Federal Civil Monetary Penalties (CMPs) and State CMPs/fines are imposed by the regulatory agencies that license nursing homes if a nursing home does not comply with regulatory standards. These fines can be used to fund innovative programs to improve the lives of nursing home residents.  This study, supported with a grant from the Commonwealth Fund, examines how states are currently using these funds, provides recommendations for way to make concrete improvements for resident quality of life and care, and provides tools for all stakeholders – families, residents, advocates, ombudsmen and providers – to help realize the potential of CMPs.