Staffing
CMS publishes a 4-star staffing rating for this facility.
RN staffing was 0.58 hours per resident day in 2026Q1, calculated from CMS PBJ records.
View staffing evidenceAsk Trust Hub Network
CMS overview
No proprietary TrustHub score. These ratings are published separately by CMS.
Facility information
CMS remains the primary federal record. Public website and additional contact details appear only when independently verified.
Decision guide
Factual evidence to examine before you decide. These summaries are not a score or recommendation.
CMS publishes a 4-star staffing rating for this facility.
RN staffing was 0.58 hours per resident day in 2026Q1, calculated from CMS PBJ records.
View staffing evidenceThe latest standard inspection on Aug 25, 2025 cited 13 deficiencies.
View inspection evidenceCMS-published records list 136 ownership or control parties.
View ownership evidenceCMS groups this facility with a chain covering 28 facilities across 2 states or territories.
View chain evidenceCMS records show a $15,593 fine in the loaded enforcement dataset.
View enforcement evidence →Ownership & operation
Operator, licensee, owner, manager, and chain stay separate. A connected organization is not automatically the party that runs daily operations.
SeniorTrustHub found evidence connecting this facility to:
27 currently connected nursing homes share this CMS organization identity with AVAMERE HEALTH SERVICES LLC.
These figures summarize currently connected CMS-certified nursing homes. Some facilities have incomplete measures; missing values are omitted, not treated as zero. Ownership structures can change. State operator or licensee evidence may differ from CMS ownership disclosures.
Ownership
These are CMS-published ownership disclosures. Medicare enrollment ownership and managerial-control information is reported by enrolled providers through CMS forms; it is not an independent determination of beneficial ownership.
Organization · 5% OR GREATER SECURITY INTEREST
Association date reported to CMS: Jan 22, 2010
Other facilities connected through this exact CMS organization identity: 0 across OR.
Individual · ADP OF THE SNF
Association date reported to CMS: Dec 31, 2024
Individual · ADP OF THE SNF
Association date reported to CMS: Jul 7, 2025
Organization · ADP OF THE SNF
Association date reported to CMS: Jul 7, 2025
Other facilities connected through this exact CMS organization identity: 0 across OR.
Organization · ADP OF THE SNF
Association date reported to CMS: Jul 13, 2025
Other facilities connected through this exact CMS organization identity: 0 across OR.
Individual · ADP OF THE SNF
Association date reported to CMS: Apr 1, 2022
Individual · ADP OF THE SNF
Association date reported to CMS: May 1, 2022
Individual · ADP OF THE SNF
Association date reported to CMS: Jan 1, 2025
Individual · ADP OF THE SNF
Association date reported to CMS: Dec 31, 2024
Individual · ADP OF THE SNF
Association date reported to CMS: Jan 1, 2024
Individual · ADP OF THE SNF
Association date reported to CMS: Mar 12, 2022
Individual · ADP OF THE SNF
Association date reported to CMS: Jan 21, 2022
Organization · ADP OF THE SNF
Association date reported to CMS: Aug 4, 2025
Other facilities connected through this exact CMS organization identity: 0 across OR.
Individual · ADP OF THE SNF
Association date reported to CMS: Feb 13, 2024
Individual · ADP OF THE SNF
Association date reported to CMS: Oct 9, 2023
Individual · ADP OF THE SNF
Association date reported to CMS: Sep 1, 2023
Individual · ADP OF THE SNF
Association date reported to CMS: Feb 10, 2025
Individual · ADP OF THE SNF
Association date reported to CMS: Mar 25, 2015
Individual · ADP OF THE SNF
Association date reported to CMS: Jan 6, 2025
Individual · ADP OF THE SNF
Association date reported to CMS: Jan 2, 2025
Individual · ADP OF THE SNF
Association date reported to CMS: May 20, 2018
Individual · ADP OF THE SNF
Association date reported to CMS: Jun 1, 2024
Individual · ADP OF THE SNF
Association date reported to CMS: Sep 6, 2022
Individual · ADP OF THE SNF
Association date reported to CMS: Jan 1, 2025
Organization · DIRECT OWNERSHIP INTEREST
Association date reported to CMS: Jan 6, 2006
Other facilities connected through this exact CMS organization identity: 0 across OR.
