Nebraska Administrative Code
Topic - HEALTH AND HUMAN SERVICES SYSTEM
Title 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES
Chapter 12 - NURSING FACILITY REGULATIONS
Section 471-12-011 - CIVIL MONEY PENALTY (CMP)

Universal Citation: 471 NE Admin Rules and Regs ch 12 ยง 011

Current through September 17, 2024

011.01 COLLECTION AND USE OF CIVIL MONEY PENALTY (CMP) FUNDS. The Nebraska Civil Money Penalty (CMP) Program is administered by the Department in accordance with Section 1919(h)(3)(C)(ii)(IV)(ff) of the Social Security Act, 42 CFR 488.400 through 488.456 and Nebraska Revised State Statutes 71-2097 to 71-20,101.

011.01(A) ASSESSMENT OF PENALTY. The Division of Public Health of the Department of Health and Human Services is authorized to act as the survey and certification agency for the Medicaid program pursuant to Neb. Rev. Stat. 81-604.03. The Division of Public Health notifies the Department of any violation by a nursing facility (NF), as defined in Neb. Rev. Stat. 71-2097. Civil penalties will be determined pursuant to Neb. Rev. Stat. 712097 to 71-20,101. Upon the recommendation of the Civil Money Penalty (CMP), the Department issues a certified letter to the provider according to 42 CFR 488.434.

011.01(B) APPEAL. See 471 NAC 2.

011.02 CIVIL MONEY PENALTY (CMP) EMERGENCY PAYMENTS. Civil money penalty (CMP) funds collected by the State are applied to actions for the protection of the health or property of nursing facility residents.

011.02(A) EMERGENCY FUND REASONS. Funds may be allocated for the following reasons:
(i) To cover payment for the non-reimbursed costs of protecting residents or relocating residents to other facilities in the event of a qualifying natural disaster or nursing facility (NF) closure;

(ii) State costs related to the operation of a facility pending correction of deficiencies or closure;

(iii) 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; and

(iv) Other activities that benefit nursing home residents as provided in 42 C.F.R. 488.433.

011.02(B) NURSING FACILITY (NF) CONTINGENCY TEAM. Upon notification to the nursing facility (NF) contingency team of the existence of an emergency situation the contingency team convenes. The team includes the Division of Public Health Licensure Unit, Office of Long Term Care Facilities, a representative from Medicaid, the State Long Term Care Ombudsman, a representative from the Nebraska Department of Health and Human Services Public Relations, and the Department legal counsel for Long Term Care Facilities. The team considers the situation and options and recommends access to funds for the relocation of residents or the maintenance of facility operations until such a time as relocation can occur.

011.02(C) FINAL APPROVAL FOR USE OF CIVIL MONEY PENALTY (CMP) FUNDS. The final determination to submit the request to Centers for Medicare and Medicaid Services (CMS) for use of Civil Money Penalty (CMP) funds is made by the Department Chief Executive Officer (CEO). Per CFR 42 488.433(b) all activities and plans for utilizing Civil Money Penalty (CMP) funds, including any expense used to administer grants utilizing Civil Money Penalty (CMP) funds, must be approved in advance by Centers for Medicare and Medicaid Services (CMS).

011.03 CIVIL MONEY PENALTY GRANT FUNDING. This program is funded through the collection of Civil Money Penalties (CMPs) imposed against nursing facilities as a result of survey deficiencies. Eligible applicants must apply for grant funding during the designated application period and submitting it as directed by the Department.

011.03(A) ELIGIBLE APPLICANTS. Civil Money Penalty (CMP) grant funding may be requested by eligible stakeholders, which include:
(i) Nebraska Medicaid-participating nursing facilities and their residents;

(ii) Professional and state nursing facility (NF) associations and advocacy groups;

(iii) Consumer advocacy organizations;

(iv) Resident or family councils;

(v) Nursing facility (NF) resident quality improvement organizations; private contractors; and

(vi) Other groups approved by Medicaid indicating an interest in the care and wellbeing of nursing facility (NF) residents.

011.03(B) ELIGIBLE PROJECTS. Civil Money Penalty (CMP) grant funding is considered for the following projects:
(i) Culture change;

(ii) Resident or family councils;

(iii) Direct improvements to quality of care or resident protection;

(iv) Quality improvement activities or resources;

(v) Consumer information; and

(vi) Training in facility improvement initiatives for staff to:
(1) Improve performance; or

(2) Develop new or innovative approaches to improve the quality of life and care for residents.

011.03(C) PROHIBITED USE OF CIVIL MONEY PENALTY (CMP) FUNDS. Civil Money Penalty (CMP) fund requests will not be considered if any of the following apply:
(i) Conflict of interest or the appearance of a conflict of interest;

(ii) Long-term projects, with a duration greater than 3 years;

(iii) Duplication of payment that is already appropriated from state or federal sources;

(iv) Capital improvement projects;

(v) Temporary manager salaries; or

(vi) Ineligible recipients. This includes nursing facilities (NFs) who were cited with an immediate jeopardy (IJ) violation or harm at deficiency level H or I during their previous standard survey. Any exceptions must be approved through Centers for Medicare and Medicaid Services (CMS).

011.03(D) GRANT FUND DETERMINATION. Designated Medicaid and Public Health staff review grant applications based upon compliance with Civil Money Penalty (CMP) laws and regulations. The final decision is made by the Director of Medicaid. Final approval is granted by Centers for Medicare and Medicaid Services (CMS).

Disclaimer: These regulations may not be the most recent version. Nebraska may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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