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​Civil Money Penalty Fund

Civil Money Penalties (CMP) are one statutory enforcement remedy available to address nursing facility noncompliance in the Medicare and Medicaid programs as defined in sections 1819(h) and 1919(h) of the Social Security Act. CMP funds must be used for activities that protect or improve the quality of care or quality of life for nursing facility residents. All activities and plans for utilizing CMP funds must be approved in advance by the Centers for Medicare and Medicaid Services (CMS). As of July 1, 2015, the following activities have been approved by CMS.

2017-2018 LTC Grant Award Recipients:

Homeland Center – Multi-Sensory Environmental Center: $27,378.00 - The project will create a multi-sensory environment center. Research has shown that exposure to this therapy-lights, sounds, scents and music-promotes well-being, along with a non-medication strategy, for individuals with Alzheimer's disease and other dementias. Short sessions are effective in decreasing wandering behavior.  The project remains on hold due to the ongoing COVID-19 pandemic. As a result of the pandemic and the need for quarantining residents, the location that was chosen for the Sensory Room was converted to a temporary Covid-19 isolation unit.  This precluded us from pursuing the project at that time.  Although COVID-19 had impacted our initial program roll-out for the 100 residents we originally planned on, we now have over 80 residents participating on a regular basis.  This is with a census that is down approximately 20%.  From mid-March 2020 until the end of June 2020, we had little ability to have group activities with more than five residents – this still holds true today.  Currently, all the 24 residents on our 1st floor unit participate in iN2L programming.  Approximately 25 to 30 residents on our 3rd floor unit participate weekly, and 25 to 30 residents on our memory care unit participate in daily activities.  On our rehab unit, 10 to 15 residents participate each week, using the tablets for content and to communicate with family members.

Rolling Meadows – Bridging the Gap: $27,337.00 - The project will utilize the "It's Never 2 Late" (iN2L) engagement system to improve the quality of life of residents, including those living with dementia/memory loss, through experiencing and learning new life skills. This person-centered technology allows residents, families, and caregivers to become more engaged in areas related to therapy, activities, cognitive fitness, socialization, and spiritual life. Enhanced, dignified mind-stimulating activities, improving hand-eye coordination, exploring the internet, and connecting with family via Skype are some examples of the way the system is used.

2018-2019 LTC Grant Award Recipients:

Assurant Learning & Performance Solutions – Mental Health First Aid: Expanding PA Nursing Home Capacities: $78,962.00 - The project aims to expand behavioral healthcare capacity for PA nursing home staff and provide actionable tools to support PA nursing homes in implementing behavioral healthcare. The applicant will offer Mental Health First Aid (MHFA) training, created, and administered by the National Council on Behavioral Health (NCBH) to staff from 180 nursing homes. Six sessions of the training (one in each district) will be provided to minimize or eliminate travel costs for nursing home staff. The applicant will also develop and share a recorded webinar with all PA nursing homes, which will provide information on the regulatory requirements associated with behavioral health. The project has experienced delays created by the COVID-19 pandemic.

Baptist Homes Society – Palliative Care Center of Excellence Initiative: $36,000.00 - The project seeks to enhance existing palliative care efforts. Grant funds would be used to underwrite the cost of education and training for staff, as well as education for residents and their families, in palliative care initiatives, disease-state management protocols, and techniques which would improve the quality of life for the residents. The goal is to become a Center of Excellence in Palliative Care and have residents' function at a higher level of independence and improve their quality of life during their stay.  The project was able to get more staff educated in September 2021 (three staff) and in October 2021 (four staff) through the STAR Program.  We have put a hold on additional STAR classes in early 2022 as we work through staffing issues. Currently, we have an anticipated start time of March 1, 2022.

Crawford County Care Center – Individualized Music for Joyful Living (Music & Memory): $11,975.00 - The applicant aims to implement the individualized music program, Music and Memory to improve nursing home residents' quality of life through "five action steps": (1) organizing a motivated team of staff and families; (2) prepare by setting; (3) begin pilot by conducting assessments to identify music preferences, creating play lists, reviewing progress; (4) launch the program throughout the organization; and (5) support the team, work with volunteers, fundraise, build up community connections, and learn and enhance the program. Ongoing education will be provided to staff throughout the life of the project. This project has experienced delays created by the COVID-19 pandemic.

Londonderry Village – Ridge & Glide Wellness: $57,310.00 - The applicant aims to create a "Ride & Glide for Wellness" program that will combine piloted trishaw bike rides and wheelchair accessible swings to incentivize their residents, especially those living with dementia, to enjoy outdoor activities. The applicant expects these new activities to help decrease feelings of isolation and boredom among their residents.  This project has been put on hold due to COVID-19 pandemic.

