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State of Michigan Coronavirus Updates

LeadingAge Michigan is the convener for policy and advocacy discussions around critical senior issues for not-for-profit and mission based providers. We partner with a broad base of like-minded entities focused on policies that support member ability to serve Michigan seniors. This page is designed to provide a current set of resources that will assist in maintaining a safe and calm environment during the potential pandemic that is now developing.






Nursing Home Testing Guidance – UPDATED TODAY!!

MDHHS has posted an updated Nursing Home COVID-19 Testing Financial Guidance to Nursing Home COVID-19 Plan. Please note in particular the following change in submission email below and important reminder about submission of confidential or sensitive data:

  • Effective July 6th, all Nursing homes should begin submitting their testing reimbursement forms to the Bureau of Audit at:
  • Please submit the testing reimbursement forms only. Please do NOT send any confidential information or beneficiary specific data to the above email.

Documents attached include:

Please note that the email for submitting testing reimbursement forms has changed to the above.


MIHAN/ MSP Communications 

During this pandemic emergency, MDHHS has been sending out many of its updates through MIHAN – the Michigan Health Alert Network. This is a web-based communication system established by MDHHS and other entities to alert key public health, healthcare and public safety

personnel to situational awareness and important, but non-emergency health related information.

We have recently noted that some members may not be familiar with or registered with MIHAN; and some have found the registration process difficulty and lengthy. We are working with MDHHS to determine how best to assist members in registering and will provide updates as we receive information.

Many communications have also been issued via the Michigan State Police – as part of the pandemic response. The first messages about the Visitation Guidance were received through that mechanisms. Members who wish to receive their alerts can sign up here.


Senate Bill 690 Signed Today

Moments after our Wednesday, July 1 Safe and Calm Webinar, Governor Gretchen Whitmer signed Senate Bill 690 into law. As reviewed in detail in our June 19th edition of the latest wrinkle, Senate Bill 690 distributes $880 million of the states COVID-19 relief funds. Long term care highlights include $120 million for an increase in hazard pay for direct care workers, $25 million in grant funds for PPE and Testing and $1.5 million for Infection Control surveys overseen by LARA.

Currently, very little is known about how these funds will be distributed. The bill puts the direct care worker funds and grant funds under the preview of MDHHS who is currently working to interpret the legislative intent behind the funds and design an effective process to release the funds to providers. LeadingAge Michigan is currently working with the department and has suggested feasible solutions for the rollout of these programs. Suggestions include:

• The $2 per hour increase for Hazard pay begin recognized as a wage pass through in order for it not to effect the reimbursement system
• A PPE and Testing Grant application and process that includes the full continuum of care when allocating grant finds.

Questions can be directed to Dalton Herbel at


MDHHS Issues Updated Guidance on Visitation

Visits may be made to residents in residential care and independent living facilities only for the following purposes:

• To ensure effective communication for those with hearing, vision, or speech impairments that could assist with addressing resident’s condition such as refusing to eat or to allow assistance with feeding to ensure adequate nutrition.
o Visitors must wear a mask at all times and use appropriate procedures for any assigned ADL tasks. The facility must ensure compliance through training.
o Such visits must be scheduled in advance and for individualized ADL tasks
o And must occur in the resident’s room if private, or in a room designed
• When a resident in in serious or critical condition or in hospice care, consistent with EO 2020-136
• For residents who need ADL assistance from families, facilities must attempt to contact the resident’s next of kin to establish arrangements
• There are numerous additional visitation rules
For purposes of this order, residential care facilities include nursing homes, assisted living, homes for the aged, adult foster care, independent living, hospice and substance abuse disorder facilities


Governor Maintains Risk Levels

Governor Whitmer today stated that she planned to move the state into lower risk categories by the July 4 holiday, but cannot do so since there are increases in new COVID cases across the state – most notably in Lansing and Grand Rapids. Lansing moved from a medium risk area to a high risk area. And Grand Rapids moved to a medium-high risk area. While many of the instances can be traced to local events, there is also community spread occurring.


FY2020 Budget Shortfall Resolved

This past weekend and late Sunday evening word starting leaking out about a bi-partisan budget agreement between the Michigan legislature and the Governor’s Office for FY 2020.

We have attached for your review a short one page summary that is presently being circulated around town explaining how the $3B budget shortfall has been resolved even without projections from the much-anticipated revenue estimating update scheduled for August. In general, it looks like the General Fund shortfalls will be backfilled by funds from the CARES Act and other transfers and shifting of funds to make the numbers add up.

The next challenge is the FY2021 budget that must be finalized in September. We suspect that this current agreement for FY2020 will kick the hard decisions to the FY2021 Budget and those who in the House will need to use the summer to campaign on those issues. Selfishly, we want to make sure that our member’s Medicaid rates and reimbursement models are not disrupted. LeadingAge Michigan has already reached out to MDHHS to initiate preliminary discussions knowing that there will be approximately an 18% savings in the Nursing Home Medicaid line due to lower utilization.


Provider Relief Fund and Medicaid

Michigan Medicaid providers who meet the following criteria can apply for relief through the CARES Act:

• Must not have received any payments from the $50 billion General Distribution
• Must have directly billed Medicaid for healthcare services during CY2018 or CY2019 or own a subsidiary that has done so either through a FFS or managed care mechanism
• Must have provided patient care after January 31, 2020
• Must not have permanently ceased providing patient care
• Must have filed a federal income tax return for either 2017, 2018, 2019 or exempt
• Individual providers must have gross receipts from provider care reported on Form 104, schedule C, line 1, excluding income reported on a W-2 as an employee

Applications must be made through the CARES Act Provider Relief Fund Payment Attestation Portal by July 20, 2020. Providers must attest to certain conditions in order to receive funding.