Organization · INDIRECT OWNERSHIP INTEREST
Association date reported to CMS: Jan 6, 2006
Other facilities connected through this exact CMS organization identity: 0 across OR.
Organization · INDIRECT OWNERSHIP INTEREST
Association date reported to CMS: Jan 6, 2006
Other facilities connected through this exact CMS organization identity: 0 across OR.
Individual · MANAGING CONTROL - GOVERNING BODY
Association date reported to CMS: Jun 1, 2025
Individual · MANAGING CONTROL - GOVERNING BODY
Association date reported to CMS: Jun 1, 2025
Individual · MANAGING CONTROL - GOVERNING BODY
Association date reported to CMS: Jun 1, 2025
Individual · MANAGING CONTROL - GOVERNING BODY
Association date reported to CMS: Jun 1, 2025
Individual · MANAGING CONTROL - GOVERNING BODY
Association date reported to CMS: Jun 1, 2025
Individual · MANAGING CONTROL - GOVERNING BODY
Association date reported to CMS: Jun 1, 2025
Individual · MANAGING CONTROL - GOVERNING BODY
Association date reported to CMS: Jun 1, 2025
Individual · MANAGING CONTROL - GOVERNING BODY
Association date reported to CMS: Jun 1, 2025
Individual · MANAGING CONTROL - GOVERNING BODY
Association date reported to CMS: Jun 1, 2025
Individual · MANAGING CONTROL - GOVERNING BODY
Association date reported to CMS: Jun 1, 2025
Individual · MANAGING CONTROL - GOVERNING BODY
Association date reported to CMS: Jun 1, 2025
Individual · MANAGING CONTROL - GOVERNING BODY
Association date reported to CMS: Jun 1, 2025
Individual · MANAGING CONTROL - GOVERNING BODY
Association date reported to CMS: Jun 1, 2025
Individual · MANAGING CONTROL - GOVERNING BODY
Association date reported to CMS: Jun 1, 2025
Individual · MANAGING CONTROL - GOVERNING BODY
Association date reported to CMS: Jun 1, 2025
Individual · MANAGING CONTROL - GOVERNING BODY
Association date reported to CMS: Jun 1, 2025
Individual · MANAGING CONTROL - GOVERNING BODY
Association date reported to CMS: Jun 1, 2025
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Aug 12, 2024
Organization · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Jan 1, 2005
Other facilities connected through this exact CMS organization identity: 0 across OR.
Organization · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Jan 1, 2005
Other facilities connected through this exact CMS organization identity: 0 across OR.
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Apr 1, 2022
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Jul 19, 2024
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: May 1, 2022
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Jul 15, 2025
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Jan 1, 2024
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Feb 13, 2024
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Oct 9, 2023
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Sep 1, 2023
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Feb 10, 2025
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Mar 25, 2015
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Jan 6, 2025
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Jan 2, 2025
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: May 20, 2018
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Jun 1, 2024
Individual · 5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date reported to CMS: Sep 1, 1997
Organization · 5% OR GREATER SECURITY INTEREST
Published ownership percentage: 100%
Association date reported to CMS: Jan 22, 2010
Other facilities connected through this exact CMS organization identity: 17 across IN, OR, WA.
Individual · ADP OF THE SNF
Association date reported to CMS: Dec 31, 2024
Individual · ADP OF THE SNF
Association date reported to CMS: Jul 7, 2025
Organization · ADP OF THE SNF
Association date reported to CMS: Jul 7, 2025
CMS classifications: Chain / home office
Other facilities connected through this exact CMS organization identity: 26 across OR, WA.
