Missoula, MT

Riverside Health & Rehabilitation

4-star overall rating with 3-star inspections with $11,027 in total fines with 16 recent health deficiencies with 5 fire-safety deficiencies in the latest cycle

1301 E Broadway, Missoula, MT

(406) 721-0680

Compare this facility

Overall

4 / 5

CMS overall stars

Health inspections

3 / 5

Survey and complaint cycles

Staffing

3 / 5

RN + nurse staffing

Quality measures

5 / 5

Resident outcomes and process measures

Quick facts

Facility snapshot

Beds

72

Certified beds

Average residents

69

Average occupied residents

Ownership

For-Profit

Publicly displayed owner type

Chain

The Goodman Group

Operator or chain grouping

Approved since

1988-12-13

CMS approved date

Coverage

Medicare + Medicaid

Participation flags

Chain footprint

10 facilities

Chain averages 3 overall / 3 health / 4 staffing / 4 quality stars

Changed ownership

No

Within the last 12 months

Family council

Yes

Resident and family council reported

Sprinklers

Yes

Automatic sprinklers in all required areas

Staffing

Hours and turnover

RN hours / resident day

0.81

Registered nurse staffing · state 0.94 · national 0.68

LPN hours / resident day

0.27

Licensed practical nurse staffing · state 0.51 · national 0.87

Aide hours / resident day

2.61

Nurse aide staffing · state 2.53 · national 2.35

Total nurse hours

3.70

All reported nurse hours · state 3.97 · national 3.89

Licensed hours

1.08

RN + LPN hours · state 1.44 · national 1.54

Weekend hours

3.44

Weekend nurse staffing · state 3.48 · national 3.43

Weekend RN hours

0.57

Weekend registered nurse coverage · state 0.69 · national 0.47

Physical therapist

0.03

Reported PT staffing · state 0.08 · national 0.07

Adjusted RN hours

0.89

CMS adjusted RN staffing hours

Adjusted total hours

4.03

CMS adjusted total nurse staffing hours

Case-mix index

1.25

Higher values indicate more complex resident acuity

RN turnover

59%

Annual RN turnover · state 46% · national 45%

Total nurse turnover

63%

Annual nurse turnover · state 56% · national 46%

SNF VBP

Value-based purchasing

Program rank

7,382

Lower is better among SNFs in the FY 2026 VBP program.

Performance score

29.9

Composite VBP score used to determine payment impact.

Payment multiplier

0.9857

Above 1.000 increases Medicare payment; below 1.000 reduces it.

Program components

How the VBP score is built

Readmission

3.87

Baseline 15.68% · Performance 19.64% · Measure score 3.87 · Achievement 3.87 · Improvement 0

Healthcare-associated infections

4.21

Baseline 6.03% · Performance 6.58% · Measure score 4.21 · Achievement 4.21 · Improvement 0

Total nurse turnover

1.06

Baseline 73.53% · Performance 65.93% · Measure score 1.06 · Achievement 0 · Improvement 1.06

Adjusted total nurse staffing

2.82

Baseline 3.70 hours · Performance 3.88 hours · Measure score 2.82 · Achievement 2.82 · Improvement 0.36

SNF QRP

Medicare quality reporting measures

Measure Facility National Note
Potentially preventable 30-day readmission 8.74%
10.72%
2 pts better
No Different than the National Rate · Eligible stays 156 · Observed rate 5.77% · Lower 95% interval 5.67%
Discharge to community 53.29%
50.57%
2.7 pts better
No Different than the National Rate · Eligible stays 159 · Observed rate 48.43% · Lower 95% interval 45.05%
Medicare spending per beneficiary 1.03
1.02
About the same
Drug regimen review with follow-up 99.05%
95.27%
3.8 pts better
Numerator 104 · Denominator 105
Falls with major injury 0.95%
0.77%
0.2 pts worse
Numerator 1 · Denominator 105
Discharge self-care score 46.48%
53.69%
7.2 pts worse
Numerator 33 · Denominator 71
Discharge mobility score 45.07%
50.94%
5.9 pts worse
Numerator 32 · Denominator 71
Pressure ulcers or injuries, new or worsened 2.86%
2.29%
0.6 pts worse
Numerator 3 · Denominator 105 · Adjusted rate 3.44%
Healthcare-associated infections requiring hospitalization 6.58%
7.12%
0.5 pts better
No Different than the National Rate · Eligible stays 94 · Observed rate 5.32% · Lower 95% interval 4.11%
Staff COVID-19 vaccination coverage 0.92%
8.2%
7.3 pts worse
Numerator 1 · Denominator 109
Staff flu vaccination coverage 41.59%
42%
0.4 pts worse
Numerator 47 · Denominator 113
Discharge function score 57.75%
56.45%
1.3 pts better
Numerator 41 · Denominator 71
Transfer of health information to provider 100%
95.95%
4 pts better
Numerator 28 · Denominator 28
Transfer of health information to patient 98.41%
96.28%
2.1 pts better
Numerator 62 · Denominator 63
Resident COVID-19 vaccinations up to date 41.38%
25.2%
16.2 pts better
Numerator 24 · Denominator 58

