ensuring the service was complete as usual.

Laura CartWright, RN

In-person Visits

Nazareth Home is currently free of Covid-19 cases, but they still give communicative approaches to the iPads use. 

While still preserving strict social distancing measures, they are beginning to open up to family councils. These reunions are getting very popular in health care centers because they allow patients to keep a safe distance from visitors. 

The problem long term care facilities residents face is that they often have hearing problems because of their advanced age. A resident with hearing limitations cannot keep up with a conversation wearing masks six feet away. During in-person visits, residents still use iPads to FaceTime with the visitors so that the video call audio makes their encounter possible.

CMP Visitations Grant

The CMS has also released a new initiative to finance measures that ensure these visits’ safety.

Apart from the Communicative Technology Grant, the CMS is also offering funds for other productive initiatives. 

The In-Person Visitations Aid CMP Grant allows long term care facilities to invest the CMP funds to purchase equipment that improves outside visitations’ safety. The application must fall in the qualifications by proving the manufacturer’s products safe. Facilities can use this grant to purchase tents and screens that allow a safe encounter with outsiders.

Learn more about the CDC instructions for visitors management

CMP Funds’ Outcomes for Nazareth Home

By applying for the CMP grants, Laura Cartwright helped Nazaret Home residents overcome the pandemic isolation struggles.

Nazaret Home

Nazareth Home is a Catholic-based SNF founded by the Sisters of Charity. Along with its sister campus in Clifton, Nazareth Home suffered the challenges Covid-19 has brought to health care facilities during the pandemic. They had to deal with cases on both campuses in Kentucky and figure out how to get it out of their community to ensure the facilities’ safety. 

Thanks to the CMP funds, Nazareth Home is now more equipped to face a situation that has taken all care facilities worldwide by surprise. 

How to Apply for the CMP Grant

Even the more prepared health systems had to take urgent measures to fight this crisis. These CMS emergency programs are a great help for long term care facilities. The process aims to be accessible enough for facilities to qualify for the funds and quickly reimburse expenses.

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All facilities need to do is finding their state contact for CMP Reinvestment in the following list and follow the easy instructions to provide the forms and documentation required.

State Contacts for CMP Reinvestment

 

