Orchards at Tulare
A nursing home in Tulare, California 93274
604 E. Merritt Ave., Tulare, California 93274. (559) 686-1601.
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The short answer
Record last released by CMS on Oct 28, 2026.
- 2of 5 CMS’s overall rating
- 23 health citations at the latest inspection cycle California average: 15.7
- 5.39 nurse hours per resident per day California average: 4.54
- 1 fine in the last three years (needs attention)
Each figure’s source sits beside it, in its section below.
What these words mean7
- Star ratings
- CMS rates some kinds of place from 1 to 5 stars, more stars meaning better on CMS’s own measures for that kind: for a nursing home, its health inspections, staffing and quality measures. A rating is CMS’s summary of those measures; it doesn’t promise good care. Source: CMS, Care Compare and the Five-Star Quality Rating System.
- Inspection (survey)
- A visit by state inspectors, often unannounced, who check a place against the rules it must meet. For nursing homes and other places Medicare pays, CMS calls these visits surveys: a standard survey of a nursing home comes at least every 15 months, and a complaint survey whenever a complaint calls for one. Source: CMS; 42 CFR 488.308.
- Deficiency, citation, violation
- What inspectors write up when a place didn’t meet a rule: the rule, what they saw, and when. CMS calls it a deficiency; states may say citation or violation. It is the inspectors’ finding, not a court’s, and the place is usually asked for a plan to correct it. Source: CMS, statement of deficiencies (Form CMS-2567); each state’s licensing agency.
- Scope and severity (A to L)
- CMS grades each nursing home deficiency with a letter. A to C: no actual harm, with potential for minimal harm. D to F: no actual harm, but potential for more. G to I: actual harm. J to L: immediate jeopardy. Within each band, the letter rises as more residents were affected or could be: one or a few, a pattern, or widespread. Source: CMS, nursing home scope and severity grid (State Operations Manual, chapter 7).
- Nurse staffing hours
- The hours registered nurses, licensed practical nurses and nurse aides worked, per resident per day, from the payroll records each home sends CMS. Source: CMS, Payroll-Based Journal.
- Fines and payment denials
- A fine (civil money penalty) is money CMS makes a nursing home pay when it falls short of federal rules. A payment denial means Medicare and Medicaid stop paying for new admissions until the home meets the rules again. Source: CMS; 42 CFR 488.430 and 488.417.
- Capacity
- The most people the licence or certification lets the place care for at once: residents, children, beds or apartments, as the state counts them. It isn’t how many are there now. Source: Each state’s licensing agency.
What did inspectors find?
23 health citations at the latest inspection cycle
The California average is 15.7.
Last standard inspection May 8, 2025.
Most serious in three years: actual harm (G), at a complaint inspection on Nov 15, 2024
CMS, Provider Information, State and US Averages and Health Deficiencies. Released Oct 28, 2026. Updated monthly.
When those citations happened
74 citations in 19 months of the last 36. Last cited Aug 2026. Most serious: actual harm (G). The last 3 years, to Nov 5, 2026.
| Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2023 | Dec | |||||||||||
| 2024 | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec |
| 2025 | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec |
| 2026 | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov |
Hover or focus a month to read it.
Hearth Record drew this from the dates and levels in the source’s own records.
All 76 citations in the last three years
Grouped by inspection, newest first. Each carries CMS grades each nursing home deficiency with a letter. A to C: no actual harm, with potential for minimal harm. D to F: no actual harm, but potential for more. G to I: actual harm. J to L: immediate jeopardy. Within each band, the letter rises as more residents were affected or could be: one or a few, a pattern, or widespread. Source: CMS, nursing home scope and severity grid (State Operations Manual, chapter 7)., from A, the least serious, to L, the most. 37 came from complaint inspections.
CMS, Health Deficiencies. Released Oct 28, 2026. Updated monthly.
Aug 7, 2026: complaint inspection1 citation
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Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Jul 6, 2026: complaint inspection1 citation
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Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Jun 29, 2026: complaint inspection3 citations
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Immediately tell the resident, the resident’s doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
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Ensure services provided by the nursing facility meet professional standards of quality.
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Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Mar 9, 2026: complaint inspection1 citation
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Let each resident or the resident’s legal representative access or purchase copies of all the resident’s records.
Mar 3, 2026: complaint inspection1 citation
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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.
Feb 26, 2026: complaint inspection1 citation
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Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Nov 24, 2025: complaint inspection1 citation
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Provide and implement an infection prevention and control program.
May 8, 2025: standard inspection14 citations
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Honor the resident’s right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
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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.
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Assess the resident when there is a significant change in condition
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Ensure each resident receives an accurate assessment.