Wellspan Health – Advance Care Planning Conversations in Skilled Nursing Facilities: $72,161.00 - The project will be implemented, with the support of a collaborative of skilled nursing facilities in WellSpan Health's service area, to empower skilled nursing facility staff to facilitate conversations regarding end of life wishes. Using the 'respecting choices' model of facilitation, 30 skilled staff from skilled nursing facilities in each of four counties will become certified trained facilitators of advance care planning conversations with residents. Facilitators will then engage at least three residents and their families per month in advance care planning conversations to improve end-of-life outcomes.  The project remains on hold due to the ongoing COVID-19 pandemic. In the interest of protecting all individuals involved in the project work, complying with COVID-19 policies and restrictions put in place by our health system as well as our intended Skilled Nursing Facility (SNF) partners, and being sensitive to the staffing shortages experienced by SNFs at this time. Wellspan Health has not obtained additional project work since last update and request for extension. In the meantime, Wellspan Health intends to continue to engage with SNFs virtually to be sure that we can begin work as soon as resources allow our partners to participate fully.

2020 LTC Grant Award Recipients:

 Masonic Village at Elizabethtown – Masonic Therapy Funding for Treatment & Prevention of Disorders: $99,684.00 - The project aims to expand residents experiencing pain associated with aging and related diseases have affected self and others as evidenced by an increase in resident to staff aggression as reported on our CASPER reports. We seek this grant to hire massage therapists to make weekly messages available to residents over a six-month period to improve their quality of life and decrease pain, anxiety, and aggressive behaviors. The Office of Long-Term Living is currently preparing the grant agreement to be reviewed and signed by the facility.

Transitions Healthcare North Huntingdon – Purpose with A Passion: A Person-Centered Dementia Program: $13,228.85 - The project "Purpose with A Passion", will focus specifically on Transitions' dementia population which today comprises 40% of the total population at the facility.  Building upon the proven Montessori approach to dementia care, facility team members across all departments (nursing, activities, dining, etc.) will purchase and assemble "life stations", purchase specialized dining ware for dementia residents, and receive robust dementia care training- all intended to ignite positive culture change and enhance quality of life for our dementia population. The Office of Long-Term Living is currently preparing the grant agreement to be reviewed and signed by the facility.

ManorCare Health Services Pittsburgh – GARDEN: Garden Access Responds to Diagnosis & Environmental Need
: $53,469.00 - The project would implement Eldergrow's therapeutic horticultural gardening program designed for elders in long-term care. In partnership with Eldergrow, the GARDEN project (Garden Access Responds to Diagnosis & Environmental Needs) is an interactive and purposeful resident program that brings nature indoors with mobile, indoor therapeutic sensory gardens and the Eldergrow Educator who teaches therapeutic horticulture classes. The Educator teaches hands-on, therapeutic gardening classes that engage the residents' five senses and focus on six therapeutic wellness goals set forth by the American Horticultural Therapy Association: socialization, cognitive stimulation, sensory stimulation, spatial awareness, motor skills, and creative expression. This program is a non-pharmacological intervention that will improve residents' quality of life and the opportunity to participate in meaningful activity. The Office of Long-Term Living is currently preparing the grant agreement to be reviewed and signed by the facility.

Pennsylvania Department of Health – Comprehensive Respiratory Program for PA Skilled Nursing Facilities: $915,200.00 - The projects described will directly benefit large numbers of nursing home residents and their family members across the Commonwealth of PA by enhancing comprehensive respiratory protection and infection prevention education and process improvements for SNF healthcare providers across the Commonwealth. Section one of the Respiratory Protection Program will equip healthcare personnel in PA's SNFs with evidenced-based infection prevention and control practices regarding transmission-based precautions, specific to airborne and droplet precautions and general hygiene etiquette and aid them in establishing their own facility-based program based on best practice recommendations.  Section 2 (The Advanced Infection Prevention and Control Training and Sustainability Program)-will directly benefit PA state SNF residents by improving their quality of care and quality of life through protection from harm relating to potentially avoidable infections. The Advanced Infection Prevention and Control Training and Sustainability Program -will assist staff in learning basic and more advanced infection prevention and control strategies to protect the residents from communicable diseases, including COVID-19, multi drug-resistant organisms (MDROs), and other emerging viral and bacterial infections. Training of multiple staff from a single facility will create staffing redundancy and ensure the residents can be kept safe when primary staff members are on leave or suddenly depart, or when a large outbreak occurs requiring the assistance from multiple staff members. 

PA CMP Quarterly Status Report