State Representative Phone Email
Alabama Dennis Blair (334) 206-5366 Dennis.Blair@adph.state.al.us 
Alaska Mary Perius (907) 334-2488 Mary.Perius@alaska.gov 
Arizona Diane Eckles (602) 364-2675  Diane.Eckles@azdhs.gov 
Arkansas Sandra Broughton (501) 320-6182 Sandra.Broughton@dhs.arkansas.gov
California Carly Carroll (916) 449-5582 Carly.Carroll@cdph.ca.gov
Colorado  Randy Kuykendall (303) 692-2945  Randy.Kuykendall@state.co.us
Connecticut  Donna Ortelle (860) 509-7520 Donna.Ortelle@ct.gov
Delaware  Renee Purzycki  (302) 421-7444 Renee.Purzycki@delaware.gov
District of Columbia  Veronica Longstreth (202) 442-4737 Veronica.Longstreth@dc.gov
Florida  Marsha Webb (850) 228-7109 Marsha.Webb@ahca.myflorida.com
Georgia  LaKeisha Levy (404) 463-8987 Lakeisha.Levy@dch.ga.gov
Hawaii  Keith Ridley (808) 692-7227  Keith.Ridley@doh.hawaii.gov
Idaho  Debby Ransom (208) 334-6626 RansomD@dhw.idaho.gov
Illinois  Aimee D. Isham  (217) 782-2363 Aimee.Isham2@illinois.gov
Indiana  Nancy Adams (317) 233-7119 NAdams1@isdh.in.gov
Iowa  Sally Oudekerk  (515) 256-4643 Soudeke@dhs.state.ia.us
Kansas  Lacey Hunter (785) 296-1269 lacey.hunter@ks.gov
Kentucky  Gina Riddell (502) 564-2888 CMPAPPLICATION_OIG@ky.gov
Louisiana  Cecile Castello (225) 342-4997 Cecile.Castello@la.gov
Maine  Elizabeth Church (207) 287-9335 Elizabeth.Church@maine.gov
Maryland  Shaliek Maxwell-West (410) 402-8189 shaliek.maxwell-west@maryland.gov
Massachusetts  Dr. Katherine T. Fillo (617) 753-7328 Katherine.Fillo@state.ma.us
Michigan  Cheryl A. Klima (517) 241-7334 Klimac@michigan.gov
Minnesota  Munna Yasiri (651) 431-2264  Munna.Yasiri@state.mn.us
Mississippi  Michelle Austin (601) 364-1106  Michelle.Austin@msdh.ms.gov
Missouri  Shelly Williamson (573) 522-6228 shelly.williamson@health.mo.gov
Montana  Todd Boucher  (406) 444-2038  Tboucher3@mt.gov
Nebraska  Catherine Gekas Steeby (402) 471-9058 Catherine.Gekassteeby@nebraska.gov
New Hampshire  Doreen Shockley (603) 271-9011 Doreen.Shockley@dhhs.nh.gov
New Jersey  Jeanette Bergeron (609) 826-3749 Jeanette.Bergeron@doh.nj.gov
New Mexico  Maurella Sooh (505) 476-9039 Maurella.Sooh@state.nm.us
New York  Sheila McGarvey (518)-408-1267 Sheila.Mcgarvey@health.ny.gov
Nevada  Leticia Metherell (775) 684-1030  lmetherell@health.nv.gov
North Carolina  Becky Wertz (919) 855-4580 Becky.Wertz@dhhs.nc.gov
North Dakota  Bridget Weidner MPH (701) 328-2352 bweidner@nd.gov
Ohio  Amy Hogan (614) 752-3076 Amy.Hogan@medicaid.ohio.gov
Oklahoma  Luvetta Abdullah (405) 271-5278 LuvettaA@health.ok.gov
Oregon  Cathy Orias (503) 373-2185 Catherine.M.Orias@dhsoha.state.or.us
Pennsylvania  Marion Boggs (717) 724-6543 Mboggs@pa.gov
Rhode Island  Gretchen Bell (401) 462-1501 Gretchen.Bell@ohhs.ri.gov
South Carolina  Mary Jo Roué (803) 545-4293 Rouemj@dhec.sc.gov
South Dakota  Chris Qualm (605) 773-5273 Chris.Qualm@state.sd.us
Tennessee Shaquallah Shanks (615) 741-6823 Shaquallah.Shanks@tn.gov
Texas  Vanessa M. Rios (512) 707-6114 CmpApplication@hhsc.state.tx.us
Utah  Joel Hoffman (801) 538-6559  Jhoffman@utah.gov
Vermont  Suzanne Leavitt (802) 241-0346  Suzanne.Leavitt@state.vt.us
Virginia  Courtney Richter (804) 225-4218 courtney.richter@dmas.virginia.gov
Washington  Candace Goehring (360) 725-2401 Goehrcs@dshs.wa.gov
West Virginia  Tina Maher (304) 558-0050 DHHROHFLACAdmin@wv.gov
Wisconsin  Pat Benesh (608) 264-9896 Patricia.Benesh@wi.gov
Wyoming  Laura Hudspeth 307) 777-7123 Laura.Hudspeth@wyo.gov

How This Long Term Care Organization Got $3000 in CMP Money Transcript

Jason Long

Hello, everyone, my name is Jason Long. I’m the general manager at Cantata Health NetSolutions division. And I’m here today with Laura Cartwright, RN and specialist in quality and education. Is that right, Laura? All right. And today, we’re gonna be talking about how you got some CMP money and what you did with it. So before we get started, though, tell me a little bit about yourself and tell me, how did you get into nursing? And how did you get into long-term care?

Laura Cartwright

Well, nursing is actually my second degree; I had a fine arts degree before that. And then I just found it interesting and wanted to go back to school. So that’s what I did. And I got my RN. And then, I started working at the university hospital here in trauma. And then I just wanted to change a scene. So I actually became a state surveyor. And when I was a state surveyor, I learned all about CMP grants and how each ton of states have just this bucket of money that nobody really uses. And ever since COVID happened, it’s a lot easier to get that money, it’s a lot easier to get those grants. So I’m tapping into that. That was kind of the jumping-off point for this.

Jason Long

You’re the first person I’ve ever met that was a surveyor. And you’re the first person I’ve ever met that went from Fine Arts to nursing. How about if you tell me about it before we go into CMP? Tell me about that for one second, like how that transition happened?

Laura Cartwright

Yeah, so I went to high school, here we call it a youth performing art school. And it was all theater. And I did like set design, costumes, that sort of stuff. So I transitioned from high school to college, and I did interior architecture; it was my major. So I have my Bachelor of Fine Arts in that. So once I graduated, I worked at Home Depot, actually, and I designed kitchens and all that stuff, but just wasn’t fulfilling what I really wanted to do. I thought I could do more than this. So I have family members, and people I know who were nurses. And I was like, let’s give this a try. Let’s see if it’s not my like, and it was the best decision I ever made.

Jason Long

That’s fantastic. That’s really good. That’s kind of a crazy story to go from Home Depot over to nursing. So you learned about CMP when you were a surveyor. How did you find out about it being a surveyor?

