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Unique Rehabilitation and Health Center

All states › District of Columbia › Washington › Unique Rehabilitation and Health Center

901 First Street NW Washington, DC 20001 · The District County

(202) 535-2011

All 16 nursing homes in Washington, DC (16 take Medicaid)

Accepts Medicare Accepts Medicaid 230 certified beds For profit

CMS certification number 095036 · See this home on Medicare Care Compare

Ratings come from CMS and are updated monthly; these are from October 2026. Check the latest inspection report and visit in person before you decide.

Is Unique Rehabilitation and Health Center a good nursing home? Reviews, ratings and inspection record

There are no official resident reviews of nursing homes: Medicare's Care Compare publishes inspections, staffing and quality data instead. Here is what that record shows for Unique Rehabilitation and Health Center as of October 2026.

CMS rates it 4 out of 5 stars overall, above the District of Columbia average of 3.5. Inspectors issued 72 citations in the last three years. CMS imposed 1 penalty, including $48,887 in fines, in that time. For short-term rehab patients CMS rates quality 3 out of 5; for long-term residents, 5 out of 5. Those results differ a lot, so ask about the unit your family member would be on.

Online reviews from families and residents are on Google Maps and other sites; they reflect individual experiences and aren't checked by CMS. The full inspection reports, including what inspectors observed, are on Medicare Care Compare.

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Staffing

Nursing staff spend about 4.08 hours per resident per day at Unique Rehabilitation and Health Center, below the District of Columbia median of 4.61 (US median: 3.72). About 1.03 of those hours are from registered nurses. On weekends it falls to 3.70 hours, 9% below its all-week average. 32.5% of nursing staff left within a year (District of Columbia median 32.6%).

Nursing care per resident per day 4.08 hours
Below the District of Columbia median of 4.61 Registered nurses, licensed practical nurses and aides combined, from payroll records.
Registered nurse hours 1.03 per resident a day RNs handle assessments, medications and changes in condition.
Weekend nursing care 3.70 hours Per resident a day. A big drop from weekdays can mean thin weekend staffing.
Nursing staff turnover 32.5% a year Share of nursing staff who left over a year. Lower usually means steadier care.
Registered nurse turnover 32.8% a year Share of registered nurses who left over a year.
Administrators who left 0 in the past year Frequent leadership changes are worth asking about on a visit.

About this nursing home

Certified beds230
Residents per day 223 About 97% of beds filled, on average
OwnershipFor profit - Limited Liability company
Payment acceptedMedicare and Medicaid
Certified sinceJuly 1997
Legal business nameUNIQUE REHABILITATION AND HEALTH CENTER LLC

Paying for care at Unique Rehabilitation and Health Center: Medicare and Medicaid

Unique Rehabilitation and Health Center is certified for both Medicare and Medicaid. Medicare Part A can cover a short skilled-nursing or rehab stay here after a qualifying hospital stay of at least three inpatient days (observation days don't count), for up to 100 days per benefit period. Medicaid can pay for long-term care for residents who meet District of Columbia's income and asset rules. Being certified doesn't guarantee a Medicaid bed is open, so ask whether the home accepts residents whose Medicaid application is still pending.

In 2026 Medicare covers days 1–20 in full after the Part A deductible ($1,736 per benefit period); for days 21–100 you pay $217 a day; after day 100 you pay all costs. Medicare doesn't pay for long-term custodial care. Medicare's coverage rules.

Health inspections

The most recent standard inspection was on November 27, 2024 and found 13 deficiencies, plus 4 from complaint inspections in the same period. In total, inspectors issued 72 citations in the last three years.

Each citation has a scope and severity letter from A to L. A–C: potential for minimal harm. D–F: potential for more than minimal harm. G–I: actual harm. J–L: immediate jeopardy to resident health or safety.

What the inspections found

Over the last three years, inspectors issued 72 citations at Unique Rehabilitation and Health Center across 6 inspection dates, 12 of them from complaint investigations. 1 was at the immediate-jeopardy level (J–L), CMS's most serious category, most recently on November 27, 2024. The most common areas cited were resident assessment and care planning (16) and resident rights (13). The most serious was cited under the CMS rule to "ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents" (tag F0689, level K, November 27, 2024). 10 citations were under CMS's abuse, neglect and exploitation rules.

