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The update to the Overall Hospital Quality Star Rating methodology beginning in CY 2027 that will reduce the Overall Hospital Quality Star Rating of any hospital in the lowest quartile of Safety of Care (based on at least three measure scores) by 1 star, to a minimum 1-star rating (Stage 2 methodological change) would have resulted in 459 (9.90 percent) hospitals receiving a lower Overall Hospital Quality Star Rating (in the simulation)

When investigating elevated B12, additional tests such as active B12 (holotranscobalamin), methylmalonic acid, and homocysteine may help clarify true B12 status

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As the activated sludge degrades materials in the wastewater, masses of biological material agglomerate into clumps called flocs