Below average — CMS composite of the measures below.
Past the typical resurvey interval — a standard survey could occur at any time
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 Stewartville Care Center during CMS and state inspections, most recent first.
A resident with a history of TBI, cognitive impairment, and angry outbursts repeatedly became upset over a shared bathroom and another resident’s commode, yelling about the commode and on more than one occasion entering the other resident’s room and removing it. Despite being told not to enter other residents’ rooms, the behavior escalated until the resident entered the roommate’s room while the shared bathroom was in use, came close to his face, waved a finger as if to strike him, and made explicit death threats to shoot him in the head. The cognitively intact resident who relied on the commode for toileting assistance reported feeling unsafe, stated he had been afraid of the other resident for over a month, and requested a room change, while staff documentation and interviews showed that the aggressive resident’s ongoing complaints and confrontations about the bathroom and commode were known prior to the threatening incident.
The facility did not identify alternatives or complete and document comprehensive assessments before installing grab bars on beds for two residents. For one resident with intact cognition and another with severe cognitive impairment, required assessments and informed consents were missing from the records, and staff interviews confirmed inconsistent documentation practices. The facility's policy requiring assessment, risk review, and consent prior to grab bar use was not followed or documented.
Surveyors found that discontinued medications, including insulin pens, IV antibiotics, and other drugs belonging to residents who had passed away or been discharged, were not returned to the pharmacy or destroyed in a timely manner. Staff interviews confirmed that these medications were left in the medication room for extended periods, with inconsistent adherence to facility policy requiring prompt disposal or return.
Two residents received cold, unappetizing breakfast meals after significant delays in meal service, with food items such as eggs, ham, and toast left out for extended periods before being served. Staff confirmed the food was cold and soggy, and facility policy on time and temperature control was not followed.
Surveyors found that food items in the kitchen, including prepared and dry goods, were not consistently labeled, dated, or discarded according to facility policy. Dietary staff confirmed that all are responsible for removing expired foods, but several items remained past their required discard dates or were undated, contrary to established procedures.
Staff failed to consistently wear required PPE, specifically gowns, when providing high-contact care to residents with conditions such as wounds, catheters, and feeding tubes who were under Enhanced Barrier Precautions. Despite EBP signage and prior staff education, multiple staff members either did not wear gowns or were unclear about the requirements, and PPE was not always readily accessible outside resident rooms. Facility leadership was unaware of the noncompliance until it was identified during the survey.
The facility did not maintain the kitchen plate warmer in safe working order, with only one side functioning and no maintenance logs or tracking system in place. Staff communicated the issue verbally, but no formal records or policy existed, resulting in some plates remaining cold and affecting meal temperatures for residents.
A resident with multiple medical conditions and significant weight loss did not receive a physician-ordered nutritional supplement due to a breakdown in order entry and communication among staff. The supplement, recommended by the RD and ordered by the provider, was not implemented because the order was misplaced and not entered into the system, resulting in the resident not receiving the additional calories needed for weight gain.
The facility failed to revise comprehensive care plans for diabetic management for two residents, leading to deficiencies in their care. One resident's care plan lacked a communication plan for a glucose monitoring app and did not address blood sugar goals or insulin refusals. Another resident's care plan did not include blood sugar range goals or interventions for hypo/hyperglycemia, despite frequent high readings. Staff interviews confirmed the lack of diabetic management in the care plans.
A resident with dementia and a history of falls experienced an unwitnessed fall due to the failure of a motion sensor alarm, resulting in significant injuries. The facility did not investigate the alarm's failure or update care plans, contributing to inadequate supervision and intervention.
A resident with dementia and a history of falls experienced an unwitnessed fall resulting in injuries, including rib fractures and a hematoma. The facility failed to report the incident to the state agency, despite the motion sensor alarm not functioning and the resident wearing compression stockings that should have been removed. The director of nursing believed the care plan was followed, and the incident was not reported as required by the facility's procedures.
A resident with dementia and a history of falls suffered serious injuries from an unwitnessed fall when the motion sensor alarm failed to sound. The resident was found with rib fractures and facial contusions, and the incident was not reported to the state agency. Staff interviews indicated the alarm did not activate, and the reason for its failure was unknown.