Quality measures

Resident outcomes and process scores

Measure Facility State National Note
Number of hospitalizations per 1000 long-stay resident days 0.9
1.3
0.4 pts better
1.9
1 pts better
Long Stay · 20240701-20250630 · Adjusted 0.9 · Observed 0.8 · Expected 1.7 · Used in QM five-star
Number of outpatient emergency department visits per 1000 long-stay resident days 0.6
2.2
1.6 pts better
1.8
1.2 pts better
Long Stay · 20240701-20250630 · Adjusted 0.6 · Observed 0.5 · Expected 1.4 · Used in QM five-star
Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine 99.1%
94.4%
4.7 pts better
93.4%
5.7 pts better
Long Stay · 2024Q4-2025Q3 · Q1 96.2% · Q2 100.0% · Q3 100.0% · Q4 100.0% · 4Q avg 99.1%
Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine 94.4%
93.7%
0.7 pts better
95.5%
1.1 pts worse
Long Stay · 2024Q3-2025Q2 · 4Q avg 94.4%
Percentage of long-stay residents experiencing one or more falls with major injury 0.5%
4.2%
3.7 pts better
3.3%
2.8 pts better
Long Stay · 2024Q4-2025Q3 · Q1 1.9% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.5% · Used in QM five-star
Percentage of long-stay residents who have depressive symptoms 3.3%
4.7%
1.4 pts better
11.4%
8.1 pts better
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 9.1% · Q4 3.6% · 4Q avg 3.3%
Percentage of long-stay residents who lose too much weight 8.5%
5.9%
2.6 pts worse
5.4%
3.1 pts worse
Long Stay · 2024Q4-2025Q3 · Q1 10.0% · Q2 10.2% · Q3 6.0% · Q4 7.8% · 4Q avg 8.5%
Percentage of long-stay residents who received an antianxiety or hypnotic medication 3.8%
17.4%
13.6 pts better
19.6%
15.8 pts better
Long Stay · 2024Q4-2025Q3 · Q1 2.0% · Q2 3.9% · Q3 3.8% · Q4 5.5% · 4Q avg 3.8%
Percentage of long-stay residents who received an antipsychotic medication 12.1%
20.6%
8.5 pts better
16.7%
4.6 pts better
Long Stay · 2024Q4-2025Q3 · Q1 12.2% · Q2 11.4% · Q3 13.6% · Q4 11.1% · 4Q avg 12.1% · Used in QM five-star
Percentage of long-stay residents who were physically restrained 0.0%
0.4%
0.4 pts better
0.1%
0.1 pts better
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0%
Percentage of long-stay residents whose ability to walk independently worsened 15.5%
19.7%
4.2 pts better
16.3%
0.8 pts better
Long Stay · 2024Q4-2025Q3 · 4Q avg 15.5% · Used in QM five-star
Percentage of long-stay residents whose need for help with daily activities has increased 16.8%
19.8%
3 pts better
14.9%
1.9 pts worse
Long Stay · 2024Q4-2025Q3 · Q1 25.0% · Q2 10.4% · Q3 14.0% · Q4 18.0% · 4Q avg 16.8% · Used in QM five-star
Percentage of long-stay residents with a catheter inserted and left in their bladder 1.9%
2.6%
0.7 pts better
1.0%
0.9 pts worse
Long Stay · 2024Q4-2025Q3 · Q1 1.8% · Q2 1.3% · Q3 3.1% · Q4 1.3% · 4Q avg 1.9% · Used in QM five-star
Percentage of long-stay residents with a urinary tract infection 1.4%
2.9%
1.5 pts better
1.7%
0.3 pts better
Long Stay · 2024Q4-2025Q3 · Q1 1.9% · Q2 0.0% · Q3 1.9% · Q4 1.8% · 4Q avg 1.4% · Used in QM five-star
Percentage of long-stay residents with new or worsened bowel or bladder incontinence 25.4%
25.4%
About the same
19.8%
5.6 pts worse
Long Stay · 2024Q4-2025Q3 · Q1 23.9% · Q2 17.2% · Q3 33.9% · Q4 26.9% · 4Q avg 25.4%
Percentage of long-stay residents with pressure ulcers 9.1%
6.4%
2.7 pts worse
5.1%
4 pts worse
Long Stay · 2024Q4-2025Q3 · Q1 15.6% · Q2 7.7% · Q3 8.3% · Q4 5.0% · 4Q avg 9.1% · Used in QM five-star
Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine 97.0%
78.7%
18.3 pts better
81.7%
15.3 pts better
Short Stay · 2024Q4-2025Q3 · Q1 94.2% · Q2 97.4% · Q3 97.5% · Q4 98.7% · 4Q avg 97.0%
Percentage of short-stay residents who had an outpatient emergency department visit 10.7%
15.0%
4.3 pts better
12.0%
1.3 pts better
Short Stay · 20240701-20250630 · Adjusted 10.7% · Observed 10.2% · Expected 10.6% · Used in QM five-star
Percentage of short-stay residents who newly received an antipsychotic medication 0.5%
1.6%
1.1 pts better
1.6%
1.1 pts better
Short Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 2.0% · Q4 0.0% · 4Q avg 0.5% · Used in QM five-star
Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine 76.9%
73.8%
3.1 pts better
79.7%
2.8 pts worse
Short Stay · 2024Q3-2025Q2 · 4Q avg 76.9%
Percentage of short-stay residents who were rehospitalized after a nursing home admission 15.9%
19.4%
3.5 pts better
23.9%
8 pts better
Short Stay · 20240701-20250630 · Adjusted 15.9% · Observed 14.3% · Expected 21.4% · Used in QM five-star

