July 8, 2026

 

Direct Care Worker Wage Impacted in Final Fiscal Year ’27 State Budget

On July 3, the Michigan Legislature sent the Fiscal Year 2026-2027 state budget to Governor Whitmer for her signature. It contains several significant provisions affecting Michigan’s skilled nursing facilities, including changes to Direct Care Worker (DCW) and Non-Clinical Staff wage funding, an increase to the Capital Asset Value (CAV) limit, and a $10 million workforce initiative funded with Civil Monetary Penalty (CMP) dollars.

SNF DCW/Non-Clinical Wages: Until final days of budget negotiations, the Legislature’s proposals maintained full funding for the DCW and Non-Clinical Staff wage reimbursement program. However, at the last-minute, language was added to Senate Bill 878 that significantly reduces program funding beginning October 1, 2026.

Under the approved budget, the reimbursement rates remain unchanged at $3.40 per hour for direct care workers and $0.85 per hour for eligible non-clinical staff, but those reimbursements will now only be paid for Medicaid resident days. Historically, providers have received the wage reimbursement for all resident days, regardless of payer source, with state General Fund dollars supporting the non-Medicaid portion of the program. Eliminating that General Fund support is expected to reduce funding for the program by approximately $73 million annually, according to MDHHS.

HCAM is urging Governor Whitmer — via a letter and a press release — to veto the budget language eliminating General Fund support for non-Medicaid resident days and preserve the current funding structure. If the reduction cannot be avoided, HCAM is requesting that it be phased in over two to three years to allow providers time to adjust budgets, minimize disruption to employee wages and maintain access to quality care. HCAM is also working with MDHHS to ensure any implementation is carried out in a way that minimizes the administrative burden and operational disruption for providers.

CAV Limit Increase: Good News —The budget includes $11.3 million to support a Capital Asset Value (CAV) limit increase for skilled nursing facilities. Effective October 1, 2026, the CAV limit will be adjusted using a rolling 15-year average of new construction costs, with future increases capped at 4%. This method will significantly increase the CAV limit. HCAM is working with MDHHS to finalize the updated CAV amount and will share additional details as they become available.

SNF Staffing Initiative: More Good News — The budget also includes a facility staffing initiative aimed at addressing chronic workforce shortages in nursing facilities. The funding uses $10 million from the state’s Civil Monetary Penalty fund and will be implemented to reflect the goals as outlined by CMS in a letter to state governors.

The goals include:
♦ Providing financial incentives, such as tuition reimbursement and stipends, for nurses to work in nursing facilities.
♦ 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 careers.

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You’re Invited to HCAM’s 2026 Convention & Expo

Skilled nursing and assisted living professionals are invited to attend the association’s Annual Convention & Expo in Grand Rapids, September 14-16, 2026. Whether you are looking for practical solutions, fresh ideas, leadership insight, valuable connections or all of the above, the HCAM Convention is where Michigan long-term care comes together. With over 30 educational and motivational sessions – including keynotes on authentic leadership, navigating challenging moments, and leading with authority and impact – you don’t want to miss this deep dive into what really moves long-term care. Check out the agenda here.

This year’s event brings together:
✅Forward-thinking education
✅Timely LTC sector discussions
✅Powerful networking
✅Providers and vendors at Michigan’s premier long-term care expo
✅Caregivers, families, friends and colleagues at the impactful Awards Luncheon
✅Opportunities to reconnect with peers and partners from across the state

Join us in person or virtually and leave with fresh insight, valuable connections, and renewed energy to make waves in your organization and across the profession.

Register by July 27 to save $100. 

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Legislative Update on Policy Bills

An agreement by House Republicans and Senate Democrats to move nearly 70 policy bills before the end of the term was included in the budget negotiations. The full list includes priorities for legislative members in both chambers, as well as legislative leadership. These bills will impact long-term care providers:

1️⃣Physical Therapy Licensure Compact – Senate Bill 501 and House Bill 4101 would include Michigan in the physical therapy licensure compact, joining 38 other states and allowing individuals licensed as physical therapists in compact states to practice physical therapy in Michigan. The Legislature passed both bills on July 3, and the governor is expected to sign them.

2️⃣Occupational Therapy Licensure Compact – House Bills 4103 and 4104 would include Michigan in the occupational therapy licensure compact, allowing individuals licensed as occupational therapists in compact states to practice occupational therapy in Michigan. The Legislature passed both bills on July 3, and the governor is expected to sign them.

3️⃣Senior Amber Alert – Senate Bill 456 requires the Michigan Department of State Police to create a missing senior or vulnerable adult medical alert system plan that can quickly disseminate to wireless devices useful information such as a physical description of the missing person, his/her address and the date/time the person was last seen. The bill’s definitions of senior and vulnerable adults indicate that the legislation would apply to most SNF and AL residents. The Legislature passed the bill on July 3, and the governor is expected to sign it.

