Invitation to Nursing Facilities to
Apply for Grants for Use of
Civil Money Penalties |
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The Application form and the Budget Form are both Adobe pdf documents.
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Office of the Governor
Division of Medicaid
Dr. Robert L. Robinson, Executive Director
Division of Medicaid
Suite 801 Robert E. Lee Building
239 North Lamar Street
Jackson, Mississippi 39201-1399
Contact: Evelyn
H. Silas , CPM, Division Director
Case Mix / Institutional
LTC
601-359-6750
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Grants for Civil Money Penalty
OVERVIEW
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Innovative State Use of the Civil Money Penalty Funds - Incentives for High
Quality Care The Division of Medicaid (DOM) has approved the use of collected sanctioned
Civil Money Penalty funds to be awarded to nursing facilities that provide the highest
qualify of care to residents via recognition as an Enhancement Grant Award; and
to provide a means for those noncompliance facilities to be awarded an Educational
Program Award to attain compliance status and stay in compliance. As funds
are available, nursing facilities are encouraged to make applications for the eligible
grant awards for the betterment of residents' quality of life.
Enhancement Grant
Award : The goal is to provide grants for enhancements to nursing facilities
that have maintained compliance with the federal requirements for long term care.
The purpose of the Enhancement Grant Award is to provide a nursing facility with
current and past compliance history of the federal requirements the opportunity
to receive funding for innovative programs/projects that will directly and/or indirectly
benefit the residents by providing an enhanced quality of life. The grant awards
range from $5000 - $50,000. The grant proposal may be obtained on the Division of
Medicaid web site at www.medicaid.ms.gov or by telephone request at 601-359-6750.
Deadline for completion and receipt of application by DOM is January 15, 2007.
Educational Program Award : The goal is to assist nursing
facilities that have not been in substantial compliance with federal requirements
for long term care facilities to obtain and maintain compliance. The purpose
of the Educational Program Award is to provide a nursing facility with current and
past noncompliance history of federal requirements the opportunity to receive funding
for educational programs/projects that will directly and/or indirectly benefit the
residents as well as assist the facility in providing an enhanced quality of life
for the residents. This grant award is a one-time award that will benefit the residents.
The grant awards range from $5000 - $20,000. The grant proposal application may
be obtained on the Division of Medicaid web site at www.medicaid.ms.gov or by telephone
request at 601-359-6750. Deadline for completion and receipt of application by DOM
is January 15, 2007 .
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Mail Applications to:
Attention: Evelyn H. Silas, CPM
Division of Medicaid
Office of the Governor
239 North Lamar Street, Suite 801
Jackson, Mississippi 39201
or via e-mail lmehs@medicaid.state.ms.us
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Grants for Civil Money Penalty
GRANT COMPARISONS |
INNOVATIVE STATE USE
Of the Civil Money Funds - Incentives for High Quality Care
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OFFICE OF THE GOVERNOR - STATE OF MISSISSIPPI
DIVISION OF MEDICAID
COMPARISON OF GRANT AWARDS
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Educational Grant Award |
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Enhancement Grant Award |
Facility with immediate jeopardy/substandard quality of care for a standard, revisit
or complaint survey during the current and previous certification periods.
Or nursing facilities identified with pattern or widespread actual harm for a standard,
revisit or complaint survey during the current and previous certification periods.
One time expenditure
Restricted grant - not allowable expense on Cost Report
$5,000 - $20,000
Must Provide Quarterly Progress Reports
Must Provide Final Report Must Benefit
Residents
Directly or Indirectly
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Facility must have had no deficiencies or must have been in substantial compliance
in the most recent certification period. Costs to maintain will be an allowable
expense on facility cost report Should be self-sustaining once implemented
Grant Award Amounts
- No deficiencies: up to $50,000
- A only deficiency(ies) up to $45,000
- B is the highest deficiency - up to $40,000
- C is the highest deficiency: up to $35,000
Must Provide Quarterly Progress
Reports Must Provide Final Report
Must Benefit Residents Directly or Indirectly
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Top |
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Grants for Civil Money Penalty
GENERAL REQUIREMENTS
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I. Required Use of Civil Money Penalties
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A.
