The national Civil Monetary Penalty Reinvestment Fund (CMPRF) balance increased to $713.6 million as of Jan. 1, 2026, up $97.6 million, or 15.85%, from $616 million reported a year earlier.
This is according to updated state-by-state data published this week by the Centers for Medicare and Medicaid Services (CMS).
Ohio recorded the largest increase in its CMP fund balance, rising by $7.96 million, or 46.99%, between Jan. 1, 2025, and Jan. 1, 2026.
Missouri was next with an increase of $7.43 million, or 61.27%, while Pennsylvania added $7.30 million, a 27.55% increase. Iowa’s balance grew by $6.86 million, or 51.17%, and Illinois increased by $5.39 million, or 21.97%.
Top states by annual net balance increase
(Source: SNN’s analysis of updated state CMP funds data)
These increases represent net changes in reported fund balances, not necessarily new collections or amounts withheld, since expenditures, project commitments and other account activity also affect the totals.
CMP funds have gone on to support workforce development, dementia education, resident engagement and quality of life.
Florida had the largest reported balance at $43.2 million, followed by North Carolina at $42.4 million and Kentucky at $37.7 million.
The 10 states with the largest balances held a combined $337.4 million, representing 47.28% of the $713.6 million reported nationally across the 50 states and the District of Columbia.
Top 10 states by CMP fund balance
(Source: SNN’s analysis of updated state CMP funds data)
Florida, which reported the nation’s largest balance used the funds mainly for bolstering staffing through its Agency for Health Care Administration’s approved CMP project listings.
Among the larger Florida awards were $1.87 million for the CaregiversFL Career Program, a workforce initiative created by the Florida Health Care Association (FHCA) in partnership with others to address staffing shortages in long-term care facilities. The program was administered by the Florida Health Care Education and Development Foundation, to strengthen the direct-care workforce, with a goal of recruiting 3,000 certified nursing assistants (CNAs) into Florida’s long-term care sector.
Second Wind Dreams received approximately $1.11 million for its Virtual Dementia Tour Comprehensive Experiential Education Program, designed to provide dementia-related education to staff at 125 certified nursing homes.
Other awards included approximately $1.07 million for LeadingAge Florida’s Eldergrow GARDEN Project, which provided therapeutic indoor gardens and horticulture activities for nursing home residents, the report’s data notes.
Texas’s topped the list for largest CMP fund balance decline, dropping by $775,084 between January 1, 2025, and January 1, 2026.
States whose CMP balances declined:
(Source: SNN’s analysis of updated state CMP funds data)
