There is nothing permanent except change. ~ Heraclitus
Sheeeew isn't that the truth! For all of you nerds (like me :) Heraclitus was a Greek philosopher that observed change as it related to the natural world. You cannot ever do the same thing, the same way, in the same place because everything is in a constant state of change. His most famous saying... "No man ever steps in the same river twice, for it's not the same river and he's not the same man."
I wonder what he would have to say about the last 30 years ....
It's been a hot minute since I've posted to our blog, and honestly, 90% of that has to do with CHANGE. Changes to our CMPRP program, both internally as well as at the national level. We all (myself, the NCCCC members, our State Agency, CMP applicants, etc.) have been doing our best to adapt to these changes. Some of them have been welcomed changes, some of them we needed but didn't realize it, and some of them still have us scratching our heads.
The catalyst for much of this change over the past year, of course, has been the CMP Revisions, QSO-23-23-NHs, released by CMS on September 25, 2023.
Just to recap, CMS announced in April 2023 that it was implementing a pause on the submission of CMP applications so that it could review the CMP program and its processes. There was no timeline given for how long this would last, whether or not we (State Agencies) should continue to receive CMP applications, or what would happen to applications that had been submitted prior to April that were still under review. We remained in limbo for the summer, with lots of speculation about 'what' those revisions would entail and 'when' they would be released. CMS announced their release in late September, prefacing the Memorandum by stating, "Over the last several years, CMS has approved a wide range of CMP-funded projects to benefit residents. As the program has grown, we have seen projects grow significantly in costs and scope, causing inconsistent availability and inequity in access to these interventions throughout the country."
The Civil Money Penalty Reinvestment Program (CMPRP) Revisions was a 16-page document that outlined changes from funding maximums to allowable uses of funding to prohibited budget items. The goals: 1) to provide a detailed list of allowable uses of CMP funding, 2) to fund projects to benefit residents that can be implemented in all nursing homes by a variety of different organizations," and 3) "to strive to enable all nursing homes have access to the similar, basic capabilities, reflective of those typically found in a traditional household."
With a collective gasp the questions came flying at us. The Revisions would inevitably mark the end to some of the bigger CMP-funded projects, as they would no longer fit into the new guidelines.
I'll admit, at first, I was a little unnerved. Ok, more than a little. I was concerned that we would have ZERO applications as SNFs, and other applicants, became discouraged at some of the bigger changes that had been made to the CMPRP. You know, the proverbial throwing up of hands and walking away. These revisions would exclude quite a few bigger projects that had been successfully implemented in North Carolina. We held a Q&A session in October, one-on-one virtual sessions with potential applicants, and we answered countless emails.
For a short while, things were quiet.
However, North Carolina will not be deterred by CHANGE. This was only a bump in the road. The applications started coming. And that's when I realized that applicants weren't focusing on these programmatic changes - they were focusing on how to adapt to these changes so that long-term care residents in our State can continue to benefit from Culture-Change projects and initiatives that would enhance their quality of care and quality of life.
Positive Change = Adaption x (Attitude + Perspective)
"If you don't like something, change it. If you can't change it, change your attitude."
~ Maya Angelou
I get to work with some pretty amazing people who are going to be doing some awesome things in long-term care communities :) And with that said, stay tuned for what's coming down the pike in North Carolina in 2024.
NC CMP Grant Fund Manager