One Nursing Home’s Fines Can Become Another Facility’s Technology — But With Strings Attached

With COVID-19 forcing skilled nursing facilities to drastically restrict visitation, technology and virtual communication have emerged as critical tools to maintain social ties between residents and their loved ones. And there are federal funds — collected from facilities deemed to have run afoul of various rules — available to help SNFs bolster their technological offerings.

But they do come with some strings attached.

The federal government routinely assesses Civil Money Penalties (CMPs) to nursing homes for non-compliance with Medicare and Medicaid participation requirements.

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The Centers for Medicare & Medicaid Services (CMS) reserves a portion of this money into the CMP Reinvestment Program (CMPRP), a system that redistributes the cash from the fines to other nursing homes in an attempt to promote better care and resident services.

SNFs can apply for these funds for some defined investments, Alan Horowitz, a partner at the law firm Arnall Golden Gregory, explained on a webinar sponsored by CDW on August 19.

These allowable initiatives might include activities to provide transition guidance and protection for residents of a SNF that is closing, or programs that support resident and family councils or joint training initiatives. There are also some caveats; funds cannot be used in any instance of conflict of interest, or for capital improvements, or for basic nursing home services and supplies.

But the CMP Reinvestment Program got a new facet in the era of the COVID-19 pandemic: technology.

CMS announced a new process on April 24 that was aimed at addressing the needs of residents during the lockdowns necessitated by the pandemic, where visitors and non-essential personnel were banned and all group activities suspended. This program was designed to use the CMPs to help SNFs provide better virtual access between residents and their family, friends, and health care providers.

“The program allows nursing homes to apply for grants to purchase communication devices and reasonable accessories like protective covers, assistive devices like stands or headsets, and manufacturer-recommended cleaners, at the rate of one device per every seven to 10 residents,” Jodi Eyigor, director of nursing home quality and policy at LeadingAge, a trade group representing nonprofit senior living and care providers, said on the webinar. “And that’s capped at a maximum of $3,000 per facility.”

The grants are approved more quickly in some cases than the allocations sent under other parts of the CMP Reinvestment Program, Eyigor noted; the COVID-19 grants are often approved within a few weeks.

SNFs can use the CMP funds to buy the devices and accessories, but they can’t be used to make infrastructural upgrades such as improving internet services or extending Wi-Fi hot spots, she noted.

There’s also been some variation between states in how SNFs have to apply for the funds, which could make this a more complicated process for SNFs with a multi-state footprint. In fact, that has caused considerable stress for some of CDW’s SNF clients, according to Ginna Baik, senior care practice leader at CDW Healthcare.

“A lot of that is related to the fact that every state has a different approval process, which can actually be sometimes a bit of a nightmare to handle,” she said on the webinar.

CDW has found several hurdles when it comes to that state-by-state process, Jessica Longly, business development strategist at CDW Healthcare, explained. These include the fact that not all states have updated their websites with the technology grant information, and the fact that each state has different requirements for the application process.

When completing the application, Longly also recommended that SNFs find a technology reseller to provide pricing below the manufacturer’s suggested retail price (MSRP), rather than using the MSRP figures on the application.

“SNFs are able to make technology investments in which there was no budget,” she noted. “I like to think of it as a $3,000 discount. On average, we do see for one location, with the device as well as the appropriate accessories, it’s about $1,000. So on average, CDW Healthcare has seen locations being able to invest in three devices per location.”

This might not seem like much, but the investment could pay significant dividends in the long term. When LeadingAge surveyed its members, most reported that even when group activities and in-person visits can resume, virtual visits — and the associated technology needs — are here to stay.

“Now that we’ve discovered all these great things that technology can do for us, and do for the residents, it’s going to become part of our everyday, and our future is changed because of it,” Eyigor said. “And all [the members] said: We could not have done it without the CMP Reinvestment Program grant.”

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