• $2,000 initial application fee
• $500 licensing fee
• $3 per bed after the first 100 beds license fee for NH and HLTCU
• $6.27 per bed license fee for HFA

Other state agencies approval is required prior to licensing actions.

Certificate of Need for HLTCU and NH
Michigan Department of Health & Human Services (MDHHS)
Lewis Cass Building, 3rd Floor
320 S. Walnut Street
Lansing, MI 48913
Email: MDHHS-ConProjects@michigan.gov 
Phone: 517-241-3344

Health Facilities Engineering Section for HLTCU, HFA, and NH
Michigan Department of Licensing and Regulatory Affairs (LARA)
611 W. Ottawa St., 2nd Floor
PO Box 30664
Lansing, MI 48909
Email: LARA-BCHS-HFES@michigan.gov
Phone: 517-241-3408

Bureau of Fire Services for HLTCU, HFA, and NH
Michigan Department of Licensing and Regulatory Affairs (LARA)
611 W. Ottawa, 4th Floor
PO Box 30700
Lansing, MI 48909
Email: bfsplanreview@michigan.gov
Phone: 517-335-5804

State licenses for homes for the aged (HFA), hospital long-term care units (HLTCU), and nursing homes (NH), including county medical care facilities (CMCF) must be renewed annually.  A license is required by MCL 333.20141(1) to establish or maintain and operate a health facility or agency. A provider’s non-renewal of a license by September 1st is not considered as a refusal to renew by the department under MCL 333.20165.

Annual renewal notices are sent within Michigan State Licensing System (MI-SLS) in the second quarter of each year. Instructions and requirements, including fees, will be completed in MI-SLS.

License renewals must be paid no later than July 31st. All licenses not renewed by September 1st will have the license closed and a notice will be posted to the license on the Verify a License page.

State law, MCL 333.20141(1), requires a license prior to operating a home for the aged (HFA).  However, the state law, MCL 333.21311a, allows a facility, under certain circumstances, to be exempt from HFA state licensure. 

An applicant will need to submit an exemption from HFA state licensure request through the MI – State Licensing System (MI-SLS). Instructions and requirements will be completed in MI-SLS. An individual may not operate a facility that offers supervised personal care to 21 or more individuals without a state license or licensure exemption confirmation from the department.

A licensee is required to submit a change application for the following:

• Change in ownership of the licensee entity 
• Change in location of the licensed health facility or agency
• Change in the facility name
• Change in the bed capacity by an increase or decrease in the number of licensed beds

A licensee is required to submit information updates for the following:

• Contact information, including designated leadership position
• Change in management company 
• Change in the lease of real property

A licensee will need to submit a change application or update information through the Michigan State Licensing System (MI-SLS). Instructions and requirements, including payment of licensing fees, as applicable, will be completed in MI-SLS.

State law, MCL 333.20155(1), requires the department to conduct inspections of licensed homes for the aged (HFA), hospital long-term care units (HLTCU), and nursing homes (NH), including county medical care facilities (CMCF) at least once every 3 years.  An inspection will be an evaluation of the facility against all applicable laws and administrative rules, as follows:

Nursing Homes and Hospital Long Term Care Units

• Michigan Public Health Code – Parts 201 and 217
• State Licensing Administrative Rules (see Licensing Health Facilities and Agencies)

Homes for the Aged

• Michigan Public Health Code – Parts 201 and 213
• State Licensing Administrative Rules

State law, MCL 333.20176, also requires the department to conduct investigations upon receipt of a complaint that alleges violation of applicable state law or administrative rules.  An investigation will be focused on evaluating only applicable to the allegations of law or rule violation.  

The department may waive the required inspection of homes for the aged (HFA), hospital long-term care units (HLTCU), and nursing homes (NH), including county medical care facilities (CMCF) in accordance with MCL 333.20155.  In lieu of performing an unannounced onsite state licensing inspection, the department will perform a desk review of documentation submitted through the waiver request, as detailed below: 

HFA:
A survey waiver process does not apply to HFAs because there is not an accepted accrediting body approved by the United States Department of Health and Human Services for purposes of 42 USC 1395bb.

NH and HLTCU:
A survey waiver may submit a finding of substantial compliance or an accepted plan of correction, if applicable, on the most recent standard federal certification survey conducted by the Bureau of Survey and Certification (BSC), LARA.

Each year a notice for survey waiver eligibility through the Michigan State Licensing System (MI-SLS) will be issued by October 1 for the next calendar year.  If a NH or HLTCU is scheduled for an inspection for the next calendar year, the provider may submit a waiver request on or before December 1 prior to the scheduled next calendar year.  The licensed provider will receive a written determination of the decision of the waiver request through MI-SLS. 

