May 27 Newsletter

 

 

 

 

May 27, 2026

 

U.S. Senate Democrats Float Plans to Reform Long-Term Care

American Health Care Association/National Center for Assisted Living (AHCA/NCAL) President Clif Porter shared concerns about a letter outlining a future long-term care agenda by a group of Senate Democrats. The letter is part of a larger effort by the Democrats to develop a comprehensive health care agenda should they take back control of Washington D.C. one day. 

The effort is focused on three areas: (1) Make home care affordable and accessible, (2) Improve the quality of care in SNFs and (3) Use incentives to strengthen the long-term care workforce.  

The letter mentions developing policies to “align incentives to strengthen nursing home staffing standards.” While this is a more positive framing than saying they want to bring back the staffing mandate outright, AHCA continues to be cautious about Senate Democrats’ ultimate goal. In addition, there continues to be a focus in the letter and throughout D.C. around financial transparency, and the association will continue to advocate for reasonable accountability.

Clif’s point is — we must remain vigilant and seek opportunities to find common ground. But also, the reality is that the Democrat’s reform plans are not going anywhere soon. For their plans to become reality, it must be under perfect political dynamics where Democrats have the majority in the House and Senate, as well as the Presidency. If that happens, changes may still many years down the road.  

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Join Us to Advocate for Long-Term Care in Michigan

HCAM’s Legislative Day at the Capitol will be June 23. This is an exclusive membership opportunity to help shape long-term care policy, discuss key issues and network with Michigan’s top policymakers. Registration is open now.

Why Should You Attend? This event is an easy way to engage with legislative advocacy. Your story matters, and your voice should be heard. HCAM fiercely advocates on behalf of Michigan’s LTC sector on the issues that matter most, and this event is your opportunity to highlight the challenges providers face, discuss ways to overcome them and build valuable connections that will help strengthen the sector. 

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Michigan House Passes Respiratory Therapist Licensure Bill

Last week, the Michigan House passed legislation making updates to the licensing requirements for respiratory therapists. House Bill 5150 makes the following changes to statute regarding the licensing and oversight of respiratory therapists in the state:

  • Require continued professional competency education as a condition of license renewal. The regulations around the continuing education requirements would be established by LARA once the bill is signed into law.
  • Allow respiratory therapists to provide services under the order of physicians and other qualified practitioners, including an advanced practice registered nurse who is acting under the delegation of a physician, or a physician’s assistant.
  • Enumerate the scope of practice of respiratory therapists beyond current statute.
  • Create a limited license for individuals enrolled in/graduated from an accredited program, allowing the individual to provide respiratory care under the supervision of a licensed respiratory therapist. Such a license would expire one year after issuance or upon full licensure and could be renewed one time.

The bill will now go to the Michigan Senate for consideration. You can track the bill on the Michigan Legislature website.

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CMS Approves Timeline for MDHHS to Make Appropriate ICO Rate Amendments

The Michigan Department of Health and Human Services (MDHHS) shared an updated timeline for the settlement of state fiscal year 2022 and 2023 MI Health Link rates. SFY ’22 and ’23 cost settled rates, which impact Integrated Care Organization (ICO) rates for calendar years 2021, 2022 and 2023, result from the Public Health Emergency flexibilities MDHHS implemented to support SNF providers. CMS has approved a plan for MDHHS to make appropriate ICO rate amendments within the following timeline:

  • ICO CY 2021 Rates – MDHHS is finalizing a CY 2021 rate certification amendment. This will reflect SFY 2022 SNF FFS rates being incorporated into ICO 2021 Q4 rates. MDHHS expects payments to ICOs by July 2026.
  • ICO CY 2022 and CY 2023 Rates — In March 2027, rate certification materials will be finalized that incorporate SFY 2022 and 2023 SNF FFS rates into CY 2022 and CY 2023 ICO rates. MDHHS has shared with CMS that payments to ICOs are expected in April 2027.
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HCAM Requests Feedback on Your MICH Claims Processing

As part of the transition from MI Health Link (MHL) to MI Coordinated Health (MICH), MDHHS implemented new reporting requirements effective January 2026 involving new encounter value code reporting by health plans. HCAM understands MDHHS expected health plans to communicate billing requirements directly to providers as part of standard managed care operations. However, there have been implementation challenges. HCAM heard concerns from several providers about MICH billing, and we are seeking additional feedback. Please share any issues you’re currently having with billing as you transition from MI Health Link to MI Coordinated Health by emailing Mike Batts.

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MDHHS Releases L Letter Addressing Medicaid Underpayments During CHOWs

The Michigan Department of Health and Human Services (MDHHS) released Numbered Letter L 26-18-NF.pdf to clarify that, in nursing facility change of ownership (CHOW) situations involving a new National Provider Identifier, any Medicaid underpayments or credits tied to periods under the prior owner will be paid directly to the preceding owner regardless of what the purchase agreement says between the buyer and seller. MDHHS states this is a clarification, not a policy change, and plans to formally add this language and related definitions (underpayments, overpayments, credits, debt, liabilities) to the Medicaid Provider Manual Cost Reporting and Reimbursement Appendix.  