MDHHS Extends Dates for Nursing Facility Satisfaction Data

Today, the Department issued a Medicaid Letter (L 20-36) identifying that the annual Resident Survey Data necessary for the Quality Measure Initiative must be submitted electronically by September 18 to


MDHHS Extends CMP Grant Deadline

The Department has extended the deadline for applications for CMP funding in support of telecommunications to August 1, 2020. MDHHS today sent the following message to providers:

You must send the CMS application template and Excel spreadsheet. Please note:

1. Send the Excel spreadsheet, not a PDF of the spreadsheet.
2. One nursing home per application.
3. Include a contact person at the nursing home.
4. Include the NPI.
5. Large facilities may submit a request for more than $3,000 if it fully complies with the guidance.
6. Please check your math. Avoid having your application returned to you.

Send your applications to The subject line of the email should include the facility name and “CMP electronic device grant”
The application and spreadsheet can be downloaded from the MDHHS CMP webpage.

Or Michigan Department of Health and Human Services >Doing business with MDHHS>Health Care Providers > Civil Monetary Penalty (CMP) Grant Program.


MDHHS Issues Updates on Testing

Yesterday, MDHHS issued testing updates via MIHAN. These documents include funding plans and other updated FAQs. Members should note that while MDHHS encourages facilities in Regions 1 through 5 and 7 to complete testing as soon as possible, MDHHS will not engage in enforcement actions if compliance is achieved by July 17. LeadingAge Michigan will continue to review the implications of these updates, and review during our next Wednesday Safe and Calm Webinar.



Executive Orders Extend the Status Quo

Governor Whitmer issued two executive orders addressing Michigan nursing facilities at this point in the ongoing pandemic. Executive Order 136 is a direct extension of EO 108. As written, there are no changes to visitation for nursing homes, assisted living, homes for the aged, adult foster care, or independent living. MDHHS has voiced concerns that while the caseload numbers are rising, this may not be the time to reopen visitation to vulnerable seniors.

However, in a call with Kate Massey from MDHHS this afternoon, the state remarked on their plans to send out additional guidance early next week that is more in alignment with the recent CMS FAQs. More details will be available at that time.

Additionally, through Executive Order 135, a bipartisan task force has been created to ‘analyze relevant data on the threat of COVID in nursing homes and making recommendations’. David Herbel, LeadingAge President and CEO will be sitting on that Task Force.


Michigan Executive Orders and MDHHS and Reimbursement for Testing

MDHHS is working with provider groups in developing process to assist members in recouping costs for serial staff testing and we are in the process of discussing their process for covering nursing home costs. Members can look for Guidance this week (hopefully) we have communicated that there is significant work in getting all staff tested (in certain regions) by July 3 and that close deadline seems unrealistic.

LeadingAge Michigan anticipates hearing about EO 108 and whether or how the Governor may wish to extend that visitation guidance. Members can review the workgroup recommendations that went to the Governor and MDHHS/MDLARA below. EO 108 is due to expire on 6/26/2020. EO 123 that defines use of Regional Hubs and other restrictions is still in force until 7/12/2020.


Resumption of Testing for CNAs

Jim Wiggins, BCHS, has informed the Association that “Prometric has 62 tests scheduled for July at 12 different locations. They can test a maximum of 8 at each test and location, so they can only do 496 candidates in July. They are looking to ramp it up and have more locations and testing in August. Many of the previous testing centers either are waiting to open or have decided they no longer wished to be testing centers. Prometric will be looking to replace those that didn’t so as to get more tests done. It is going to take probably at least 3-4 months to get through the candidates already waiting. More test centers will be opening. It’s my understanding there are more than 1800 waiting to test right now.”


MDLARA Planning for Infection Control Inspections

The Michigan Department of Licensing and Regulatory Affairs is currently drafting a plan for infection control surveys in accordance with Michigan legislation providing $1.5 million for these additional activities. They are currently reviewing a three phased approach – hiring, consultative visits, and unannounced inspections. Note that these inspections are state driven and in addition to any federally required survey inspections. The Department plans to share its planning and obtain input from LeadingAge Michigan and other providers.


Governor Extends State of Emergency to July 16

In Executive Order 2020-127, Governor Whitmer extended the Michigan State of Emergency to July 16, citing the need to continue aggressive action to contain the virus which slowly reopening the businesses within the state.



Executive Order 2020-123 extends 2020-50/95 to July 12, 2020.

This order describes the requirements for transferring and discharging residents, and use of regional hubs. There are no new provisions in this guidance.


Bureau of Fire Safety will Resume Onsite Inspections

Effective June 15, the Bureau of Fire Safety will be resuming onsite inspections for regulated healthcare facilities. Inspections will restart with priority to the most overdue for annual visits. Normal inspection rotations will resume for facilities who have not experienced delays in inspections. These inspections will be allowed under Executive Orders that limit certain visitors to healthcare facilities.

