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LARA Completes 100% of Required Nursing Home Investigations, Positioned for Additional Federal CARES Act Funding

Media Contact: LARA Communications (517-335-LARA (5272))

July 7, 2020 – Michigan’s Survey Agency, the Bureau of Community and Health Systems (BCHS) — within the Department of Licensing and Regulatory Affairs (LARA) — has completed 100% of the federally required infection control surveys of nursing homes more than two months before the deadline. All 442 federally certified nursing homes in the state went through an infection control survey from March 26 through June 19.  BCHS serves as an agent of the Centers for Medicare and Medicare Services (CMS) and provides regulatory oversight of the state’s nursing homes.

“Our BCHS health care surveyors have consistently been on the frontlines, with a focus on mitigating the spread of this virus; they’ve conducted in-person inspections and investigations of our long term care providers from the onset of the declared COVID-19 emergency,” said LARA Director Orlene Hawks. “Throughout the pandemic, LARA has made it a priority to continue our work protecting the health and safety of the public and, in particular, our nursing home residents. Reaching the 100% mark two months early is due to the hard work of our dedicated team of surveyors. As we continue to learn more about COVD-19, we know that there is more work still to be done.”

Complaint investigations have included those that rise to an immediate jeopardy level where residents may be put at high risk for harm. When a complaint is received by BCHS that may fall in this category, health care surveyors have 48 hours to go on-site to conduct the investigation. If immediate jeopardy is confirmed — whether through a complaint investigation or during an inspection — the survey team works with the provider to remove the immediacy of the potential harm or risk to residents before exiting the facility.

“Our staff led the way here in Michigan and among our Midwest peers,” said Larry Horvath, director of LARA’s BCHS. “I am very proud of our team and the work they did to protect both our state’s vulnerable population and the dedicated health care staff working in these facilities daily. Our staff, and those on the frontline delivering care, deserve the highest praise and recognition for the work that they did and the work they continue to do.”

Recently, CMS initiated a performance-based funding requirement tied to the Coronavirus Aid, Relief and Economic Security (CARES) Act supplemental grants for State Survey Agencies. The new mandate requires states complete 100% of the focused infection control surveys of federally certified nursing homes by August 31, 2020 or lose up to 15% of the CARES federal funding. LARA reached this standard on June 19, 2020, nearly 2.5 months ahead of the deadline, ensuring that the state will continue to receive its complete share of CARES funds to protect these vulnerable populations.

The new requirements recently instituted by CMS necessitate all states to perform on-site surveys – within 30 days – of nursing homes that fall into any of these categories:

  • confirmed cases of 10% or more of their bed capacity
  • confirmed plus suspected cases of 20% or more of their bed capacity
  • ten or more COVID-19-related deaths

CMS also now requires states to perform on-site surveys – within 3 to 5 days – of nursing homes that either identify three or more new COVID-19 suspected and confirmed cases in a week or identify its first resident case of COVID-19. States that do not perform these surveys risk losing a portion of their CARES Act allocation.

Additionally, in recently published guidance from CMS, states can begin to conduct certification surveys that were suspended since March 26. Having finished the required surveys two months early, LARA is well-positioned to leverage its limited resources to continue to maximize federal funding and will add to its workload these surveys along with the follow-up on-site surveys and investigations as directed by CMS.

This federal work will soon be supplemented by additional follow-up infection control surveys that will be done under the LARA’s state authority thanks to the legislature appropriating $1.4 million in supplemental funding that will allow for BCHS to hire 10 limited term state surveyors.

LARA also encourages residents, family members, other agencies, and the public to file a complaint regarding concerns or issues with a provider by emailing the bureau at, fax 517-335-7167, or call the complaint hotline 800-882-6006. A complaint can also be submitted online.

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