Oswego Operator, LLC

Location & what’s nearby

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Nearest of each type, straight-line distance. Hospitals come from the CMS Hospital General Information registry; everything else from Overture Maps (public data). Hospital and park hours are typical — call ahead to confirm.

Quality measures — how residents actually fare

Quality-measure stars summarize outcomes CMS tracks from the assessments each home submits — avoidable hospitalizations and ER visits, falls with injury, pressure ulcers, unplanned weight loss, and long-term antipsychotic use. Because the underlying data is self-reported, weigh a high score against the independent inspection record. Long-stay = permanent residents; short-stay = rehab and post-hospital stays.

Short-stay rehab — if you are coming here from a hospital

Arriving from a hospital right now? Read the discharge guide → — your appeal rights, how to slow a rushed discharge, and what to ask about the numbers below.

56.4% of the Medicare patients who left this home got back to the community and stayed there for at least 31 days — which CMS reads as no different from the national rate. This is CMS’s risk-adjusted rate over 29 Medicare stays in Oct 2022–Sep 2024, and CMS’s own comparison — not ours.

Therapy staffing: this home’s payroll records show 0.32 therapist hours per resident per day in 2026Q1 — more than 52% of the 13,892 homes that report any therapy hours at all.

Weekend therapy: weekend therapy hours are 5% of this home’s weekday level — it runs therapy on weekdays, with essentially none at the weekend. The median home that reports therapy runs 13% — weekday-focused therapy is the industry norm, not a shortfall. But recovery does not pause on a Saturday: ask what the weekend actually looks like here.

This section is about rehab stays, not living here. Most of this page — the stars, the quality measures, the inspection record — describes the home the way a permanent resident experiences it. These figures describe the short Medicare stay after a hospital discharge: a hip, a stroke, a bad infection, six weeks and home. They are different residents, different staff, often a different wing. Therapy hours are per resident in the building, not per rehab patient — the count includes every long-stay resident, and they mostly get no therapy at all. So a home with a small rehab wing inside a large nursing population reads low here even if its rehab patients get plenty of therapy, and a mostly-rehab home reads high. Use it to compare homes doing similar work, ask what a rehab resident actually gets in a day, and remember that CMS does not publish therapy minutes per patient — nobody does.

Staffing

How full it usually is: this home is certified for 40 beds and averages 30.1 residents a day — about 75% occupied, or roughly 10 beds typically open. It usually has some room. This is a CMS average, not live availability — no public source publishes real-time vacancies, and a home can be full the day you call. Confirm with the home, and if you need a Medicaid bed specifically, ask about that separately: a home with open beds may still not have an open Medicaid bed.

Against a benchmark — not a legal minimum. In May 2024 CMS finalized the first federal staffing floor for nursing homes: 3.48 total nurse hours per resident per day, including 0.55 RN hours and 2.45 nurse-aide hours. Its hour requirements never took effect and are no longer on the books. Homes had until 2026 (2027 if rural) to comply, and that deadline never arrived: a federal court vacated the hour requirements in April 2025 (CMS has appealed), Congress then barred enforcement until 2034, and CMS formally repealed them by rule effective February 2026. This home is not required to meet these numbers, and is not violating anything by missing them. We still show the comparison because the figures are CMS’s own published estimate of adequate staffing, which makes them a useful yardstick — but they are our benchmark, not federal law: this home’s total nurse staffing of 3.90 hrs/resident/day is at or above the 3.48-hour benchmark and RN staffing of 0.91 is at or above the 0.55-hour RN benchmark and nurse-aide staffing of 2.73 is at or above the 2.45-hour aide benchmark. What federal law does require today is unchanged: “sufficient” nursing staff for residents’ needs and an RN on duty at least 8 consecutive hours a day, 7 days a week (42 CFR 483.35). Those are judged by inspectors on site, not by these averages, so read this comparison alongside the inspection record rather than as a pass/fail.