Survey summary

Recent inspection cycles

Cycle 1 Health 2024-11-07 · Fire 2024-11-07

16 health deficiencies

Top issue: Resident Assessment and Care Planning (5 deficiencies)

5 fire-safety deficiencies

Top issue: Gas and Vacuum and Electrical Systems (2 deficiencies)

Cycle 2 Health 2023-11-20 · Fire 2023-11-20

6 health deficiencies

Top issue: Infection Control (2 deficiencies)

8 fire-safety deficiencies

Top issue: Smoke (3 deficiencies)

Cycle 3 Health 2022-09-15 · Fire 2022-09-15

9 health deficiencies

Top issue: Quality of Life and Care (4 deficiencies)

2 fire-safety deficiencies

Top issue: Egress (2 deficiencies)

Fire safety

Fire-safety citations

E · Potential for more than minimal harm 2024-11-07

K222 · Egress Deficiencies

Fire Safety

Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.

Corrected 2024-12-31

E · Potential for more than minimal harm 2024-11-07

K920 · Gas, Vacuum, and Electrical Systems Deficiencies

Fire Safety

Ensure proper usage of power strips and extension cords.

Corrected 2024-12-31

D · Potential for more than minimal harm 2024-11-07

K363 · Smoke Deficiencies

Fire Safety

Install corridor and hallway doors that block smoke.

Corrected 2024-12-31

D · Potential for more than minimal harm 2024-11-07

K911 · Gas, Vacuum, and Electrical Systems Deficiencies

Fire Safety

Meet requirements for the installation and maintenance of electrical systems.

Corrected 2024-12-31

C · Minimal harm 2024-11-07

K353 · Smoke Deficiencies

Fire Safety

Inspect, test, and maintain automatic sprinkler systems.

Corrected 2024-12-31

F · Potential for more than minimal harm 2023-11-20

E39 · Emergency Preparedness Deficiencies

Fire Safety

Conduct testing and exercise requirements.

Corrected 2024-01-05

F · Potential for more than minimal harm 2023-11-20

K712 · Miscellaneous Deficiencies

Fire Safety

Have simulated fire drills held at unexpected times.

Corrected 2023-12-11

F · Potential for more than minimal harm 2023-11-20

K918 · Gas, Vacuum, and Electrical Systems Deficiencies

Fire Safety

Have generator or other power source capable of supplying service within 10 seconds.

Corrected 2023-12-11

F · Potential for more than minimal harm 2023-11-20

K921 · Gas, Vacuum, and Electrical Systems Deficiencies

Fire Safety

Ensure that testing and maintenance of electrical equipment is performed.

