Meadow Lake Senior Living – Tyler
Nursing Home, Assisted Living & Memory Care · Tyler, TX
CMS overall rating Info The Overall CMS Rating is scored from 1 to 5 stars and combines results from health inspections, staffing levels, and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.

Meadow Lake Senior Living – Tyler

Nursing Home, Assisted Living & Memory Care · Tyler, TX
CMS overall rating Info The Overall CMS Rating is scored from 1 to 5 stars and combines results from health inspections, staffing levels, and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
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Meadow Lake Senior Living – Tyler accepts Medicare and private pay.

Overview of Meadow Lake Senior Living – Tyler

Meadow Lake Senior Living is a vibrant senior living community for adults and seniors who wish to retire in a luxurious community. Offering residential assisted living, independent living, memory care, and skilled nursing services– the nurturing environment empowers and enhances the quality of life for residents by providing tailored care to each unique individual. Residents are given the freedom and choice to build a lifestyle on their terms with the unwavering support of the professional staff.

Meadow Lake’s all-inclusive amenities include delicious and nutritious daily meals, weekly housekeeping and laundry, transportation to and from, specialized programs, social gatherings, and educational activities. 

(903) 526-5599

Quality ratings

Measured by Centers for Medicare & Medicaid Services (CMS)

Overall rating Info The Overall CMS Rating combines results from health inspections, staffing levels and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
▲ 66.1% Above TX avg.
Health Inspection Info Based on the results of the facility's three most recent standard inspections and any complaint investigations. CMS reviews the number, scope, and severity of deficiencies, with more recent findings weighted more heavily.
▲ 73.0% Above TX avg.
Staffing Info Measures average nursing staff hours per resident per day, including Registered Nurses (RNs) and total nursing staff. Ratings are adjusted based on the level of care residents require and are compared to state and national benchmarks.
▲ 66.7% Above TX avg.
Quality Measures Info Based on clinical and physical health indicators reported to CMS, such as hospital readmissions, falls, pressure ulcers, and improvements in mobility. These measures reflect how well residents' health needs are being managed.
At TX avg.

Staffing hours breakdown

Info Daily nursing hours per resident by staff type, reported to CMS. Higher is generally better — compare this facility to state and national averages to see where staffing stands.

Hours per resident per day — compared to Texas state averages

Total nursing care / resident Info This home is ranked 52nd out of 240 homes in Texas.

Total adjusted nursing hours per resident per day, combining RN, LPN, and aide time. CMS adjusts this for case-mix so facilities can be fairly compared.
4h 18m per day
Rank #52 / 240Nurse hours — state benchmarkedThis home is ranked 52nd out of 240 homes in Texas.Shows adjusted nurse hours per resident per day benchmarked to the Texas average, with a ranking across 240 Texas SNFs. More hours mean more direct care. The national average is about 3.5 hrs; below 3.0 is a red flag.
This facility Texas avg (3h 47m per day)
vs Texas avg
+14%

2 of 6 metrics below state avg

Standout metric Registered Nurse (RN) is +177% above state avg
Staff type Hours / day vs state avg
Registered Nurse (RN) Info RNs hold the highest nursing license and can assess residents, interpret test results, and direct care plans. More RN hours per day often signals stronger clinical oversight and faster response to health changes. 1h 12m per day ▲ 177% State avg: 26m per day · National avg: 41m per day
LPN / LVN Info Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs) deliver routine hands-on care — medication administration, wound dressing, and monitoring vital signs. They work under RN supervision and make up a large share of daily bedside care. 24m per day ▼ 58% State avg: 57m per day · National avg: 52m per day
Nurse Aide Info Certified Nurse Aides (CNAs) provide the most direct day-to-day assistance: bathing, dressing, feeding, and mobility. Nurse aide hours are typically the largest staffing category and directly affect residents' quality of life. 2h 32m per day ▲ 26% State avg: 2h 1m per day · National avg: 2h 21m per day
Total Nursing (Weekend) Info Combined nursing hours (RN + LPN + Nurse Aide) per resident per day on weekends. Staffing often drops on weekends — this figure reveals whether the facility maintains adequate coverage outside of weekday hours. 3h 26m per day ▲ 15% State avg: 2h 59m per day · National avg: 3h 26m per day
Physical Therapist Info Hours per resident per day provided by licensed Physical Therapists (PTs) or PT Assistants. PT services help residents recover mobility after injury or illness and are especially important for post-acute (short-stay) rehabilitation. 3m per day ▼ 25% State avg: 4m per day · National avg: 4m per day
RN (Weekend) Info Registered nurse hours specifically on weekends. Facilities sometimes reduce RN presence on Saturdays and Sundays — a low weekend RN figure compared to weekday hours can indicate reduced clinical oversight when most administrative staff are absent. 50m per day ▲ 138% State avg: 21m per day · National avg: 29m per day

