A December deadline to begin distributing $67 million from the state of Michigan to nursing homes came and went with zero dollars going to providers. 

Gov. Gretchen Whitmer (D) signed into law in February 2022 a supplement to the state’s budget that provided $300 million to healthcare facilities overall for staff recruitment and retention. The $225 million designated for hospitals has been distributed, as has the $8 million for federally qualified healthcare centers that are typically in rural areas.

But nursing homes’ funding — the remaining $67 million — is still sitting in state coffers, said Melissa Samuel, president and CEO of the Health Care Association of Michigan. She said the staffing grants are desperately needed.

“There’s a great deal of frustration,” Samuel told McKnight’s Long-Term Care News on Tuesday. “Every nursing home in Michigan has openings and the desire to hire right now.”

A spokeswoman for the Department of Health and Human Services said it received requests for “much higher” than the $67 million appropriated and there was no timeline for when the review process would end and distribution begin. On Wednesday, an official told McKnight’s the requests totaled more than $150 million.

The association estimates that nursing homes have lost more than 10,000 workers since the start of the pandemic in 2020. That loss is higher than any other healthcare sector. The American Health Care Association reported this month that the nursing home workforce nationally is at the lowest level since 1994.

The situation in Michigan may grow even more urgent in the coming weeks, as more than 1,000 workers at 13 nursing homes in the state are threatening to strike over wages and benefits. Facilities cannot use any of the grant money to hire temporary workers if there are openings due to labor disputes, according to the health department memo. 

The $300 million pledged last year to Michigan’s healthcare sector was part of a larger, $1.2 billion bill designed primarily to aid schools recover with in-classroom instruction. The money originated from the federal American Rescue Plan Act. 

Nursing home providers could apply for a grant and were asked to submit a narrative of five pages or less detailing a “reasonable budget,” their location, and how the money would be used, according to an August memo from the state Department of Health and Human Services. The memo stated that approved facilities would receive an “initial advance” of 25% of their proposal before Dec. 1, 2022. The requests were due by Aug. 31, 2022. 

Facilities would have to submit monthly requests for their actual expenses to receive reimbursement, and reimbursement requests would be offset against the advanced amount until all costs associated with the advance are balanced, according to the memo. 

Nursing homes cannot use the staffing grants for cash recruitment or retention bonuses, the memo noted. 

“The funding was appropriated to meet an urgent need,” HCAM’s Samuel said.

Samuel said the industry is doing everything it can — including modeling programs on what other states have done — to increase hiring and staff retention. Facilities have raised wages and increased benefits packages, to the extent their already-tight budgets allow. Since 2019, Medicaid reimbursement rates have increased by just 5%, despite facilities facing increased costs of 15% or more, according to the HCAM.

Samuel said the association also hopes to secure $26 million in grants to create the Michigan Certified Nurse Aide Investment Program to attract people to skilled nursing. Leaders also are encouraging facilities to be more flexible in scheduling and to help with ancillary benefits such as childcare.