February 18 Newsletter

 

 

 

 

 

February 18, 2026

 

HCAM Phone Lines are Now Back in Service

We have resolved the issue with our phone lines, and they are now fully operational. Thank you for your patience and understanding while they were temporarily unavailable.

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Let’s Celebrate Careers in Aging 2026!

It’s not too late to join us in celebrating Careers in Aging this spring! Last year, we recognized over 100 employees who have made long-term care their calling in our skilled nursing and assisted living member facilities.

We Need Your Help: Please consider spotlighting an employee this year. Any position is eligible including administrators/executive directors, nurses, CNAs, medication aides, housekeepers, maintenance staff, therapy services providers, dining staffers, life enrichment directors, etc. To participate, please send an email telling us about a team member with a strong history in long-term care by sharing:

  • Their name, job title and length of time in LTC.
  • A few sentences about what makes them special and why they love their career.
  • A photo or two of them in action.

Deadline extended: Please email HCAM’s Lisa Reibsome by Monday, February 23. Throughout the spring, HCAM will share their stories in our publications, communications with the legislature and on social media to spread the word about the wide-ranging LTC career opportunities as well as celebrate current caregivers.

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Help Us Share the LTC Story – Join AHCA/NCAL’s New ‘Live Fully’ Campaign

HCAM’s national affiliate – the American Health Care Association/National Center for Assisted Living (AHCA/NCAL) – launch a new campaign, “Live Fully,” to demonstrate the value of LTC as part of our nation’s health care continuum and encourage policymakers to strengthen our sector. This campaign is a great opportunity to proactively tell LTC stories in our own words, instead of letting others define it. A campaign website, livefullyltc.com, is now live, and the first video, “Value of Care,” is being shared on digital platforms. You can watch the video on the campaign website.

How Can You Get Involved? This campaign will only be as strong as the stories behind it. Policymakers need to see and hear the real people who make LTC possible every day – you, your caregivers, your residents and their families. The campaign website includes a “Share Your Story” button where you, your staff, residents and families can upload videos and photos. A video could be testimonial from a caregiver about what their job means to them or an inspirational resident story. Photos could capture everyday moments of connection, special events in your community, or the dedication and passion of your staff. No story is too small. A short testimonial or a single photo can help policymakers see the faces, hear the voices and understand the value behind long-term care.

If you have questions or would like help submitting content, please email [email protected].

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Governor Presents Proposed 2027 Budget 

On February 11, Governor Whitmer’s State Budget Office (SBO) presented her proposal for the state fiscal year 2027 budget to the Michigan House and Senate Appropriations Committees. The SBO emphasized the significant deficit the state is experiencing in the Medicaid budget due to cuts included last year at the federal level in the One Big Beautiful Bill Act (OBBBA). To address this shortfall, the Governor is proposing $804.4 million in new revenue from various new taxes on tobacco, vape, casinos, internet gambling and digital advertising.

In a press conference, House Speaker Matt Hall opposed the tax increases. Negotiations between the Republican majority in the House, the Democrat majority in the Senate, and the governor will continue over the next several months and will include discussion around the proposed tax increases and potential impact to Michigan’s Medicaid program. While the governor did not propose any cuts to nursing facility or other Medicaid providers, HCAM will emphasize with state policymakers that the OBBBA explicitly excluded nursing facility Medicaid from the cuts, and the state budget should reflect the same. The House, Senate and governor have all indicated their goal to pass the budget before July 1.

DCW and Non-Clinical Wage Increases for SNF, AFC and HFA: The governor’s proposed budget continues the direct care worker and non-direct care worker wage increases at $3.40 and $0.85 per hour, respectively.

Nursing Facility Staffing Initiative: Her proposed budget also includes a nursing facility staffing initiative aimed at addressing “chronic workforce shortages in nursing facilities.” The funding for the initiative would entail $10 million from the state’s Civil Monetary Penalty fund. The initiative would be implemented to reflect the goals as outlined by CMS in a letter to state governors, which include:

  • Providing financial incentives for nurses to work in nursing facilities, such as tuition reimbursement and stipends;
  • Making it easier for individuals to enroll in free, state-approved certified nurse aide training programs; and
  • Launching an awareness campaign to highlight the benefits of working in nursing facilities — such as the rewarding experience and availability of career progression — and resources available to help individuals pursue nursing.