Weekend coverage: total nurse staffing is 3.34 hrs/resident/day on weekends vs 4.12 on weekdays — 19% thinner on weekends. RN hours go from 0.95 to 0.81 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)

This home’s total nursing-staff turnover of 40% is about the same as the national median of 45%.

Payroll-based (PBJ) staffing hours, as reported for Jan–Mar 2026 (CMS PBJ CY2026Q1) — the most recent quarter CMS has published, so they can lag a change of operator or staffing agency. Higher is generally better. Registered-nurse coverage and weekend staffing are the numbers families most often overlook — an RN on site matters most when something goes wrong, and coverage usually thins on weekends. High turnover means residents rarely see the same caregiver twice. One caveat: these are hours as reported, not adjusted for how sick or heavy-care this home’s residents are. CMS separately publishes a case-mix-adjusted view; we show the reported hours. A home caring for higher-acuity residents needs more hours to deliver the same care, so compare these figures against homes doing similar work, and read them next to the inspection record rather than alone.

Inspection trend

Deficiencies are unchanged from the previous inspection. Fewer citations over time suggests a home is fixing problems; a rising count is a warning sign — though two surveys are a short record, and survey teams differ. These counts are from the standard annual health survey only; the full citation list below may also include findings from complaint investigations, so the two won’t always add up.

Inspection deficiencies

State health-inspection citations, most serious first. Each carries an F-code (the federal rule it cites, e.g. F-684 = quality of care) and a letter A–L marking how serious and how widespread the problem was — we translate that grid into the plain tiers shown here. Wording is the official federal description.

Each letter is a CMS scope-severity level; highlighted ones are where this home has citations. A–C = no harm found; D–F = potential for harm; G–I = actual harm; J–L = immediate jeopardy. Within each band the later letter is the more widespread finding (an isolated G is one resident; a widespread I is a pattern), so rightward and downward is worse.

18 citations, most serious first. The 11 most serious are shown; the remaining 7 are one tap away and print in full.

• Actual harm · G2022-08-16 · tag F0689 — failed to keep residents free of avoidable accidents; supervise adequately — isolated
  Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY The facility reported a census of 31 resident with 13 selected for review, including three reviewed for accident hazards. Based on observation, record review, and interview, the facility failed to implement an intervention following a fall to prevent further falls for one of the sampled residents, Resident (R)20. Additionally, the facility failed to implement an intervention following a laceration (wound to the skin) to his head which required medical treatment out of the facility, after he bumped it on the corner of a television, located in the common television room of the facility. Findings included: - The medical diagnosis tab in the electronic medical record (EMR) for Resident (R)20, included diagnoses of dementia (progressive mental disorder characterized by failing memory, confusion), unsteadiness on feet, muscle weakness, and abnormalities of gait (manner or style of walk) and mobility. The Quarterly Minimum Data Set (MDS) dated [DATE] assessed R20 with a Brief Interview of Mental Status (BIMS) score of…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Potential for harm · F2025-12-30 · tag F0812 — failed to store, cook, and serve food safely — widespread
  Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
  What the surveyor found here — an excerpt from the official record, may be distressing

  The facility reported a census of 29 residents and one kitchen. Based on observation, interview, and record review, the facility failed to provide sanitary conditions for food storage and preparation to prevent the spread of food borne illness to the residents of the facility. - Initial tour of the kitchen on 12/28/25 at 10:40 AM, revealed the following areas of concerns:There was an area on the floor at the entry to the kitchen from the dining area, approximately six inches long and one inch wide, that was missing tiles.There were multiple areas of the ceiling, including one area above the hand washing sink, that had flaking paint.There were three flies in the kitchen and an open tub of butter sitting on the counter next to an open bag of biscuits.There were various food waste items on the floor.In the food storage pantry, there was a package of spaghetti that was open with no date on the package.There was scattered flour on top of a flour container, the floor and on several shelves of a transport cart.The spice drawer had 16 open spice containers that were not dated. An opened…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
• Potential for harm · F2025-12-30 · tag F0924 — widespread
  Put firmly secured handrails on each side of hallways.
  What the surveyor found here — an excerpt from the official record, may be distressing