November 24, 2025 · 2 citations · includes complaint inspection

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

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0656 · Complaint inspection · Deficient, Provider has date of correction (Dec 9, 2025)

DSafeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0842 · Complaint inspection · Deficient, Provider has date of correction (Dec 9, 2025)

September 19, 2025 · 1 citation · includes complaint inspection

DTimely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

Potential for more than minimal harm · Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0609 · Complaint inspection · Past Non-Compliance (Sep 17, 2025)

June 6, 2025 · 1 citation · includes complaint inspection

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

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0656 · Complaint inspection · Deficient, Provider has date of correction (Jul 10, 2025)

November 27, 2024 · 21 citations, includes immediate jeopardy · includes complaint inspection

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

Immediate jeopardy · Quality of Life and Care Deficiencies · Tag F0689 · Deficient, Provider has date of correction (Feb 22, 2025)

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

Potential for more than minimal harm · Nutrition and Dietary Deficiencies · Tag F0812 · Deficient, Provider has date of correction (Jan 17, 2025)

EProvide and implement an infection prevention and control program.

Potential for more than minimal harm · Infection Control Deficiencies · Tag F0880 · Deficient, Provider has date of correction (Jan 17, 2025)

EKeep all essential equipment working safely.

Potential for more than minimal harm · Environmental Deficiencies · Tag F0908 · Deficient, Provider has date of correction (Jan 17, 2025)

EMake sure that a working call system is available in each resident's bathroom and bathing area.

Potential for more than minimal harm · Environmental Deficiencies · Tag F0919 · Deficient, Provider has date of correction (Jan 17, 2025)

DKeep residents' personal and medical records private and confidential.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0583 · Deficient, Provider has date of correction (Jan 17, 2025)

DHonor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0584 · Complaint inspection · Deficient, Provider has date of correction (Jan 17, 2025)

DHonor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0585 · Complaint inspection · Deficient, Provider has date of correction (Jan 17, 2025)

DProtect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

Potential for more than minimal harm · Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0600 · Complaint inspection · Deficient, Provider has date of correction (Jan 17, 2025)

DDevelop and implement policies and procedures to prevent abuse, neglect, and theft.

Potential for more than minimal harm · Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0607 · Complaint inspection · Deficient, Provider has date of correction (Jan 17, 2025)

DTimely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

Potential for more than minimal harm · Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0609 · Complaint inspection · Deficient, Provider has date of correction (Jan 17, 2025)

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

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0656 · Complaint inspection · Deficient, Provider has date of correction (Jan 17, 2025)

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

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0684 · Complaint inspection · Deficient, Provider has date of correction (Feb 22, 2025)

DEnsure 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.

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0693 · Deficient, Provider has date of correction (Jan 17, 2025)

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

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0694 · Deficient, Provider has date of correction (Jan 17, 2025)

DProvide safe and appropriate respiratory care for a resident when needed.

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0695 · Deficient, Provider has date of correction (Jan 17, 2025)

DEnsure the resident's doctor reviews the resident's care, writes, signs and dates progress notes and orders, at each required visit.

Potential for more than minimal harm · Nursing and Physician Services Deficiencies · Tag F0711 · Deficient, Provider has date of correction (Jan 17, 2025)

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

Potential for more than minimal harm · Pharmacy Service Deficiencies · Tag F0755 · Deficient, Provider has date of correction (Jan 17, 2025)

DEnsure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.

Potential for more than minimal harm · Pharmacy Service Deficiencies · Tag F0761 · Deficient, Provider has date of correction (Jan 17, 2025)

DPut firmly secured handrails on each side of hallways.

Potential for more than minimal harm · Environmental Deficiencies · Tag F0924 · Deficient, Provider has date of correction (Jan 17, 2025)

DGive their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation.

Potential for more than minimal harm · Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0943 · Complaint inspection · Deficient, Provider has date of correction (Jan 17, 2025)

September 26, 2022 · 31 citations, includes actual harm

GProtect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

Actual harm · Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0600 · Deficient, Provider has date of correction (Dec 5, 2022)

GProvide appropriate pressure ulcer care and prevent new ulcers from developing.

Actual harm · Quality of Life and Care Deficiencies · Tag F0686 · Deficient, Provider has date of correction (Dec 5, 2022)

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

Actual harm · Quality of Life and Care Deficiencies · Tag F0689 · Deficient, Provider has date of correction (Jan 9, 2023)

EHonor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0584 · Deficient, Provider has date of correction (Dec 5, 2022)

EEnsure each resident receives an accurate assessment.

