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Long Term Care Adverse Action Notices

Refer to the provider-specific policy links above for more information regarding notice requirements.  

  • Adequate Notice
    An Adequate Notice must be sent when an individual appears to be functionally ineligible for services based on the LOCD. 
    Nursing Facility        MI Choice/PACE Programs  
  • Advance Action Notice 
    An Advance Action Notice must be sent when the individual is currently receiving program services,but is no longer functionally eligible for services based on the LOCD. The Nursing Facility Transition Team is available to assist.
    Nursing Facility        MI Choice/PACE Programs  
  • Request for an Administrative Hearing Form (DCH-0092)
    The provider must supply a copy of the DCH-0092 to the applicant when the applicant believes a decision is inappropriate.   DCH-0092    Michigan Office of Administrative Hearings and Rules