Below average — CMS composite of the measures below.
The next survey window likely opens around March 2027
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Bailey Creek Health And Rehab during CMS and state inspections, most recent first.
A facility failed to keep two residents’ care plans current after falls and new interventions were identified. One resident with severe cognitive impairment and a history of falls had post-fall changes such as mattress baffles and assist bars in use, but the care plan did not clearly reflect those interventions. Another resident, who was dependent for transfers and walking and was high risk for falls, had non-skid socks implemented after an unwitnessed fall, but the care plan and Kardex did not include that intervention. The DON, MDS Coordinator, and Administrator all confirmed the care plans were not fully updated to match the residents’ current fall-related interventions.
Failure to Follow EBP During G-Tube Medication Administration: A resident with an indwelling catheter and feeding tube was on EBP, with orders and a care plan requiring gown and glove use for high-contact care. During G-tube medication administration, an LVN used gloves but did not don a gown, and the LVN’s sweater touched the resident’s bed while disconnecting the feeding tubing and preparing medication. The LVN, IP, and DON all confirmed that gown and gloves were required for this type of direct care.
Surveyors found that the facility failed to follow physician orders for PICC line dressing changes, wound care, and catheter care for two residents. One resident with osteomyelitis, pressure ulcers, and an indwelling catheter had multiple missing entries on the TAR for ordered PICC line dressing changes, daily pressure ulcer treatments to the heel and coccyx, and catheter care every shift, with the DON confirming that blank TAR blocks indicated treatments were not completed. Another resident with a PICC line for antibiotic therapy had an order for weekly dressing changes, but the dressing was not changed as scheduled, the PICC site was left uncovered for several minutes during medication administration, and an LPN admitted initialing the TAR to indicate a dressing change that she had not performed, while the TN and APN confirmed the order required adherence to the weekly schedule.
A resident with MRSA colonization and a PICC line for IV antibiotics experienced multiple breaches in infection control by nursing staff. An LPN repeatedly double-gloved, handled room surfaces, trash can lids, and the medication cart, then donned new gloves without performing hand hygiene before preparing and administering oral and IV medications. During PICC access, the LPN wiped the access port for only a few seconds, allowed IV tubing to touch bedding, let the access port fall onto the resident’s arm, and then re-accessed the line without hand hygiene or glove changes. At another time, the PICC site was left uncovered while a treatment nurse prepared for a dressing change, and the LPN entered without prior hand hygiene, disconnected IV tubing, and flushed the line after only a brief alcohol wipe. Staff interviews showed uncertainty and inconsistency regarding required scrub times, glove use, and dressing change schedules, which conflicted with facility policies and stated expectations for aseptic PICC care and hand hygiene.
The facility exhibited several deficiencies in maintaining sanitary conditions and proper hand hygiene in the kitchen. Observations included an unclean ice scoop holder, unsealed food items in the freezer, and expired spices. Dietary staff failed to follow proper handwashing protocols, contaminating clean dishes and food items. These actions were against the facility's policy on cleanliness and handwashing.
The facility failed to lock cleaning cart doors, exposing residents to hazardous chemicals, and did not repair a broken air conditioner with sharp edges in a resident's room. Housekeeping staff confirmed the locks had been non-functional for years, and the resident expressed fear of the air conditioner, which posed a risk of injury.
The facility failed to securely store medications, with an unlocked treatment cart and medications found in resident rooms. A nurse confirmed the cart should have been locked, and the DON acknowledged the risk of misuse if medications are left in resident rooms.
The facility failed to serve meals according to the planned menu, affecting residents on pureed, mechanical soft, and regular diets. Incorrect portion sizes were used, deviating from the specified menu, compromising the nutritional balance of meals provided.
The facility failed to provide dementia training for its nursing aide staff, as required by its policy. Only the closed unit received training, last conducted over a year ago. Interviews confirmed that CNAs had not received dementia training, and the DON acknowledged the deficiency, which potentially affected 18 residents needing specialized dementia care.
A facility failed to ensure the privacy and dignity of a resident during transport from the shower room, as the resident was observed with their buttocks exposed. Despite the resident's care plan indicating a need for privacy, staff confirmed that the resident should have been covered. The resident later reported feeling cold while being transported wet, highlighting a breach of dignity and privacy rights.