Capacity and availability

This home usually has availability

Occupancy lower than 85% suggests more openings may be available.

Higher occupancy than the Texas average: 63.5%
Occupancy rate 80.1% Rank #67 / 252Occupancy rate — state benchmarkedThis home is ranked 67th out of 252 homes in Texas.Shows this facility's occupancy rate versus the Texas average, with its statewide rank out of 252. Higher occupancy signals strong local demand and financial stability.
Avg. Length of Stay 70 days
Occupancy rate
80.1% Rank #67 / 252Occupancy rate — state benchmarkedThis home is ranked 67th out of 252 homes in Texas.Shows this facility's occupancy rate versus the Texas average, with its statewide rank out of 252. Higher occupancy signals strong local demand and financial stability.
Avg. Length of Stay
70 days

Who this home usually serves

TYPE OF STAY

Mostly short-term rehab stays

Most residents typically stay for a few weeks or months before returning home or moving on.

Breakdown by payment type

Medicare

70% of new residents, usually for short-term rehab.

Typical stay 29 days

Private pay

30% of new residents, often for short stays.

Typical stay 6 - 7 months

Finances and operations

Voluntary non-profit community
Home revenue
$11.3M
Operating deficit
-$5.6M
Voluntary non-profit community
Home revenue
$11.3M Rank #108 / 252Revenue — state benchmarkedThis home is ranked 108th out of 252 homes in Texas.Shows this facility's annual revenue compared to the Texas SNF average. Higher revenue generally means more resources for staffing and capital — read alongside Payroll %.
Operating deficit
-$5.6M
Payroll costs Info The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations. Rank #114 / 252Payroll — state benchmarkedThis home is ranked 114th out of 252 homes in Texas.Shows total annual staff payroll benchmarked to the Texas average. Higher payroll investment relative to peers often signals better staffing and less reliance on cheaper contract labor.
$5.6M
49.6% of revenue Rank #125 / 230Payroll % — state benchmarkedThis home is ranked 125th out of 230 homes in Texas.Shows payroll as a percentage of revenue versus the Texas average. Well-run SNFs often land around 55–65%. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings.
Other operating costs Info All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
$11.3M
Total costs $16.9M
Years in operation
15 years in operation
A community with a solid operating history and experience delivering ongoing care.
Walk Score
Walk Score: 33 / 100 Rank #147 / 207Walk Score — state benchmarkedThis home is ranked 147th out of 207 homes in Texas.Shows how walkable this facility's neighborhood is compared to the average Walk Score across Texas SNFs. Higher scores benefit residents, families, and staff.
Somewhat walkable. A few nearby services may be reachable on foot, but most trips require transportation.
BBB Rating
BBB Rating: A+ (Accredited)
An independent rating from the Better Business Bureau based on factors such as complaint history, transparency, and business practices.
How BBB ratings work

About this community

Awards

Awards5-Star Rating from Centers for Medicare & Medicaid Services

License Details

License Number104686

Safety & Compliance

Secured Perimeter
Safety FeaturesEmergency response system.

Staffing

Key information about the people who lead and staff this community.