Section 1919 [42 U.S.C. 1396r],(h)(2)(A)(ii), specifies that, "funds collected
by a State as a result of imposition of such a penalty... shall be applied to the
protection of the health or property of residents of nursing facilities that the
State or the Secretary finds deficient, including payment for the costs of relocation
of residents to other facilities, maintenance of operation of a facility pending
correction of deficiencies or closure, and reimbursement of residents for personal
funds.
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B. The dispositions of collected civil money penalties (CMP) provided
by federal regulations are as follows:
A CMP collected by a State from a Medicaid
facility that the State or CMS finds deficient must be applied to the protection
of the health or property of residents of nursing facilities that the State
or CMS finds deficient. A CMP collected from a dually participating facility is
apportioned commensurate with the relative proportions of Medicare and Medicaid
beds at the facility actually in use by residents covered by the respective programs
on the date the CMP begins to accrue. Some examples of appropriate uses by
the State of the collected CMP include:
- State costs related to the operation
of a facility pending correction of the deficiencies or closure;
- Reimbursement
of residents for personal funds or property lost at a facility as a result
of actions by the facility or by individuals used by the facility to provide services
to residents. Established procedures for the reimbursement of residents are
followed; and/or
- Payment for the cost of relocating residents to other
facilities.
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C. Section 1919 (h) (2) (E) provides that the reasonable
expenditures of a State to provide for temporary management and other
expenses are
considered, for purposes of section 1903(a)(7), to be necessary for the proper and
efficient administration of the State plan.
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D. Costs for the Relocation
of Residents to Other Facilities.
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- The closure or termination of a nursing facility
can occur as a result of survey and certification regulatory requirements not met
in 42 CFR 483.5, 483.10 - 483.75. The closure or termination proceedings could
be based on findings including but not limited to immediate jeopardy, actual harm,
potential for harm but not actual harm, and not achieving or maintaining substantial
compliance during a specified time per the regulatory requirements. Sections
1819(h)(4) and 1919(h)(5) of the act and 42 CFR 488.456 and 489.53 provide for termination
of skilled nursing facility and nursing facility provider agreements.
- Costs for
the relocation of residents to other facilities (e.g., another nursing facility,
hospital or swing beds, assisted living facilities; any residential type facility
that can meet the medical necessity of the resident being transferred) when the
current residing facility has not met the requirements to achieve or maintain substantial
compliance may lead to the transfer of residents, or closure of the facility and
transfer of residents as required in CFR 42, Section 488.426 which states that in
an emergency, the State (Survey agency) has the authority to -
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a. Transfer Medicaid
and Medicare residents to another facility; or
b. Close the facility and transfer
the Medicaid and Medicare residents to another facility.
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It is required to transfer
residents when a facility's provider agreement is terminated; the State survey agency
arranges for the safe and orderly transfer of all Medicare and Medicaid residents.
A finding of immediate jeopardy will not, in and of itself, require the State to
close a facility and transfer residents. It could, however, result in the
immediate termination of a Medicaid provider agreement and the subsequent
transfer of residents. During an emergency, the State Survey Agency can permanently
or temporarily transfer residents to another facility until the original facility
maintains substantial compliance for a specified time frame and has been determined
by the licensing and certification agency and the Division of Medicaid that is
able to care for its residents. |
E. Maintenance of Operation of a Facility
Pending Correction of Deficiencies or Closure. |
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During the pending closure or termination
of a facility's provider agreement, the Division of Medicaid may incur costs to
monitor maintenance of the facility's improvement or correction of the deficient
practice(s) for the health and safety of the residents including providing education
and/or training as described in II. B. The criteria outlined must be followed
in order to implement this technical assistance during a noncompliance status
of a nursing facility. |
F. Reimbursement of Residents for Personal Property
Lost |
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A Statement of Deficiency must be cited by licensure and certification, for
the lack of meeting requirements to replace a lost item that has been filed with
the nursing facility of residence. If the facility's protocol and federal
survey protocol were not followed and a deficiency was cited by the licensure and
certification agency, reimbursement will be considered on a case by case basis.