Organization · ADP OF THE SNF
Association date reported to CMS: Jul 13, 2025
Other facilities connected through this exact CMS organization identity: 17 across OR, WA.
Individual · ADP OF THE SNF
Association date reported to CMS: Apr 1, 2022
Individual · ADP OF THE SNF
Association date reported to CMS: May 1, 2022
Individual · ADP OF THE SNF
Association date reported to CMS: Jan 1, 2025
Individual · ADP OF THE SNF
Association date reported to CMS: Dec 31, 2024
Individual · ADP OF THE SNF
Association date reported to CMS: Jan 1, 2024
Individual · ADP OF THE SNF
Association date reported to CMS: Mar 12, 2022
Organization · ADP OF THE SNF
Association date reported to CMS: Aug 17, 2017
CMS classifications: Real estate investment trust (REIT), Holding company
Other facilities connected through this exact CMS organization identity: 0 across OR.
Organization · ADP OF THE SNF
Association date reported to CMS: Aug 17, 2017
CMS classifications: Holding company
Other facilities connected through this exact CMS organization identity: 0 across OR.
Roles are shown as CMS publishes them. Different CMS sources can describe different enrollment, ownership, and control concepts, so TrustHub keeps each source-specific disclosure distinct.
Chain context
Chain-level values describe this CMS-defined group, not any one facility. CMS Chain ID 58 is a grouping identifier, not a legal organization.
| Month | Facilities | Overall rating | Staffing rating |
|---|---|---|---|
| Wed Jul | 28 | 3.1 | 4.1 |
| Mon Jun | 29 | 3.1 | 4.1 |
| Fri May | 29 | 3.1 | 4.1 |
| Wed Apr | 31 | 3 | 4.1 |
| Sun Mar | 33 | 2.9 | 3.8 |
| Sun Feb | 33 | 2.9 | 3.8 |
Nursing Home Chain Performance Measures, fixed version da2db00a-0f3d-40a9-a535-588ff1220c55. Membership comes separately from CMS Skilled Nursing Facility Enrollments.
View official CMS sourceInspections & deficiencies
Scope and severity terms below are CMS classifications. They are not a TrustHub score.
No health-deficiency rows were deterministically linked to this inspection.
Reasonably accommodate the needs and preferences of each resident.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Sep 11, 2025)
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Sep 11, 2025)
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Sep 11, 2025)
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Sep 11, 2025)
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Sep 11, 2025)
Provide safe and appropriate respiratory care for a resident when needed.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Sep 11, 2025)
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Sep 11, 2025)
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Sep 11, 2025)
Ensure that residents are free from significant medication errors.
CMS scope/severity G: Isolated; Actual harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Sep 11, 2025)
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Sep 11, 2025)
Provide or obtain dental services for each resident.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Sep 11, 2025)
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Sep 11, 2025)
Provide and implement an infection prevention and control program.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Sep 11, 2025)
No health-deficiency rows were deterministically linked to this inspection.
No health-deficiency rows were deterministically linked to this inspection.
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (May 29, 2024)
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (May 29, 2024)
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (May 29, 2024)
Provide safe and appropriate respiratory care for a resident when needed.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (May 29, 2024)
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (May 29, 2024)
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (May 29, 2024)
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
CMS scope/severity F: Widespread; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (May 29, 2024)
Employ or obtain outside professional resources to provide services in the nursing home when the facility does not employ a qualified professional to furnish a required service.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (May 29, 2024)
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (May 29, 2024)
Provide and implement an infection prevention and control program.
CMS scope/severity F: Widespread; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (May 29, 2024)
Develop and implement policies and procedures for flu and pneumonia vaccinations.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (May 29, 2024)
Ensure services provided by the nursing facility meet professional standards of quality.
CMS scope/severity J: Isolated; Immediate jeopardy to resident health or safety.
Correction status: Past Non-Compliance (Nov 14, 2023)
Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.
CMS scope/severity J: Isolated; Immediate jeopardy to resident health or safety.