  • All inspections will be scheduled with the facility no more than 24 hours in advance. Inspectors will wear a mask, maintain social distancing (when possible) and take other precautions while onsite. The inspector will go over information needed for the inspection, additional precautions and procedures that we will be using during the inspection.
  • Prior to confirming the inspection, the inspector will verify if there are any Covid-19 positive residents or staff in the facility or if there are any suspected Covid-19 that is waiting on confirmation. If Covid-19 is present or suspected, an inspection will not be conducted at this time and you will be requested to complete a self-inspection checklist. It will not be counted as your regular inspection and licensing is aware of these delays in your fire safety inspections.
  • System inspections (fire alarm, sprinkler, hood, etc.) may be out of date due to visitor restrictions. BFS will not be taking adverse actions against facilities until restrictions are lifted and facilities have a period of time to come into compliance. Temporary approvals may be issued in those instances.

Michigan Works to Contain COVID-19 

UK’s Imperial College has released a report demonstrating that through aggressive actions, Michigan was able to lower the spread of COVID significantly and few states dropped their infection rate as low for as long as Michigan. Social distancing was a critical element in reducing transmission, and careful monitoring and mitigation is critical to avoiding a resurgence, according to the Governor’s press release.


Executive Order 2020-108 Extends Restriction for Health Care Facilities

On Saturday, Governor Whitmer extended the provisions of EO 2020-72 through June 26, 2020. EO 2020-108 continues restrictions on visitation and the need for screening persons entering the facility for nursing homes, adult foster care, homes for the aged, and independent living facilities. The directive also continue to require that all persons where a mask when in public indoor venues.


Governor Moves Michigan to Phase IV

This afternoon, Governor Whitmer announced the relaxation of the Stay at Home orders, through Executive Order 110. Michiganders are no longer required to stay at home. Certain businesses will remain closed. Any work that is capable of being performed remotely must be performed remotely.

Workplace rules as identified in EO 2020-97 still apply as indicated in that directive. Retailers will be allowed to resume operations on June 4. Stores may resume normal operations subject to capacity constraints and standards in EO 2020-97. Restaurants and bars may reopen fully on June 8, also subject to the requirements in EO 2020-97.

Michiganders must continue to wear face coverings when in enclosed public spaces and should continue all social distancing. Indoor social gatherings and events of more than ten persons are prohibited. Outdoor social gatherings are permitted when persons maintains a six foot distance and the assembly consists of no more than 100 persons. Indoor social gatherings continue to be restricted up to ten persons. Public swimming pools may open on June 8 with 50% capacity. Libraries and museums may open on June 8. Still closed will be theaters, gyms, non-essential personal care services, casinos, and amusement parks.

Health care facilities, residential care facilities, and congregate care facilities are not included in this directive.


Resources for Homebound Seniors

The MDHHS Aging & Adult Services Agency is working with Area Agencies on Aging and federal and local partners on a number of food programs during the pandemic. One new program is the U.S. Department of Agriculture Farmers to Families Food Box. Through this program, Van Eerden Foodservice of Grand Rapids and LaGrasso Bros. Produce of Detroit will provide homebound older Michiganders with fresh fruit and vegetable boxes on weekly basis through the area agencies on aging. Information on any area agencies on aging food program can by obtained by calling the Elder Locator at 800-677-1116.


Data Reporting Training for Nursing Homes

MDHHS will hold a webinar to provide an overview of the COVID-19 reporting requirements through EMResource. Data will be transmitted automatically into NHSN for those providers who have agreed to participate in that process. The training is scheduled for May 28, 2020 at 1:00 p.m.

To attend the webinar click Join Microsoft Teams Meeting
Conference phone line: 248-509-0316
Conference ID: 588 227 231#


COVID-19 Reporting Instructions and Definitions for AFCs/HFAs/Assisted Living


COVID-19 Reporting Requirements in Survey Gizmo for Adult Foster Care Facilities, Home for the Aged, and Assisted Living Facilities

Effective May 22, 2020, the Michigan Department of Health and Human Services (MDHHS), and in partnership with the Department of Licensing and Regulatory Affairs (LARA), requires all longterm care facilities (including Adult Foster Care Facilities, Home for the Aged, and Assisted Living Facilities; excluding skilled nursing facilities) to report specific data elements identified by the Centers for Medicare and Medicaid Services (CMS) and MDHHS. These data elements include, but are not limited to, Personal Protective Equipment (PPE) available onsite, information related to COVID-19 cases, and staff shortages. MDHHS implements this requirement pursuant to Executive Order 2020-95 (EO 20-95).


A Plan to Re-Engage Michigan's Economy


Governor Whitmer Issues 2020-104 

Today the Governor expanded testing availability by creating a new category of community testing site were persons can be tested without an advance order and without any out of pocket cost. Additionally, a new online dashboard has been created to inform the public of the status of the pandemic in Michigan.


Whitmer Wins in Court

Just this afternoon, Judge Stephens ruled that the Emergency Powers of the Governor Act provides the authority to act and extend a state of emergency in response to legislative Republicans concerns that it was unconstitutional. However, if acting under the Emergency Management Act she would have to obtain approval from the Legislature.



Michigan Reporting

Today, MDHHS issued provider letter L-32 that defines how the Department will transmit CMS required SNF data to the NHSN system using information collected through EMResource. Facilities can opt to continue to submit data through NHSN if they choose, but still must complete the state-required elements into EMResource.

Members wishing to take advantage of this coordination of data collection but submit additional information into EMResource on a one time basis: facility name, CMS certification number (CCN), and NHSN facility identification number. If this is not completed, MDHHS will not be able to transmit your data to NHSN. Review the updated guidance for detailed instructions on submitting data along with a few revisions.