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0641 · Deficient, Provider has date of correction (Dec 5, 2022)

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

Potential for more than minimal harm · Pharmacy Service Deficiencies · Tag F0755 · Deficient, Provider has date of correction (Jan 27, 2023)

EProvide timely, quality laboratory services/tests to meet the needs of residents.

Potential for more than minimal harm · Administration Deficiencies · Tag F0770 · Deficient, Provider has date of correction (Jan 9, 2023)

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

Potential for more than minimal harm · Nutrition and Dietary Deficiencies · Tag F0812 · Deficient, Provider has date of correction (Dec 5, 2022)

EKeep all essential equipment working safely.

Potential for more than minimal harm · Environmental Deficiencies · Tag F0908 · Deficient, Provider has date of correction (Dec 5, 2022)

DHonor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0550 · Deficient, Provider has date of correction (Jan 9, 2023)

DGive residents notice of Medicaid/Medicare coverage and potential liability for services not covered.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0582 · Deficient, Provider has date of correction (Dec 5, 2022)

DDevelop and implement policies and procedures to prevent abuse, neglect, and theft.

Potential for more than minimal harm · Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0607 · Deficient, Provider has date of correction (Dec 5, 2022)

DDevelop and implement policies and procedures to ensure (1) employees report any suspicion of a crime against any resident, according to timelines; (2) post the notice of employee rights; and (3) prohibit and prevent retaliation for reporting.

Potential for more than minimal harm · Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0608 · Deficient, Provider has date of correction (Dec 5, 2022)

DTimely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

Potential for more than minimal harm · Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0609 · Deficient, Provider has date of correction (Jan 9, 2023)

DRespond appropriately to all alleged violations.

Potential for more than minimal harm · Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0610 · Deficient, Provider has date of correction (Jan 9, 2023)

DNot transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0622 · Deficient, Provider has date of correction (Dec 5, 2022)

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

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0623 · Deficient, Provider has date of correction (Jan 9, 2023)

DNotify 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.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0625 · Deficient, Provider has date of correction (Dec 5, 2022)

DAssess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0636 · Deficient, Provider has date of correction (Dec 5, 2022)

DEnsure a qualified health professional conducts resident assessments.

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0642 · Deficient, Provider has date of correction (Dec 5, 2022)

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

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0656 · Deficient, Provider has date of correction (Dec 5, 2022)

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

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0657 · Deficient, Provider has date of correction (Dec 5, 2022)

DEnsure services provided by the nursing facility meet professional standards of quality.

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0658 · Deficient, Provider has date of correction (Dec 5, 2022)

DPlan the resident's discharge to meet the resident's goals and needs.

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0660 · Deficient, Provider has date of correction (Dec 5, 2022)

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

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0684 · Deficient, Provider has date of correction (Jan 9, 2023)

DAssist a resident in gaining access to vision and hearing services.

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0685 · Deficient, Provider has date of correction (Dec 5, 2022)

DProvide safe and appropriate respiratory care for a resident when needed.

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0695 · Deficient, Provider has date of correction (Dec 5, 2022)

DEnsure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.

Potential for more than minimal harm · Nursing and Physician Services Deficiencies · Tag F0726 · Deficient, Provider has date of correction (Dec 5, 2022)

DEnsure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.

Potential for more than minimal harm · Nutrition and Dietary Deficiencies · Tag F0803 · Deficient, Provider has date of correction (Dec 5, 2022)

DSafeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0842 · Deficient, Provider has date of correction (Jan 9, 2023)

DProvide and implement an infection prevention and control program.

Potential for more than minimal harm · Infection Control Deficiencies · Tag F0880 · Deficient, Provider has date of correction (Dec 5, 2022)

October 13, 2020 · 16 citations

EHonor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0584 · Deficient, Provider has date of correction (Dec 11, 2020)

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

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0657 · Deficient, Provider has date of correction (Dec 11, 2020)

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

Potential for more than minimal harm · Pharmacy Service Deficiencies · Tag F0756 · Deficient, Provider has date of correction (Dec 11, 2020)

EImplement 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.