Correction status: Past Non-Compliance (Nov 14, 2023)
No health-deficiency rows were deterministically linked to this inspection.
Reasonably accommodate the needs and preferences of each resident.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Apr 14, 2023)
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Apr 14, 2023)
Respond appropriately to all alleged violations.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Apr 14, 2023)
Assess the resident when there is a significant change in condition
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Apr 14, 2023)
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Apr 14, 2023)
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Apr 14, 2023)
Provide safe, appropriate dialysis care/services for a resident who requires such services.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Apr 14, 2023)
Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Apr 14, 2023)
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Apr 14, 2023)
Provide or obtain dental services for each resident.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Apr 14, 2023)
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Apr 14, 2023)
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Apr 14, 2023)
Ensure staff are vaccinated for COVID-19
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Apr 14, 2023)
No health-deficiency rows were deterministically linked to this inspection.
Penalties & enforcement
Published fine amount: $15,593.00
Questions to ask
Facility history
9 historical events available. Dates and values come from published CMS and official state regulator evidence, not a score.
RN staffing increased from 0.36 to 0.58 hours per resident day between 2025Q4 and 2026Q1. Staffing improved across those reported periods.
0.36 → 0.58
CMS · Reported in a source release · View related evidence
RN staffing decreased from 0.52 to 0.36 hours per resident day between 2025Q3 and 2025Q4. Staffing declined across those reported periods.
0.52 → 0.36
CMS · Reported in a source release · View related evidence
13 deficiencies were recorded. That includes 1 higher-severity deficiency.
CMS · Recorded event date · View related evidence
No linked health-deficiency findings were recorded for this survey.
CMS · Recorded event date · View related evidence
No linked health-deficiency findings were recorded for this survey.
CMS · Recorded event date · View related evidence
11 deficiencies were recorded.
CMS · Recorded event date · View related evidence
2 deficiencies were recorded. That includes 2 higher-severity deficiencies.
CMS · Recorded event date · View related evidence
CMS recorded a $15,593 civil monetary penalty.
CMS · Recorded event date · View related evidence
13 deficiencies were recorded.
CMS · Recorded event date · View related evidence
Staffing
CMS staffing rating: 4 of 5 stars. CMS calculates that rating separately using its published methodology. The values below are calculations from daily PBJ records for 2026Q1 (current source quarter).
| Measure | Monday–Friday | Saturday–Sunday |
|---|---|---|
| Total nursing | 4.824 | 4.016 |
| RN categories | 0.651 | 0.405 |
Contract staff accounted for 1.5% of reported nursing hours included in this quarter calculation.
Reported RN-category hours per resident day were 0.224 higher than the prior loaded quarter.
Solid bar: Total nursing · Outlined bar: RN categories
| Quarter | Total nursing | RN categories | LPN/LVN | CNA | Contract share | Days |
|---|---|---|---|---|---|---|
| 2025Q2 | 4.422 | 0.596 | 0.756 | 2.623 | 1.4% | 91 |
| 2025Q3 | 4.54 | 0.518 | 0.921 | 2.655 | 2.5% | 92 |
| 2025Q4 | 4.605 | 0.356 | 1.02 | 2.785 | 0.6% | 92 |
| 2026Q1 | 4.591 | 0.58 | 0.837 | 2.841 | 1.5% | 90 |
Hours-per-resident-day values are calculated by this platform from CMS-published daily PBJ hours and MDS census. For each displayed period, included hours are summed and divided by the summed census for days with a positive census. They are not CMS case-mix-adjusted staffing measures or a staffing rating.
View official CMS PBJ sourceWhat we can verify today
These measures come from the current successfully ingested CMS Nursing Home Provider Information release.
Planned evidence layers
These areas require separate authoritative CMS datasets. No findings are shown until those sources are ingested and reviewed.
Trust participation
Claims, corrections, and factual context are free. Submissions never replace CMS evidence or affect ranking.
Source register
No paid placements. Facilities cannot pay to rank higher. We cite. You decide.