facebook tracking Kimes Nursing and Rehab, Athens OH: CMS Ratings
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Kimes Nursing and Rehab

All states › Ohio › Athens › Kimes Nursing and Rehab

75 Kimes Lane Athens, OH 45701 · Athens County

(740) 593-3391

All 2 nursing homes in Athens, OH (2 take Medicaid)

SFF candidate Accepts Medicare Accepts Medicaid 61 certified beds For profit

CMS certification number 366250 · See this home on Medicare Care Compare

Special Focus Facility candidate CMS lists this nursing home as a candidate for its Special Focus Facility program, which means it qualifies to be selected for the program based on its inspection record. Shown as of October 2026. About the program (CMS).

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 Kimes Nursing and Rehab 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 Kimes Nursing and Rehab as of October 2026.

CMS rates it 1 out of 5 stars overall, below the Ohio average of 3.2. Inspectors issued 71 citations in the last three years. CMS imposed 3 penalties, including $186,564 in fines, in that time. For short-term rehab patients CMS rates quality 1 out of 5; for long-term residents, 4 out of 5. Those results differ a lot, so ask about the unit your family member would be on. CMS lists it as a Special Focus Facility candidate.

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 2.95 hours per resident per day at Kimes Nursing and Rehab, below the Ohio median of 3.58 (US median: 3.72). About 0.55 of those hours are from registered nurses. On weekends it falls to 2.61 hours, 11% below its all-week average. 83.9% of nursing staff left within a year (Ohio median 48.9%). High turnover can mean residents see unfamiliar caregivers; ask how long the nurses on the unit have worked there. 2 administrators left in the past year.

Nursing care per resident per day 2.95 hours
Below the Ohio median of 3.58 Registered nurses, licensed practical nurses and aides combined, from payroll records.
Registered nurse hours 0.55 per resident a day RNs handle assessments, medications and changes in condition.
Weekend nursing care 2.61 hours Per resident a day. A big drop from weekdays can mean thin weekend staffing.
Nursing staff turnover 83.9% a year Share of nursing staff who left over a year. Lower usually means steadier care.
Registered nurse turnover 70% a year Share of registered nurses who left over a year.
Administrators who left 2 in the past year Frequent leadership changes are worth asking about on a visit.

About this nursing home

Certified beds61
Residents per day 57 About 93% of beds filled, on average
OwnershipFor profit - Corporation
Payment acceptedMedicare and Medicaid
Certified sinceJune 2002
Part of a chainRhg Healthcare Services
Legal business nameKIMES NURSING AND REHAB LLC

Paying for care at Kimes Nursing and Rehab: Medicare and Medicaid

Kimes Nursing and Rehab 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 Ohio'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 June 2, 2026 and found 29 deficiencies, plus 18 from complaint inspections in the same period. In total, inspectors issued 71 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 71 citations at Kimes Nursing and Rehab across 9 inspection dates, 21 of them from complaint investigations. 2 were at the immediate-jeopardy level (J–L), CMS's most serious category, most recently on July 14, 2026 (complaint inspection). The most common areas cited were quality of life and care (20) and infection control (10). The most serious was cited under the CMS rule to "provide appropriate treatment and care according to orders, resident’s preferences and goals" (tag F0684, level J, July 14, 2026). 5 citations were under CMS's abuse, neglect and exploitation rules.

July 14, 2026 · 5 citations · includes complaint inspection

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

Immediate jeopardy · Quality of Life and Care Deficiencies · Tag F0684 · Complaint inspection · Deficient, Provider has date of correction (Jul 16, 2026)

FEstablish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility.

Potential for more than minimal harm · Administration Deficiencies · Tag F0837 · Complaint inspection · Deficient, Provider has date of correction (Jul 16, 2026)

DRespond appropriately to all alleged violations.

Potential for more than minimal harm · Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0610 · Complaint inspection · Deficient, Provider has date of correction (Jul 16, 2026)

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

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0689 · Complaint inspection · Deficient, Provider has date of correction (Jul 16, 2026)

DProvide or get specialized rehabilitative services as required for a resident.

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0825 · Complaint inspection · Deficient, Provider has date of correction (Jul 16, 2026)

June 2, 2026 · 31 citations, includes actual harm · includes complaint inspection

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

Actual harm · Quality of Life and Care Deficiencies · Tag F0684 · Deficient, Provider has date of correction (Jun 25, 2026)

FNot hire anyone with a finding of abuse, neglect, exploitation, or theft.

Potential for more than minimal harm · Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0606 · Deficient, Provider has date of correction (Jun 25, 2026)

FHave a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.

