renegotiate its affiliation agreement with CWRU that same year. Cleveland Clinic publishes the peer-reviewed Cleveland Clinic Journal of Medicine monthly, focusing on internal medicine, endocrinology, and diabetes. Reputation Cleveland Clinic is consistently regarded as one of the top hospital systems in the United States and in the world, and it is well regarded particularly in technological management systems. Rankings In 2020–2021, Cleveland Clinic was ranked as the #2 overall hospital in the United States by the U.S. News & World Report, behind the Mayo Clinic in Rochester, Minnesota. A total of 4,656 hospitals were considered in 12 main data-driven medical and surgical specialty areas and four additional specialty areas, collating data on patient safety, performance measures, and complication rates. Cleveland Clinic was found to be nationally ranked in 14 adult specialties and 10 children's specialties and was recognized as the #1 hospital in Ohio and in the Cleveland Metropolitan Area. It also achieved the highest rating possible in 9 specified procedures or conditions: abdominal aortic aneurysm repair, aortic valve surgery, chronic obstructive pulmonary disease, colon cancer surgery, heart bypass surgery, heart failure, hip replacement, knee replacement, and lung cancer surgery. In addition, for the 14th year in a row, Cleveland Clinic was ranked as the #1 hospital in the United States for cardiology and heart surgery as a specialty. Similarly, in 2021, Newsweek named Cleveland Clinic the number 2 hospital in the world, behind Mayo Clinic. In 2021, Gartner ranked Cleveland Clinic as the #1 healthcare supply chain. In 2022, The American Hospital Association (AHA) partnered with the Society for Healthcare Strategy and Market Development to engage the branding agency, Monigle to conduct consumer research with 28,000 Americans to rank hospital brands °… on their performance in delivering a humanized experience". The Cleveland Clinic was ranked first, followed by two other Ohio systems. Other systems, including Johns Hopkins ranked 6th; Mass General, 11th; and the Mayo Clinic ranked 15h. Safety In a Kaiser Family Foundation review of Centers for Medicare and Medicaid Services (CMS) data for hospital acquired conditions in 2014, Cleveland Clinic received an 8.7 score (1–10 possible, with 10 being the worst), in the bottom 7% of hospitals. Between 2010 and 2013, CMS undertook an extensive series of investigations into the Cleveland Clinic Foundation, with at least a dozen inspections and follow-up visits triggered by patient complaints. An analysis of Medicare inspection data between 2011 and 2014 found