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Provide appropriate treatment and care according to orders, resident’s preferences and goals.
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Provide enough food/fluids to maintain a resident’s health.
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Provide safe, appropriate pain management for a resident who requires such services.
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Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
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Ensure medication error rates are not 5 percent or greater.
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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.
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Ensure each resident receives and the facility provides drinks consistent with resident needs and preferences and sufficient to maintain resident hydration.
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Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
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Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
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Provide and implement an infection prevention and control program.
Apr 10, 2025: complaint inspection1 citation
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Ensure services provided by the nursing facility meet professional standards of quality.
Mar 26, 2025: complaint inspection1 citation
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Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility.
Mar 6, 2025: complaint inspection1 citation
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Ensure services provided by the nursing facility meet professional standards of quality.
Jan 16, 2025: complaint inspection1 citation
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Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Dec 11, 2024: complaint inspection2 citations
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Provide medically-related social services to help each resident achieve the highest possible quality of life.
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Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility.
Dec 2, 2024: complaint inspection2 citations
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Ensure services provided by the nursing facility meet professional standards of quality.
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Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Nov 15, 2024: complaint inspection2 citations
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Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
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Immediately tell the resident, the resident’s doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Oct 24, 2024: complaint inspection1 citation
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Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.
Oct 18, 2024: complaint inspection3 citations
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Ensure services provided by the nursing facility meet professional standards of quality.
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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.
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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.
Oct 17, 2024: complaint inspection1 citation
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Develop and implement a complete care plan that meets all the resident’s needs, with timetables and actions that can be measured.
Aug 22, 2024: complaint inspection1 citation
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Immediately tell the resident, the resident’s doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
May 29, 2024: complaint inspection1 citation
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Provide timely, quality laboratory services/tests to meet the needs of residents.
Apr 18, 2024: standard inspection25 citations
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Ensure that residents are fully informed and understand their health status, care and treatments.
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Reasonably accommodate the needs and preferences of each resident.
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Honor the resident’s right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
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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.
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Create and put into place a plan for meeting the resident’s most immediate needs within 48 hours of being admitted
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Provide care and assistance to perform activities of daily living for any resident who is unable.
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Provide activities to meet all resident’s needs.
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Assist a resident in gaining access to vision and hearing services.
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Provide appropriate pressure ulcer care and prevent new ulcers from developing.
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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.
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Provide safe, appropriate dialysis care/services for a resident who requires such services.
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Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
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Obtain a doctor’s order to admit a resident and ensure the resident is under a doctor’s care.
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Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident’s well being.
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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.
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Provide routine and 24-hour emergency dental care for each resident.
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Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
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Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
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Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility.
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Inform resident or representatives choice to enter into binding arbitration agreement and right to refuse.
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Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
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Provide and implement an infection prevention and control program.
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Implement a program that monitors antibiotic use.
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Develop and implement policies and procedures for flu and pneumonia vaccinations.
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Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Apr 9, 2024: complaint inspection1 citation
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Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Feb 13, 2024: complaint inspection3 citations
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Let each resident or the resident’s legal representative access or purchase copies of all the resident’s records.
-
Immediately tell the resident, the resident’s doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
-
Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility.
Jan 30, 2024: complaint inspection1 citation
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Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Jan 24, 2024: complaint inspection1 citation
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Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident’s well being.
Dec 21, 2023: complaint inspection3 citations
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Immediately tell the resident, the resident’s doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
-
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
-
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Nov 28, 2023: complaint inspection1 citation
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Provide and implement an infection prevention and control program.
Nov 13, 2023: complaint inspection1 citation
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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.
Is it certified, and in good standing?
- Certified for Medicare and Medicaid since Jan 17, 1974.
- Not on CMS’s special focus list.
- No abuse icon from CMS.
- No change of ownership in the last 12 months.
- CMS lists its ownership as for profit, limited liability company.
- 99 certified beds.
CMS, Provider Information. Released Oct 28, 2026. Updated monthly.
Has it been fined or penalized?
- 1 fine in the last three years, $68,938 in all.
- No Medicare payment denials in the last three years.
- 37 citations in the last three years came from complaint inspections.
CMS, Penalties and Health Deficiencies. Released Oct 28, 2026. Updated monthly.
| Date | Kind | Amount |
|---|---|---|
| Oct 17, 2024 | Fine | $68,938 |
Who does the caring?
5.39 nurse hours per resident per day
The California average is 4.54.
CMS publishes staffing about four months after the fact.