Leadership

ContactDavid Gustafson, Executive Director

Payment & Insurance

1 service
Accept Medicare

Therapy & Rehabilitation

2 services
Rehabilitation Services
Respite Care

Staffing & Medical

1 service
24-Hour Staffing

Amenities & Lifestyle

Multiple Dining Venues
Five-Acre Lake
Walking Trails
Rustic Community Lodge
Clubs
Classes
Hobby Groups
Private Dining Room
Catering Services
Priority Access To Health Center
Personal Safe In Each Home
Exercise Area
Beauty Salon
Arts And Crafts
Library
Cards And Game Room
Gated Campus
Scheduled Transportation
Active Life Enrichment Program
ActivitiesActivities include clubs, classes, and hobby groups.

Dining & Nutrition

Food DescriptionFulfilling, mouth-watering, and nutritious meals are offered daily by a dining team who serves with excellence.

What does this home offer?

Pets allowed icon
Pets allowed icon

Pets Allowed

Housing options icon
Housing options icon

Housing Options: 1 Bed / 2 Bed

Building type icon
Building type icon

Building Type: Two-story

Transportation services icon
Transportation services icon

Transportation Services

Fitness and recreation icon
Fitness and recreation icon

Fitness and Recreation

Types of Care at Meadow Lake Senior Living – Tyler

Assisted Living Memory Care Nursing Home

Contact Meadow Lake Senior Living – Tyler

Inspection History

In Texas, the Health and Human Services Commission (HHSC) is the primary regulatory body that conducts unannounced inspections and publishes quality reports for all long-term care homes.

Since 2023 · 3 years of data 4 citations

Inspection Scorecard Info This scorecard compares key inspection, citation, and complaint metrics at this facility against the Texas state average. Metrics rated ≥15% worse than average are highlighted in red; those ≥15% better are highlighted in green.

Since 2023 vs. Texas state average
Overall vs. TX average 0 Worse No metrics in this bucket. 2 Better Metrics better than Texas average:
• Total citations (33% below)
• Citations per year (35% below)
Latest Inspection September 24, 2025 Other

Citations Info Citations are formal regulatory issues recorded during state inspections.

Metric This Facility TX Average vs. TX Avg
Total citations Info Formal regulatory issues recorded by inspectors across all inspection types. 4 6 This facility has 33% fewer total citations than a typical Texas nursing home (4 vs. TX avg 6).↓ 33% better
Citations per year Info Average citations per year since 2023. 1.3 2 This facility has 35% fewer citations per year than a typical Texas nursing home (1.3 vs. TX avg 2).↓ 35% better

Inspection Reports Summary Info An editor-reviewed summary of the themes and findings across this facility's recent inspection reports.

The most recent inspection on September 24, 2025, found no deficiencies. Earlier inspections showed some issues related to notification and reporting protocols, including a failure to notify a resident’s physician and family after a fall in May 2025 and incomplete care planning in August 2024. Prior complaint investigations in July 2023 cited failures to timely report and investigate injuries and suspected abuse involving two residents. No fines, immediate jeopardy findings, or license actions were listed in the available reports. The record shows improvement over time, with the latest survey indicating compliance with regulatory requirements.

Read the full inspection reports for this facility, including detailed findings and corrective actions.

Show Inspection Reports

Health Inspection History

Inspections
Total health inspections 3

Texas average 7.4


Last Health inspection on May 2025

Total health citations
4 Rank #3 / 243Health citations — state benchmarkedThis home is ranked 3rd out of 243 homes in Texas.Shows this facility's total health deficiency citations benchmarked to the Texas state average, with a ranking across all 243 TX SNFs. Lower citation counts earn a better rank.

Texas average 25.9

Citations per inspection
1.33 Rank #3 / 243Citations per inspection — state benchmarkedThis home is ranked 3rd out of 243 homes in Texas.Shows average deficiency citations per CMS inspection for this facility versus the Texas mean across 243 SNFs with citation data. Lower is better.

Texas average 3.67


Health citations are formal notices following inspections when they fail to comply with safety and care standards.

3 of 4 citations resulted from standard inspections; and 1 of 4 resulted from complaint investigations.