A facility failed to provide written notification of the reason for a hospital transfer to a resident and/or their representative, violating resident rights. The resident, with diagnoses including heart failure and pneumonia, was transferred to the hospital for acute respiratory failure. The facility lacked documentation of the transfer notification and their policy did not address this requirement.
A facility failed to provide written notification of the bed hold policy to a resident or their representative during a hospital transfer. The resident, with a history of heart failure and other conditions, was transferred to the hospital for acute respiratory failure. The facility could not produce the required notification, and their policy did not address this requirement.
A facility failed to ensure staff used appropriate PPE for a resident on Enhanced Barrier Precautions. An LPN was observed checking a gastrostomy tube without wearing an isolation gown, despite the resident's status requiring such precautions. The resident had severe cognitive impairment and other medical conditions. The facility's policy mandates gown and glove use during high-contact care activities, which was not followed in this instance.
Care Plans Not Updated After Falls and New Interventions
Penalty
Summary
The facility failed to update the care plans for two residents after falls and related interventions were identified. For one resident, the record showed severe cognitive impairment, multiple diagnoses including stroke, dementia, aphasia, bipolar disorder, and intellectual disabilities, and a history of falls and weakness. After a fall in which the resident was found on the floor beside the bed with blood from the bridge of the nose and was sent to the hospital, the record showed changes such as baffles on the mattress and hand rail changes, but the care plan did not clearly reflect the interventions implemented after the fall. The resident’s existing care plan listed fall-risk interventions related to weakness, transfers, wheelchair positioning, restorative programming, and monitoring after prior falls, but it did not show clear interventions added on or immediately after the fall with major injury. During observation, CNA staff indicated that the baffles and bilateral assist bars were in place after the fall and had not been on the bed before the fall. The MDS Coordinator and DON both stated that care plans were to be updated after a fall and that interventions such as side rails, assist bars, and baffles needed to be included when in use, with the DON stating these changes were expected within 24 to 48 hours after initiation. For the second resident, the admission MDS showed the resident was dependent for transfers and walking and was identified as high risk for falls. After an unwitnessed fall in which the resident was found sitting on the floor with a bump on the head and pain to the left shoulder, the resident was sent to the hospital and returned with no new orders and no fractures reported. The incident report noted that non-skid socks were implemented as a new intervention, and a later progress note stated that non-skid socks were added to the care plan; however, the care plan reviewed by surveyors did not include the non-skid socks intervention, and the printed Kardex also did not reflect it. The MDS Coordinator stated the intervention should have been added no later than 07/06/2025, and the Administrator confirmed it was not listed on the care plan or Kardex.
Failure to Follow EBP During G-Tube Medication Administration
Penalty
Summary
The facility failed to initiate and follow Enhanced Barrier Precautions (EBP) for one resident who had an indwelling catheter and a feeding tube. The resident was admitted with diagnoses including chronic diastolic congestive heart failure, protein calorie malnutrition, hemiplegia and hemiparesis following cerebrovascular disease affecting the right dominant side, gastrostomy complications, dysphagia, and gastrostomy status. The resident’s quarterly MDS showed severely impaired cognition, dependence on staff for all ADLs, an indwelling catheter, a feeding tube, and pressure-reducing devices for the chair and bed. The resident’s orders included care for the G-tube site every shift, enteral feedings every shift, and EBP related to the indwelling catheter and G-tube. The care plan also identified the need for EBP with interventions including hand hygiene before and after leaving the room, not wearing the same gown and gloves for more than one resident, and wearing gloves and gowns for high-contact resident care activities. During observation of the morning medication pass, an LVN prepared multiple medications to be administered via the resident’s G-tube, removed gloves, sanitized hands, and applied new gloves before disconnecting the feeding tubing, but did not don a gown as required for EBP during this high-contact care activity. The LVN’s sweater touched the resident’s bed while disconnecting the feeding tubing and again while medication was being prepared for administration through the G-tube. During interview, the LVN confirmed the resident was on EBP, read the sign posted outside the room, and stated that gloves and a gown were required for direct care, acknowledging that a gown should have been worn during G-tube medication administration. The IP stated EBP should be used for residents with catheters, IVs, feeding tubes, and other indwelling devices, and should include a barrier gown and gloves during direct care such as bathing, dressing, incontinent care, or giving medication through a G-tube. The DON also stated that gown and gloves should be worn during medication administration through a G-tube. Facility policy described EBP as targeted gown and glove use during high-contact resident care activities, including device care or use such as feeding tubes.