A resident with Lewy body dementia, who was easily startled and at risk for falls, had a pressure sensor alarm added to her bed without an assessment of its appropriateness. The alarm, which sounded in her room, was implemented despite the resident's sensitivity to environmental sounds, potentially increasing her fall risk. The facility did not provide evidence of a person-centered care plan tailored to the resident's needs.
The facility did not employ a full-time RD or qualified DM, affecting all 45 residents. The previous DM left, and the RD has not been providing support. The facility's dietary staff are contracted, and there has been a lack of communication about a replacement DM. A new DM was hired but delayed due to a pending background check.
The facility failed to maintain safe food storage and kitchen cleanliness, affecting all residents receiving meals. Observations included soiled areas in the kitchen, unlabeled and undated food items in storage, and expired juices in the dining room. The facility's dietary policies on labeling, dating, and equipment maintenance were not followed.
A resident with chronic kidney disease was not provided with the prescribed renal diet due to the unavailability of appropriate protein substitutes and lack of action by the cook to seek guidance. The resident received a meal that included items not compliant with her dietary restrictions, and a box of condiments, including salt, was observed in front of her, which she stated was not part of her diet.
Failure to Prevent Verbal Abuse Between Room-Sharing Residents
Penalty
Summary
The deficiency involves the facility’s failure to protect a resident from verbal abuse by another resident. One resident (R1), who had a known history of traumatic brain injury with resulting personality changes, impulsiveness, angry outbursts, and poor judgment, repeatedly became upset about a shared bathroom arrangement and the presence of a commode used by another resident (R4). R4 was cognitively intact, required assistance with ADLs, and used a commode over the toilet due to weakness, pain, and mobility limitations. Over a period of time, R1 complained about the bathroom door being locked when he needed to use it and expressed frustration with the commode being in the shared bathroom or in R4’s room. Progress notes show that R1’s behavior escalated prior to the main incident. On multiple occasions, R1 yelled about R4’s commode, removed it from the room, and pushed it down the hall to the shower room, slamming it into the wall. Staff informed R1 that he was not allowed to enter other residents’ rooms or remove their items, but R1 continued to be frustrated with the shared bathroom situation and the commode. R4 reported to staff that he had been telling them for over a month that R1 was “nuts” and that he was fearful of R1’s behavior related to the bathroom and commode issues. The primary abusive incident occurred when R1 became angry that the shared bathroom door was locked while R4 was using it. Despite staff communicating that they were almost finished, R1 entered R4’s room, came very close to R4’s face, waved his finger as if he was going to hit him, and threatened to shoot R4 in the face or in the head, including while he was sleeping. R4 was found visibly shaken, choked up, and stated he did not feel safe and wanted to change rooms. Staff observed R1 leave R4’s room and then return to continue threatening him. R4 later stated he was afraid of R1, had wanted staff to call the police because of the death threat, and did not want to share a bathroom or be located near R1 if he returned. The facility’s own policies state that all residents have the right to be free from abuse from other residents and that prevention includes assessing vulnerability, care planning identified risks, and monitoring for worsening cognitive impairment and aggressive behavior; however, R1’s escalating behaviors and threats culminated in verbal abuse toward R4.
Failure to Assess, Document, and Obtain Consent for Bed Grab Bar Use
Penalty
Summary
The facility failed to identify and attempt alternatives prior to installing or using grab bars on beds for two residents. For one resident with intact cognition and diagnoses including Type 2 diabetes and chronic heart failure, the care plan indicated independent bed mobility and use of bilateral grab bars. Although an informed consent form was signed, there was no evidence in the electronic health record (EHR) that a grab bar assessment had been completed to determine necessity or safety. The resident confirmed using the grab bars and recalled signing paperwork but could not remember the details. For another resident with severely impaired cognition, dementia, and a history of stroke, the care plan required assistance of two staff for bed mobility and transfers but lacked information about grab bars. The EHR for this resident also lacked evidence of a grab bar assessment, education on risks, or a signed consent form. The resident's wife was unaware of any discussion about risks or paperwork regarding the grab bars. Staff interviews revealed inconsistent documentation practices. Registered nurses and LPNs stated that a nurse manager was responsible for completing grab bar assessments, which were reportedly done on paper and placed in the resident's paper chart. However, neither the assessments nor the consents could be located in the EHR or paper records for the two residents. The facility's policy required assessment of alternatives, risk of entrapment, discussion of risks and benefits, and informed consent prior to grab bar installation, but these steps were not documented or verifiable for the affected residents.
