Hearth Record

Signature Healthcare of Bremen

A nursing home in Bremen, Indiana 46506

316 Woodies Lane, Bremen, Indiana 46506. (574) 546-3494.

CMS’s own record, on Care Compare

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The short answer

Record last released by CMS on Oct 28, 2026.

The last 24 months 43 citations in 7 months of the last 36. Last cited May 2026. Most serious: immediate jeopardy to health or safety (J). Every month

Each figure’s source sits beside it, in its section below.

What these words mean8
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.
Immediate jeopardy
CMS’s most serious finding: the place’s failure to meet a rule caused, or was likely to cause, serious injury, harm, impairment or death to someone in its care. Source: CMS; 42 CFR 489.3.
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?

5 health citations at the latest inspection cycle

The Indiana average is 7.2.

Last standard inspection May 21, 2026.

Most serious in three years: immediate jeopardy to health or safety (J), at a complaint inspection on May 21, 2026

Source:

CMS, Provider Information, State and US Averages and Health Deficiencies. Released Oct 28, 2026. Updated monthly.

When those citations happened

43 citations in 7 months of the last 36. Last cited May 2026. Most serious: immediate jeopardy to health or safety (J). The last 3 years, to Nov 5, 2026.

43 citations by month over the last 3 years. Each cell is one month.
JanFebMarAprMayJunJulAugSepOctNovDec
2023 Dec
2024 JanFebMarAprMayJunJulAugSepOctNovDec
2025 JanFebMarAprMayJunJulAugSepOctNovDec
2026 JanFebMarAprMayJunJulAugSepOctNov

Hover or focus a month to read it.

No visit on record Visited, nothing cited A stronger orange is more serious, on its source’s own levels, read onto four bands: from the least serious it publishes to the most
Source:

Hearth Record drew this from the dates and levels in the source’s own records.

All 43 citations in the last three years

Grouped by inspection, newest first. Each carries , from A, the least serious, to L, the most. 18 came from complaint inspections.

Source:

CMS, Health Deficiencies. Released Oct 28, 2026. Updated monthly.

May 21, 2026: standard inspection2 citations

  • Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

    Rule F0657. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: May 23, 2026.

  • Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.

    Rule F0693. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: May 23, 2026.

May 21, 2026: complaint inspection1 citation

  • Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.

    Rule F0678. J: immediate jeopardy to health or safety. From a complaint. Correction date, as CMS recorded it: May 23, 2026.

Oct 10, 2025: complaint inspection2 citations

  • Develop and implement a complete care plan that meets all the resident’s needs, with timetables and actions that can be measured.

    Rule F0656. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Dec 15, 2025.

  • Provide appropriate pressure ulcer care and prevent new ulcers from developing.

    Rule F0686. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Dec 15, 2025.

Feb 17, 2025: standard inspection9 citations

  • 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.

    Rule F0578. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Mar 14, 2025.

  • Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.

    Rule F0623. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Mar 14, 2025.

  • Ensure each resident receives an accurate assessment.

    Rule F0641. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Mar 14, 2025.

  • Develop and implement a complete care plan that meets all the resident’s needs, with timetables and actions that can be measured.

    Rule F0656. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Mar 14, 2025.

  • Provide care and assistance to perform activities of daily living for any resident who is unable.

    Rule F0677. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Mar 14, 2025.

  • Provide appropriate treatment and care according to orders, resident’s preferences and goals.

    Rule F0684. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Mar 14, 2025.

  • Ensure each resident must receive and the facility must provide necessary behavioral health care and services.

    Rule F0740. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Mar 14, 2025.

  • Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

    Rule F0812. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Mar 14, 2025.

  • Provide and implement an infection prevention and control program.

    Rule F0880. F: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Mar 14, 2025.

Nov 1, 2024: complaint inspection9 citations

  • Honor the resident’s right to be treated with respect and dignity and to retain and use personal possessions.

    Rule F0557. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Nov 27, 2024.

  • Immediately tell the resident, the resident’s doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.

