Johns Hopkins Hospital has taken the first place again according to U.S. News and World Report’s annual rankings of American hospitals. Baltimore hospital has won it 20 years in a row.

Calling the two-decade record “astonishing,” the leadership of Johns Hopkins Medicine said the credit belongs to those who have demonstrated continuous commitment to excellence and improvement.

“As much as we’ve become happily accustomed to saying so, it bears repeating that the credit for this honor belongs to Hopkins Hospital’s people — our wonderful nurses and staff, the school of medicine’s faculty physicians, residents and fellows, and our many community physicians with whom we have close ties and on whom we greatly depend,” said, in a joint letter of congratulations, Edward D. Miller, M.D., dean and CEO of Johns Hopkins Medicine, and Ronald R. Peterson, president of The Johns Hopkins Hospital and Health System.

The hospital ranked No. 1 in areas dealing with ear, nose and throat; gynecology, neurology and neurosurgery, urology and rheumatology.