  The facility reported a census of 29 residents. Based on observation, interview and record review the facility failed to provide a safe and functional handrails in three of four hallways. Findings included:- Observed on 12/28/25 2:15 PM, there was a total of four loose handrails in the north resident hall. Observed on 12/29/25 at 09:53 AM, five handrails on the east resident hall were loose. There were three handrails on the south resident hall that were loose. Observed on 12/30/25 at 10:20 AM, administrative staff were checking the handrails throughout the building and marking those handrails that were loose for residents and staff to safely identify. During an interview on 12/30/25 at 09:44 AM, Administrative Nurse D stated that every employee was responsible and could submit work orders. Administrative Nurse D confirmed there were loose handrails on the resident halls. During an interview on 12/30/25 at 09:56 AM, Dietary GG stated every staff person was responsible for building maintenance and reporting damage. During an interview on 12/30/25 at 10:08 AM, Maintenance U stated…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Environmental Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2025-12-30 · tag F0628 — isolated
  Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
  What the surveyor found here — an excerpt from the official record, may be distressing

  The facility reported a census of 29 residents. The sample included 12 residents with four residents reviewed for hospitalization. Based on interview and record review, the facility failed to provide Resident (R) 4, R9, and R32 a written notification of transfer to the resident and/or his representative as soon as practicable and failed to send a copy of that notification to the ombudsman. The facility also failed to provide R4 or the responsible party with a bed hold. Findings included:1. R4's Electronic Medical Record (EMR) revealed a diagnosis of end-stage renal disease (ESRD- a terminal disease of the kidneys), cognitive communication deficit (an impairment in organization, sequencing, attention, memory, planning, problem-solving, and safety awareness), and dependance on dialysis (a procedure where impurities or wastes are removed from the blood).R4's Nursing Progress Note dated 08/20/25 at 06:38 PM documented R4 was not to eat or drink in the morning, and was to have a shower with Hibiclense (a strong hospital-grade antiseptic cleanser).R4's Nursing Progress Note dated 08/21/25…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Resident Rights Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2025-12-30 · tag F0658 — failed to meet professional standards of care — isolated
  Ensure services provided by the nursing facility meet professional standards of quality.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY The facility reported a census of 29 residents; there were 12 residents sampled, which included two residents selected for closed record review. Based on observation, interview, and record review the facility failed to ensure nursing documentation in Resident (R) 10's health record met the professional standards of care when staff repeatedly documented application and removal of compression stockings even when they were not applied, inaccurately representing the provision of treatments. Findings included:- R10's Electronic Medical Record (EMR) documented diagnosis of rhabdomyolysis (breakdown of damaged skeletal tissue), unspecified atrial fibrillation (rapid, irregular heartbeat), hypothyroidism (a condition characterized by decreased activity of the thyroid gland), and edema (swelling resulting from an excessive accumulation of fluid in the body tissues). R10's admission Minimum Data Set (MDS), dated [DATE], documented a Brief Interview for Mental Status (BIMS) score of nine, which indicated some cognitive…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Fcited before2024-05-20 · tag F0851 — widespread
  Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.
  What the surveyor found here — an excerpt from the official record, may be distressing