Breakdown of citation severity (last 3 years)
Critical Health citations More info
0
100% better than Texas average

Texas average: 2


Serious Health citations More info 0
100% better than Texas average

Texas average: 0.4

0 critical citations More info Texas average: 2

0 serious citations More info Texas average: 0.4

4 moderate citations More info Texas average: 23

0 minor citations More info Texas average: 0.4
Citations history (last 3 years)
Resident Rights moderate citation Info Issues related to resident's rights, including dignity, privacy, and the ability to make decisions about their care. May 19, 2025
Corrected

Care Planning moderate citation Info Issues related to creating and updating personalized care plans for residents based on their needs and conditions. Aug 21, 2024
Corrected

Abuse/Neglect moderate citation Info Issues related to protecting resident's from harm, including abuse, neglect, or mistreatment. Jul 19, 2023
Corrected

Abuse/Neglect moderate citation Info Issues related to protecting resident's from harm, including abuse, neglect, or mistreatment. Jul 19, 2023
Corrected

Financial Assistance for
Nursing Home in Texas

Meadow Lake Senior Living – Tyler is located in Tyler, Texas.
Here are the financial assistance programs available to residents in Texas.

Get Financial aid guidance

Community Care for the Aged and Disabled (CCAD)

TX Medicaid CCAD

Age 65+ or disabled
General Texas resident, Medicaid-eligible, care need (not always nursing home level).
Income Limits (2025) ~$2,829/month 300% FBR, individual
Asset Limits $2,000 (individual), $3,000 (couple).
TX

Large state; rural access challenges.

Benefits
Personal care (5-7 hours/day) Respite (240 hours/year) Adult day care (~$60/day) Home aides

Texas Community Care Services

TX CCS

Age 60+
General Texas resident, at risk of decline.
Income Limits ~$2,000/month individual, varies
Asset Limits $5,000 individual
TX

Limited funding; high demand in urban areas.

Benefits
In-home care (3-5 hours/week) Respite (up to 10 days/year) Transportation (~5 trips/month)

Area Agency on Aging (AAA) Services

Texas AAA Services

Age 60+
General TX resident; no income/asset limits.
Income Limits (2025) None; donations encouraged.
Asset Limits Not assessed.
TX

28 AAAs; includes Meals on Wheels in some areas.

Benefits
Meals (~$5-$7/meal) Transportation Homemaker services (~4 hours/week) Respite (~5 days/year) Legal aid

Medicare Savings Program (MSP)

Texas Medicare Savings Program

Age 65+ or disabled
General TX resident, Medicare Part A/B.
Income Limits (2025) ~$2,510/month (QMB), ~$3,380/month (SLMB), ~$3,598/month (QI)—individual.
Asset Limits $9,430 (individual), $14,130 (couple).
TX

Includes Extra Help for Part D; no waitlist.

Benefits
Covers Part B premiums ($174.70/month) Deductibles ($240/year) Copays (~20%)

Family Caregiver Support Program (FCSP)

Texas Family Caregiver Support Program

Age
General Caregivers of 60+ needing care or 55+ caregivers of others; TX resident; 2+ ADLs.
Income Limits (2025) No strict cap; prioritizes low-income ~$24,980/year
Asset Limits Not assessed.
TX

High rural demand; includes grandparent caregivers.

Benefits
Respite (4-6 hours/week or 5 days/year) Adult day care ($60/day) Training Supplies (~$500/year)

VA Aid and Attendance (A&A) and Housebound Benefits

Texas VA Aid and Attendance/Housebound

Age 65+ or disabled veteran/spouse
General TX resident, wartime service, ADL help (A&A) or homebound.
Income Limits (2025) Net income < ~$1,984/month (veteran with dependent, A&A); pension offsets income.
Asset Limits ~$155,356 net worth
TX

High veteran population; supports rural/urban needs.

Benefits
Cash (~$1,433-$2,642/month veteran, ~$951-$1,318 spouse) for care costs

Property Tax Exemption for Seniors

Texas Senior Property Tax Exemption

Age 65+
General TX resident, homeowner (homestead).
Income Limits (2025) None; tax-based eligibility.
Asset Limits Not assessed.
TX

$25,000+ exemption; optional freeze in some counties; saves ~$500-$1,000/year.