Acceptance of a waiver request and review is at the discretion of the department and may be denied for reasons including:

• Submission of an accreditation report that does not meet the timeframe specified in code and/or demonstrates the licensed provider is not in "good standing" with the accrediting organization.
• That the most recent standard federal certification survey demonstrates non-compliance and does not have a department-approved plan of correction.
• There is indication of substantial non-compliance with licensure standards or deficiencies that represent a threat to public safety or patient care.  The department may review and consider recent history of complaints, status of current license (e.g., temporary vs. permanent), as well as other inspection reports available to the department for consideration.

Pursuant to MCL 333.20155(10), the denial of a waiver request is not subject to appeal.

State licensed and federally certified nursing homes (NH), including county medical care facilities (CMCF), and hospital long term care units (HLTCU) must comply with state and federal regulations when an involuntary transfer or discharge (state) or a facility-initiated transfer or discharge (federal) of resident occurs.

Providers must comply with the following requirements:

Michigan Public Health Code

• MCL 333.21773 – Involuntary transfer or discharge of a patient
• MCL 333.21774 – Resident right to appeal
• MCL 333.21775 – Continuation of Medicaid funding during appeal
• MCL 333.21776 – Transfer or discharge of patient, plan, counseling services

State Administrative Rule 325.20116

Federally certified NHs and HLTCUs participating in the Medicare or Medicaid programs must also comply with 42 CFR 483.15(c).

The following forms must be completed and followed when there is a proposed discharge of a resident to another location with the expectation that the resident will not return to the NH or HLTCU.

• ITD-100 Notice of Involuntary Transfer or Discharge and Facility-Initiated Discharge and Appeal Form
• ITD-101 Proposed Involuntary Transfer or Discharge Plan

Basic Steps:

• Prepare ITD-100 form.
  • Recommendation: Have initial discussion with resident or resident representative to assist in identification of transfer or discharge location.
  • The notice form will be accepted by the department only when all information has been provided, including a proposed transfer or discharge location, date, and specific information about the reasons for transfer or discharge.
  • If the destination changes and this change was initiated by the facility, an updated notice with the new destination must be issued. This type of change restarts the 30-day timeline for transfer or discharge.
• Completed ITD-100 form must be provided to the resident or resident representative at least 30 days prior to an involuntary transfer or discharge along with envelope and postage for appeal request.
• A copy of ITD-100 form must be submitted to Michigan Long Term Care Ombudsman via MLTCOP@meji.org.
• A copy of ITD-100 form must be submitted through the Michigan State Licensing System (MI-SLS).
• A copy of ITD-100 form must be included in the resident’s medical record.
• A resident has the right to request a hearing within 10 days from the date of the notice.
• Request for a hearing places a hold on the resident involuntary transfer or discharge.
• Prepare ITD-101 form to outline the proposed transfer or discharge plan and submit the form through the MI-SLS.
  • The resident shall not be transferred or discharged from the facility:
    • Before the 34th day following receipt of the notice or the 10th day following appeal hearing decision, whichever is later, and
    • Without LARA approval of the proposed transfer or discharge plan.
• LARA will provide written approval of the acceptance of the proposed transfer or discharge plan. The approval of the proposed transfer or discharge plan shall be placed in the resident’s medical record.

Note: These basic steps are not a comprehensive outline of all state and federal requirements.

Contact Information:
Phone: 877-458-2757
FAX: 517-763-0213
E-Mail: LARA-BCHS-InvoluntaryTransfer@michigan.gov

Homes for the Aged (HFA) provide supervised personal care individuals 55 years of age and older. State law allows a wavier to be requested to the age requirement. A licensee will need to submit an age waiver request through the Michigan State Licensing System (MI-SLS). Age waiver documentation must be uploaded from the proposed resident or the resident’s representative, proposed resident’s physician, and the Licensee that confirms compliance with MCL 333.21311(3), as follows:
    a. The home for the aged can meet all the proposed resident's medical, social, and other needs as determined in the proposed          resident's plan of service.
    b. The proposed resident will be compatible with the other residents of that home for the aged.
    c. The placement in that home for the aged is in the best interests of the proposed resident.

A resident younger than 55 years of age must not be admitted to an HFA without department approval.

Homes for the aged (HFA), nursing homes (NH), including county medical care facilities (CMCF), and hospital long term care units (HLTCU) must conduct a criminal history check on all employees, contractors, and individuals granted clinical privileges that have access to residents or resident protected financial and health information in accordance with MCL 333.20173a. Access to the Workforce Background Check (MWBC) Long Term Care Portal is granted upon initial licensure. Additional guidance and resources on criminal history checks is located on the Workforce Background Check website.