Corrected 2024-01-11

E · Potential for more than minimal harm 2023-11-20

K374 · Smoke Deficiencies

Fire Safety

Install smoke barrier doors that can resist smoke for at least 20 minutes.

Corrected 2023-12-11

D · Potential for more than minimal harm 2023-11-20

K225 · Egress Deficiencies

Fire Safety

Have stairways and smokeproof enclosures used as exits that meet safety requirements.

Corrected 2023-12-11

D · Potential for more than minimal harm 2023-11-20

K341 · Smoke Deficiencies

Fire Safety

Install a fire alarm system that can be heard throughout the facility.

Corrected 2023-12-11

D · Potential for more than minimal harm 2023-11-20

K355 · Smoke Deficiencies

Fire Safety

Properly select, install, inspect, or maintain portable fire extinguishes.

Corrected 2023-12-11

F · Potential for more than minimal harm 2022-09-15

K222 · Egress Deficiencies

Fire Safety

Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.

Corrected 2022-10-31

E · Potential for more than minimal harm 2022-09-15

K223 · Egress Deficiencies

Fire Safety

Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.

Corrected 2022-10-31

Inspection history

Recent health citations

D · Potential for more than minimal harm 2026-01-15

F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies

Health

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

Corrected 2026-01-08

D · Potential for more than minimal harm 2025-03-25

F657 · Resident Assessment and Care Planning Deficiencies

Health

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

Corrected 2025-04-24

D · Potential for more than minimal harm 2025-03-25

F686 · Quality of Life and Care Deficiencies

Health

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

Corrected 2025-04-24

E · Potential for more than minimal harm 2024-11-07

F550 · Resident Rights Deficiencies

Health

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

Corrected 2024-12-07

E · Potential for more than minimal harm 2024-11-07

F585 · Resident Rights Deficiencies

Health

Honor 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.

Corrected 2024-12-07

E · Potential for more than minimal harm 2024-11-07

F791 · Quality of Life and Care Deficiencies

Health

Provide or obtain dental services for each resident.

Corrected 2024-12-07

E · Potential for more than minimal harm 2024-11-07

F919 · Environmental Deficiencies

Health

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

Corrected 2024-12-07

D · Potential for more than minimal harm 2024-11-07

F558 · Resident Rights Deficiencies

Health

Reasonably accommodate the needs and preferences of each resident.

Corrected 2024-12-07

D · Potential for more than minimal harm 2024-11-07

F641 · Resident Assessment and Care Planning Deficiencies

Health

Ensure each resident receives an accurate assessment.

Corrected 2024-12-07

D · Potential for more than minimal harm 2024-11-07

F655 · Resident Assessment and Care Planning Deficiencies

Health

Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted

Corrected 2024-12-07

D · Potential for more than minimal harm 2024-11-07

F656 · Resident Assessment and Care Planning Deficiencies

Health

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

Corrected 2024-12-07

D · Potential for more than minimal harm 2024-11-07

F657 · Resident Assessment and Care Planning Deficiencies

Health

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

Corrected 2024-12-07

D · Potential for more than minimal harm 2024-11-07

F685 · Quality of Life and Care Deficiencies

Health

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

Corrected 2024-12-07

D · Potential for more than minimal harm 2024-11-07

F761 · Pharmacy Service Deficiencies

Health

Ensure 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.

Corrected 2024-12-07

D · Potential for more than minimal harm 2024-11-07

F810 · Nutrition and Dietary Deficiencies

Health

Provide special eating equipment and utensils for residents who need them and appropriate assistance.

Corrected 2024-12-07

B · Minimal harm 2024-11-07

F567 · Resident Rights Deficiencies

Health

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

Corrected 2024-12-07

E · Potential for more than minimal harm 2023-11-20

F585 · Resident Rights Deficiencies

Health

Honor 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.

Corrected 2023-12-22

E · Potential for more than minimal harm 2023-11-20

F804 · Nutrition and Dietary Deficiencies

Health

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

Corrected 2023-12-22

E · Potential for more than minimal harm 2023-11-20

F880 · Infection Control Deficiencies

Health

Provide and implement an infection prevention and control program.

Corrected 2023-12-22

D · Potential for more than minimal harm 2023-11-20

F695 · Quality of Life and Care Deficiencies

Health

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

Corrected 2023-12-22

D · Potential for more than minimal harm 2023-11-20

F761 · Pharmacy Service Deficiencies

Health

Ensure 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.