Failure to Follow Physician Orders for PICC Line, Wound, and Catheter Care
Penalty
Summary
The deficiency involves the facility’s failure to follow physician orders for PICC line dressing changes, wound care, and indwelling catheter care for two residents. One resident was admitted with osteomyelitis of the vertebra, sacral and sacrococcygeal region, type 2 diabetes mellitus, and a pressure ulcer, and had a BIMS score indicating moderate cognitive impairment. Physician orders included a PICC line dressing change every three days, daily dressing changes to an unstageable right heel pressure ulcer, daily cleansing and dressing of an unstageable coccyx pressure ulcer, and catheter care every shift and PRN with soap and water or wipes for wound healing. Review of the Treatment Administration Record (TAR) for June showed multiple dates where there were no initials or check marks to indicate that the PICC line dressing changes, right heel dressing changes, coccyx pressure ulcer treatments, and catheter care had been completed as ordered. The TAR for this resident showed no documentation of PICC line dressing changes on several specified dates, despite an active order for changes every three days. Similarly, the TAR lacked initials or check marks for the ordered daily dressing changes to the right heel pressure ulcer on multiple dates. For the coccyx pressure ulcer, there were two separate orders—one to cleanse and apply wet-to-dry dressings with a specific brand dressing and island dressing every day shift, and a later order to cleanse and apply wet-to-dry dressings with a specific brand dressing and foam dressing every day shift. On several dates, the TAR contained open blocks with no initials or check marks, indicating that these treatments were not completed. Additionally, the TAR showed that catheter care ordered every shift and PRN was not documented as completed on multiple day shifts over a series of days. The DON confirmed that open blocks on the TAR indicated treatments were not completed. For the second resident, who was admitted with infection and inflammatory reaction due to an internal left hip prosthesis, MRSA, and pain related to orthopedic prosthetic devices, there was an order for a PICC line dressing change to the left upper arm every Wednesday on the day shift. The March TAR reflected this order and showed documented dressing changes on two Wednesdays, with check marks and initials indicating the treatment had been administered. During a medication pass observation, an LPN examined the PICC line dressing and was unsure of the last dressing change date, noting that the handwritten date on the dressing was unclear and that PICC line dressings could only be changed by an RN. Later observation showed the treatment nurse at the bedside with the PICC line site uncovered after the dressing had been removed, while the LPN administered oral medications and hung an antibiotic through the PICC line, leaving the site uncovered for several minutes. The treatment nurse stated the dressing change had been due the previous day but was not completed because the dressing was not available, and also stated she signed the TAR after completing the dressing change. Further interviews revealed documentation discrepancies for this second resident. The DON’s nursing incident/accident note documented that the PICC line dressing change was not completed on the scheduled day and was instead changed the following day. The LPN later acknowledged that the initials on the TAR for the scheduled dressing change date were hers, and admitted she had not changed the dressing but had only looked at it after being told by the treatment nurse that the dressing was within a seven-day time frame. She stated she placed her initials in the TAR block to indicate she had looked at the dressing, even though the TAR coding indicated that initials in the block meant the treatment was given. The treatment nurse reported changing the dressing on one earlier date and, when changing it later, observed a written date on the removed dressing that did not match any documented TAR entry and could not identify whose initials were on that dressing. The treatment nurse and APN both confirmed that the physician’s order required the dressing to be changed every Wednesday and that, even if changed on another day, it still needed to be changed on Wednesday per the order. The DON confirmed that staff initials in a TAR block indicated the treatment was given, an X indicated the treatment was not ordered for that day, and an open block indicated the treatment was not completed.
