Skip to main content
U.S. flag

An official website of the United States government

Return to Search

Civil Money Penalty Reinvestment Program

This guidance announces Civil Money Penalty Reinvestment Program


Issued by: Centers for Medicare & Medicaid Services (CMS)

About the Civil Money Penalty Reinvestment Program (CMPRP)


Civil Money Penalty (CMP) Funds

About Civil Money Penalty (CMP) Funds

A CMP is a monetary penalty the Centers for Medicare & Medicaid Services (CMS) may impose against nursing homes for either the number of days or for each instance a nursing home is not in substantial compliance with one or more Medicare and Medicaid participation requirements for long-term care facilities. A portion of CMPs collected from nursing homes are returned to the states in which CMPs are imposed. State CMP funds may be reinvested to support activities that benefit nursing home residents and that protect or improve their quality of care or quality of life.

What CMP Funds Can Be Used For

CMP funds may be used for (but not limited to) the following:

  • Assistance to support and protect residents of a facility that closes or is decertified
  • Time-limited expenses incurred in the process of relocating residents to home and community-based settings or another facility when a facility is closed or downsized pursuant to an agreement with the state Medicaid agency
  • Projects that support resident and family councils and other consumer involvement in assuring quality care in facilities
  • Facility improvement initiatives, such as joint training of facility staff and surveyors, or technical assistance for facilities implementing quality assurance and performance improvement programs.

As part of its continued commitment to the nation’s most vulnerable populations, the Centers for Medicare & Medicaid Services (CMS) has launched the Civil Money Penalty Reinvestment Program (CMPRP) to improve quality of life by equipping nursing home staff, administrators and stakeholders with technical tools and assistance to enhance resident care. CMPRP is one of several initiatives CMS has underway to strengthen safety and health outcomes for nursing home residents

How to Apply for CMP Funds

  • The application process for CMP funds is determined by the state in which the nursing home is located. The process for each state may differ, and some states have their own applications for CMP funds. Applicants should use their state-specific application and instructions, if applicable. Please use the “CMP Contacts by States” link  in the “Downloads” section to find specific state contacts
  • A CMP Frequently Asked Questions (FAQ) is also available in the “Downloads” section below.

How to Find Information about Previously Funded Projects

CMS publishes and updates information about CMP funded projects annually. To view a list of funded projects, please download the “State CMP Reinvestment Projects Funded by Calendar Year” zip file in the “Downloads” section below.

Wireless Internet Access

CMS believes that all nursing home residents should have access to the internet, just as they would in a common household. If your facility does not have facility-wide wireless internet access for residents, please fill out and submit the Wi-Fi questionnaire by 12/22/23 for CMS to explore the reasons and possible solutions. Questionnaire can be found in the downloads section below.

Mental & Behavioral Health Support CMP Applications

CMS is committed to improving the quality of care for residents with underlying serious mental illness (SMI) and/or substance use disorder (SUD). CMS has partnered with SAMHSA to launch a national Center of Excellence, which provides technical support and training to nursing homes to help care for individuals with SMI and/or SUD. Nursing homes are encouraged to pursue accessing SAMHSA’s training and technical assistance, as CMS will not accept applications for these topics. Dementia is not an included diagnosis for the Center of Excellence. To obtain information and access to this program, visit


CMS is committed to improving the nursing home workforce. As announced on September 1, 2023, CMS plans to launch a national campaign to help increase the nursing workforce in nursing homes. More information on this campaign will be released in the future, and there will be opportunities for states to partner with CMS on this program. To avoid duplication, CMS will no longer accept Nursing Workforce applications for CMP funding.


Toolkit Resources are available under the downloads section below to aid nursing home teams in reducing adverse events, improving staffing quality, and improving dementia care. Use of these tools is not mandated by CMS and their use does not ensure compliance with Federal requirements.

Reducing Adverse Events & Improving Dementia Care Toolkits

CMS developed optional toolkits to aid nursing home teams with reducing adverse events and improving dementia care.

Head to Toe Infection Prevention (H2T) Toolkit

Infections comprise a large share of adverse events in nursing homes. The Head to Toe Infection Prevention Toolkit contains educational materials and practical tools to support the clinical team in providing person-centered care that helps prevent and control common infections like pneumonia, skin infections, and urinary tract infections.

Developing a Restful Environment Action Manual (DREAM) Toolkit

As many as 70% of adults with dementia experience sleep disturbances, which are associated with various negative health outcomes. High quality sleep is necessary for optimal cognitive and physical functioning, especially for residents who already experience cognitive decline due to dementia. The DREAM Toolkit provides educational material and practical tools for nursing home staff to help all residents living with dementia improve sleep quality.

Improving Staff Competency & Employee Satisfaction Toolkits

CMS developed optional toolkits to aid nursing home teams with improving staff competency and employee satisfaction. There are three toolkits in this series.

Toolkit 1: Nursing Home Staff Competency Assessment

Quality care is complex. That’s why the CMPRP competency assessment helps nursing homes break down and self-examine some of the most important building blocks of quality care. Use the competency assessment to identify areas where your nursing home is doing well, versus where your facility might need support.

Toolkit 2: Nursing Home Employee Satisfaction Survey
The employee satisfaction survey can help your nursing home to recruit, motivate and retain staff that are critical to better resident health and quality of life. This free, anonymous survey offers employees an opportunity to share their perceptions about the nursing home workplace. Survey topics include: employee engagement and team building, job satisfaction, management and leadership, scheduling and staffing and training.

An Implementation Guide and a Data Analysis Tool are available to support managers in implementing the survey, as well as aggregating and interpreting survey results.

Toolkit 3: Guide to Improving Nursing Home Employee Satisfaction
There are many resources out there to help nursing facilities improve quality, but it can be overwhelming to identify which are most relevant to your facility’s specific needs and to stay up-to-date on the latest guidance. This employee satisfaction guide helps nursing homes determine the most appropriate and helpful resources to address challenges.

Once your facility completes the employee satisfaction survey, you will be ready to address the identified improvement opportunities. The employee satisfaction guide is a repository of evidence-based approaches, solutions and interventions to address challenging areas discovered through the survey.

If you have CMPRP questions, comments or page content feedback, email the CMPRP Team at

August 2021- New and updated CMP resources added to the Downloads section.

September 2021- New and updated State CMP funded projects located in the State CMP Reinvestment Projects Funded by Calendar year Zip folder in the Downloads section.

October 2022- New and updated CMP resources added to the Downloads section.

September 2023- New and updated CMP resources added to the Downloads section.

HHS is committed to making its websites and documents accessible to the widest possible audience, including individuals with disabilities. We are in the process of retroactively making some documents accessible. If you need assistance accessing an accessible version of this document, please reach out to the

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.