4️⃣Med Aide Fees – Senate Bill 569 would allow the Department of Licensing and Regulatory Affairs (LARA) to annually increase the fees (within limits) for nurse aides, nurse aide trainers, medication aides and medication aide trainers. The bill also allows LARA to impose a $75 late fee for renewal applications received after the permit expires. The Senate passed the bill on July 3, and it now is before the House for consideration. It is possible it will pass in the coming months.

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HCAM Needs Your Input: MI Coordinated Health Payment & Billing Survey

HCAM continues to advocate with the Michigan Department of Health and Human Services, Michigan’s HIDE-SNP health plans and state policymakers to address ongoing payment and billing challenges affecting nursing facilities. To strengthen these efforts, we need data from providers across the state. We are asking members to complete a survey on HIDE-SNP claims payment timeliness, billing issues, denials, administrative burden and outstanding accounts receivable. Your responses will help us quantify the impact on providers, identify trends across health plans, and support our advocacy for timely payments, clearer billing guidance and policy improvements. Examples shared in the survey may be used anonymously in discussions with state officials and health plans.

Please complete the survey by Wednesday, July 22. It takes approximately 15-20 minutes to complete, and every response will help strengthen HCAM’s advocacy on behalf of Michigan nursing facilities.

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Recording Available: HUD 232 Webinar Event

AHCA/NCAL recently hosted a webinar with HUD on the Section 232 program. The webinar recording is now available free of charge. It provides a brief overview of the Section 232 program and addresses key asset management and production matters, along with additional information and resources. 

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Upcoming Nursing Facility Touchpoint Meeting July 9

The Michigan Department of Health and Human Services (MDHHS) next touchpoint meeting with nursing facility providers is tomorrow, July 9 at 11 am. Click here to register.

You may also visit the Medicaid Nursing Facilities webpage to register for any upcoming touchpoint meetings. For questions or trouble registering, contact [email protected].  

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CHAMPS Enrollment Reminder

As a reminder, all providers and managed care entities who serve Michigan Medicaid beneficiaries are required to be screened and enrolled in the Community Health Automated Medicaid Processing System (CHAMPS). Pursuant to 42 CFR §455 Subparts B & E, all in-state and out-of-state providers are to comply with screening and enrollment requirements to submit claims for services rendered to eligible Medicaid beneficiaries.  For additional information, including assistance with CHAMPS enrollment, refer to the MDHHS Provider Enrollment webpage. Detailed information pertaining to provider enrollment and screening requirements can be found within the General Information for Providers chapter of the Michigan Department of Health and Human Services [MDHHS] Medicaid Provider Manual. 

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Outbreak of Cyclosporiasis in Michigan (SNF/AL)

The Michigan Department of Health and Human Services (MDHHS) and the Michigan Department of Agriculture and Rural Development (MDARD) are investigating a large and growing outbreak of cyclosporiasis, as over 700 cases in Michigan have been reported as of July 6, 2026.

Cyclosporiasis is an intestinal illness caused by the Cyclospora parasite which infects the small intestine and usually causes frequent diarrhea. The onset time is usually about one week but can range from two days to two weeks or more. Untreated, the illness may last from a few days to more than a month. Symptoms may go away and then return. Cyclosporiasis is not usually life-threatening, but dehydration from frequent bouts of diarrhea can cause severe illness, particularly among younger or older people and those who have weakened immune systems. Cyclosporiasis is treated with antibiotics along with rest and drinking plenty of fluids to maintain hydration.

MDHHS and MDARD have not been able to determine a specific source of the outbreak but have provided recommendations for entities that are preparing, processing, or serving raw produce:
♦ Lettuce/leafy greens:  buy whole heads of lettuce (rather than prewashed, bagged lettuce or salad mixes), throw away the outer 2–3 layers of leaves and wash the inner leaves under running water. For leafy greens that can be cooked, cooking is the safest option.
♦ Cilantro, basil: Wash thoroughly under running water, separating the leaves.  Safest when cooked.
♦ Green onions: Trim the root end and remove the outer layer, wash thoroughly under running water. Safest when cooked.
♦ Raspberries: Their bumpy surface makes them especially hard to clean; the parasite can hide in the tiny crevices.  Safest when cooked (pies, jams etc.). Consider frozen raspberries as an alternative (freezing may reduce but does not guarantee elimination of the parasite).
♦ Snow peas: Wash under running water and rub the surface. Safest when cooked.

Additional information is available at About Cyclosporiasis | Cyclosporiasis | CDC.

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CMS Corrects iQIES PBJ Launch Announcement (SNF)

The Centers for Medicare & Medicaid Services (CMS) issued a correction to some of the details in their June announcement that, effective August 17, 2026, the Payroll-Based Journal (PBJ) system will transition to the Internet Quality Improvement and Evaluation System (iQIES), which is CMS’s secure cloud-based system. 

CMS provided a correction to their iQIES PBJ Launch Announcement, reordering the task numbering, as shown below.