Failure to Timely Dispose of Discontinued Medications
Penalty
Summary
The facility failed to ensure that discontinued medications were returned to the pharmacy or destroyed in a timely manner, as observed during a survey of the medication room. On inspection, 108 cards of various oral medications, creams, bulk powdered medications, bottled liquids, insulin pens, and IV antibiotics were found stored on a shelf and in bins. These included unopened boxes of insulin pens and IV antibiotics for residents who had either passed away or been discharged, as well as medications that had been discontinued. Some medications were undated or unlabeled. Interviews with staff confirmed that these medications were from residents who were no longer in the facility or whose medication orders had changed, and that the medications were awaiting return to the pharmacy or destruction. Staff interviews revealed that all nursing shifts were responsible for handling discontinued medications, but the process was not consistently followed. The consultant pharmacist stated that medications eligible for credit should be returned to the pharmacy within 30 days, while others should be destroyed as soon as possible. However, the administrator and DON acknowledged that medications often remained in the medication room for extended periods, sometimes up to a month, before being destroyed or returned. Facility policy required discontinued medications to be destroyed or returned in accordance with established procedures, but observations and staff statements indicated that this was not being done in a timely manner.
Failure to Serve Palatable and Appropriately Heated Meals
Penalty
Summary
The facility failed to ensure that meals were served at a warm or hot and palatable temperature, as required to promote quality of life and nutritional intake. Observations showed that breakfast items such as toast, eggs, and ham were prepared early and left sitting for extended periods before being served. Specifically, toast was cooked at 7:07 a.m. and was still being served to residents nearly two hours later. During meal service, food was plated and delivered to different wings in sequence, resulting in significant delays for some residents. Staff confirmed that the food, including eggs, ham, and toast, was cold and the toast was soggy by the time it reached the last residents. Two residents who received their trays last reported that their meals were cold and unappetizing, with one resident eating only a quarter of the portion and the other leaving the meal uneaten due to the poor quality. Staff interviews corroborated that breakfast foods can be difficult to keep warm and that toast left out for two hours should not have been served. The facility's policy required safe food handling procedures for time and temperature control during food transportation and delivery, which was not followed in this instance.
Improper Food Labeling and Storage Practices Identified
Penalty
Summary
Surveyors observed that the facility failed to ensure proper labeling, dating, and discarding of food items stored in refrigerators and dry storage areas. During a kitchen tour, multiple food items, including hot dogs, bratwurst, tuna salad, clam chowder, cranberry, celery, corn, ground all spice, and ground cloves, were found either undated or kept past their expiration or preparation dates. The dietary manager confirmed that the facility's policy requires foods to be labeled with the date they were opened or prepared and discarded after one week, but several items did not meet this standard. Interviews with dietary staff, including a cook and a dietary aide, revealed that all staff are responsible for discarding expired foods, and they acknowledged the foods should be thrown out one week after the date marked. The dietary district manager verified that several items were not discarded as required by policy, including items with expired manufacturer dates. The facility's food storage policy also requires storage areas to be neat, arranged for easy identification, and date marked as appropriate, which was not consistently followed.