Laura Cartwright

So anytime a facility is fined, the survey team goes in, and they find that harm has occurred, or there’s an Immediate Jeopardy situation, that facility has to pay a fine. And that fine can be one set amount of money, or it can be based on how many days they were out of compliance; it just kind of depends. So over the years, that money just accumulates, and it goes into this interest-bearing account that the state holds that no one can touch, so the governors can’t touch it, nobody can mess with that money. The only way that money goes is to go back to the long-term care facility as a whole. So it goes back into the community, which is for the best. So you can write a grant and request it. And normally it has to be very intense, it’s got to be, you have to be able to prove that you were trying to do something and then evidence-based, you have to be going through it and making sure that you’re tracking what you wanted to do, and then have outcomes at the end so that people can then look on that grant and say, “Oh, this was successful,” or “this was not successful.” But since COVID, all that money is still there. And there’s a lot of need in the community and long-term care communities. So one of those was technology needs. So that was a big part of why we went with this grant that we did. And there’s another grant that was just released, I believe, last week, it was in September, and it is for visitation. So they’ll be providing free money. All you have to do is ask for it and follow the simple steps, and you get like tents. So you can do outside visitation. I think it was tents and like screens so that you can do safe outside visitation with families.

Jason Long

That’s really cool. Is that like one of those hugs screens?

Laura Cartwright

I don’t know if they’re. I mean, it’s whatever you want. So that’s what’s cool about it, as long as it falls in their qualifications, and you can prove that it’s safe, you get the manufacturer’s information to show that it’s a safe product, then you can use it.

Jason Long

Gotcha. So the way it’s working right now, you just have to follow their grant, or if there’s a grant out there, somebody wrote that grant, and there’s just money, you can pull off that grant. Is that right?

Laura Cartwright

CMS has put out like an emergency grant. So they make it very simple. There’s a very simple form that you can get. You have to go through your state agency, though. So whoever your state contact is available on the CDC website, or sorry, the CMS website. If you go on the CMS website, you can see who your grant representative is, you can contact that person, and then they’ll tell you exactly what to do. So like for Kentucky, it was right on our website, it said, you know, technology grant, click here, and it just has you fill out whatever you want it. So we’ve chosen iPads. Because we can FaceTime, a lot of our family members had iPhones; it was just an easy transition for us. So we got eight iPads, all you had to do was fill out this form, it asks what technology wanted how much it costs, we got up to $3,000. So however you wanted to use that. A lot of people got iPads, but you could also get adaptive equipment like stylists, something, so you’re not touching it with your hands. You could get cases for the iPad, to make it easier to clean down, you could get the cleaning solution itself. Whatever you want to do that $3,000 for it just had to fall in the confines of those rules. You couldn’t use it for things outside of that. But you could get little mini cameras to do zooms; you could do telehealth with it. So anything, you just had to prove it was for telecommunication for your residence.

Jason Long

Gotcha. That’s really cool. So I’ll go find some of those links for people so we can post them in this blog article. So that they can just go ahead and start taking advantage of that. What has been the outcome so far for you?

Laura Cartwright

We have eight, which is loving; we’re a 150 beds facility. But I mean, that’s still a lot to be able to use, and some of our residents can use them themselves, and then some need assistance. We have had COVID residents, and then we, you know, we kind of default, depending on our situation. But right now, we don’t have any, thankfully. But that was nice to have, one iPad dedicated to our COVID unit that nobody else could touch. And we’re not moving it around. It just stayed there, but they could still visit so that they’re not missing that, that needed communication with their families and friends.

Jason Long

That’s really good. That’s a really good idea. That’s it. Did you have other ideas, other things that you were thinking about for the technology money?

Laura Cartwright

Well, that was our biggest need. If you read the grant requirements, it’s really meant to be for residents to communicate. So telehealth was the other reason. So we had a nurse practitioner who was under investigation, she had been tested, but we weren’t sure. But she still wanted to be able to work. She was asymptomatic. So she was working from home, and we were able to use that. She could look at the patient, ask questions of the patient, and see what was going on. And she couldn’t really do that full assessment that we could do. But you know, there was a nurse right there who’s saying, “oh, their blood pressure is this,” you know? All those assessment signs. So it was kind of like a teamwork thing where we’re just ensuring safety by just using this device that we got for free. So that was a nice benefit.

Jason Long

That’s really cool. When did you get them?

Laura Cartwright

So I first heard about it in April. I think April 29th or 30th was when we sent it to the state. We went ahead and bought it with our own money, and then they reimburse you. So we bought eight iPads. I think the 32 GB black iPads. And then we got some cases for them just to make them nice. And it was right at 2950; it was like right on the cusp. But probably the hardest part, because so many people want iPads and stuff right now, is finding a place that would send so many to us, like there were limits; you can only get one or two at a time. So we had to go through a vendor who helps us with our computer and stuff here. But we got eight of them. We started using them, and then I think middle of May, they sent us a check to reimburse us for that amount.