Governor Updates Executive Order 2020-50/2020-84

Last evening, Governor Whitmer re-issued her orders on protections for resident and employees in nursing facilities related to the COVID pandemic. While much of the language remained unchanged, and continued to define provisions for long term care facilities, the orders only apply to AFCs/HFAs/assisted living to a very minor degree. In a follow-up meeting with MDHHS today, Kate Massey confirmed that regional hubs continue to be designated for hospital post-acute admissions and transfers from other nursing facilities. Additionally, reporting mechanisms continue to be developed for those settings and further guidance is anticipated soon.


MDHHS Continues Work on Testing Plan 

Since the National Guard completed testing of LTC Facilities in the Upper Peninsula, they will begin testing this week in Oakland, Genesee, and Kent Counties. These counties comprise Phase I of the next tier that includes Wayne, Muskegon, and Washtenaw (Phase II) and Ingham, Detroit City, Wayne, and Macomb (III). The Michigan State Police and National Guard will coordinate with local health officials in each area. Understanding that some testing has been completed, local health officials will be helping to prioritize facilities in each area where testing still needs to be completed. Orders for testing will be completed under each Medical Directors order, and testing is voluntary.


Governor Opens Retail, Restaurants, and Offices in Northern Michigan

EO 2020-92 allows for the reopening of retail businesses, office work that cannot be done remotely, and limited opening of restaurants and bars. Starting on May 22, MERC Regions 6 and 8 are open to the above businesses and EO 2020-91 identifies the workplace precautions that must be taken.


MDLARA Surveys AFCs/HFAs on Testing Capacity

In follow up to last week’s survey sent to nursing homes on their capacity to test residents and staff for COVID, the Department of Licensing and Regulatory Affairs has sent a similar survey to AFCs/HFAs. This information will be used to help identify where local health departments should be focusing their efforts. Currently MDHHS has a goal of 100% testing of staff and residents. Both departments will use this information, along with AFC/HFA COVID case reporting soon to be implemented as required in EO 2020-50, to prioritize need for assistance from both local health departments and iPRAT teams. Although the target date for completion of the survey is past, AFCs and HFAs can still submit their information. The link is Members can contact for questions and issues.


Executive Order 2020-50 Expires Today 

One of the Governor’s more controversial orders, 2020-50, expires today but at this point we have no idea about how the provisions in that directive may evolve. This morning, MDHHS Director Robert Gordon, MDLARA Director Orlene Hawks, and staff responded to concerns from legislators serving on the Michigan Senate Committee on Oversight about placement of COVID positive residents in Michigan nursing homes, alongside persons who do not have the disease. Accuracies and delays in reporting were also issues, however, Director Gordon stated that the data should be improving. While significant concerns were raised about the MDHHS plan for handling persons with COVID who have post-acute or long term care needs, there was no discussion about Department next steps or potential changes in these provisions.


Governor Issues Executive Order 2020-82


Today, Governor Whitmer issued EO2020-82, which extends an earlier executive order (2020-49) to June 9, 2020. This order continues previous flexibilities to address staffing and surge needs.

  • MDHHS may issue emergency certificates of need and defer strict compliance
  • MDLARA may grant hospital waivers to stand up temporary or mobile facilities
  • MDLARA may issue temporary registration as a CNA if course completed but exam not passed
  • MDLARA may renew licenses without satisfying continuing education credits
  • MDLARA may recognize hours responding to COVID-19 panic toward continuing education
  • MDLARA may allow a non-nursing assistant such as activity coordinator, social worker, volunteer to help feed or transport in alignment with care plan


MDHHS Volunteer Staffing List

The Department has solicited many volunteers over the past several weeks in order to address the staffing crises caused by the pandemic. While the program has had limited success to date, interested members can use this form to request a volunteer.


COVID-19 Health Care Jobs Portal

MDHHS and the Department of Labor and Economic Opportunity have launched a new portal to make it easier for health professionals to apply for jobs. Members interested in using this avenue to post positions can find more information here.


CDC Symptom Based Strategies and MDHHS Testing 

Recent CDC guidance this week includes a shift from test-based to symptom-based criteria for both return to work and for discontinuation of transmission based precautions to symptom-based criteria. They state that continued testing for staff and residents may be impractical where there is continued community transmission. They have moved to a time-since-illness onset and time-since-recovery protocol although they note that practical application of a symptom based strategy will likely not prevent all infections.

Although the CDC has moved away from preferences for testing for returning to work and for removing transmission based precautions, only testing can identify the community burden since many persons are asymptomatic but may be infecting others. Currently, MDHHS is asking for detailed information about provider capabilities in terms of testing to better understand the barriers each organization may face. Yesterday, they sent a survey to all nursing home administrators in Michigan to be completed and returned by 5/7/2020 end of day. The link for the survey is included here -

LeadingAge Michigan has been working with the Department to ensure that members have the support and supplies that they need. We encourage everyone to complete the survey so that the state can identify member immediate needs.


Testing for Staff and Residents 

With the creation of iPRAT (Infection Protection Resource and Assessment Teams), the Department is looking closely at best ways to use these resources to assist with analyzing and mitigating COVID spread throughout residential care facilities. Since testing has lagged since the beginning of the pandemic, there is a strong focus on fostering COVID testing for staff and residents in facilities in order to determine the extent of spread. They are working with the Michigan State Police and local health coalitions to determine how much testing is going on in long term care residential settings. They will use this information to prioritize areas of need for first testing and then also additional assistance. The Department’s plan is still in draft form and we will keep members up to date as policies develop.


