title: The collection and use of funds from civil money penalties and fines from nursing homes.
abstract: OBJECTIVE
  This study examined federal and state civil money penalties and fines collected from nursing homes and how states used the collected funds.
  
  
  METHODS
  We used a telephone survey of state officials, Freedom of Information Act requests, state Web site searches, and stakeholder interviews to describe the funds collected, the availability and the use of funds, public information about penalties and fines, and the state allocation process and policies.
  
  
  RESULTS
  In 2004, 43 states collected a total of $21 million from more than 3,000 federal and state penalties and fines. Forty-two states had $60.5 million in fund accounts from penalties and fines available in 2005, and 32 states spent $28 million on a wide range of projects. Fifteen states spent $17.9 million on survey and certification activities, 19 states spent $5.6 million on provider projects, 6 states spent $1.3 million on advocacy projects, and 12 states spent $2.7 million for other projects. Most states did not provide information to the public about issuing penalties and fines, have formal procedures to inform stakeholders and allocate funds, or involve stakeholder groups in the decision-making process.
  
  
  CONCLUSIONS
  Funds from federal and state penalties and fines vary widely across states. These funds are a resource for improving the quality of nursing home care that needs more attention from policy makers and stakeholder groups.
authors.affiliation: Department of Social & Behavioral Sciences, University of California, 3333 California Street, Suite 455, San Francisco, CA 94118, USA.
authors.forename: Theodore
authors.initials: T
authors.lastname: Tsoukalas
authors.forename: Cynthia
authors.initials: C
authors.lastname: Rudder
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Mollot
authors.forename: Meghan
authors.initials: M
authors.lastname: Shineman
authors.forename: Hyang Yuol
authors.initials: HY
authors.lastname: Lee
authors.forename: Charlene
authors.initials: C
authors.lastname: Harrington
mesh_terms: D006801:Humans; D016365:Liability, Legal / Q000191:economics*; D009735:Nursing Homes / Q000191:economics* / Q000331:legislation & jurisprudence*; D014481:United States