The Johns Hopkins Hospital fell a notch to fourth place in the nation in rankings released Tuesday by U.S. News and World Report, an important assessment in which the Baltimore hospital ranked for years in first place.

The Mayo Clinic in Rochester, Minn., ranked number one this year, followed by the Cleveland Clinic and Massachusetts General Hospital in Boston.

Hopkins began slipping in the rankings in 2012, when the magazine changed its methodology to put less emphasis on reputation. The change ended Hopkins' 21-year run at the top spot.

The Baltimore hospital remained ranked No. 1 in the magazine's comparison of Maryland hospitals. Ten specialties at the hospital ranked among the top five in the nation and 14 specialties in the top 10.

“The Johns Hopkins Hospital's record as a U.S. News & World Report Best Hospital over the past 27 years is unparalleled,” Dr. Paul B. Rothman, dean of the medical faculty and CEO of Johns Hopkins Medicine, and Ronald R. Peterson, president of the Johns Hopkins Health System and executive vice president of Johns Hopkins Medicine, wrote in a note to employees.

“It is thanks to our employees that Johns Hopkins' legacy of clinical excellence and patient- and family-centered care continues to flourish,” they wrote.

The hospital earned the highest ranking for 22 years, including an unprecedented 21 years in a row from 1991 to 2011.

Rothman and Peterson also congratulated the Mayo Clinic.

“We are honored to be among all the hospitals that made the list and, like us, continue to improve care for the people in our local communities and around the world,” they said.

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