Nursing Homes and Hospital Long Term Care Units

• Michigan Public Health Code – Parts 201 and 217
• State Licensing Administrative Rules - Licensing Health Facilities and Agencies

Homes for the Aged

• Michigan Public Health Code – Parts 201 and 213
• State Licensing Administrative Rules – Homes for the Aged

The Michigan State Licensing System (MI-SLS) is a modernized platform to complete licensure activities. Health facilities and agencies include homes for the aged, hospital long term care units, and nursing homes will use MI-SLS for state licensing actions.  

MI-SLS Instructional Videos - YouTube Channel

Quick User Guides

Creating a New Mi-Login Account

MI-SLS Access

MI-SLS Home Screen

MI-SLS Initial Application Process

MI-SLS Linked Licenses

MI-SLS License Details

MI-SLS Change Application

MI-SLS Involuntary Transfer or Discharge

MI-SLS Bulk Renewals

MI-SLS License Renewal

Survey Waiver

User Profile

The forms below may be necessary and utilized by the department for specific licensure actions. Form will include instructions and may require a form to be loaded in Michigan State Licensing System (MI-SLS).

• NH and HLTCU Notice Involuntary Transfer or Discharge - ITD-100
• NH HLTCU Proposed Involuntary Transfer or Discharge Plan – ITD-101
• Health Facility Door Locking Request Form – HLPD-DL-200
• HFA Quality Review Program - Incident Review Form - HFLD-HFA-QRP-IR-300
• HFA Quality Review Program - Annual Review Form - HFLD-HFA-QRP-AR-301

Visit the LARA-BCHS Verify a License site to look up state licensed homes for the aged (HFA), both licensed and exempted from licensure, nursing home (NH), including county medical care facilities (CMCF), or hospital long term care unit (HLTCU). This site includes recent inspection and complaint investigation reports.

The following provider resources offer additional information to providers to deliver quality care services in Michigan and help providers remain compliant with state and federal regulations.

• Dining Assistants - State law, MCL 333.21794, requires nursing homes to use a state-approved dining assistant training course. Records must be maintained by the nursing home demonstrating compliance with the requirements and individual records for those that have successfully completed the training course and working as a paid dining assistant.
  • Paid Dining Assistant Curriculum

• Bed Rails - State law, MCL 333.21794, requires nursing homes to use a state-approved dining assistant training course. Records must be maintained by the nursing home demonstrating compliance with the requirements and individual records for those that have successfully completed the nursing home’s training course and working as a paid dining assistant.
  • Bed Rail Overview
  • Bed Rail Tool

• Looking for consultative services? The bureau offers consultative services in accordance with MCL 333.20151. For more information, visit our State Licensing Consultative Section (SLCS) website.

• Looking for additional training opportunities? The department offers biannual long term care training in compliance with MCL 333.20155. For more information, visit the Joint Provider Survey Training Information (JPST) website.

The residents, family, and public resources page provides information for the consumer such as what a complaint investigation against a licensed health facility or agency includes and other informational resources.

A complaint investigation of a state licensed health facility or agency does:

• Holds the facility to compliance with the state licensing laws or rules appliable to the allegations of the complaint
• Requires the facility to establish a corrective action plan if found in violation of state licensing laws or rules
• Identifies deficient practices and ensures that the facility establishes and maintains compliance of state licensing laws or rules

A complaint investigation against a state licensed health facility or agency is not:

• Going to result in any civil penalties for the facility
• Likely going to result in the closure of the facility
• Completed for the benefit of a private legal proceeding

Complaint investigations into Homes for the Aged (HFA) exempt facilities are limited in accordance with MCL 333.21311a(7) following:

• Allegations that the facility is not operating in compliance with the exemption criteria
• Allegations made by a physician, physician assistant, or nurse practitioner that the facility has been found negligent, which negligence results in serious physical injury, death of a resident, or serious mental anguish, as defined in the law, and there continues to be a risk to the health and safety of the residents at that facility.

Resources

• Looking for a nursing home? Visit the department’s Verify-a-License website. This website includes recent state licensing inspection and investigation reports and connects you to the federal certificate website for federal reports too.

• Looking for a Medicare certified provider or supplier? Visit the Centers for Medicare and Medicaid Services (CMS) website to find a provider or supplier in your area and how they compare to like providers or suppliers.

• Want to file a complaint against state licensed health facility? Visit the department’s website for more information.