Washington, D.C. — When Pam Bondi took over as attorney general last year, one of the first things her Justice Department did was quietly close an investigation into a Virginia nursing home with a documented history of patient abuse. It wasn’t the only case to disappear.
In the first six months of the Trump administration, the DOJ dropped more than 23,000 criminal cases without prosecution — a record pace that included hundreds of investigations into nursing home abuse, healthcare fraud, terrorism, and white-collar crime, according to a sweeping new analysis by ProPublica.
A Record Number of Declinations
The bulk of the shelved cases came from a February 2025 directive that ordered federal prosecutors to review every open case launched before October 2022 and decide whether to close it. The review was supposed to take months; prosecutors were given 10 days.
In that single month, nearly 11,000 cases were declined — the most in any month since at least 2004. The previous high was just over 6,500 in September 2019, also under Trump.
For comparison, the DOJ has consistently pursued more aggressive case volume under prior administrations, both Republican and Democratic. The ProPublica analysis, which examined two decades of DOJ data, concluded the surge in declinations is not explained by a larger inherited caseload.
Nursing Home Abuse Among the Cases Dropped
The Virginia nursing home probe is just one example of what the shift has meant for long-term care oversight. The investigation was closed despite the facility having a recent record of patient abuse — the kind of case that federal prosecutors typically spend years building before bringing charges.
That pattern played out across healthcare more broadly. The DOJ declined over 900 cases involving federal program or procurement fraud. About three times as many major fraud cases against the U.S. were declined under Trump compared with the average for similar periods under prior administrations.
Former DOJ prosecutor Michael Gordon, who worked white-collar crime cases until recently, described a department increasingly focused on generating favorable statistics rather than pursuing complex investigations. “It was either ‘give us stats we can use to make ourselves look good,’ or ‘give us the stats to show how bad things are in this area,'” he said. “It was never productive fact-finding.”
The shift matters directly for nursing home residents and their families. Federal fraud prosecutions — particularly under the False Claims Act — have long been one of the most powerful tools for holding operators accountable. The federal government’s healthcare fraud enforcement apparatus has historically returned billions to taxpayers while deterring billing abuse at nursing facilities nationwide.
Resources Shifted to Immigration
The DOJ says the declinations reflect an effort to “clean, remediate, and validate data” in prosecutors’ case management systems and insists it “remains committed to investigating and prosecuting all types of crime.”
But the numbers tell a different story. The department prosecuted 32,000 new immigration cases in the first six months of the administration — nearly triple the Biden-era pace — while pursuing fewer prosecutions of nearly every other type of crime than any new administration dating back to 2009.
Joseph Gerbasi, who retired as acting deputy chief for policy in the DOJ’s drug section after 28 years, described what happened when his team was ordered to abandon years of work building fentanyl cases. “All of the building blocks of what would become successful prosecutions were pulled out,” he said. The move had an “overwhelming deflating effect on morale.”
What It Means for the Industry
For nursing home advocates and patient safety watchdogs, the scale of the DOJ retreat is alarming. Federal criminal cases serve a different function from civil enforcement actions or state inspections — they carry potential prison sentences, and the prospect of prosecution often drives compliance in ways that fines alone don’t.
Critics argue the administration can’t credibly claim to be fighting fraud and waste through DOGE while simultaneously walking away from hundreds of fraud investigations. Former federal prosecutor Barbara McQuade, who served under both parties, said that while new administrations routinely adjust enforcement priorities, the changes under Bondi represent something far beyond the norm. “We would revise those about every five years,” she said. “Not having anything to do with any administration — just because it made sense.”
The nursing home industry is watching closely. With federal oversight already under strain, the withdrawal of criminal enforcement is one more signal that accountability for operator misconduct may increasingly fall to states — many of which are already overwhelmed.