Failure to Ensure Proper PPE Use for Enhanced Barrier Precautions
Penalty
Summary
The facility failed to ensure proper use of personal protective equipment (PPE) for residents requiring Enhanced Barrier Precautions (EBP). Multiple residents with conditions such as chronic pain, artificial joints, urinary catheters, open wounds, and feeding tubes were identified as needing EBP, as indicated by signage on their room doors. Despite this, staff members, including nursing assistants and an LPN, were observed providing direct care activities such as toileting, hygiene, wound care, and device management without wearing gowns, as required by EBP protocols. Staff interviews revealed inconsistent understanding and application of EBP requirements, with some staff acknowledging awareness of the need for gowns but choosing not to wear them, while others were unsure of the meaning of EBP signage or the specific PPE required. Observations documented that staff entered rooms with EBP signage and performed high-contact care activities—such as assisting with toileting, changing briefs, wound care, and managing feeding tubes—without donning gowns. In several cases, staff stated they were aware of the EBP signage and the expectation to wear gowns but did not comply. Some staff expressed confusion about the location of PPE supplies or the specific requirements for EBP, and one staff member incorrectly believed that only gloves were required. PPE carts were found in central locations rather than immediately accessible outside resident rooms, contributing to inconsistent PPE use. Interviews with facility leadership, including the DON, infection preventionist, and administrator, confirmed that staff had received education on EBP and were expected to follow the protocols. However, leadership was unaware that staff were not consistently using proper PPE in EBP rooms. The facility's posted EBP signage clearly outlined the requirement for both gloves and gowns during high-contact care activities, and the facility's infection control policy emphasized the importance of preventing disease transmission. Despite these policies and education efforts, the lack of adherence to EBP protocols was observed and confirmed through staff interviews and documentation review.
Failure to Maintain Kitchen Equipment in Safe Operating Condition
Penalty
Summary
The facility failed to maintain essential kitchen equipment in safe operating condition, specifically the left side of the plate warmer, which was not functioning for an extended period. The cook reported that only the right side of the plate warmer worked, resulting in some plates remaining cold and causing dissatisfaction among residents when their food cooled quickly. The issue had been communicated verbally to the dietary manager, but no maintenance logs or tracking systems were in place for the plate warmer, and the administrator confirmed that no such records existed. The dietary district manager also stated that maintenance issues were communicated by word of mouth and could not specify when the facility became aware of the malfunction. No equipment maintenance policy was provided when requested.
Failure to Provide Ordered Nutritional Supplement for Weight Loss
Penalty
Summary
A resident with a history of traumatic brain injury, digestive system surgery, vascular intestinal disorder, ischemic colitis, intestinal obstruction, and dysphagia experienced significant weight loss over several months. The resident was on a pureed diet with thickened liquids and required substantial assistance with daily activities. The care plan identified risks for dehydration and aspiration, and the nutritional assessment documented an 11% weight loss in six months. The registered dietician recommended a nutritional supplement three times daily to address the weight loss, and a physician's telephone order for the supplement was issued. Despite the provider's order for a nutritional supplement, the order was not entered or implemented. The director of nursing was unaware that the order had not been processed, attributing the failure to a lack of an effective system for order entry and the order being misplaced among paperwork. As a result, the resident did not receive the prescribed supplement intended to increase calorie intake and support weight gain, contrary to the provider's instructions and the resident's care needs.
Deficient Diabetic Management in Care Plans
Penalty
Summary
The facility failed to revise the comprehensive care plans for diabetic management for two residents, R1 and R2, which led to deficiencies in their care. R1, diagnosed with type 1 diabetes mellitus, had a care plan that did not address a communication plan for the Dexcom smart phone application used to monitor blood sugars. The care plan also lacked specific blood sugar goal ranges and did not include individualized interventions to manage hypo/hyperglycemia or address R1's refusals to take insulin. Despite having blood sugar readings as low as 47 and as high as 600, the care plan did not adequately address these issues. R2, diagnosed with type 2 diabetes and diabetic chronic kidney disease, also had a care plan that was insufficient in managing their diabetic condition. The care plan did not include blood sugar range goals, management of the Dexcom sensor, or interventions for hypo/hyperglycemia. R2 frequently had blood sugar readings above 200, yet the care plan did not reflect a focus on diabetic management. During an observation, it was confirmed that R2's care plan lacked diabetic management details. Interviews with facility staff, including an LPN and the DON, revealed that the care plans for both residents did not clearly address diabetic management. The DON acknowledged the deficiencies and expressed an expectation for care plans to include diabetic management. The facility's policy on comprehensive care plans emphasized the need for personalized plans based on the nature of the illness and treatment prescribed, which was not adhered to in these cases.