Improper Hand Hygiene and PICC Line Management During MRSA-Positive Resident Care
Penalty
Summary
The deficiency involves the facility’s failure to ensure proper infection prevention and control practices during the care of a resident with a PICC line and MRSA colonization. The resident was admitted with diagnoses including infection and inflammatory reaction due to an internal left hip prosthesis, MRSA, and pain related to orthopedic prosthetic devices. The resident had a PICC line in the left arm for IV antibiotic therapy to treat the hip infection, and the care plan included contact isolation, use of gowns and gloves during physical contact, handwashing before leaving the room, and standard precautions for infection control. Orders and the TAR showed that PICC line dressings were to be changed weekly, and the MAR showed daily IV antibiotic administration. Surveyor observations on one morning showed that an LPN performed hand hygiene and donned two pairs of gloves along with other PPE before entering the resident’s room to obtain blood pressure and administer medications. The LPN entered the room multiple times, repeatedly double-gloving, and handled the blood pressure cuff, trash can lid, medication cart, and medication cards without performing hand hygiene between glove removal and donning new gloves. At one point, the LPN removed gloves, closed the trashcan lid with a gloved hand, then removed gloves and immediately donned a clean pair without hand hygiene before preparing and administering the resident’s oral medications. Later, when preparing to administer IV antibiotic through the PICC line, the LPN again donned PPE, placed supplies on paper towels on the overbed table, removed the cap from the PICC access port, and wiped the port with an alcohol pad for less than three seconds before flushing with normal saline. During this process, IV tubing touched the resident’s bedding, the access port fell back onto the resident’s arm, and the LPN discarded the contaminated tubing, obtained new tubing, and again wiped the access port for less than three seconds before attaching the tubing and starting the IV medication, without performing hand hygiene or changing gloves during the sequence. A subsequent observation the same day showed the treatment nurse at the bedside with the resident’s PICC line dressing removed, leaving the site uncovered while the resident looked at the open site and was not wearing a mask. The LPN entered without performing hand hygiene before donning PPE, administered oral medication, disconnected the IV tubing from the PICC line, wiped the access port for three seconds, and flushed with normal saline. The treatment nurse stated responsibility for PICC dressing changes and believed the last dressing change had occurred the prior week, but also reported that the dressing removed that day was marked with a date indicating it was due for change the previous day and that the dressing had not been changed because supplies had to be ordered. Facility records showed that the TAR had been signed for a PICC dressing change on a scheduled day, while later nursing documentation described that a dressing change ordered for a specific day had not been performed as ordered. Facility policies and CDC-based documents required hand hygiene before and after glove use, hand hygiene after glove removal, and disinfection of needleless access devices for at least 15 seconds, and the DON stated that the PICC port should be cleaned for 15 seconds and that the dressing should be in place before starting medication, which contrasted with the observed practices. Interviews with the LPN revealed that double gloving was used so gloves would not have to be changed as often, and the LPN acknowledged that hand hygiene should have been performed after removing gloves and before donning new ones. The LPN initially could not state the required length of time for scrubbing the PICC access port and later stated it should have been cleaned for at least 15 seconds, which differed from the observed practice of wiping for less than three seconds. The treatment nurse described limited availability of PICC dressing kits and that no specific person was responsible for ordering them, and reported having changed the resident’s PICC dressing two to three times since admission. The APN and DON both stated expectations that PICC sites and access ports be kept sterile or clean during medication administration and flushing, that staff use only one set of gloves at a time with handwashing between glove changes, and that the PICC port be cleaned for 15 seconds with alcohol swabs even when medicated caps are used. These expectations and policies contrasted with the observed failures in hand hygiene, glove use, PICC port disinfection, and maintaining an intact dressing prior to accessing the PICC line.
Sanitation and Hand Hygiene Deficiencies in Kitchen
Penalty
Summary
The facility failed to maintain proper sanitary conditions in the kitchen, leading to potential contamination risks. Observations revealed that the ice scoop holder had a wet, coral-colored residue, which was easily removed, indicating inadequate cleaning practices. Additionally, opened food items in the freezer, such as boxes of beef patties, were not sealed, risking cross-contamination. Expired spices, including oregano and parsley flakes, were found on the spice rack, further highlighting lapses in food safety standards. Dietary staff demonstrated poor hand hygiene practices, contributing to the risk of contamination. Instances included staff turning off faucets with clean hands, handling clean plates with unwashed hands, and failing to wash hands after touching dirty objects before handling food. Staff members were observed contaminating gloves by not washing hands before putting them on and then using these gloves to handle food and utensils. These actions were contrary to the facility's policy on employee cleanliness and handwashing techniques, which mandates handwashing before shifts, after handling trash, and whenever necessary.