Medical Services Administration Extends End Dates for NFLOC Determinations

On Friday, the Department issued L – 20-19 that extends the end dates for NFLOC Determinations that end between March 1, 2020 and June 30, 2020. The revised end-dates will be available in CHAMPS. Beneficiaries with existing NFLOCDs using Doors 1-8, 67, 77 with end states between March 1 and April 30 will be extended 180 days. Beneficiaries with existing NFLOCDs using Doors 1-8, 67, 77 with end dates between May 1 and June 30, 2020 will be extended 120 days. Providers must ensure that beneficiaries continue to meet eligibility criteria, and are responsible to conduct a new LOCD if there is a significant changes in condition.


Michigan Executive Order 2020-72 Continues Visitation Restrictions

Late Sunday, Governor Whitmer issued EO 2020-72 which continues the restriction on visitation to health care facilities. The order specifically extends all provisions within 2020-37 to May 31, 2020 and adds that all staff and visitors of a residential care facility, congregate living facility, or juvenile just facility must wear a face covering over their nose and mouth when indoors or within six feet of another person. For purposes of this order, residential care facility means homes for the aged, nursing homes, adult foster care facilities, hospice facilities, substance abuse disorder residential facilities, independent living facilities, and assisted living facilities.









Executive Order 2020-59 - 4/24/2020









Through executive order issued yesterday, Governor Whitmer has extended stay at home provisions, while loosening some requirements for certain businesses. In general, the order does not directly affect senior living providers, although one section states that persons are allowed to visit an individual under the care of a health care facility, residential or congregate care facility, to the extent otherwise permitted. Please note that this does not mean that the visitation restrictions have changed, but that persons who are currently allowed to visit under special circumstances can do so.















MDHHS Publishes Nursing Home COVID Case Data












On 4/24, MDHHS issued its first publicly reported nursing home data and its current list of Regional Hub facilities. Regional Hubs include:

  • Medilodge of Grand Traverse County
  • Medilodge of Frankenmuth
  • The Lodge at Taylor
  • Advantage Living Center Northwest
  • Advantage Living Center Redford
  • Samaritan Manor

Currently there is a total of 2108 cases in nursing homes as of 4/24/20.

These topics will be discussed in greater detail during our Weekly Wednesday Safe and Calm Webinar on April 29.














MDHHS Refines Nursing Home Reporting Requirements











Starting on April 21, MDHHS required nursing homes to submit information to MDHHS through the use of EMResource. Members who do not currently have access to that program should contact their local public health department or local healthcare coalition.

Today, April 23, the Department has issued further guidance that expands the information required for the two categories: “COVID-19 Daily LTC Bed Availability & PPE” and “COVID-19 Daily Clinical Summary” events. All data fields in these two categories must now be completed. The reporting period includes 24 hours ending at midnight the previous night and information must be submitted by noon. This data must be submitted every day, including weekends.















MDHHS Provides Additional Testing Announcement














MDHHS would like to alert you to significant available testing capacity throughout the state including NxGen Laboratories, a Grand Rapids laboratory certified by CLIA for high complexity testing that uses a method of COVID-19 testing that has received Food and Drug Administration Emergency Use Authorization.

NxGen Laboratories is able to provide specimen collection materials, shipping from the collection site to their laboratory, and 48-hour turnaround on results.

MDHHS strongly encourages health care providers interested in COVID-19 testing to reach out to Laboratories as a potential partner and to promote broad COVID-19 testing for patients who may need it, especially given recent expansions in testing priority criteria.

MDHHS will alert health care providers regularly as new laboratory and specimen collection capacity becomes available in the state.






Clarifications for Implementation of Executive Order 2020-50



For a summary of recent updates regarding the implementation of Executive Order 2020-50, members are encouraged to review thewebinar andpowerpoint from today’s Safe and Calm Webinar.   







Latest Update on Executive Order 2020-50 and Regional Hubs




Last evening, MDHHS issued an emergency order to address several areas of concern during the COVID-19 crisis in Michigan. In summary, they identified that regional hubs will accept only transfers from hospitals and other nursing facilities.







MDHHS Seeks Waivers for Home and Community Based Services




MDHHS is seeking several temporary changes to its HCBS programs including MI Choice and MI Health Link that would increase payment rates for direct care givers, expand meal services and telehealth, cover protective equipment, relax some training requirements, and modify services to address care and safety issues during the pandemic.






MDHHS Details on New Reporting Requirements





Effective April 21, 2020 MDHHS will implement its new reporting requirements that nursing facilities must report. These requirements are in addition to the standard reporting to Local Health Departments. The reporting must be completed through EMResource at










MDHHS Expands Testing








Today, MDHHS announced that it is expanding the priority for COVID testing to include all essential workers still reporting to work in person, whether they have symptoms or not, and launched a large-scale effort with more than 2,000 volunteers to expand contact tracing capacity. This will help identify asymptomatic cases who may still be spreading the virus as they report to work. Volunteers can to assist public health efforts in contact testing at









More on Michigan Executive Order 2020-50






After Governor Whitmer issued Executive Order 2020-50 last Wednesday evening, MDHHS held a conference call on Friday to solicit feedback and issues from the provider community. During that call, concerns about several areas were shared. This order was intended to both ensure appropriate post-acute and long term services and supports for COVID-19 affected persons as well as safeguard senior communities and their staff.