HCAM will share further details on the initiative as more information is available. Questions? Email Rich Farran.

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HCAM Lobbying Information for 2025 and 2026 Tax Purposes (SNF/AL)

In case you missed it: In December 2025, HCAM furnished providers with its annual Lobby Information Letter along with 1st quarter invoices, which were sent electronically.

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Last Call for HCAM Wage Survey Data (SNF)

HCAM tracks staff wage compensation to share with you to help with workforce strategies and advocate on your behalf with the Legislature, administration and state departments. This data is critical as we work to help shape Medicaid reimbursement policy and the SFY 2027 budget. 

Please complete the wage survey. We are asking for data on your facilities’ expenses over the last three years, primarily related to staffing wages. We will share aggregate data results with those who complete the survey. If your building is part of a multi-facility organization, please coordinate survey completion with your corporate leadership.

Survey Instructions: 1) Fill out one survey per facility. 2) After opening, save the excel document to your computer, rename as (Your Location) Wage Survey. 3) Please answer all questions, if possible, in the space given. 4) For wage information, give hourly rates only. Assume a standard year at 2080 hours. 5) Hourly rates are meant to be an average starting wage per position, without DCW.

Email Michael Batts your completed survey or with questions.

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QAA and QMI February Invoices Include an Adjustment (SNF)

The Michigan Department of Health and Human Services issued Quality Assurance Assessment (QAA) and Quality Measures Initiative Assessment (QMI) invoices for October 2025 through January 2026 using estimated amounts. The February 2026 invoices include an adjustment to actual costs for these estimated invoices. If a credit balance remains after applying the adjustment to your facility’s February invoice, the credit will be applied to your subsequent invoices for each respective program until exhausted. Questions? Email Terri Waddill or call (517) 284-9372. 

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MDHHS to Host Nursing Facility Cost Report Preparation Webinar (SNF)

The Michigan Department of Health and Human Services LTC Reimbursement and Audit Division will host a Nursing Facility Cost Report Preparation webinar February 25, 2026, from 9 to 10:30 am. The department asks that you register to secure your spot before February 23 at 6 pm. MDHHS will send a Microsoft Teams Meeting Link on February 24 to everyone who registers. Click here and complete the registration information to secure your spot.

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CMS Finalizes Provider Tax Rule (SNF)

On January 29, the Centers for Medicare & Medicaid Services finalized a rule to close a loophole and tighten federal oversight of Medicaid provider taxes, which are a key mechanism that state Medicaid agencies use to finance their share of Medicaid. The policies in the final rule, “Preserving Medicaid Funding for Vulnerable Populations – Closing a Health Care-Related Tax Loophole Final Rule,” implement and align with several sections of the One Big Beautiful Bill Act (OBBBA), the Medicaid Fiscal Accountability Rule (2019) and the proposed rule. Notable changes from the proposed rule include a revised transition period for Michigan’s Medicaid Provider Taxes to come into compliance, whether assessed against Managed Care Organizations or other provider classes.  

Recall that Section 71117 of O​BBBA restricts states’ ability to obtain waivers from requirements that Medicaid provider taxes be uniform, broad based, and generally redistributive and prohibiting tax structures that impose differential rates based on providers’ Medicaid volume. 

Good News: The final rule authorizes a long transition period — Michigan’s Skilled Nursing Medicaid Provider Tax structure may remain in place through September 30, 2028.  

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CMS Updates Vaccine Roster Billing Guidance (SNF)

The Centers for Medicare and Medicaid Services updated the MLN Booklet titled Medicare Billing: CMS 1450 & 837I.  The updated guidance added COVID-19 vaccinations to its roster billing options. The CMS website has more information about roster billing.  You can also find vaccine billing resources on AHCA’s #GetVaccinated page under the Billing and Reimbursement resources tab. 

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CMS Issues Memo Outlining Revisions to the State Operations Manual (SNF) 

Resources are now available to help providers better understand the State Operations Manual revisions, which take effect March 30, 2026. As we previously shared, on January 30, the Centers for Medicare and Medicaid Services released a 300-page memo to state survey agencies outlining revisions to chapters 5 and 7 of the manual. 

To provide detailed information about the changes, the American Health Care Association released a comprehensive four-part webinar series, “Updates to the SOM Chapters 5 and 7.”  AHCA Regulatory team members will guide attendees through the most significant changes and discuss their impact on providers. AHCA’s also released a summary with highlights. Questions? Email HCAM’s Colin Bercher.