Potential for more than minimal harm · Pharmacy Service Deficiencies · Tag F0758 · Deficient, Provider has date of correction (Dec 11, 2020)

ESafeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0842 · Deficient, Provider has date of correction (Dec 11, 2020)

EKeep all essential equipment working safely.

Potential for more than minimal harm · Environmental Deficiencies · Tag F0908 · Deficient, Provider has date of correction (Dec 11, 2020)

DHonor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0550 · Deficient, Provider has date of correction (Dec 11, 2020)

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

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0580 · Deficient, Provider has date of correction (Dec 11, 2020)

DNot transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0622 · Deficient, Provider has date of correction (Dec 11, 2020)

DEnsure each resident receives an accurate assessment.

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0641 · Deficient, Provider has date of correction (Dec 11, 2020)

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

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0656 · Deficient, Provider has date of correction (Dec 11, 2020)

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

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0690 · Deficient, Provider has date of correction (Dec 11, 2020)

DProvide appropriate colostomy, urostomy, or ileostomy care/services for a resident who requires such services.

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0691 · Deficient, Provider has date of correction (Dec 11, 2020)

DProvide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results.

Potential for more than minimal harm · Administration Deficiencies · Tag F0773 · Deficient, Provider has date of correction (Dec 11, 2020)

DEnsure food and drink is palatable, attractive, and at a safe and appetizing temperature.

Potential for more than minimal harm · Nutrition and Dietary Deficiencies · Tag F0804 · Deficient, Provider has date of correction (Dec 11, 2020)

DProvide and implement an infection prevention and control program.

Potential for more than minimal harm · Infection Control Deficiencies · Tag F0880 · Deficient, Provider has date of correction (Dec 11, 2020)

Questions to ask on a tour of Unique Rehabilitation and Health Center

  1. Inspectors cited the home at the immediate-jeopardy level on November 27, 2024 under the rule on quality of life and care. What changed afterwards, and can I see the plan of correction?
  2. CMS cited the home under its abuse and neglect rules on September 19, 2025. How are staff trained, and how are concerns reported?
  3. Do you have a Medicaid bed open now, and will you admit someone whose Medicaid application is still pending?
  4. When is the first care-plan meeting, and can family attend?

Questions come from this home's CMS data: its inspections, staffing and ownership record.

Fines and payment denials

1 penalty in the last three years, including $48,887 in fines.

DateTypeAmount or length
Nov 27, 2024 Fine $48,887

Rating history

CMS monthOverallInspectionStaffingQuality
October 2026 4/5 2/5 5/5 5/5
August 2026 4/5 2/5 5/5 5/5
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Location

Hospitals near Unique Rehabilitation and Health Center

The Medicare-certified hospitals closest to this nursing home, with their CMS data. Ask the home which hospital it usually sends residents to.

Hospital ratings, ER visit times and more at Hospitals In Each State
Source: CMS Care Compare. Distances are approximate.

Nearby nursing homes

Bridgepoint Subacute and Rehab Capitol Hill Washington · 1.1 mi away ★★★☆☆ Inspection 2/5 · Staffing — 117 beds · Medicaid
Inspire Rehabilitation and Health Center Washington · 2.0 mi away ★★★★☆ Inspection 3/5 · Staffing 4/5 180 beds · Medicaid
Washington Center for Aging SVCS Washington · 2.3 mi away ★★★☆☆ Inspection 2/5 · Staffing 5/5 259 beds · Medicaid
Jeanne Jugan Residence Washington · 2.6 mi away ★★★★★ Inspection 5/5 · Staffing 5/5 40 beds · Medicaid
Stoddard Baptist Nursing Home Washington · 2.8 mi away ★★★☆☆ Inspection 3/5 · Staffing 4/5 164 beds · Medicaid

More nursing homes near Unique Rehabilitation and Health Center ›   All nursing homes in Washington ›

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Source: CMS Provider Data Catalog (provider information, health deficiencies, penalties), October 2026. Inspection citations and penalties cover the last three years. Nursing Homes In Each State is independent and not affiliated with CMS or Medicare. About the data · Report a problem with this listing. Is this your nursing home? Feature it here.

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https://www.nursinghomesineachstate.com/district-of-columbia/washington/unique-rehabilitation-and-health-center/ · Data: CMS, October 2026 · Nursing Homes In Each State, not affiliated with CMS or Medicare.