Governor Whitmer Issues EO 2020-55





Through this Executive Order, the Governor has created a task force to address the disproportionately impacted communities of color. African Americans represent 40% of COVID related deaths. The task force will be led by Lt. Governor Gilchrist and includes a long list of health care experts.










Executive Order 2020-50 Creating Concern






LeadingAge Michigan has been in frequent discussions with MDHHS about the need to provide care and services to our seniors who are highly vulnerable to COVID-19 and at the same time, protect our current residents and staff, as well as provide immunity for our members during this time of continued pandemic crisis. We believe it important to find a mechanism to deliver appropriate reimbursement and resources to providers who serve COVID-19 affected persons.








MSA 20-27 - MDHHS Policy for Regional Hubs






Regional Hubs are designed to address the care needs of the growing senior population who have contracted COVID-19. The program is intended to support hospital capacity by balancing caseload, provide capabilities needed to serve the COVID-19 population, and preserve staffing. The primary criteria for admission is the diagnosis of COVID-19 and the need for medical care or additional support.
















Midwest Governors Partner















Yesterday, Governor Whitmer announced that the Michigan will be working with other Midwest states to coordinate reopening the economy. The Governor’s announcement focused on prioritizing worker health in that process, and using a fact-based and data-driven approach.

The Governor’s have landed on the following four factors as basic to the reopening plan:

  • Sustained control of the rate of new infections and hospitalizations
  • Enhanced ability to test and trace
  • Sufficient health care capacity to handle any resurgence
  • Best practices for social distancing in the workplace

LeadingAge Michigan will continue to monitor these developments and their potential impact on the health and safety of Michigan Seniors and our mission-based members who serve them.











LeadingAge Michigan Conference Call with Mike Shirkey








This week, LeadingAge Michigan held a conference call with Senate Majority Leader Mike Shirkey who shared this thinking on current Michigan budget issues and the potential for workers to return to employment. He anticipates a budget deficit between $1 billion and $4 billion. Our conversations have indicated that the potential budget impact will be between the $2.5-$3.0 billion range. As a result, the Senate has begun working on a budget plan that includes a 20% overall reduction in available funds.





Executive Order 2020-50



LeadingAge Michigan's initial review of the Governor's Executive Order 2020-50. Although we know that this EO has immediate effect, we do anticipate further guidance from MDHHS as discussions evolve.











MDHHS Testing Priorities









Along with the Governor's announcement of expanded testing capabilities in Michigan and the revised priority system issued last week, MDHHS has developed a COVID-19 test site finder at to assist individuals regarding testing. Testing priorities continue to be focused on 1) hospitalized person, 2) health care workers with symptoms, 3) persons in congregate settings with symptoms, 4) other persons with symptoms, and 5) persons with only mild symptoms. 



















Whitmer Discusses Re-opening the State
















Yesterday, during a press conference, the Governor discussed criteria for when she will consider relaxing the Stay at Home Order once the pandemic comes under better control. The order recently was extended through April 30 and at that point she identified the following elements to be reviewed to make this decision:

  • Current incidence and prevalence of COVID-19 infections and the rate of spread,
  • Whether sufficient medical personnel and hospital resources are available to meet medical need,
  • The availability of PPE for health care workers,
  • State capacity to conduct testing, and
    The economic conditions in the state.

On Monday, she included the ability to trace the virus and the development of best practices in the workplace. Last Saturday, the Governor announced expanded drive-up testing operations in 13 cities, including high risk areas such as Detroit and Flint.  



Whitmer Extends Stay at Home Order through April 30




As expected, today Governor Whitmer extended the executive order that mandates persons stay at home with some exceptions through April 30. The order originally was set to sunset on April 13.






MDHHS Updates: COVID Testing Priorities



Effective April 8, the following prioritization criteria for COVID-19 testing is in place, clarifying the definitions for Priority 1: Healthcare Facility Workers with Symptoms and Priority 2: Patients in Long Term Care Facilities.








Michigan Congressman Introduces Tax Breaks for Health Care Personnel






US Representative Bill Huizenga introduced the HEROES Act to provide a four month federal income tax holiday for workers on the frontlines, covering February 15 through June 15. This would apply to workers in counties with at least one positive case of COVID-19 for: Law Enforcement Officers; Corrections Officers; Firefighters, EMTs, and paramedics; Pharmacists; Nurses and Nurse Practitioners; Physician Assistants; Hospital and Licensed Medical Support Staff; and Senior Care Facility Staff.






Michigan Paycheck Protection Program



The Governor's staff and current president of the Small Business Association Brian Calley have launched a new website to provide key resources to assist with applying for the Paycheck Protection Program.













Executive Order 2020-37 Extends Visitation Restrictions to Independent Living










On Sunday, Governor Whitmer extended restrictions to certain healthcare facilities; effective immediately and through May 3, 2020. Staff screening and visitor restrictions remain unchanged.  However, for the first time the Governor defined residential settings to include independent living facilities. The question of the ability to limit visitation in independent living had until this time been difficult with strong consideration of resident rights.  Some experts have stated that visitor movement into the facilities could be restricted but not outright visitation. This executive order applies the same restrictions and staff screening guidelines to independent livingRead More.