There is a maximum of $1,000 and a minimum of $100 per item in a fiscal year per
beneficiary. |
II Innovative
State Use of the CMP Funds - Incentives for High Quality Care |
Section 1919 ((h)(2)(F) provides that in addition to the remedies specified in this
paragraph, a State may establish a program to reward, through public recognition,
incentive payments, or both, nursing facilities that provide the highest quality
care to residents who are entitled to medical assistance. CMP funds may also be
used as incentive and educational funds for noncompliant facilities to attain compliance
status and stay in compliance.
For purposes of section 1903(a)(7), proper
expenses incurred by a State in carrying out such a program are considered as expenses
necessary for the proper and efficient administration of the State plan under
this title. |
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A. Enhancement Grant Award |
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CMP funds used for an Enhancement Grant Award are for those facilities which have
maintained compliance with the federal requirements for long term care. The purpose
of the Enhancement Grant Award is to provide a nursing facility with the opportunity
to receive funding for innovative programs/projects that will directly and/or indirectly
benefit the residents by providing an enhanced quality of life; e.g., provide environmental
changes that include participation of the resident on a regular basis. The grant
award should be self-sustaining once implemented. The application should include
plans for maintaining the program/project once the grant for implementation has
ended. Costs to maintain the program/project will be allowable on the facility's
cost report. The criteria are as follows: |
- Facility must have had no
deficiencies or must have been in substantial compliance in the most recent certification
period (Amended 7/18/06). (Definition – scope and severity A, B, or C; or no deficiencies
cited).
- Includes all survey types – standard, revisit and complaint surveys.
- Facility must not have any pending enforcement actions.
- Facility must not
have any outstanding penalties/sanctions by the Division of Medicaid or Center for
Medicare and Medicaid Services.
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B. Educational Program Award |
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An Educational
Program Award may be requested by nursing facilities for educational training or
other innovative means to prevent continued noncompliance with the federal
requirements for long term care facilities. The proposal should address the
areas of noncompliance and how the facility can use the grant to obtain and maintain
compliance. Facilities requesting a grant award for this purpose must meet criteria
either in 1, 2 or 3, and 4, 5, and 6 as follows:
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- Facilities with immediate jeopardy/substandard quality of care for a standard, revisit
or complaint survey during the current and previous certification periods.
- Facilities identified with pattern or widespread actual harm for a standard, revisit
or complaint survey during the current and previous certification periods.
- An active Quality Assessment and Assurance Committee of
the facility must identify, respond to, and evaluate its responses to issues which
require quality assessment and assurance activity on a routine basis. Consistent
plans of correction to deficient practices cited by survey and certification were
implemented but continue to fail to maintain substantial compliance should
be identified.
- The facility must be able to identify areas of education/training
needs not available via current corporate or facility/contract employment.
- The
facility must identify efficient uses of the Educational Program Award to accomplish
and maintain compliance status as required under CFR 42. 483.10 - 483.75.
- The grant award will be a one time expenditure that will benefit the residents.
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C. Bids
and Quotations |
All applications must include three quotes for costs of equipment,
construction and/or labor for both grant award types. The quotes shall be from reputable
companies that comply with all federal, state and local laws as required for the
health and safety of residents in the nursing facilities.
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III. CMP Funds Used for the Issuance of Grants
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A. General
Requirements |
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The Division of Medicaid will set aside an annual grant award amount from the Civil
Money Penalty Fund as follows:
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The dollar amount of the annual
set aside shall not be greater than $250,000. At no time shall a grant set
aside cause the CMP Fund to go below $2,000,000.