    Rule F0580. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Nov 27, 2024.

  • Develop and implement a complete care plan that meets all the resident’s needs, with timetables and actions that can be measured.

    Rule F0656. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Nov 27, 2024.

  • Provide care and assistance to perform activities of daily living for any resident who is unable.

    Rule F0677. E: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Nov 27, 2024.

  • Provide appropriate treatment and care according to orders, resident’s preferences and goals.

    Rule F0684. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Nov 27, 2024.

  • Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

    Rule F0755. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Nov 27, 2024.

  • Ensure each resident’s drug regimen must be free from unnecessary drugs.

    Rule F0757. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Nov 27, 2024.

  • Ensure that residents are free from significant medication errors.

    Rule F0760. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Nov 27, 2024.

  • Provide and implement an infection prevention and control program.

    Rule F0880. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Nov 27, 2024.

Oct 4, 2024: complaint inspection5 citations

  • Immediately tell the resident, the resident’s doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.

    Rule F0580. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Oct 21, 2024.

  • Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.

    Rule F0623. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Oct 21, 2024.

  • Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.

    Rule F0625. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Oct 21, 2024.

  • Provide appropriate treatment and care according to orders, resident’s preferences and goals.

    Rule F0684. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Oct 21, 2024.

  • Provide for the safe, appropriate administration of IV fluids for a resident when needed.

    Rule F0694. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Oct 21, 2024.

Jun 13, 2024: complaint inspection1 citation

  • Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

    Rule F0689. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Jul 5, 2024.

Mar 12, 2024: standard inspection14 citations

  • Honor the resident’s right to and the facility must promote and facilitate resident self-determination through support of resident choice.

    Rule F0561. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Apr 8, 2024.

  • Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.

    Rule F0623. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Apr 8, 2024.

  • Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.

    Rule F0625. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Apr 8, 2024.

  • Develop and implement a complete care plan that meets all the resident’s needs, with timetables and actions that can be measured.

    Rule F0656. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Apr 8, 2024.

  • Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

    Rule F0657. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Apr 8, 2024.

  • Provide care and assistance to perform activities of daily living for any resident who is unable.

    Rule F0677. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Apr 8, 2024.

  • Provide activities to meet all resident’s needs.

    Rule F0679. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Apr 8, 2024.

  • Provide appropriate treatment and care according to orders, resident’s preferences and goals.

    Rule F0684. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Apr 8, 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.

    Rule F0688. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Apr 8, 2024.

  • Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.

    Rule F0690. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Apr 8, 2024.

  • Provide enough food/fluids to maintain a resident’s health.

    Rule F0692. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Apr 8, 2024.

  • Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.

    Rule F0756. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Apr 8, 2024.

  • 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.

    Rule F0758. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Apr 8, 2024.

  • Ensure that residents are free from significant medication errors.

    Rule F0760. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Apr 8, 2024.

Is it certified, and in good standing?

  • Certified for Medicare and Medicaid since Oct 27, 1992.
  • 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 government, city/county.
  • 73 certified beds.
Source:

CMS, Provider Information. Released Oct 28, 2026. Updated monthly.

Has it been fined or penalized?

  • No fines in the last three years.
  • No Medicare payment denials in the last three years.
  • 18 citations in the last three years came from complaint inspections.
Source:

CMS, Penalties and Health Deficiencies. Released Oct 28, 2026. Updated monthly.

Who does the caring?

3.60 nurse hours per resident per day

The Indiana average is 3.73.

CMS publishes staffing about four months after the fact.

Source:

CMS, Provider Information and State and US Averages. Released Oct 28, 2026. Updated monthly.

Staffing measures
MeasureThis homeIndiana average
Nurse hours per resident per day3.603.73
Of which registered nurses0.830.68
At weekends3.023.26
Nursing staff turnover44.6%45.9%
Registered nurse turnover41.7%40.5%
Administrators who left0Not given

Who owns it?