Governor Issues New Executive Orders 







Under Executive Order 2020-36, any and all individuals who test positive for COVID-19 or who display one or more of the principal symptoms – fever, atypical cough and atypical shortness of breath – must remain in their home or place of residence until three days have passed since their symptoms resolved or seven days since symptoms first appeared or were swabbed for a test that came back positive.





Medicaid Bulletin Suspends All Medicaid Closures
















SNF Infection Control Focused Surveys and Entrance Conference Worksheet 










Michigan surveyors initiated their COVID-19 focused surveys in at least two member facilities this week – and to date, no issues were found. There was a sense that surveyors were learning through the process that includes only one or two surveyors, and focuses most review from recent information about infection control issues on that campus with little time spent in the actual facility. Survey teams who approach a facility with active COVID-19 will contact the State Agency, State Health Department, and CMS Regional Office. Follow up actions will depend on CDC guidance about entering the facility or delay. CMS has developed an Entrance Conference Worksheet specifically for these surveys. Remember that although the survey is focused on infection control, surveyors will still cite any issues that appear to rise to the level of immediate jeopardy. To date, exit conferences have been held by phone.






Fingerprinting Suspended in Nursing Homes 




Executive Order 2020-30

In accordance with Executive Order 2020-30 of March 29, 2020, the LARA Bureau of Community and Health Systems is issuing the following background check guidance for nursing homes, county medical care facilities, and inpatient psychiatric hospitals and units.

























HUD and MSHDA Resources During the Pandemic






















The US Department of Housing and Human Development has created a webpage addressing the numerous issues facing members.

Additional links to resources:  




MDHHS Relief Hospital and Alternative Setting Guidance


This guidance covers the use of Relief Healthcare Facilities including hospitals and nursing homes. The guidance may change as resource availability and demands for healthcare services change.





MDHHS UpdatesPPE Optimization Guidance





MDLARA HFA/AFC Conference Call Summary



On April 1, LeadingAge Michigan participated in a conference call with MDLARA Director Jay Calewarts regarding the HFA/AFC Q&A document issued on 3/31/2020. The Department anticipates that the Q&A document will be updated in the near future.








Governor Extends State of Emergency and Announces State of Disaster - Executive Order 2020-33





The Governor today declared a state of emergency and disaster across the state which will terminate when conditions have reverted and appropriate programs implemented for recovery. Additionally, she has requested the Legislature to extend the state of emergency by 70 days. This order rescinds EO 2020-04, but other expiration dates in previous executive orders remain.




Medical Services Administration Bulletin 20-17


MDHHS today issued MSA 20-17 to address coding guidance and test coverage for COVID-19.



LARA Publishes Q&A for the Pandemic








MDHHS/MDLARA Conference Call - 3/30/20




Late Monday, MDHHS and MDLARA held a conference call with provider associations concerning nursing home challenges with COVID-19 patients. Please note that some of the discussion included a slightly different message when it comes to hospital discharges of COVID-19 patients. The Department is looking at nursing home financial and funding issues every 30 days.






LTSS Providers and the MDHHS Transfer Form




Today, MDLARA and MDHHS convened a call to discuss the VOLUNTARY use of an MDHHS approved transfer form to assist in communication with hospital for discharges to nursing facilities. The tool can be found among MDHHS resources (under What Protocols Should I use to Treat a COVID-19 Patient).












Trump Approves Michigan Disaster Request








The Trump Administration approved the request for federal assistance to Michigan on Friday by declaring that a major disaster exists in our state. The state has received over 100,000 N95 masks on Saturday morning. Federal funding will be available for crisis counseling for affected persons, and support for emergency protective measures such as transporting and positioning equipment, medical supplies, medical care and transport, and child care. The Governor’s request for hazard mitigation assistance to help provide relief during planning for recovery is still under review by the administration.










Governor Whitmer Signs Supplemental Bills








Today the Governor signed to supplemental appropriations bills for $125 million to help the state respond to the pandemic. She also struck down $80 million (leaving over $312 million in additional funding for state programs) in a second supplemental through line item vetoes to prioritize spending on the impact of COVID-19. Many of the vetoes were for small funded projects and agencies; additional funding for Medicaid Home Health care, a senior community health grant, federal qualified health care transitions, and positions for independent living were the only LTSS related vetoes. Pure Michigan again was unfunded with a $16 million line item veto.





Whitmer Suspends Scope of Practice Laws - Executive Order 2020-30



On Sunday, Governor Whitmer temporarily suspended Michigan scope of practice laws, a move designed to allow licensed, registered and certified health care professions to support the facility response to the pandemic as appropriate to their license and background and in consultation with facility medical leadership.










Bureau of Fire Safety Inspections Postponed








The Bureau of Fire Safety (BFS) has temporarily postponed routine inspections of Homes for the Aged and Adult Foster Care Facilities (licensed for 7 or more) but will be investigating complaints of serious nature. When asked for clarity, BFS agreed that postponing sprinkler and alarm testing by vendors at this time would be a wise choice. Currently, there is a 60-day suspension for now and BFS will reassess if the crisis extends beyond that.

This communication assumes members will continue to immediately address any issues with their fire equipment and panel.





Governor Whitmer Declares Michigan a Major Disaster Area


More information to come









MDHHS Issues Recommendations for Caregivers of Older Adults





With the recent issuance of Executive Order 2020-21 that requires 'sheltering in place' for Michigan residents, MDHHS has provided the following recommendations for caregivers. "Actions for Caregivers of Older Adults During COVID-19" includes safeguards for direct caregivers in order to contain further spread of COVID-19.