Facility Fails to Secure Cleaning Supplies and Address Hazardous Equipment
Penalty
Summary
The facility failed to ensure that cleaning cart doors were locked, allowing residents potential access to hazardous cleaning supplies and chemicals. During observations, surveyors noted that cleaning carts on multiple halls had doors ajar, revealing disinfectants and bathroom cleaners. Interviews with housekeeping staff revealed that the locks on these carts had not been functional for at least a year, with one housekeeper expressing concern about the risk of residents accessing the chemicals. The Housekeeping Supervisor confirmed that none of the cleaning carts had been lockable for the past four years, and the Administrator was unaware of this issue, despite training housekeepers to keep chemicals secured. Additionally, the facility did not address a safety hazard in a resident's room, where sharp, jagged plastic shards were protruding from a broken air conditioner frame. This posed a risk of injury to the resident, who had medical diagnoses including kidney disease, chronic pressure ulcers, and anemia. The resident expressed fear of the air conditioner, and a registered nurse confirmed the potential for injury. The Director of Nursing acknowledged that staff should report broken equipment, as per facility policy, to prevent harm to residents.
Medication Storage Deficiency
Penalty
Summary
The facility failed to ensure medications were securely stored, leading to potential misappropriation of resident medications. An unlocked treatment cart was observed near Nurses Station 2, containing various medical solutions and topical medications. A Registered Nurse acknowledged that the cart should have been locked when unattended to prevent residents from accessing the medications inappropriately. Additionally, medications were found in resident rooms, which is against facility policy. Antimicrobial wound gel and ointment gel were observed in a resident's bedroom window, and another resident's bedside table contained vapor rub, vitamin C, and menthol rub. The staff confirmed that medications should not be left in resident rooms, as there is a risk of misuse by residents or visitors. The Director of Nursing confirmed that medications should be removed from resident rooms to prevent potential abuse or misuse.
Failure to Serve Meals According to Planned Menu
Penalty
Summary
The facility failed to ensure that meals were prepared and served according to the planned written menu, which compromised the provision of nutritionally balanced meals for residents. On September 4, 2024, the lunch menu specified that residents on pureed diets should receive a #6 scoop (5.3 ounces) of pureed lasagna. However, the dietary staff member used a 3-ounce spoon to portion the meal, deviating from the planned menu. This discrepancy was observed during meal preparation, where bread and meat sauce were blended with thickener, but the portion size did not meet the menu requirements. On September 5, 2024, further discrepancies were noted during the noon meal service. Residents on regular and mechanical soft diets were supposed to receive a 4 by 4 square serving of lasagna, typically weighing around 8 ounces, while those on pureed diets were to receive a #6 scoop. Instead, a dietary staff member used a #10 scoop, equivalent to 3/8 cup, for pureed lasagna, and a 3-ounce ladle for regular and mechanical soft diets, both of which were below the specified portion sizes. When questioned, the staff member confirmed using the incorrect scoop size for all residents, indicating a failure to adhere to the planned menu and portion sizes.
Lack of Dementia Training for Nursing Aides
Penalty
Summary
The facility failed to provide necessary dementia training for its nursing aide staff, which is essential to meet the needs of the residents with dementia. The facility's policy, dated 10/2017, mandates that all staff attend scheduled in-services and that CNAs complete a performance review every 12 months. However, it was confirmed that only the closed unit had received dementia in-service training, and this was last conducted in June 2023. Interviews with CNAs revealed that they had not received dementia training, and the Director of Nursing confirmed that dementia training had not been provided to all staff in the past year. This deficiency potentially affected 18 residents who require specialized care for dementia, as the staff may not be adequately trained to care for them.
