Annual Notice of Grant Opportunity to Benefit Nursing Facility Residents and Update to Application Requirements

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AFL 21-19 From the California Department of Public Health

June 8, 2021

TO: Skilled Nursing Facilities
Nursing Facilities
SUBJECT: Annual Notice of Grant Opportunity to Benefit Nursing Facility Residents and Update to Application Requirements

AUTHORITY:     Title 42 Code of Federal Regulations section 488.433

All Facilities Letter (AFL) Summary

  • This AFL serves as an annual notice to skilled nursing facilities (SNFs) and nursing facilities (NFs) regarding 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, 2021, CDPH’s available funds for new CMP projects is $12,280,834.00. CDPH highly encourages eligible organizations and individuals to apply for CMP grants to benefit residents.

Who Can Apply for CMP Funds

Eligible organizations and individuals that may apply for CMP funding include, but are not limited to:

  • Certified Skilled Nursing Facilities/Nursing Facilities
  • Private contractors
  • Professional or State nursing home associations
  • Resident or family councils
  • Consumer advocacy organizations
  • Non-profit and for-profit organizations

How to Apply for CMP Funds

Applicants must complete a CMP Grant Application (PDF) and a Budget Proposal (Excel). The application should include details such as the project’s purpose, specific benefits to nursing home residents, projected itemized budget, deliverables, risks, and sustainability of the project. Please submit applications electronically to or by mail to:

California Department of Public Health
Licensing and Certification
Attention: Carly Carroll
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 Americans with Disabilities Act needs
  • Whether the proposal goes above and beyond current programs/guidelines

If the proposal meets the CMS guidelines, CDPH will submit the application within 30 business days of receipt to CMS for review and final approval. Applications are currently experiencing delays in reviews due to COVID-19 emergency workload. Following an approval by CMS, CDPH will initiate the contract process with approved applicants. Once applications are approved by the CDPH and CMS, applicants will be contacted to start the contracting process. Grantees should expect approximately six to seven months for contract processing and execution.

For more information on CMP grant funds, please visit CDPH’s CMP webpage. CDPH’s CMP website contains information regarding previously approved projects, CMP project funding, and application requirements. The CMP website also details application information for COVID-19 specific grant opportunities.

If you have any questions about this AFL, please email


Original signed by Cassie Dunham

Cassie Dunham

Acting Deputy Director