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CDC Shares New Infection Control Resources for LTC Facilities

The Centers for Disease Control and Prevention (CDC) released three new infection control resources for long-term care facilities:

  1. Sepsis Prevention Assessment Tool for Nursing Homes – This tool identifies gaps in sepsis policies, training and practices in nursing facilities that can be targeted to improve infection prevention, sepsis recognition and health outcomes.
  2. Targeted Assessment for Burnout Facility Assessment Tool – This tool may be used by individual health care facilities at any time to identify potential factors which may contribute to burnout.
  3. Webinar Recording: Preventing and Responding to Respiratory Infections and Outbreaks in Long-Term Care – The CDC provides the latest information on how to prevent and respond to respiratory infections and outbreaks in LTC facilities. One free CE is available via the CDC TRAIN website.
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CMS Updates Respiratory Critical Element Pathway (SNF)

The Centers for Medicare and Medicaid Services updated its Survey Resource folder, which included technical changes as well as an update to the Respiratory Critical Element Pathway. You can find the updated Survey Resources folder in the downloads section of CMS’s Nursing Home webpage. The update includes a clarification for “No Smoking” signs:

  • Smoking facilities: Are doors labeled “No Smoking” at all locations where oxygen is stored or used? 
  • Non-smoking facilities: Are “No Smoking” signs posted at all major entrances and on doors to all oxygen storage locations? 

Questions” Email [email protected].

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New Ruling on Temporary Protected Status Could Impact Workers (SNF/AL)

A Ninth Circuit panel ruled on February 16 to pause a lower court order vacating the Secretary of Homeland Security’s decision to terminate temporary protected status (TPS) for immigrants from Nicaragua, Honduras and Nepal. This means the federal government is now legally cleared to proceed with terminating TPS for these three countries while an appeal moves forward. The government’s next step is to put out a notice in the Federal Register, which is the guidance employers should follow.

Which employees are impacted?

  • Nepal, Honduras and Nicaragua: The Department of Homeland Security will likely now enforce termination dates.
  • Haiti: TPS protections for Haiti remain temporarily active. A separate court in D.C. blocked the termination of Haiti TP on February 2, 2026, preserving work authorization for now.
  • Venezuela: Termination remains in effect.

What employers can expect:

  • I-9 Reverification: Do not reverify early. Employers should only reverify employees when their current work authorization truly expires. Blanket reverification based on news reports can lead to national origin discrimination claims.
  • Legal Documentation: Employees may present Employment Authorization Documents (EADs) with past dates that have been automatically extended by federal notices. Check official USCIS updates before making employment decisions.

Action steps:

  • Audit: Review your EAD-based employees to identify work permits expiration date. 
  • Documentation: Retain a PDF or printout of the relevant USCIS webpage or court order in the employee’s I-9 file to justify continued employment during litigation.
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HFA Administrative Rule Changes Update: 7 of 15 JCAR Days Now Completed
The Homes for the Aged ruleset continues to move through the rule promulgation process. On December 12, 2025, the new ruleset was sent to Joint Committee on Administrative Rules (JCAR). The timeline requires 15 legislative days to allow JCAR to review and approve the rule changes. The Michigan Department of Licensing and Regulatory Affairs reports that 7 of those 15 days are now completed.  

HCAM expects the rules will take effect withing the next month. The rules modify requirements for communicable disease screening to comport with today’s practice standards; allow HFAs to reduce how frequently primary care providers are contacted each time residents refuse medication; provide regulatory requirements: (a) for a corrective action plan for identified violations, (b) for criteria for dismissing complaint allegations, and (c) to update physical plant requirements to nationally recognized models in congregate settings. Questions? Email HCAM’s Jenny Post.

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LARA Updates Adult Foster Care Resources

The Michigan Department of Licensing and Regulatory Affairs (LARA) updated their website with revised Technical Assistance for the new combined Adult Foster Care Ruleset. Additional resources include example policies, templates and procedures. Updated forms will be labeled with BCHS instead of BCAL. Questions? Email HCAM’s Jenny Post.

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HCAM Welcomes New Members

We are pleased to welcome three new assisted living community members:

We look forward to partnering with these communities to continue to promote excellence in senior care.

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