  • Jackson County Schneck Memorial Hospital owns 100% directly since May 1, 2014.
  • LP Bremen Management, LLC and Healthcare Services Group Inc. and ASBR Holdings LLC and Midcap Funding IV Trust run it.
  • 46 owners or officers are people: Jack L Mccory (on the governing body (managing control)); Jack L Mccory (trustee); Rick L Smith (on the governing body (managing control)); Rick L Smith (trustee); Andrew B Markel (on the governing body (managing control)); Andrew B Markel (trustee); Courtney B Kleber (on the governing body (managing control)); Courtney B Kleber (trustee); Linda Lewis (runs it (operational or managerial control)); Linda Lewis (additional disclosable party (controls, leases property to, or provides services to the home)); Ira Smedra (runs it (operational or managerial control)); Barbara Revelette (runs it (operational or managerial control)); Barbara Revelette (additional disclosable party (controls, leases property to, or provides services to the home)); Charles Syer (runs it (operational or managerial control)); Deborah A Mann (runs it (operational or managerial control)); Deborah A Mann (on the governing body (managing control)); Maria Doyle (additional disclosable party (controls, leases property to, or provides services to the home)); Matthew K Reedy (on the governing body (managing control)); Matthew K Reedy (trustee); Jennifer Moore (runs it (operational or managerial control)); Jennifer Moore (additional disclosable party (controls, leases property to, or provides services to the home)); Jacob Wintner (runs it (operational or managerial control)); Terrence L Gilliland (on the governing body (managing control)); Terrence L Gilliland (trustee); Susan D Bevers (on the governing body (managing control)); Susan D Bevers (trustee); Eric D Fish (runs it (operational or managerial control)); Eric D Fish (on the governing body (managing control)); Charles M Stigler (runs it (operational or managerial control)); Jared B Houck (runs it (operational or managerial control)); Jared B Houck (additional disclosable party (controls, leases property to, or provides services to the home)); Paul R Gettinger (runs it (operational or managerial control)); Paul R Gettinger (additional disclosable party (controls, leases property to, or provides services to the home)); John H Harrison (runs it (operational or managerial control)); John H Harrison (additional disclosable party (controls, leases property to, or provides services to the home)); Nicole Blimling (runs it (operational or managerial control)); Nicole Blimling (additional disclosable party (controls, leases property to, or provides services to the home)); Brandon J Harpe (on the governing body (managing control)); Brandon J Harpe (trustee); Roland G Rapp (runs it (operational or managerial control)); Marc Storey (on the governing body (managing control)); Marc Storey (trustee); Elmer Joseph Steier III (runs it (operational or managerial control)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); Timothy H Lehner (runs it (operational or managerial control)); Timothy H Lehner (additional disclosable party (controls, leases property to, or provides services to the home)).
  • Part of Signature Healthcare (67 homes in CMS’s data).
  • No private-equity firm among the owners CMS lists.
  • A real-estate investment trust is among the owners CMS lists.
Source:

CMS, All Owners. Checked Nov 5, 2026. Updated monthly.

CMS, Provider Information. Released Oct 28, 2026. Updated monthly.