Failure to Implement Fall Prevention Measures
Penalty
Summary
The facility failed to implement care-planned fall interventions for a resident with dementia, anxiety, and depression, resulting in actual harm. The resident, who had a history of falls and was at high risk due to cognitive deficits, experienced an unwitnessed fall while self-transferring. The motion sensor alarm, intended to alert staff of such movements, did not sound, and the facility did not investigate the reason for this failure. The resident sustained significant injuries, including rib fractures and facial contusions, and was admitted to the emergency department. The resident's care plan included several fall prevention measures, such as using a call light for assistance, keeping the bed low and locked, and employing a motion sensor alarm to alert staff of self-transfers. However, the nursing assistant care sheet did not reflect these interventions, and the staff failed to ensure the alarm was functioning. Interviews with staff revealed that the motion sensor alarm was not operational at the time of the fall, and there was confusion about the resident's alarm system, with some staff unaware of its status or the reasons for its failure. The facility did not update the care plan or staff instructions following the incident, nor did they assess the impact of adding a second pressure sensor alarm, which could potentially startle the resident due to her condition. The lack of investigation into the alarm's failure and the absence of updated care planning contributed to the deficiency, as the facility did not provide adequate supervision and intervention to prevent avoidable accidents and injuries.
Failure to Report Unwitnessed Fall with Injury
Penalty
Summary
The facility failed to report an unwitnessed fall with injury to the state agency for a resident who was at risk for falls due to dementia and other cognitive impairments. The resident, who had a history of falls and was on antipsychotic medication, was found on the floor with a large hematoma above the left eye and upper lip. The fall was unwitnessed, and the resident was later admitted to the emergency department with rib fractures and a urinary tract infection. The care plan included measures such as using a call light for assistance, keeping the bed low and locked, and using a motion sensor alarm, but the alarm did not activate during the incident. Interviews with staff revealed that the motion sensor alarm was not functioning at the time of the fall, and the resident was found wearing compression stockings that should have been removed before bed. Despite these issues, the director of nursing did not report the fall to the state agency, believing that the care plan was followed and the staff adhered to it. The facility's procedure for reporting suspected maltreatment of vulnerable adults was not followed, as the incident was not reported to the Minnesota Department of Health Office of Health Facility Complaints.
Failure to Investigate Unwitnessed Fall with Serious Injury
Penalty
Summary
The facility failed to thoroughly investigate an unwitnessed fall involving a resident with dementia, anxiety, and depression, who suffered serious injuries including rib fractures and facial contusions. The resident, who was at risk for falls due to cognitive decline and poor decision-making, was found on the floor with a large hematoma above the left eye and upper lip. The motion sensor alarm, which was part of the resident's fall prevention program, did not sound to alert staff of the movement, and the fall was unwitnessed. The resident was subsequently admitted to the emergency department with rib fractures and a urinary tract infection. Interviews with staff revealed that the motion sensor alarm did not activate, and the fall was not reported to the state agency. The director of nursing believed the care plan was followed, as the sensor alarm was present in the room, and the bed was low and locked. However, the reason for the alarm's failure to sound was unknown. The facility's vulnerable adult procedure required an internal investigation with written statements from involved staff, but there is no indication that this was completed following the incident.
Failure to Implement Person-Centered Dementia Care Plan
Penalty
Summary
The facility failed to assess, develop, and implement a person-centered dementia care treatment plan for a resident diagnosed with Lewy body dementia. The resident, who was easily startled and at risk for falls, had a pressure sensor alarm added to her bed, which sounded in her room. This intervention was implemented without evidence of an assessment process to determine its appropriateness given the resident's diagnosis and sensitivity to environmental sounds. The resident's care plan included measures such as using a call light for assistance, keeping the bed low and locked, and using a motion sensor alarm, but did not account for the potential negative impact of the pressure sensor alarm. Observations and interviews revealed that the resident was easily startled by noises, which could increase her risk of falls. Nursing assistants noted that the resident could be startled by moderate noises, such as a mop bucket or someone speaking to her unexpectedly. Despite this, the facility added a pressure sensor alarm that sounded in the resident's room, potentially exacerbating her startle response and fall risk. The facility did not provide evidence that this intervention was tailored to the resident's specific needs, highlighting a deficiency in person-centered care planning for dementia patients.