  1. Create a HCQIS Access Roles and Profile System (HARP) account: Skip this step if you already have a HARP If you do not have an account, register here.
  2. Request access to iQIES: Submit your request early so your access is ready before launch. Although you may request your PBJ role before August 17 (and CMS strongly recommends you do so), PBJ functionality will not be available for use in iQIES until August 17, 2026.
  3. Choose the correct PBJ role within iQIES:
    1. PSO: Can view, upload, edit PBJ data and run PBJ reports. This role also approves user access.
    2. PBJ Submitter (Provider or Vendor): Can view, upload, edit PBJ data and run PBJ reports.
    3. Provider Administrator: View-only access and run PBJ reports.
    4. PBJ Viewer: View-only access and run PBJ reports.
    5. Additional information on roles can be found in the iQIES Onboarding Process – Provider User Roles Manual posted on the iQIES Reference and Manuals on QTSO under iQIES Onboarding Guides.
  4. Get approval from your facility’s Provider Security Official (PSO): Your access will not become active until they approve it.  Each facility must have at least one PSO to manage access for additional users.
  5. Once you register for an iQIES account, be sure to log in regularly. If you do not log in for 60 days, you’ll lose access to iQIES. Additional information on the iQIES Inactive User Policy can be found on QTSO.

Vendors must request access for each facility they represent and get approval from a PSO at each facility, using the facility’s CMS Certification Number (CCN).

CMS will provide additional information before the launch through various email notifications regarding onboarding, training, details on what to expect and more.

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Rule Requiring Providers to Acquire Accessible Medical Equipment Now in Effect (SNF/AL)

A grace period allowing providers to continue to use non-accessible exam tables and weight scales for disabled individuals ends today, July 8, 2026.

In May 2024, the U.S. Department of Health and Human Services (HHS) released a final rule, Nondiscrimination on the Basis of Disability in Programs or Activities Receiving Federal Financial Assistance. The rule affects providers participating in Medicare, Medicaid, and other HHS-funded programs. HHS adopted the U.S. Access Board’s Standards for Accessible Medical Diagnostic Equipment (MDE) as part of its broader efforts to ensure health care accessibility for individuals with disabilities. The standards specify what is required for medical equipment to be accessible. HHS issued these new requirements because people with disabilities continue to face barriers in getting medical care due to inaccessible medical equipment. Barriers include exam tables or chairs with heights that cannot be adjusted and weight scales that do not allow the use of wheelchairs.

The rule allowed each recipient that uses exam tables and weight scales two years (until July 8, 2026) to have in place at least one accessible exam table and one accessible weight scale. 

What this means for nursing facilities and assisted living communities: 

If the facility is a recipient (is participating in Medicare, Medicaid, and other HHS-funded programs), by July 8, 2026, the facility is required to purchase, lease, or otherwise acquire the following, unless the recipient already has them in place:  
(1) At least one examination table that meets the Standards for Accessible MDE, if the recipient uses at least one examination table; and  
(2) At least one weight scale that meets the Standards for Accessible MDE, if the recipient uses at least one weight scale.  

Recipients are also expected to do the following: 
♦ Maintain accessible MDE for patient use; 
♦ Ensure staff are trained to operate accessible equipment; 
♦ Assist patients with transfers and positioning when necessary; and 
♦ Provide accessible healthcare services in a manner that affords equal access to individuals with disabilities. 

For more information, see HHS fact sheet New Requirements for Accessible Medical Diagnostic Equipment 

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Renew Your Homes for the Aged License

The state is strongly requesting that Homes for Aged license renewals be completed by July 31, 2026. The renewal site will shut down on August 1 in preparation for the Michigan Department of Licensing and Regulatory Affairs planned Michigan State Licensing System (MI-SLS) launch to replace the current eLicense platform. Any license not renewed by July 31, 2026, will have to wait for the release of the new state licensing database to complete license renewal in late August. During this time when the site is not available any license not renewed will expire with a status of lapsed on the department webpage without the ability to renew the license.  Therefore, getting the renewals done before July 31 is essential. 

Instructions to renew an HFA license are as follows:

  1. Go to https://www.thepayplace.com/MI/deleg/HFA
  2. Enter the License Number listed above and select the “Submit” button directly underneath.
  3. Review “Your Information” to ensure that license number, facility name, and fee amount is correct for the license renewal payment.
  4. Choose the Method of Payment by clicking either pay by electronic check or pay by credit card.
  5. Follow the prompts to provide electronic payment information for the license renewal fee. Note: the address requested is the address of the credit card being used and not the facility address.
  6. Print the receipt for the payment, this is the only opportunity to print a receipt for the payment.

Any questions about license renewal can be directed to the long-term-care state licensing team at (877) 458-2757 or [email protected].

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Join Our Connected Community

Don’t forget that HCAM Assisted Living members have access to an online community just for our group to facilitate communication among members. We can use this community to communicate, collaborate and securely share information and electronic files with one another. Our Connected Community includes a discussion board, a library and a community member directory — and it’s very easy to use. If you have questions about the community or need help, please email HCAM’s Jenny Post. 

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National Assisted Living Week Merchandise Available

September 13-19, 2026, is National Assisted Living Week. This year’s theme is “Shining Through the Years.” You can explore the official NALW collection and planning resources by visiting the NALW website.

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