MDHHS Releases NABP Proposed Interim Policy Effective October 1
The Michigan Department of Health and Human Services (MDHHS) issued a Non-Available Bed Plan (NABP) proposed interim policy that covers the period between October 1, 2025, and September 30, 2026, while the department works on developing a permanent policy. Issuing this interim policy is the department’s way of temporarily extending some of the COVID-era policy that provide flexibilities to providers for placing unused beds in a non-available bed plan. The department is also using this interim policy to introduce other changes.
HCAM is reviewing the proposed interim policy and will submit feedback to MDHHS on several areas of concern including the treatment of square footage within rooms, amendment allowances and CHOWs.
Policy Specifics
Qualifying Criteria: There are no discrete area or contiguous physical arrangement requirements for the designation of a non-available bed. During this interim policy period, providers may designate as non-available beds individual beds within a room that are not being used for resident care. A portion of the common physical space within a room containing both non-available beds and available beds will be designated as a non-available bed area for cost report statistical purposes.
Cost Reporting/Treatment of Square Footage: The variable and plant costs attributed to the area(s) designated as non-available and the related capital asset cost are not Medicaid reimbursable costs. The non-available rooms and bed numbers must be reported as a non-available beds cost center on the provider’s Medicaid cost report. This includes entire rooms that are part of the NABP and rooms that contain both non-available and available beds.
NABPs that have rooms containing both non-available and available beds will have their square footage calculated to take plant and applicable variable costs into reimbursement consideration. The calculation will be based on the ratio of beds available (Medicaid-reimbursable) to beds non-available (not Medicaid-reimbursable).
Life of an Approved NABP: Renewal of existing NABPs will be extended for a period of 12 months (with an end date of September 30, 2026) if the nursing facility chooses to do so. Nursing facilities that wish to continue their NABP must contact the MDHHS Reimbursement and Rate Setting Section (RARSS) no later than November 30, 2025, which is 60 days after October 1, 2025, which is the effective date of this policy. Facilities with existing NABPs that do not contact RARSS by November 30, 2025, will have their plans end-dated to September 30, 2025.
Nursing facilities without an existing NABP may apply for an NABP during this interim period with any plan ending September 30, 2026. Providers will have 60 calendar days from the date that the provider removes bed(s) from service to submit the written non-available bed plan request.
Non-available bed designations will be effective on the first day of the month. If MDHHS does not receive the notice within the required 60 calendar day period, the NABP will become effective on the first day of the month in which RARSS received the notice if the beds have not been used during that month. All NABPs extended or created during this period, regardless of start date, will end September 30, 2026.
Amending an NABP: NABP amendments will not be allowed under this interim policy.
Returning Beds to Service: In special circumstances, such as a sudden increase in demand due to closure of a nearby facility, non-available beds may be returned to service before the end of the approved NABP with prior RARSS approval.
Questions or concerns? Email HCAM’s Mike Batts.