  The facility reported a census of 29 residents. Based on interview and record review, the facility failed to electronically submit to Centers for Medicare and Medicaid Services (CMS), complete and accurate direct care staffing information, including information for agency and contract staff, based on payroll and other verifiable and auditable data in a uniform format according to specifications established by CMS (i.e., Payroll Base Journal [PBJ]), related to licensed nursing coverage 24 hours/day. Findings included: - Review of the Payroll Base Journal (PBJ) Staffing Data Report for the second quarter of fiscal year (FY) 2023 (01/01/23 through 03/31/23), documented the facility lacked Licensed Nursing Coverage 24 hours/day on Sunday (SU) 01/01/2023, Saturday (SA) 01/07/2023, (SA) 01/15/23, (SU) 01/21/23, (SA) 01/29/23, (SU) 02/05/23 (SU), (SA) 02/11/23, (SA) 03/11/23, (SU) 03/12/23, (SA) 03/18, (SA) 03/25/23, and (SU) 03/26/23. Review of the facility's time sheets for licensed nursing staff and Staff Posting on the above dates, revealed the facility with RN coverage for eight…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Administration Deficiencies · Deficient, Provider has date of correction
• Potential for harm · F2024-05-20 · tag F0880 — failed to prevent and control infections — widespread
  Provide and implement an infection prevention and control program.
  What the surveyor found here — an excerpt from the official record, may be distressing

  The facility reported a census of 29 residents. Based on observation, interview, and record review, the facility failed to ensure staff distributed ice to residents in a sanitary manner, failed to sanitize glucometers with appropriate sanitizing agent and failed to ensure staff administered medications in a sanitary manner to prevent the spread of infections amongst the residents. Findings included: - Observation, on 05/15/24 at 10:05 AM, revealed housekeeping staff U distributed ice to residents' mugs. The ice was in a large, uncovered container on the snack cart with the scoop stored directly in the ice. Interview, at that time with housekeeping staff U, revealed she did not know the ice should have a lid and the scoop should be kept out of the ice. Interview, on 05/15/24 at 10:15 AM, with Administrative Staff A, confirmed she would expect staff to keep the ice in a covered container and the scoop separate from the ice to prevent contamination of the ice. The facility policy Food Preparation and Service dated 2024, instructed staff to serve food in a manner that complies with safe…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Infection Control Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Dcited before2024-05-20 · tag F0755 — failed to provide safe pharmacy services — isolated
  Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY The facility identified a census of 29 residents, with 13 residents sampled, including five residents reviewed for unnecessary medications. Based on interview, record review, and observation, the facility failed to follow physician's orders for one of the five sampled residents, Resident (R)20, regarding blood pressure (BP-the amount of force your blood uses to get through your arteries) parameters for this resident on anti-hypertensive (medication used to help control BP) medication. Findings included: - Review of Resident (R)20's electronic medical record (EMR) revealed a diagnosis of hypertension (HTN--elevated blood pressure BP). The Significant Change Minimum Data Set (MDS), dated [DATE], documented the staff assessment for cognition revealed severely impaired cognition and he had a diagnosis of HTN. The Functional Abilities (Self-Care and Mobility) Care Area Assessment (CAA), dated 02/16/24, did not trigger. The Quarterly MDS, dated 01/10/24, documented the staff assessment for cognition revealed severely…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Pharmacy Service Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Dcited before2024-05-20 · tag F0756 — failed to review each resident's drug regimen — isolated
  Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY The facility reported a census of 29 residents with 13 residents sampled, which included five residents reviewed for unnecessary medications. Based on observation, interview, and record review, the facility failed to ensure the consultant pharmacist identified and reported the facility's staff failure to obtain blood pressures (BP-the amount of force your blood uses to get through your arteries) for one Resident (R)20 prior to administering his anti-hypertensive medication (medication used to help control BP), as ordered. Findings included: - Review of Resident (R)20's electronic medical record (EMR) revealed a diagnosis of hypertension (HTN--elevated blood pressure BP). The Significant Change Minimum Data Set (MDS), dated [DATE], documented the staff assessment for cognition revealed severely impaired cognition and he had a diagnosis of HTN. The Functional Abilities (Self-Care and Mobility) Care Area Assessment (CAA), dated 02/16/24, did not trigger. The Quarterly MDS, dated 01/10/24, documented the staff…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Pharmacy Service Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2024-05-20 · tag F0881 — failed to use antibiotics responsibly — isolated
  Implement a program that monitors antibiotic use.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY The facility reported a census of 29 residents with 13 residents selected for review, which included five residents reviewed for unnecessary medications. Based on observation, interview, and record review, the facility failed to ensure nursing staff followed antibiotic stewardship for one of the five residents, Resident (R) 28, with a urinary tract infection with a microorganism resistant to the prescribed antibiotic. Findings included: - Review of Resident (R)28's electronic medical record revealed diagnoses that included diabetes (when the body cannot use glucose, not enough insulin made or the body cannot respond to the insulin), congestive heart failure (a condition with low heart output and the body becomes congested with fluid) and anxiety (mental or emotional reaction characterized by apprehension, uncertainty, and irrational fear). The admission Minimum Data Set (MDS), dated [DATE], assessed the resident with a Brief Interview for Mental Status Score (BIMS) of 15, which indicated normal cognitive…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Infection Control Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2022-08-16 · tag F0661 — isolated
  Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY The facility reported a census of 31 residents, with 13 residents sampled, including two sampled for discharge. Based on interview and record review, the facility failed to complete a discharge summary from the facility, which included a recapitulation of resident (R)33's stay at the facility. Findings included: - Review of Resident's (R)33's, undated Physician Orders, revealed diagnoses included, malignant neoplasm of the brain (brain cancer/tumor), osteoarthritis (degenerative changes to one or many joints characterized by swelling and pain), chemotherapy, and sepsis (infection of the blood). The admission Minimum Data Set (MDS) dated [DATE], documented the resident admitted on [DATE], with a Brief Interview for Mental Status (BIMS) score of 15, which indicated cognitively intact. The discharge plan addressed the goal for the resident to return to the community. He did not need a referral to the local contact agency. The ADL Functional/Rehabilitation Potential Care Area Assessment (CAA), dated 06/08/22,…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction

“Cited before” means this same F-tag appears on at least one other survey date in the record we hold — counting complaint investigations as well as standard surveys, with no time limit. It is our own read of the data, not CMS’s: CMS uses repeat deficiency as a formal term tied to consecutive standard surveys, and that is a narrower test than this one. A tag marked here may or may not meet it.

Fines & penalties

No federal fines in the current CMS record.

Part of a chain

This home belongs to MISSION HEALTH COMMUNITIES — 30 facilities. Here is how its ratings compare with the chain’s average across all its homes: See the whole chain — ratings, flags, fines and finances →

A home rated well below its chain’s average can signal local problems; a chain with a low average across the board is a bigger pattern worth researching. CMS chain data under-reports private-equity and REIT ownership, so treat this as a floor, not the full picture.

Who owns this facility

CMS files one row per role, so the 13 rows in the source record cover these 10 parties — each is shown once here with every role it holds. Nothing is omitted.

5 organizational owners listed — a facility can be part of a larger chain. CMS ownership data is known to under-report private-equity and REIT ties; treat as a starting point.

Follow the money — this home’s finances

Where a nursing home’s revenue comes from and where it goes — including money paid to companies under the same ownership. Most consumer sites never show this; we reproduce it straight from the Medicare cost report.

This home reported $194K paid to related parties (affiliated landlords or management companies) in its most recent cost report.

Source: CMS Healthcare Provider Cost Reporting Information System (HCRIS), Medicare cost report Form CMS-2540 · fiscal year 2023. Facilities self-file these reports; figures are unaudited and a year or two behind. A home with no Medicare cost report on file shows no figures here.

Cost & finances

Straight from this home’s Medicare cost report (CMS, FY2023). These are its operating economics — what it costs to run per resident-day and what it collects on average across Medicare, Medicaid, and private pay — not a private-pay quote. Your out-of-pocket cost depends on payer and room type, so ask the facility directly; a higher operating cost can reflect richer staffing or a sicker population. The cost-of-care planner shows regional benchmarks by care type.

What families pay in KS