Benefits
Tax exemption or freeze (~$500-$1,000/year savings)

Senior Farmers’ Market Nutrition Program (SFMNP)

Texas SFMNP

Age 60+
General TX resident, low-income.
Income Limits (2025) ~$2,322/month 185% FPL
Asset Limits Not assessed.
TX

Vouchers (~$50/season); serves ~20,000 via 28 AAAs.

Benefits
Vouchers (~$50/season) for produce at farmers’ markets

Places of interest near Meadow Lake Senior Living – Tyler

Address 8.5 miles from city center Info Estimated distance in miles from Tyler's city center to Meadow Lake Senior Living – Tyler's address, calculated via Google Maps. — 1.61 miles to nearest hospital (Lice Clinics of America - Tyler)

Calculate Travel Distance to Meadow Lake Senior Living – Tyler

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Address

Staffing Data (Q2 2025)

This data corresponds to Q2 2025 and is based on CMS Payroll-Based Journal.

Total staff 59
Employees 44
Contractors 15
Staff to resident ratio 0:0
100% worse than Texas average

Texas average ratio: 1.51:1

Avg staff/day 20
Average shift 7.4 hours
9% worse than Texas average

Texas average: 8.1 hours

Total staff hours (quarter) 13,401

Nursing staff breakdown

Registered Nurse

Manages medical care and health needs.

Total count 9
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 8.5 hours

This role is partially covered by contractors.

Licensed Practical Nurse

Assists with medical care and medications.

Total count 4
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 10 hours

No contractors work on this role.

Certified Nursing Assistant

Helps with daily care and mobility.

Total count 23
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 7.1 hours

No contractors work on this role.

Contractor staffing

Total hours from contractors

15.4%

2,059 contractor hours this quarter

Speech Language Pathologist: 4 Respiratory Therapy Technician: 4 Qualified Social Worker: 2 Physical Therapy Aide: 2 Physical Therapy Assistant: 2 Registered Nurse: 1

Staff by category

Certified Nursing Assistant 23 0 23 5,281 91 100% 7.1
Registered Nurse 8 1 9 1,195 83 91% 8.5
Licensed Practical Nurse 4 0 4 1,127 86 95% 10
Medication Aide/Technician 3 0 3 1,016 77 85% 10.9
Speech Language Pathologist 0 4 4 699 78 86% 6.1
Clinical Nurse Specialist 1 0 1 496 62 68% 8
Administrator 1 0 1 480 60 66% 8
Mental Health Service Worker 1 0 1 477 60 66% 8
Qualified Social Worker 0 2 2 465 68 75% 6.6
RN Director of Nursing 1 0 1 460 58 64% 7.9
Nurse Practitioner 1 0 1 456 58 64% 7.9
Other Dietary Services Staff 1 0 1 420 62 68% 6.8
Physical Therapy Aide 0 2 2 372 54 59% 6.3
Physical Therapy Assistant 0 2 2 304 60 66% 5
Respiratory Therapy Technician 0 4 4 153 59 65% 2.2
23 Certified Nursing Assistant
% of Days 100%
9 Registered Nurse
% of Days 91%
4 Licensed Practical Nurse
% of Days 95%
3 Medication Aide/Technician
% of Days 85%
4 Speech Language Pathologist
% of Days 86%
1 Clinical Nurse Specialist
% of Days 68%
1 Administrator
% of Days 66%
1 Mental Health Service Worker
% of Days 66%
2 Qualified Social Worker
% of Days 75%
1 RN Director of Nursing
% of Days 64%
1 Nurse Practitioner
% of Days 64%
1 Other Dietary Services Staff
% of Days 68%
2 Physical Therapy Aide
% of Days 59%
2 Physical Therapy Assistant
% of Days 66%
4 Respiratory Therapy Technician
% of Days 65%

Quality of care over time

These measures show how residents usually do over time at this home, based on health outcomes and preventive care.