Corrected 2023-12-22

D · Potential for more than minimal harm 2023-11-20

F883 · Infection Control Deficiencies

Health

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

Corrected 2023-12-26

G · Actual harm 2023-07-06

F726 · Nursing and Physician Services Deficiencies

Health

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

Corrected 2023-08-03

E · Potential for more than minimal harm 2023-07-06

F609 · Freedom from Abuse, Neglect, and Exploitation Deficiencies

Health

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

Corrected 2023-08-03

D · Potential for more than minimal harm 2023-07-06

F657 · Resident Assessment and Care Planning Deficiencies

Health

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

Corrected 2023-08-03

D · Potential for more than minimal harm 2023-07-06

F684 · Quality of Life and Care Deficiencies

Health

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

Corrected 2023-08-03

D · Potential for more than minimal harm 2023-07-06

F689 · Quality of Life and Care Deficiencies

Health

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

Corrected 2023-08-03

F · Potential for more than minimal harm 2022-09-15

F677 · Quality of Life and Care Deficiencies

Health

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

Corrected 2022-10-30

E · Potential for more than minimal harm 2022-09-15

F584 · Resident Rights Deficiencies

Health

Honor 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.

Corrected 2022-10-30

D · Potential for more than minimal harm 2022-09-15

F657 · Resident Assessment and Care Planning Deficiencies

Health

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

Corrected 2022-10-30

D · Potential for more than minimal harm 2022-09-15

F689 · Quality of Life and Care Deficiencies

Health

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

Corrected 2022-10-30

Penalties and ownership

What sits behind the stars

$11,027 2023-07-06

Fine

Fine · fine $11,027

Fine

Ownership

John B. Goodman 2006 Irrv Grantor Tr

5% Or Greater Indirect Ownership Interest · Organization

25% 7 facilities 2017-02-28
Benson, Randall

5% Or Greater Indirect Ownership Interest · Individual

10% 7 facilities 2017-02-28
Salmen, Thomas

5% Or Greater Indirect Ownership Interest · Individual

10% 9 facilities 2017-02-28
Weichert, James

5% Or Greater Indirect Ownership Interest · Individual

10% 9 facilities 2017-02-28
Wilson, Mark

5% Or Greater Indirect Ownership Interest · Individual

10% 16 facilities 2017-02-28
Benson, Randall

General Partnership Interest · Individual

0% 7 facilities 2017-02-28
Benson, Randall

Corporate Officer · Individual

0% 7 facilities 2015-06-26
Caron Corporation

5% Or Greater Direct Ownership Interest · Organization

0% 1 facilities 1988-11-01
Caron Corporation

General Partnership Interest · Organization

0% 1 facilities 1998-11-01
Edinger, Craig

Corporate Officer · Individual

0% 9 facilities 2016-10-21
Jbgrs Inc

5% Or Greater Direct Ownership Interest · Organization

0% 1 facilities 1996-01-01
Jbgrs Inc

General Partnership Interest · Organization

0% 1 facilities 2010-07-14
John B. Goodman 2006 Irrv Grantor Tr

General Partnership Interest · Organization

0% 7 facilities 2017-02-28
Knacke, Clinton

Corporate Officer · Individual

0% 10 facilities 2022-10-12
Olson, Denise

Corporate Officer · Individual

0% 7 facilities 2013-09-16
Riverside Health Care Center

5% Or Greater Direct Ownership Interest · Organization

0% 1 facilities 1987-09-04
Salmen, Thomas

General Partnership Interest · Individual

0% 9 facilities 2017-02-28
Waylett, Annie

W-2 Managing Employee · Individual

0% 1 facilities 2020-12-04
Weichert, James

General Partnership Interest · Individual

0% 9 facilities 2017-02-28
Weichert, James

Corporate Director · Individual

0% 9 facilities 2017-03-30
Wilson, Mark

General Partnership Interest · Individual

0% 16 facilities 2017-02-28

Nearby options

Other facilities in reach

#2

Village Health & Rehabilitation

Missoula, MT

3-star overall rating with 3-star inspections with $27,846 in total fines with 8 recent health deficiencies with 7 fire-safety deficiencies in the latest cycle

Overall
3 / 5
Health
3 / 5
Staffing
4 / 5
Fines
$27,846
#3

The Living Centre

Stevensville, MT

5-star overall rating with 4-star inspections with $37,525 in total fines with 2 recent health deficiencies with 4 fire-safety deficiencies in the latest cycle

Overall
5 / 5
Health
4 / 5
Staffing
5 / 5
Fines
$37,525

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