Average — CMS composite of the measures below.
A standard survey is most likely before around November 2026
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Westgate Health And Rehabilitation Center during CMS and state inspections, most recent first.
A resident with multiple medical conditions and communication barriers reported being physically abused by staff upon admission, using handwritten notes and contacting 911. Despite these efforts, staff did not immediately report the allegations to administration or authorities, resulting in a significant delay. The administrator only became aware of the situation days later and did not report the incident to the state agency until nearly three weeks after the initial allegation.
Two residents did not receive their medications as scheduled, with one experiencing repeated late administration of both morning and evening doses, and another waiting several hours for essential medications including insulin and pain relief. Staff interviews and record reviews confirmed that medications were not given within the required timeframes, and communication lapses among nursing staff contributed to the delays.
Failure to Provide a Urinal: A resident with severe cognitive impairment was observed using a bowl to urinate because no urinal was present in his room. Staff later confirmed the resident sometimes uses a urinal, but most of the time goes in his brief, and the DON was informed after a bowl of urine was found under the bed.
Failure to provide ordered wound care for a resident with a stage 3 sacral pressure ulcer. The resident had a BIMS score of 13, was at risk for skin breakdown due to weakness and incontinence, and had an active wound order for cleansing, Silvadene, calcium alginate, and a dressing. During observation, the wound care nurse had left the wound open to air after requesting an order change without the wound MD seeing the resident that day, and later could not produce documentation of the prior day's wound care or explain why the ordered treatment was not done.
Failure to secure a Foley catheter and timely assess removal for two residents: one resident with intact cognition reported staff did not seem to know she had a Foley and observed the catheter was not attached to the statlock despite shift documentation indicating it was in use, and there was no documented assessment for removal before the survey date. A second resident had a urinary drainage device left in place for a week after a negative UA and a documented NP plan for removal and a voiding trial, with no rationale in the record for the delay.
Failure to Reweigh Resident After Significant Weight Variance: The facility did not follow its weight assessment policy when a resident with mild cognitive impairment, depression, and MS had a 30-pound weight gain documented without a confirming reweigh. The RD noted the weight clarification issue and the resident said his usual weight was 175 to 180 pounds, but the record showed no reweigh afterward. The report also noted a prior significant weight loss that was not confirmed by reweighing, and interviews with the RD and DON identified that CNA staff weighed residents and the RD entered the weights into the record.
Respiratory Care Deficiencies: Two residents did not receive respiratory care as ordered or as described in facility guidance. A resident with chronic respiratory failure and tracheostomy status had oxygen delivered via trach collar at a higher flow than the physician-ordered 3 L/min, and an LPN administering a nebulizer treatment to another resident did not obtain the resident’s pulse during the treatment as required by the facility’s nebulizer process.
The facility failed to ensure accurate MDS assessments for two residents. One resident’s MDS listed a hypoglycemic medication even though the MAR showed no documented administration during the look-back period, and another resident’s MDS incorrectly stated there were no falls despite record evidence of two falls and the resident reporting multiple falls. The MDS Coordinator agreed both assessments were inaccurate.
The facility failed to provide necessary care for two residents, including gastrostomy tube management and skin assessments. One resident experienced complications due to inadequate PEG tube care, leading to hospitalization. Upon return, there was insufficient documentation of the PEG tube site and missed weekly skin assessments. Another resident with a Stage IV pressure ulcer also lacked consistent skin assessments. Staff interviews revealed a lack of adherence to care protocols, highlighting deficiencies in managing residents' medical needs.
The facility failed to properly disinfect glucometers, dispose of used lancets, implement Enhanced Barrier Precautions (EBP), and ensure hand hygiene during meal tray distribution. Observations revealed inadequate PPE availability and improper infection control practices, which were confirmed by the DON.
The facility failed to ensure timely smoking privileges for two residents, with staff often being late for scheduled smoking times. Residents expressed frustration, particularly with the last smoking time of the day, which was frequently delayed by 30 minutes or more.
