- This section addresses requests for a change in Medicare / Medicaid bed designations. An increase or decrease in bed designations is defined by a change in the total number of beds designated as Medicare-Only, Dually Certified (Medicare / Medicaid), and Licensed-Only. This type of request will not change the total bed capacity at the nursing home.
To request an increase or decrease in the number of beds designated for Medicare / Medicaid purposes, including Dually Certified beds, the nursing home must submit:
- A state licensure application (BCHS-HFD-100), Appendix D, and the current and proposed floor plans for the changes being requested. The floor plans must clearly identify each room as either Medicare-Only, Dually Certified, or Licensed-Only.
- The bureau will process and approve all Medicare requests on behalf of CMS.
- FOR MEDICAID CHANGES – A nursing home must simultaneously submit a request to MDHHS Long-Term-Care Policy Section via email MDHHS-BEDCERTS@michigan.gov. Subject line: Medicaid Bed Designation Request. The request must include BCHS-HFD-100, Appendix D, and current and proposed floor plans. For any questions, please call 517-241-4079.
- The bureau will only update the Medicaid designations upon Medicaid approval. Medicaid will notify the provider.
For more information on Medicaid requirements, see the Survey, Certification & Enforcement Appendix of the Nursing Facility Chapter in the Medicaid Provider Manual.
IMPORTANT: Bed designation changes are limited by Medicare / Medicaid requirements including, but not limited to, submitting a request 45 days prior to the start of the cost reporting year/quarter. The approval and effective date will be determined by the Medicare / Medicaid programs and cannot be approved on a retroactive basis. An effective date for the bed designation changes will be the first working day of the cost reporting year / quarter after approval.
By submission of a Medicare-Only bed designation request, the nursing home is attesting to the fact that the request meets the requirements set forth in the CMS State Operations Manual (3202a, 3202A1, and 3202A2 starting on page 97) for distinct part units. In additional guidance to the Department, CMS has provided the following clarifications on the published definition of distinct part:
- A corridor can be divided in half, lengthwise, by designating the beds at one end of the corridor.
- Corridor doors and common areas are acknowledged as a physical barrier for the separation of distinct parts.
CMS may update or modify these provisions from time to time. It is the nursing home’s responsibility to comply with the requirements for distinct part units promulgated by CMS, and any future updated requirements.