Potential for more than minimal harm · Nursing and Physician Services Deficiencies · Tag F0727 · Deficient, Provider has date of correction (Jun 25, 2026)

FObserve each nurse aide's job performance and give regular training.

Potential for more than minimal harm · Nursing and Physician Services Deficiencies · Tag F0730 · Deficient, Provider has date of correction (Jun 25, 2026)

FProcure 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 (Jun 25, 2026)

FAdminister the facility in a manner that enables it to use its resources effectively and efficiently.

Potential for more than minimal harm · Administration Deficiencies · Tag F0835 · Complaint inspection · Deficient, Provider has date of correction (Jun 25, 2026)

FHave a plan that describes the process for conducting QAPI and QAA activities.

Potential for more than minimal harm · Administration Deficiencies · Tag F0865 · Deficient, Provider has date of correction (Jun 25, 2026)

FProvide 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 (Jun 25, 2026)

FEnsure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.

Potential for more than minimal harm · Nursing and Physician Services Deficiencies · Tag F0947 · Deficient, Provider has date of correction (Jun 25, 2026)

EHonor the resident's right to manage his or her financial affairs.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0567 · Deficient, Provider has date of correction (Jun 25, 2026)

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 (Jun 25, 2026)

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

Potential for more than minimal harm · Pharmacy Service Deficiencies · Tag F0757 · Deficient, Provider has date of correction (Jun 25, 2026)

EEnsure 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 (Jun 25, 2026)

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 (Jun 25, 2026)

DEnsure that residents are fully informed and understand their health status, care and treatments.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0552 · Deficient, Provider has date of correction (Jun 25, 2026)

DProperly hold, secure, and manage each resident's personal money which is deposited with the nursing home.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0568 · Deficient, Provider has date of correction (Jun 25, 2026)

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 (Jun 25, 2026)

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 (Jun 25, 2026)

DProvide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0628 · Deficient, Provider has date of correction (Jun 25, 2026)

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 (Jun 25, 2026)

DCoordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0644 · Deficient, Provider has date of correction (Jun 25, 2026)

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 (Jun 25, 2026)

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

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0677 · Deficient, Provider has date of correction (Jun 25, 2026)

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 (Jun 25, 2026)

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

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0689 · Complaint inspection · Deficient, Provider has date of correction (Jun 25, 2026)

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 (Jun 25, 2026)

DEnsure 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 (Jun 25, 2026)

DProvide 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 (Jun 25, 2026)

DImplement a program that monitors antibiotic use.

Potential for more than minimal harm · Infection Control Deficiencies · Tag F0881 · Deficient, Provider has date of correction (Jun 25, 2026)

DDevelop and implement policies and procedures for flu and pneumonia vaccinations.

Potential for more than minimal harm · Infection Control Deficiencies · Tag F0883 · Deficient, Provider has date of correction (Jun 25, 2026)

DEducate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.

Potential for more than minimal harm · Infection Control Deficiencies · Tag F0887 · Deficient, Provider has date of correction (Jun 25, 2026)

March 9, 2026 · 9 citations, includes immediate jeopardy · includes complaint inspection

JEnsure that residents are free from significant medication errors.

Immediate jeopardy · Pharmacy Service Deficiencies · Tag F0760 · Complaint inspection · Deficient, Provider has date of correction (Mar 9, 2026)

FFollow rules about disclosure of ownership requirements and tell the state agency about changes in ownership and/or administrative personnel.

Potential for more than minimal harm · Administration Deficiencies · Tag F0844 · Complaint inspection · Deficient, Provider has date of correction (Mar 9, 2026)

FDevelop, implement, and/or maintain an effective training program for all new and existing staff members.

Potential for more than minimal harm · Administration Deficiencies · Tag F0940 · Complaint inspection · Deficient, Provider has date of correction (Mar 10, 2026)

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 · Complaint inspection · Deficient, Provider has date of correction (Mar 9, 2026)

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 (Mar 10, 2026)

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

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0677 · Complaint inspection · Deficient, Provider has date of correction (Mar 10, 2026)

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 (Mar 9, 2026)

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

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0689 · Complaint inspection · Deficient, Provider has date of correction (Mar 10, 2026)

DProvide and implement an infection prevention and control program.

Potential for more than minimal harm · Infection Control Deficiencies · Tag F0880 · Complaint inspection · Deficient, Provider has date of correction (Mar 10, 2026)

January 15, 2026 · 1 citation · includes complaint inspection

FProvide and implement an infection prevention and control program.

