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State of California—Health and Human Services Agency
California Department of Public Health

AFL 19-03
January 16, 2019

Skilled Nursing Facilities
Nursing Facilities

Grant Opportunity to Benefit Nursing Facility Residents

AUTHORITY:     Title 42 Code of Federal Regulations section 488.433

All Facilities Letter (AFL) Summary

This AFL notifies skilled nursing facilities (SNFs) and nursing facilities (NFs) of the availability of federal civil money penalty (CMP) funds that may be used to support projects that benefit and improve the care of residents. Applicants may submit a CMP grant application to the California Department of Public Health (CDPH) electronically or by mail.

The Centers for Medicare and Medicaid Services (CMS) may impose federal penalties against a skilled nursing facility when it is not in compliance with one or more Medicare and Medicaid participation requirements. A portion of the funds are returned to the states where the CMPs are imposed. These funds are reinvested via a grant process to support activities that benefit SNF residents by improving their quality of life. These activities may include:

  • projects that support resident and family councils and other involvement in assuring quality care in SNFs, and
  • facility improvement initiatives approved by CMS, such as joint training of facility staff and surveyors or technical assistance for facilities implementing quality assurance and performance improvement programs

As of January 1, 2019, CDPH’s available funds for new CMP projects is $12,411,000. CDPH highly encourages SNFs and NFs to apply for CMP grants to benefit residents. 
How to Apply for CMP Funds
Applicants must complete a CMP Grant Application and should include details such as the target audience, intended outcome, deliverables, sustainability, and replicability of the project. Please submit applications electronically to or by mail to:

California Department of Public Health
Licensing and Certification
Attn: CMP Grant Applications
P.O. Box 997377, MS 3000
Sacramento, CA 95899-7377

Application Review
CDPH will review applications within 14 business days of receipt and assess projects based on:

  • eligibility of the proposed project
  • benefit to residents of SNFs
  • proposed outcome metrics, replicability, budget, and distribution of funds
  • targeted population: diversity, geographic locations, and consideration of ADA needs

If approved, CDPH will submit the application within 30 business days of receipt to CMS for review and signatory acceptance.

For more information on CMP grant funds, please visit Long-Term Care Facility Citation Penalty Account Funds, Reports, and Grant Application. If you have any questions about this AFL, please email


Original signed by Heidi Steinecker

Heidi Steinecker
Deputy Director

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