On November 7, 2016, the U.S. District Court for the Northern District of Mississippi granted a preliminary injunction against CMS’s enforcement of the mandatory pre-dispute arbitration agreement ban, which has recently triggered a flurry of litigation. As the Order explains, in enacting the final rule promoting the pre-dispute arbitration ban, CMS relied fundamentally upon disparities in bargaining power that are inherent in the nursing home admission process. While the court claims to be sympathetic to CMS’s public policy concerns in support of its pre-dispute arbitration ban, the court dismisses what it describes as CMS’s “creep” and overstepping of federal agency authority. In reaching its ultimate conclusion to temporarily block enforcement of the pre-dispute arbitration ban, the court noted that CMS failed to appreciate the gravity of enacting a sweeping ban of an entire form of arbitration, nor has CMS directly proven nursing home arbitration’s negative effects aside from accumulating public comments reinforcing its point of view. The court ultimately concluded that CMS’s general statutory authority to establish rights on behalf of nursing home residents is simply too vague a grant of authority to justify such a sweeping ban. The court did concede, however, that nursing home litigation has certain fundamental defects, particularly with respect to mental competency concerns.