Jason Long

Okay, so about six weeks. Great. That’s fantastic. Have you had experience with anybody else who’s got access to that money and anything that they’ve done?

Laura Cartwright

Well, so we have a sister facility too, the Clifton campus. It’s a little up the road from us. So when we did the grant way, if you have more than one group with you, like we’re under the Nazareth home, Arch, so both of us, we order them at the same time. So I got eight for this campus and eight for the other candidates.

Jason Long

Gotcha, okay.

Laura Cartwright

Same kind of way. And then the only other ways we’re using them are now doing in-person visits. They let us open up that phase for us. But of course, it’s still socially distance. So we have some people, some residents who are hard of hearing. So we’ll still put FaceTime on the phone with their family download into the table, and then they’ll have the iPad there. So they can still hear a little bit better, helps the seeker amplification part of it. They’re not looking at it, but they’re hearing better, and they can turn the volume up a lot higher. Because six feet is a lot, especially for someone who’s extremely hard of hearing, and they can’t read lips when they’re that far away as easily. So that’s kind of all, they have to have masks on too. So there’s a lot of workarounds. We’re trying to get it so that they can visit in person and see the people that they love and care about, but also be safe.

Jason Long

That’s really good. That’s really smart. I was gonna ask, the iPads you got, do you sanitize them as well? Like, how do you clean them up? Like you just wipe them down right now? Or do you have some special process for that?

Laura Cartwright

Anything that’s alcohol 70% or higher is a proof to kill COVID. We have Sani wipes, an antiviral wipe. But in between each use, we wipe them down. It has to sit for two minutes to be effective. And then we can use it. So we usually just store them and then wipe them down before we give them to somebody. And then after they’re done, we wipe them down.

Jason Long

Gotcha. Okay, cool. Any other stories of how you’re using it? Have you heard of other companies that have done it, and what’s gone into it with the CMP money?

Laura Cartwright

I know other people who have asked me about it and what we’ve done, but I don’t know what their outcomes were, what they were doing specifically, but it’s the most easy, amazing opportunity to get set in your building. And then, when COVID is over there, take them away, you know? I mean, you have those iPads or whatever you purchase forever. So you can use them for your CNA document or whatever it is that you need them for. So they’re great for now. And then you can always use them later. So it’s just free money.

Jason Long

So perfect. That is fantastic. That was so good. And thank you so much for doing this interview so that we can tell everybody how to do this. I really appreciate it. I know that people all across the US are gonna appreciate it as well.

Laura Cartwright

We’ll get the tips to get the tents, get the dividers… That’s what we’re working on right now, what would be best for us in our, you know, the layout of our parking lots and stuff like that, what would we need. But we have every intention of taking a bit of free money. It’s free money, like why wouldn’t you take it? So it’s nothing to fill out the request. You got to figure out what you want, fill it out, purchase it, send it in; they send you a check. So I mean, it’s like a rebate. Kinda.

Jason Long

That’s fantastic. Before we wrap up, can you tell me about your facilities? Like, where you located? Who did you serve? Like, we’re doing this interview. Let’s give you guys a shout out. So tell me a little bit about your facility.

Laura Cartwright

I am at the Highlands Campus, at Nazareth Home. And it was founded by the Sisters of Charity of Nazareth. So it is a Catholic-based facility. And then we have our sister campus, which is Clifton, which is over in another part of the town. But we have a lot of sisters here, fathers, brothers, mothers, and we have a lot of clergies and families. We also have all kinds of people. We have a dementia unit, we have traditional long-term care, we have rehab, and we have personal care. We have lots of levels of care that we deal with. And they’re all unique in their own way. And COVID has affected them all in their own way. So it’s been a challenge working around all that. But we have had COVID cases on both campuses. And that has been challenging too, but just trying to chug through it and that we can figure out and get it out of our community and then we’ll be much safer and happier.

Jason Long

Yeah, for sure. All right. Well, perfect. Well, thank you so much. I appreciate all of your time today. This was really helpful. Did you have anything else you want to bring up before we wrap it up?

Laura Cartwright

Not really. No.

Jason Long

All right, perfect. Well, thank you so much. And I’m gonna get this published out to everybody, hopefully, this week. So look for it coming back out to that Facebook group and look for it coming out, being emailed out to facilities across the US. So yeah, and people are gonna thank you a lot for this. I think they will, for sure. So thank you. I’ll talk to you soon.

Laura Cartwright

Thanks.

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