Civil Money Penalties (CMPs) are monetary penalties that the Centers for Medicare and Medicaid Services (CMS) may impose on nursing facilities for each day or instance of noncompliance with Medicare and Medicaid participation requirements. A portion of these funds are returned to the state and may be reinvested into activities that protect or benefit residents of Virginia’s nursing facilities. The Virginia General Assembly appropriates the Commonwealth’s CMP funds for uses allowable by CMS. Virginia must maintain an emergency reserve of funds to provide assistance, support, and protection for residents in the event that a facility closes, loses certification, or experiences an emergency or natural disaster. Funds in excess of the emergency reserve may be used for special projects that benefit residents and improve quality of life or care. The Department of Medical Assistance (DMAS) has the responsibility to administer and disburse CMP Reinvestment Funds as approved by CMS.

In State Fiscal Year (FY) 2026, DMAS continued administration of the Civil Money Penalty Reinvestment Program (CMPRP), overseeing the activities and funding of special projects to improve quality of care and quality of life for residents of nursing facilities (NFs) in the Commonwealth. In addition to the CMPRP, DMAS sought and gained approval from CMS to use CMP reinvestment funds to carry out training opportunities for nursing facility staff under the Nursing Facility Quality Improvement Program (NFQIP)(*1).

On September 29, 2025, CMS updated the policies and procedures for the use of CMP reinvestment funds. These updates included streamlining the approval process by creating a centralized application review process and modifying reporting policies. The updates also increased project funding caps from $5,000 to $6,000 per facility per year. Finally, the updates have expanded allowable uses of funds to include workforce development projects, behavioral health projects, and a broader definition of allowable technologies.

On July 1, 2025, the Virginia CMP Fund held $13,840,471. During the year, facility penalty payments totaled $1,702,240. Fund expenditures totaled $636,424. Net accounts payable accruals to clear in SFY27 totaled ($10,484). This resulted in a year-end balance of $14,895,803 in the CMP Fund.
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(*1) Chapter 2, Acts of Assembly (Virginia, 2022)