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Nursing Facility QMI Resident Satisfaction Survey Data Due in August

The Michigan Department of Health and Human Services (MDHHS) issued Numbered Letter L 26-33-NF QMI.pdf requiring facilities to submit acceptable resident satisfaction survey data and supporting documentation by August 14 to continue to receive 100% of their standard QMI payment. Facilities that do not submit acceptable information will have payments reduced to 85% of the standard amount. Providers may use their own survey methodology and questions, as long as the survey is specifically focused on resident satisfaction. Facilities must submit survey questions, response summaries, participation data, survey methodology details and an explanation of how results are used to improve resident care. Surveys must have been completed on or after June 27, 2025, and submissions are due electronically to MDHHS by August 14, 2026.

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AHCA/NCAL to Host Free Webinar with HUD

AHCA/NCAL will host a free webinar with HUD on the Section 232 program on June 18, 2026, from 2-3 pm EDT. The webinar is open to AHCA/NCAL members and non-members. The Office of Residential Care Facilities (ORCF) administers the Section 232 loan program, and ORCF will provide a brief program overview and address key asset management and production matters. Presentation topics will include: 

  1. Section 232 Program Overview 
  2. Underwriting Hot Topics 
  3. Improving Loan Performance in the Portfolio 
  4. Policy Updates 
  5. Resources and Questions

Please register here to attend.

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CMS Shares FY 2026 Guidance for Federal Monitoring Surveys (SNF)

CMS released Admin Info Memo 26-06-NH on May 15, 2026, outlining Fiscal Year ’26 guidance for Federal Monitoring Surveys (FMS) in nursing facilities. The memo details how CMS will oversee Long Term-Care Health, Emergency Preparedness (EP), and Life Safety Code (LSC) surveys conducted by federal surveyors. It also explains how CMS locations will select facilities, conduct oversight activities and issue State Reports, while clarifying the reconsideration process for State Agencies (SAs). 

CMS noted that the ’26 calculation for the required number of LTC FMS Health and EP/LSC was adjusted by 10% due to the 2025 federal government shutdown that caused delays in travel and survey activity. Please note: In Michigan, this will lower the total amount of Federal Monitoring Surveys from 22 in FY2025 to 20 in FY2026.

Three Types of Federal Monitoring Activities
♦ Resource and Support Surveys: Federal surveyors accompany SA surveyors to provide real-time guidance, education and survey process support. 
♦ Comparative Surveys: Federal surveyors conduct an independent survey within 60 days of the SA’s standard or complaint survey to determine whether deficiencies were appropriately identified and cited. 
♦ EP/LSC Desk Audits: Federal surveyors conduct a desk audit after the SA completes a standard survey.  

Enforcement: If deficiencies are identified during any FMS activity that requires facility action, the CMS Location will take appropriate enforcement action based on the survey findings.  

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CMS Encourages Electronic Payment for CMPs (SNF)

​The Centers for Medicare and Medicaid Services (CMS) is reinforcing the federal government’s broader push toward electronic payments by encouraging providers to submit Civil Money Penalty (CMP) payments electronically through Pay.gov. While CMS has not issued a standalone memo specifically requiring CMP payments to be submitted through electronic funds transfer (EFT), the agency’s direction aligns with Executive Order 14247, “Modernizing Payments To and From America’s Bank Account,” signed on March 25, 2025. The Executive Order directs federal agencies to transition payments and receipts to electronic methods to improve security, reduce fraud, and lower administrative costs. 

CMS has incorporated updated payment instructions into its Due & Payable Letter Template, encouraging providers to pay CMPs directly through the CMP Pay.gov portal. In the letter, CMS notes that electronic payment through Pay.gov helps avoid delays in processing and ensures timely receipt and application of payments to the appropriate case file. 

The CMP Pay.gov portal is available 24 hours a day, seven days a week, and providers will need the following information when submitting payment: CMS Certification Number and CMP Case Number. Providers can access the CMP payment portal here. For technical assistance with Pay.gov, providers may call Customer Service at (800) 624-1373.  

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Toolkit Available to Help Prevent Falls (SNF/AL)

The American Healthcare Association/National Center for Assisted Living (AHCA/NCAL) developed a Falls Toolkit called Safe Steps Forward to support providers in strengthening their fall prevention programs. This toolkit was developed with practical, evidence-informed strategies to help interdisciplinary teams identify risk factors, implement target interventions and continuously evaluate outcomes. Resources within this toolkit include the following elements:
♦ Structured approaches to fall risk assessment and reassessment
♦ Evidence-based interventions tailored to resident-specific needs
♦ Environmental and systems-based strategies to reduce risk
♦ Staff education and team communication tools
♦ Guidance for tracking, trending, and using data to drive improvement

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Renew Your Homes for the Aged License

The 2026-2027 state licensing renewal cycle for Homes for Aged is open. The state is strongly requesting that renewals be completed by July 31, 2026. The renewal process is completed through using a credit card or electronic check for payment of the licensing fees.  Do not mail paper checks to the department for license renewal fees.

To renew an HFA license, please use the following process:

  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.
  6. Print the receipt for the payment, this is the only opportunity to print a receipt for the payment.

Please note: The renewal site will shut down on August 1, 2026, in preparation for the release of MI-SLS, the new state licensing database. Any license not renewed by July 31, 2026, will have to wait for the release of the MI-SLS to complete license renewal in late August. During this time when MI-SLS is not available, any license not renewed will be expired with a status of lapsed on the department web page without the ability to renew the license.

Questions? Email Long-Term-Care State Licensing Section or call (877) 458-2757.

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