Yesterday, MDHHS issued its proposed policy for nursing home beds intended to address access issues during the viral outbreak. 2023-NF-P is intended to provide facility flexibility in order to better meet emergent needs. The policy does not allow for providers to exceed their licensed bed limits, however MDLARA is working on streamlining the process to add beds should they be needed.







MDLARA Issues Notice of Temporary Registration




In alignment with Executive Order 2020-13, MDLARA has issued a document that can serve as a notice of temporary registration. This document will be posted on the BCHS website and will cover anyone who meets the criteria. Members will have to keep a log of persons covered under this temporary registration.






Governor Whitmer signs Executive Order 2020-25





Executive Order 2020-25 provides for emergency prescription refills for up to 60 days for non-controlled substances and allows pharmacists to substitute therapeutic equivalents without prescriber approval for drug shortages. Prescribers must be notified in writing of any refill dispensed under this order. This flexibility is effective through April 22, 2020.




Governor Whitmer signs Executive Order 2020-24

Executive Order 2020-24 allows persons seeking unemployment benefits to request a registration and search waiver from employers and extends benefits for up to six weeks for those with active unemployment claims.





Governor Whitmer signs Executive Order 2020-23

Temporarily allows administrative hearings to be held by video conference or telephone, in place of in-person hearings




Governor Whitmer signs Executive Order 2020-22


Extends the deadline to complete the canvass of the March 10 primary to April 24






MDHHS Letter to Personal Care Services Providers



The Governor’s Executive Order 2020-21 directs all businesses to temporarily suspend in person operations that are not necessary to sustain or protect life. MDHHS has issues a letter to further explain the role of personal care workers as critical infrastructure workers.








MDHHS Temporary Changes for Prior Authorization


The Department has initiated changes to prior authorization processes for 30 days during the viral outbreak. Effective immediately, we ask that you submit your requests electronically through the CHAMPS system to help minimize delays in authorization.


Governor Whitmer signs Executive Order 2020-21


Shelter in Place for Michigan and LeadingAge Michigan's Summary







MDHHS Plans Temporary Changes to Medicaid Bed Use



The Department is currently working on provider letters that delineate new temporary flexibilities in order to enhance bed availability. As of today, the letter is scheduled to go out later this week and this link provides a summary of possible options.



MDHHS Nursing Home Provider Conference Call


The Department held a provider conference call on Friday that delineated plans for survey and certification as well as testing and other updates.





MDLARA Issues Guidance for Healthcare Workers



The Department of Licensing and Regulatory Affairs today issued two sets of guidance for healthcare workers. As the spread of the outbreak continues, it is important to closely review these requirements and implement in ways that work.



Governor Whitmer signs Executive Order 2020-20


Temporary restrictions on the use of places of public accommodation




Governor Whitmer signs Executive Order 2020-19



Provides a temporary prohibition against entry to premises for the purpose of removing or excluding a tenant or mobile homeowner from their home



Governor Whitmer signs Executive Order 2020-18


Enhances restrictions on price gouging



MDHHS Proposes Medicaid Telehealth Policy





Governor Whitmer signs Executive Order 2020-17


Temporary restrictions on non-essential medical and dental procedures





Governor Whitmer signs Executive Order 2020-14

Temporary extension of deadline to redeem property for nonpayment of delinquent property taxes




Governor Whitmer signs Executive Order 2020-15



Temporary authorization of remote participation in public meetings and hearings and temporary relief from monthly meeting requirements for school boards



Governor Whitmer signs Executive Order 2020-16


Expanding childcare access during the COVID-19 emergency





BCHS Call Summary



The Bureau of Community Health Systems has announced changes to nursing home survey and other licensed setting requirements during a conference call this morning (3/19). A summary has been provided for your review.



Medicaid Bulletin MSA 20-12 and Announcement


Discusses COVID-19 Response: Relaxing Face-to-Face Requirement 





Michigan Senate passes HB 4729

Michigan Senate passes HB4729 with $125 Million to assist with COVID-19. It will now go to the House.



Governor Whitmer signs Executive Order 2020-13





MDHHS L Letter 20-16





LTC Ombudsman Virtual Visit Memo





Governor Whitmer signs Executive Order 2020-07


Temporary restrictions on entry into health care facilities, residential care facilities, congregate care facilities, and juvenile justice facilities Rescission of Executive Order 2020-6



Governor Whitmer signs Executive Order 2020-08


Enhanced restrictions on price gauging


Governor Whitmer signs Executive Order 2020-09


Temporary restrictions on the use of places of public accommodation



Governor Whitmer signs Executive Order 2020-10


Temporary expansions in unemployment eligibility and cost-sharing




Governor Whitmer signs Executive Order 2020-11

Temporary prohibition on large assemblages and events, along with temporary school closures



Governor Whitmer signs Executive Order 2020-12


Enhanced support for deliveries



Governor Whitmer signs Executive Order 2020-04


Declaration of a State of Emergency







State of Michigan Coronavirus Updates




This state website is based on that of the CDC and provides many links to that document. Most helpful for members might include Michigan’s activities to date accessed through the banner. Health professionals can access reporting forms, interim guidance for health care facilities, and most importantly Strategies to prevent the spread in long term care facilities.



MDHHS Interim Recommendations for communities and health care




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