Failure to Ensure Resident Privacy and Dignity
Penalty
Summary
The facility failed to ensure the privacy and dignity of a resident, identified as Resident #33, during transport from the shower room to their personal room. The incident was observed when Resident #33 was rolled down the hallway in a shower chair with their buttocks exposed. This was contrary to the facility's policy on dignity, which mandates that residents should be treated with respect and dignity, including being covered during personal hygiene assistance. The resident's care plan indicated a preference for privacy, such as having the door closed, despite a fear of being alone, which was not adhered to in this instance. Interviews with staff, including CNAs and the Director of Nursing, confirmed that residents should be covered when being transported to protect their dignity. CNA #9 acknowledged that Resident #33 refused to be covered due to feeling hot, but also confirmed that the resident should have been covered. The resident later reported feeling cold while being transported wet after a shower. The facility's failure to cover the resident during transport was a breach of their dignity and privacy rights, as outlined in the facility's policies and the resident's care plan.
Failure to Provide Transfer Notification
Penalty
Summary
The facility failed to provide written notification of the reason for transfer or discharge to the hospital to a resident and/or the resident's representative, which is a violation of resident rights. This deficiency was identified for one resident who was reviewed for hospitalization. The resident, who was cognitively intact with a BIMS score of 15, had diagnoses including heart failure, pneumonia, and chronic obstructive pulmonary disease. On April 18, 2024, a nurse assessed the resident after a report of abnormal behavior and, in consultation with a Nurse Practitioner, decided to transfer the resident to the hospital due to a change in condition. The resident was subsequently admitted to the intensive care unit for acute respiratory failure. Upon review, it was found that the facility did not generate a report for the notification of transfer at the time of the resident's hospital transfer. The facility's Administrator confirmed the absence of such documentation when requested by the surveyor. Additionally, the facility's policy on emergency transfer or discharge did not address the requirement to notify the resident and/or the resident's representative of the reason for the transfer, further contributing to the deficiency.
Failure to Notify Resident of Bed Hold Policy During Hospital Transfer
Penalty
Summary
The facility failed to provide written notification of the bed hold policy, including reserve bed payment, to a resident and/or their representative during a transfer to the hospital. This deficiency was identified for one of the two residents reviewed for hospitalization. The resident in question had a history of heart failure, pneumonia, and chronic obstructive pulmonary disease, and was cognitively intact as per the Brief Interview for Mental Status. On April 18, 2024, the resident exhibited abnormal behavior, prompting a nurse to assess the situation and contact a Nurse Practitioner, who decided the resident should be transferred to the hospital. The resident was subsequently admitted to the intensive care unit for acute respiratory failure. Upon review, it was found that the facility did not generate a bed hold notification report for the resident's transfer to the hospital. When asked, the facility's administrator could not provide a copy of the notification and acknowledged that it should have been generated. Additionally, the facility's policy on transfer or discharge in emergencies did not address the requirement to notify the resident or their representative about the bed hold policy, including reserve bed payment, when a resident is transferred to the hospital.
Failure to Use PPE for Resident on Enhanced Barrier Precautions
Penalty
Summary
The facility failed to ensure that staff applied appropriate personal protective equipment (PPE) when interacting with a resident under Enhanced Barrier Precautions. During an observation, a Licensed Practical Nurse (LPN) was seen checking the placement of a gastrostomy tube for a resident without wearing an isolation gown, despite the resident being on Enhanced Barrier Precautions. The LPN only wore gloves during the procedure, which was not in compliance with the facility's policy for Enhanced Barrier Precautions. The resident involved had a history of severe cognitive impairment, as indicated by a BIMS score of 3, and had diagnoses including gastrostomy status and hemiplegia. The facility's policy on Enhanced Barrier Precautions, which was provided to the surveyor, clearly stated that gown and glove use is required during high-contact resident care activities, such as device care or use. The LPN acknowledged the oversight during an interview, stating that a gown should have been worn to prevent infections and contamination by body fluids.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Texarkana
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| The Cottages At Texarkana | 0.3 mi | ★★★★★ | 0 | 0 |
| Heritage Plaza Nursing Center | 1.3 mi | ★★★★★ | 2 | 0 |
| The Villa At Texarkana | 1.4 mi | ★★★★★ | 9 | 0 |
| Avir At Texarkana | 1.4 mi | ★★★★★ | 7 | 3 |
| Reunion Plaza Senior Care And Rehabilitation Cente | 2.1 mi | ★★★★★ | 25 | 2 |
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