est</span></span></span>
<span class="r-in"><span><span class="co"># so we nest the tests to get to one row per institution. Those institutions</span></span></span>
<span class="r-in"><span><span class="co"># with invalid scores are excluded.</span></span></span>
<span class="r-in"><span><span class="va">cms_history</span> <span class="op">=</span> <span class="fu">tidyr</span><span class="fu">::</span><span class="va"><a href="https://tidyr.tidyverse.org/reference/cms_patient_experience.html" class="extern