Potential for more than minimal harm · Infection Control Deficiencies · Tag F0880 · Complaint inspection · Deficient, Provider has date of correction (Jan 16, 2026)

December 4, 2025 · 1 citation · includes complaint inspection

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

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0677 · Complaint inspection · Deficient, Provider has date of correction (Dec 5, 2025)

June 3, 2025 · 1 citation · includes complaint inspection

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

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0686 · Complaint inspection · Deficient, Provider has date of correction (Jun 17, 2025)

December 5, 2024 · 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 · Deficient, Provider has date of correction (Dec 20, 2024)

October 17, 2024 · 10 citations · includes complaint inspection

EDevelop and implement policies and procedures for flu and pneumonia vaccinations.

Potential for more than minimal harm · Infection Control Deficiencies · Tag F0883 · Deficient, Provider has date of correction (Nov 29, 2024)

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 (Nov 29, 2024)

DCoordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0644 · Deficient, Provider has date of correction (Nov 29, 2024)

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 (Nov 29, 2024)

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 (Nov 29, 2024)

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

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0686 · Complaint inspection · Deficient, Provider has date of correction (Nov 29, 2024)

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

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0689 · Deficient, Provider has date of correction (Nov 29, 2024)

DProvide care or services that was trauma informed and/or culturally competent.

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0699 · Deficient, Provider has date of correction (Nov 29, 2024)

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 (Nov 29, 2024)

DImplement a program that monitors antibiotic use.

Potential for more than minimal harm · Infection Control Deficiencies · Tag F0881 · Deficient, Provider has date of correction (Nov 29, 2024)

July 6, 2023 · 12 citations

FProcure 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 (Aug 10, 2023)

FProvide 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 (Aug 10, 2023)

DHonor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0561 · Deficient, Provider has date of correction (Aug 10, 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 (Aug 10, 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 (Aug 10, 2023)

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 (Aug 10, 2023)

DCoordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0644 · Deficient, Provider has date of correction (Aug 10, 2023)

DNotify the appropriate authorities when residents with MD or ID services has a significant change in condition.

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0646 · Deficient, Provider has date of correction (Aug 10, 2023)

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 (Aug 10, 2023)

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

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0686 · Deficient, Provider has date of correction (Aug 10, 2023)

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

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0689 · Deficient, Provider has date of correction (Aug 10, 2023)

DMake sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.

Potential for more than minimal harm · Environmental Deficiencies · Tag F0921 · Deficient, Provider has date of correction (Aug 10, 2023)

Questions to ask on a tour of Kimes Nursing and Rehab

  1. Inspectors cited the home at the immediate-jeopardy level on July 14, 2026 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 July 14, 2026. How are staff trained, and how are concerns reported?
  3. CMS rates staffing 1 out of 5. How many residents does each nurse aide care for on day, evening and night shifts?
  4. Nursing staff turnover was 83.9% a year. How many of the staff come from agencies?
  5. Several administrators left in the past year. What has changed for residents since then?
  6. CMS rates short-stay quality 1 out of 5. How often do rehab patients go back to the hospital, and how many therapy sessions a week are typical?
  7. Do you have a Medicaid bed open now, and will you admit someone whose Medicaid application is still pending?
  8. 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

3 penalties in the last three years, including $186,564 in fines.

DateTypeAmount or length
Jun 2, 2026 Fine $118,132
Jun 2, 2026 Payment Denial 20 days of payments denied
Mar 9, 2026 Fine $68,432

Rating history

CMS monthOverallInspectionStaffingQuality
October 2026 1/5 1/5 1/5 3/5
August 2026 1/5 1/5 1/5 2/5
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Location

Hospitals near Kimes Nursing and Rehab

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

The Laurels of Athens Athens · 3.1 mi away ★★☆☆☆ Inspection 2/5 · Staffing 4/5 111 beds · Medicaid
Hickory Creek of Athens The Plains · 4.2 mi away ★★★★☆ Inspection 4/5 · Staffing 2/5 90 beds · Medicaid
Arbors at Pomeroy Pomeroy · 15.5 mi away ★★★☆☆ Inspection 3/5 · Staffing 4/5 91 beds · Medicaid
Arcadia Valley Skilled Nursing and Rehabilitation Coolville · 17.4 mi away ★★☆☆☆ Inspection 2/5 · Staffing 3/5 50 beds · Medicaid
Maple Hills Skilled Nursing & Rehabilitation McArthur · 19.2 mi away ★★★☆☆ Inspection 2/5 · Staffing 2/5 42 beds · Medicaid

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Other Rhg Healthcare Services nursing homes in Ohio

Affiliation comes from CMS's affiliated-entity data, October 2026. All 3 Rhg Healthcare Services nursing homes ›

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/ohio/athens/kimes-nursing-and-rehab/ · Data: CMS, October 2026 · Nursing Homes In Each State, not affiliated with CMS or Medicare.