HCBS News 2026July3

Kierstin Reed • July 2, 2026

Waiver Provider Handbook and DDA Updates

DDA has released a new AD/TBI Waiver Provider Handbook which details requirements for providers of these services. There are significant concerns with information in the handbook and we continue to work with the department on the areas that impact providers. 

CPR for ALL Direct Care Staff

A new waiver requirement for all HCBS providers has gone into effect on July 1st. There is a 60 day grace period for providers to have all staff trained in CPR, First Aid and one hour of abuse/neglect training. This is a significant departure from what ALF providers have been doing. While it is not a requirement to perform CPR on a waiver resident, it is a Medicaid requirement for all staff to be trained to do so. If you are in need of resources in your area to complete this training, please reach out to LeadingAge Nebraska or DHHS for assistance. 

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Waiver Provider Handbook and DDA Updates
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OIG Finds Errors in PBJ Reporting An audit from the Department of Health & Human Services (HHS) Office of Inspector General (OIG) found that payroll-based journal (PBJ) reporting by nursing homes is not always accurate. In a report released June 18, OIG stated that nearly half of all sample items reviewed were 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 CMS’s 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 .
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PBJ System Transitioning to iQIES in August: The Centers for Medicare & Medicaid Services (CMS) announced on June 12, that the Payroll-Based Journal (PBJ) system will transition to internet Quality Improvement and Evaluation System (iQIES) on August 17, 2026. The PBJ system is the only system remaining in the previous QIES system while all other programs have transitioned to iQIES. iQIES is a secure, cloud-based system that CMS uses to collect and manage quality and compliance information. Effective on August 17, 2026, long-term care providers must submit all PBJ staffing data in iQIES. CMS will provide additional information before the launch through various email notifications regarding onboarding, training, details on what to expect, and more. Until then, please ensure that you complete the following (if you haven’t done so already): Create a HCQIS Access Roles and Profile System (HARP) account. Skip this step if you already have a HARP account. If you don’t have an account register here. Request access to iQIES – submit your request early so your access is ready before launch. Although you may request your PBJ role before August 17 (CMS strongly recommends you do so), PBJ functionality will not be available before August 17, 2026. Choose the correct PBJ role within iQIES – Provider Security Official (PSO) – Can view, upload, edit PBJ data and run PBJ reports. This role also approves user access. PBJ Submitter (Provider or Vendor): Can view, upload, edit PBJ data and run PBJ reports. Provider Administrator: View – only access and run PBJ reports. PBJ Viewer: View-only access and run PBJ reports. Additional information on roles can be found in the iQIES Onboarding Process – Provider User Roles Manual posted on the iQIES Reference and Manuals on the QTSO under iQIES Onboarding Guides. 4. Get approval from your facility’s PSO – Your access will not become active until they approve it. Each facility must have at least one PSO to manage access for additional users. Once you register for an iQIES account, be sure to log in regularly. If you don’t log in for 60 days, you’ll lose access to iQIES. Additional information on the iQIES Inactive User Policy can be found on QTSO. Vendors must request access for each facility they represent and get approval from a PSO at each facility, using the facility’s CMS Certification Number (CCN). Policy questions should be emailed to nhstaffing@cms.hhs.gov Technical questions: Contact the iQIES Service Center at 800.339.9313 Monday – Friday 8 a.m. – 8 p.m. ET (7 a.m. – 7 p.m. CT) You may also request assistance via secure chat or schedule a call through CCSQ Support Central. Please note that Chat Support is currently limited to 8 a.m. – 4 p.m. CT Monday – Friday.
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Don’t miss our next Assisted Living Survey Session
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