Failure to Employ Qualified Dietary Staff
Penalty
Summary
The facility failed to employ a full-time registered dietitian (RD) or a qualified dietary manager (DM) to oversee the food and nutrition services, potentially affecting all 45 residents. The previous DM left earlier in the month, and the regional manager quit in April 2024. Since then, an untrained staff member, C-A, has been handling orders and scheduling without formal training for the DM position. The facility's RD, who is contracted, has not been providing support or visiting the kitchen since the DM's departure, and C-A could not recall the last visit by the RD. The facility's dietary staff are contracted through an outside company, and there has been a lack of communication regarding the replacement of the DM, who has not been present since May 10, 2024. The administrator confirmed the absence of a DM and stated that the RD, also contracted, last visited in April 2024. The dietary company was aware of the situation, and a new DM was hired but could not start due to pending background check results. The facility's policy requires a qualified dietitian or clinically qualified nutrition professional to provide guidance and oversight, which was not being fulfilled.
Deficiencies in Food Storage and Kitchen Cleanliness
Penalty
Summary
The facility failed to ensure safe food storage and kitchen cleanliness, which could potentially affect all 45 residents who receive meals from the kitchen. During a kitchen tour, several issues were observed, including a black thick dry substance around the legs of prep tables and cabinets, and adhered dry substances of varying sizes and colors on the wall, floor, and piping underneath the dishwasher. The cook, C-B, confirmed the presence of these soiled areas and was unsure when they were last cleaned. Additionally, the cabinets containing clean pans had a white substance and food crumbs, and the ice machine had a white thick substance along the bottom with several towels underneath, indicating a possible leak. C-B was unaware of the last maintenance of the ice machine. In the walk-in cooler, pasteurized egg flats and a bag of carrots were found without received or open dates, with the carrots showing signs of mold. In the walk-in freezer, opened and unopened bags of food were not labeled or dated, and C-B confirmed that some items had been there for at least three months. In dry storage, a box of snack bars and a large bag of flour were stored directly on the floor, contrary to policy. Additionally, expired juices were found in the dining room, with C-A unaware that the juices were only good for seven days after opening. The facility's dietary policies require proper labeling, dating, and storage of food items, as well as regular cleaning and maintenance of equipment, which were not adhered to in these instances.
Failure to Follow Therapeutic Diet for Resident
Penalty
Summary
The facility failed to ensure that a therapeutic diet prescribed by the attending physician was followed for a resident with chronic kidney disease, functional dyspepsia, and moderate protein-calorie malnutrition. The resident was on a renal dialysis diet, which included specific restrictions on sodium, protein, potassium, and phosphorus intake. During a kitchen observation, it was found that the facility did not have the appropriate protein substitute for the renal diet, as the pork chops were unavailable, and no alternative was prepared. The cook, who was not trained on different diet types, did not seek guidance from the registered dietitian available for questions. The resident received a meal that did not comply with the prescribed renal diet, including Hawaiian baked ham, which was not part of the diet. The resident acknowledged the discrepancy but did not request an alternative meal. Additionally, a box of condiments, including salt, was observed in front of the resident, which she stated was not supposed to be part of her diet. The regional director of operations confirmed that diet exchanges were available and expected the ordered diets to be followed, as per the facility's dietary policy.
What surveyors are citing around you — mapped
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Illustrative
What surveyors actually found near you
We read the 147 citations issued within 25 miles in the last 12 months — including the 3 immediate-jeopardy cases — and tell you exactly what happened, in plain English, matched to your record.
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.
Illustrative
A prioritized, do-first checklist
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Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Stewartville
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Rochester Restorative Care Center | 11.2 mi | ★★★★★ | 36 | 1 |
| Meadow Manor | 11.3 mi | ★★★★★ | 5 | 0 |
| Charter House Inc | 11.6 mi | ★★★★★ | 4 | 0 |
| Samaritan Bethany Home On Eighth | 12.1 mi | ★★★★★ | 8 | 0 |
| Spring Valley Care Center | 12.1 mi | ★★★★★ | 15 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.