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1. The Enhancement Grant Award
will not be less than $5000 and shall be awarded as follows:
- No deficiencies: up to $50,000
- A only deficiency(ies): up to $45,000
- B is the highest deficiency: Up to $40,000
- C is the highest deficiency: Up to $35,000
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2. The Educational Program Award will not be less than $5000 and not over $20,000
per nursing facility. The Educational Program Grant shall not include construction
or building funding. |
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3. The grant award will be a one time award that will benefit the residents of the
nursing facility.
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4. A nursing facility may not submit a request
for or receive a grant for the same type of program/project previously awarded to
that facility. |
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5. The nursing facility may only receive a maximum of two
(2) grants within a five-year period. |
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6. The nursing facility must provide evidence
that the Enhancement Grant Award or the Educational Program has been implemented.
Progress reports will be required quarterly following the date of the award
through completion . The reports must include outcome measures. |
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7.
The nursing facility must return the grant award or the Division of Medicaid will
recoup all moneys awarded if the Enhancement Grant Award or the Educational Program
is not implemented within the approved time period of the grant award. 8.
The grant award will be a restricted grant. The related expenses will not be allowable
on the cost report. 9. Grant Moines must only be requested for programs/projects
outside the scope of normal operations for the facility. 10. The grant award
cannot be used for employee salaries. 11. Each grant must score an average
of at least 80% to recommend to the Executive Director for an award.
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B. Protocol for Grant Reviews and Awards: |
- A Grant Award
Review Committee will review all grant applications submitted within the required
time frame utilizing a point system indicated on the Instruction Application Sheet
as follows:
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Evaluation Criteria
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Maximum Points
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a. Objectives
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(5 points)
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b. Background and Importance
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(15 points)
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c. Benefits to Residents
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(25 points)
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d. Applicant's ability to provide the required services as reflected/evidenced by
the qualifications (education, experience, etc.) to implement the project/program.
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(20 points)
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e. Applicant's proposed continuation of project/program upon completion.
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(20 points)
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f. Applicant's ability to provide adequate use of current resources including contract
resources, personnel, equipment, facilities, and financial resources to implement
the project/program
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(10 points)
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g. Budget
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(5 points)
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2. The seven-member Committee will consist of the following:
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- Institutional Long Term Care Director
- Long Term Care Bureau Director
- Mississippi State Department of Health, Licensure & Certification Representative
- Reimbursement Bureau Representative
- Mississippi Health Care Association Representative
- Independent Nursing Home Association Representative
- Executive Director Representative
- Office of the State Ombudsman, Area on Aging, Department of Human Services, Ad Hoc
member
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3. Each Grant application
must include at least the following: |
a. Application Division
of Medicaid Forms
b. Abstract/Summary
c. Project/Program Narrative |
- Background and Importance
- Benefits to Residents and Number of Residents to be served
- Evaluation and Analysis Plan
- Work Plan
- Program/Project Staff
- Continuation Potential, including projected costs
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d. Budget |
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e. Qualifications of Professionals and other staff |
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Instructions and forms
required will be available via the Division of Medicaid web site: www.medicaid.ms.gov or by written request. |
4. Timelines: |
a. The Grant Award application must be received no later than April
15 for the first year of the grant
award program and thereafter no later than January
15 of each year grant funds are available.
b. The Grant Awards will be awarded on
or before June 15 for the first year of the grant award
program and thereafter on or before April 1 of
each year grant funds are available.
c. Issuance of Grant Awards:
July 1 of each year grant funds available.
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5. The grant award
will be provided in three phases as follows: |
a. Initially, 50 % of the grant will be awarded.
b. Second Request with Progress Report - additional
25% of the grant award.
c. Third Request with Progress Report - final
25% of the grant award.
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6. Purchase of an item(s) as a one time
only grant award will be provided in full. The grantee must provide
a quarterly progress report and Final Report
for one year from the date of the grant award addressing the items listed
in item number 7.
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7. A Final Report must be submitted to
the Division of Medicaid within 60 days of completion of the
program/project. It must include the following: |
a. Purpose of the Grant
b. Projected Outcomes
c. Actual Outcomes
d. Number of Residents Benefited from the Program/Project
e. Action Plan for Continuation
f. Projected Costs for Continuation of Program. |
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