An audit from the Department of Health & Human Services (HHS) Office of Inspector General (OIG), in a report released June 18, 2026, found that payroll-based journal (PBJ) reporting by nursing homes is not always accurate, with nearly half of all sample items reviewed not supported in accordance with federal requirements.
Inaccuracies were due to a number of issues, including reporting hours that were not worked; not reporting hours that were worked and paid for; reporting hours that were not paid; reporting hours that were unreportable including meal breaks, training, and other hours when staff were not available to perform their primary role, and off-site hours; and reporting hours for which the nurses working were not properly licensed. OIG concluded that the Centers for Medicare and Medicaid Services’ (CMS) processes were not effective in ensuring the accuracy of PBJ reporting and made four recommendations including recommendations to require PBJ auditors to verify whether nursing homes took corrective actions on findings from PBJ audits, educate nursing homes on updated guidance, and regularly communicate with nursing homes the trends identified through PBJ audits.
Read the full report of findings and recommendations here.