High-risk clinical events score Info A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline. 4.2
52% better than Texas average

Texas average: 8.6

Functional decline score Info A composite score based on activities of daily living decline, walking ability decline, and incontinence. 10.4
35% better than Texas average

Texas average: 16.0

Long-stay resident measures
Significantly above average Texas avg: 4.1 Info CMS star rating based on long-stay quality measure performance. 5 stars = significantly above average, 1 star = significantly below average.
Need for Help with Daily Activities Increased Info Percent of long-stay residents whose need for help with daily activities has increased 5.4%
67% better than Texas average

Texas average: 16.2%

Low Risk Residents with Bowel/Bladder Incontinence Info Percent of low risk long-stay residents who lose control of their bowels or bladder 15.3%
In line with Texas average

Texas average: 15.7%

Falls with Major Injury Info Percent of long-stay residents experiencing one or more falls with major injury 1.5%
55% better than Texas average

Texas average: 3.2%

High Risk Residents with Pressure Ulcers Info Percent of long-stay high risk residents with pressure ulcers 4.3%
In line with Texas average

Texas average: 4.4%

Urinary Tract Infection Info Percent of long-stay residents with a urinary tract infection 0.0%
100% better than Texas average

Texas average: 0.8%

Lost Too Much Weight Info Percent of long-stay residents who lose too much weight 5.6%
60% worse than Texas average

Texas average: 3.5%

Depressive Symptoms Info Percent of long-stay residents who have depressive symptoms 6.3%
118% worse than Texas average

Texas average: 2.9%

Antipsychotic Use Info Percent of long-stay residents who received an antipsychotic medication 13.0%
66% worse than Texas average

Texas average: 7.9%

Pneumococcal Vaccine Info Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine 100.0%
In line with Texas average

Texas average: 97.3%

Influenza Vaccine Info Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine 95.5%
In line with Texas average

Texas average: 97.9%

Short-stay resident measures
Average Texas avg: 3.1 Info CMS star rating based on short-stay quality measure performance. 5 stars = much above average, 1 star = much below average.
Pneumococcal Vaccine Info Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine 100.0%
11% better than Texas average

Texas average: 90.4%

Antipsychotic medication increase Info Percent of short-stay residents who newly received an antipsychotic medication 2.2%
52% worse than Texas average

Texas average: 1.4%

Influenza Vaccine Info Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine 100.0%
14% better than Texas average

Texas average: 88.0%

Re-hospitalized after SNF stay Info Percentage of short-stay residents who were re-hospitalized after their nursing home admission. 26.0%
In line with Texas average

Texas average: 25.9%

Emergency department visits Info Percentage of short-stay residents who had an outpatient emergency department visit. 12.0%
In line with Texas average

Texas average: 12.0%

Falls with major injury Info Percentage of SNF residents who experience falls with major injury during their stay. 0.0%
100% better than Texas average

Texas average: 0.8%

Ability to care for self at discharge Info Percentage of residents at or above expected ability to care for themselves at discharge. 57.1%
6% better than Texas average

Texas average: 53.7%

Successful return to home or community Info Rate of successful return to home or community from a skilled nursing facility. 55.4%
9% better than Texas average

Texas average: 50.6%

Penalties and fines

Federal penalties imposed by CMS for regulatory violations, including civil money penalties (fines) and denials of payment for new Medicare/Medicaid admissions.

Source: CMS Penalties Database

No penalties in the past 3 years

No civil money penalties or payment denials were reported in the last 3 years.

Guides for Better Senior Living

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Frequently Asked Questions about Meadow Lake Senior Living – Tyler

Is Meadow Lake Senior Living – Tyler in a walkable area?

Meadow Lake Senior Living – Tyler has a walk score of 33. Somewhat walkable. A few nearby services may be reachable on foot, but most trips require transportation.

Are there photos of Meadow Lake Senior Living – Tyler?

Yes — there are 14 photos of Meadow Lake Senior Living – Tyler in the photo gallery on this page.

What is the phone number of Meadow Lake Senior Living – Tyler?

(903) 526-5599 will put you in contact with the team at Meadow Lake Senior Living – Tyler.

Is Meadow Lake Senior Living – Tyler Medicare or Medicaid certified?

Yes — Meadow Lake Senior Living – Tyler is a CMS-certified provider of Medicare and Medicaid.

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