CMS, Provider Information and State and US Averages. Released Oct 28, 2026. Updated monthly.
| Measure | This home | California average |
|---|---|---|
| Nurse hours per resident per day | 5.39 | 4.54 |
| Of which registered nurses | 0.47 | 0.68 |
| At weekends | 4.71 | 4.10 |
| Nursing staff turnover | 44.5% | 36.6% |
| Registered nurse turnover | 66.7% | 37.8% |
| Administrators who left | 0 | Not given |
Who owns it?
- Swc CA Opco 2 LLC owns 100% directly since May 1, 2022.
- Ajc Healthcare LLC runs it.
- 10 owners or officers are people: Aaron Chesley (owns 5% or more through other companies, 50%); James B Gamett (owns 5% or more through other companies, 50%); Lucille Epperson (runs it (operational or managerial control)); Lucille Epperson (additional disclosable party (controls, leases property to, or provides services to the home)); Jiakun Wang (runs it (operational or managerial control)); Jiakun Wang (additional disclosable party (controls, leases property to, or provides services to the home)); Aaron Chesley (corporate officer); Aaron Chesley (runs it (operational or managerial control)); James B Gamett (corporate officer); James B Gamett (runs it (operational or managerial control)).
- Part of Ajc Healthcare (16 homes in CMS’s data).
- No private-equity firm among the owners CMS lists.
- No real-estate investment trust among the owners CMS lists.
CMS, All Owners. Checked Nov 5, 2026. Updated monthly.
CMS, Provider Information. Released Oct 28, 2026. Updated monthly.
| Organisation | Role | Share | Since |
|---|---|---|---|
| Swc CA Opco 2 LLC | Owns 5% or more directly | 100% | May 1, 2022 |
| Ajc Healthcare LLC | Owns 5% or more through other companies | 50% | May 1, 2022 |
| JBG Partners LLC | Owns 5% or more through other companies | 50% | May 1, 2022 |
| Ajc Healthcare LLC | Runs it (operational or managerial control) | May 1, 2022 |
How do residents fare?
- CMS rates its quality measures 5 of 5 (California average 4.2).
CMS, Provider Information and State and US Averages. Released Oct 28, 2026. Updated monthly.
| Measure | Rating |
|---|---|
| Overall rating | 2 of 5 |
| Health inspections | 1 of 5 |
| Staffing | 3 of 5 |
| Quality measures | 5 of 5 |
How does it compare nearby?
- Among the 12 nearest homes, within 18.9 miles, this one had the 3rd most health citations at the latest inspection cycle (23; the middle value was 16.5).
CMS, Provider Information. Released Oct 28, 2026. Updated monthly.
| Place | Miles away | Citations, latest cycle |
|---|---|---|
| Tulare Healthcare & Wellness Center, LP | 0.0 | 21 |
| Orchards at Tulare This nursing home | 23 | |
| Grand Oaks Care | 0.1 | 7 |
| Westgate Gardens Care Center | 6.8 | 14 |
| Sequoia Vista | 6.8 | 28 |
| Linwood Meadows Care Center | 6.9 | 16 |
| Kaweah Health Skilled Nursing Center | 7.1 | 8 |
| Delta Healthcare & Wellness Center, LP | 8.2 | 10 |
| Visalia Post Acute | 9.1 | 24 |
| Lindsay Gardens Nursing & Rehabilitation | 12.8 | 17 |
| Brighton Post Acute | 18.7 | 17 |
| Kings Healthcare & Wellness Center LP | 18.9 | 8 |
What the record doesn’t say
- Complaints that didn’t lead to a citation aren’t published.
- Inspections reach CMS’s data about six weeks after they happen, and staffing about four months after.
- CMS publishes the inspectors’ full written findings in a separate monthly file, which isn’t loaded yet.
- Fines and Medicare payment denials are the only enforcement CMS publishes; state licence actions aren’t included.
Sources
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Centers for Medicare & Medicaid Services, Provider Information (4pq5-n9py).
Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, Health Deficiencies (r5ix-sfxw).
Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, Penalties (g6vv-u9sr).
Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, All Owners (afe44b85-cc6d-40d7-b5df-00ae8910d1d2).
Checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, State and US Averages (xcdc-v8bm).
Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
If you believe something here is wrong, a correction starts with the agency whose record this copies: CMS. CMS’s own record is on Care Compare. If Hearth Record copied something wrongly, it will fix it and log the correction publicly, with its date: how corrections work.
This copy of the record was made on Nov 5, 2026.
From the home
The public record above comes first. Anything the home adds will appear here, below it, and say who wrote it.
Replies
None. Replies aren’t open yet. When they open, the home will be able to answer any finding for free, and the reply will show beside that finding, unedited and dated.
Paid listing
None. Paid listings aren’t open yet. When they open, anything paid for will say “Paid by the home”, and paying will never change a finding, a rating or the order of results.