Organisations CMS lists
OrganisationRoleShareSince
Jackson County Schneck Memorial HospitalOwns 5% or more directly100%May 1, 2014
Jackson County Schneck Memorial HospitalOwns 5% or more through other companies100%May 1, 2014
Midcap Funding IV TrustHolds 5% or more security interest100%Feb 23, 2023
An organisation CMS lists without a nameAdditional disclosable party (controls, leases property to, or provides services to the home)Aug 12, 2015
An organisation CMS lists without a nameAdditional disclosable party (controls, leases property to, or provides services to the home)May 1, 2018
LP Bremen Management, LLCRuns it (operational or managerial control)0%May 1, 2014
LP Bremen Management, LLCAdditional disclosable party (controls, leases property to, or provides services to the home)May 1, 2014
Healthcare Services Group Inc.Runs it (operational or managerial control)Jun 1, 2021
Healthcare Services Group Inc.Additional disclosable party (controls, leases property to, or provides services to the home)Jun 1, 2021
An organisation CMS lists without a nameAdditional disclosable party (controls, leases property to, or provides services to the home)Aug 12, 2015
Shc Medical Partners of Indiana, LLCAdditional disclosable party (controls, leases property to, or provides services to the home)Mar 20, 2020
Shc Medical Partners LLCAdditional disclosable party (controls, leases property to, or provides services to the home)Jan 1, 2017
ASBR Holdings LLCRuns it (operational or managerial control)May 1, 2018
An organisation CMS lists without a nameAdditional disclosable party (controls, leases property to, or provides services to the home)Aug 12, 2015
LP Bremen LLCAdditional disclosable party (controls, leases property to, or provides services to the home)Sep 26, 2025
Signature Healthcare Clinical Consulting Services LLCAdditional disclosable party (controls, leases property to, or provides services to the home)May 1, 2014
Signature Healthcare Consulting Services LLCAdditional disclosable party (controls, leases property to, or provides services to the home)May 1, 2014
Stakeholder Payroll Services LLCAdditional disclosable party (controls, leases property to, or provides services to the home)May 1, 2014
An organisation CMS lists without a nameAdditional disclosable party (controls, leases property to, or provides services to the home)Jan 1, 2025
An organisation CMS lists without a nameAdditional disclosable party (controls, leases property to, or provides services to the home)May 7, 2018
Jackson County Schneck Memorial HospitalAdditional disclosable party (controls, leases property to, or provides services to the home)Sep 26, 2025
An organisation CMS lists without a nameAdditional disclosable party (controls, leases property to, or provides services to the home)May 1, 2014
Midcap Funding IV TrustRuns it (operational or managerial control)Feb 23, 2023
An organisation CMS lists without a nameAdditional disclosable party (controls, leases property to, or provides services to the home)Nov 18, 2024

How do residents fare?

  • CMS rates its quality measures 5 of 5 (Indiana average 4.3).
Source:

CMS, Provider Information and State and US Averages. Released Oct 28, 2026. Updated monthly.

CMS’s star ratings, from 1 to 5
MeasureRating
Overall rating2 of 5
Health inspections1 of 5
Staffing3 of 5
Quality measures5 of 5

How does it compare nearby?

  • Among the 12 nearest homes, within 17.0 miles, this one had the 8th most health citations at the latest inspection cycle (5; the middle value was 7.5).
Source:

CMS, Provider Information. Released Oct 28, 2026. Updated monthly.

The 12 nearest, by straight-line distance
PlaceMiles awayCitations, latest cycle
Signature Healthcare of Bremen This nursing home5
The Waters of Wakarusa Skilled Nursing Facility8.812
Pilgrim Manor11.114
Miller’s Merry Manor12.17
Southfield Village12.48
Brickyard Healthcare - Twelfth Street Care Center14.410
Trailpoint Village14.43
Hubbard Hill Estates Inc.15.31
Valley View Healthcare Center16.712
The Restoracy of Goshen16.85
Brickyard Healthcare - Elkhart Care Center16.912
Cardinal Nursing and Rehabilitation Center17.00

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

  • 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).

  • 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).

  • 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).

  • Centers for Medicare & Medicaid Services, All Owners (afe44b85-cc6d-40d7-b5df-00ae8910d1d2).

    Checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).

  • 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.

Source:

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.

How to read a record

Four things every record does, shown on an example record made up for this guide.

An example record, made up for this guide

An example nursing home

Made up for this guide: no real place is shown

Not fully inspected in over two years (CMS flag)

11 health citations at the latest inspection cycle

The state average is 14.3.

Source:

CMS, State and US Averages and Health Deficiencies. Released Oct 28, 2026. Updated monthly.

From the homeNone yet. Replies and paid listings aren’t open, and when they open they will sit here, below the record.

1 of 4

Every fact names its source.

Who published it, when, and how often it changes sit beside each fact, with a link to the agency’s own file.

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