The facility failed to ensure accurate MDS assessments for three residents. One non-verbal resident was incorrectly documented with a BIMS score, another resident's antibiotic use was inaccurately recorded, and a third resident's discharge location was wrongly entered as a hospital instead of home. Staff interviews confirmed these errors.
The facility failed to provide appropriate catheter care for a resident with chronic kidney disease and severe cognitive impairment. Observations revealed that the catheter was not properly anchored, and there were discrepancies in the documentation of catheter changes, leading to a deficiency.
The facility failed to change the PICC line dressing for a resident as ordered, despite physician instructions for the dressing to be changed every 7 days and within 24 hours of admission, insertion, or reinsertion. The resident confirmed that the dressing had not been changed by the facility staff since admission, and the Director of Nursing acknowledged the discrepancy.
The facility failed to ensure proper oxygen and respiratory care for two residents. One resident's oxygen tubing was repeatedly found disconnected from the concentrator, and another resident's nebulizer mask was improperly stored and the machine was dirty. Staff acknowledged the issues but did not correct them.
A facility failed to implement physician-ordered blood pressure monitoring for a resident with hypertension. The resident's blood pressure was inconsistently documented, and medication was administered even when the systolic blood pressure was below the specified threshold. The Unit Manager confirmed the oversight.
Failure to Timely Report Alleged Abuse and Injuries of Unknown Source
Penalty
Summary
The facility failed to ensure that all allegations of abuse, including injuries of unknown source, were reported immediately, as required. A resident who is deaf and mute, but cognitively intact, was admitted with multiple medical conditions including recent back surgery and was receiving anticoagulation therapy. Upon admission, the resident reported experiencing significant pain and alleged that two nurses hit her on her abdomen and back when she was unable to open her legs for care. The resident attempted to communicate her distress and allegations to staff through handwritten notes and also contacted 911, resulting in police visiting the facility. Despite these efforts, the initial allegations were not reported to the appropriate administrative staff or authorities in a timely manner. Multiple staff members, including a registered nurse and a physical therapist assistant, became aware of the resident's allegations but did not immediately escalate the report to facility administration or external authorities. The registered nurse admitted to receiving a handwritten note from the resident about the alleged abuse but assumed the next shift would handle the report and did not notify the administrator or supervisor. The physical therapist assistant eventually reported the incident to her supervisor and the administrator, but this occurred several days after the initial allegation. Facility records did not show a timely report of the abuse allegation, and the administrator only became aware of the situation after being informed by the therapist assistant. When the administrator was finally informed, she initially reported the incident to the state agency and police but later withdrew the report, categorizing it as a grievance due to perceived communication issues. It was not until nearly three weeks after the initial occurrence that the administrator interviewed the resident with an interpreter and reported the allegation to the agency. Documentation and interviews confirmed that the facility did not follow required protocols for immediate reporting of abuse allegations, resulting in a significant delay in addressing the resident's concerns.
Failure to Administer Medications Timely for Two Residents
Penalty
Summary
The facility failed to ensure timely administration of medications as ordered for two residents, resulting in multiple occurrences of late medication delivery. For one resident with severe cognitive impairment, review of the Medication Administration Record (MAR) over a 24-day period showed that scheduled 10 AM medications were repeatedly administered late, often between 11:11 AM and 12:38 PM, exceeding the facility's stated policy of administering medications within one hour before or after the scheduled time. Evening medications scheduled for 6 PM were also administered late, with times ranging from 7:28 PM to 8:43 PM. A family member reported concerns about the inconsistent timing of medication administration, and staff interviews confirmed the expectation for timely delivery was not met. Another resident, who was cognitively intact and had diagnoses including hypertension, pain, diabetes, and gastroesophageal reflux disease, did not receive scheduled morning medications, including insulin and pain medication, in a timely manner. The resident reported not receiving medications after a nurse stated she would return, and multiple observations confirmed the resident's call light remained on while she waited for assistance. Staff were observed searching for the responsible nurse, who was later found to be outside on a phone call. The resident ultimately received her medications several hours late, with pain medication administered at 11:54 AM and other scheduled medications given between 12:09 PM and 2:19 PM, well after the scheduled times. Interviews with staff, including the DON and ADON, revealed a lack of awareness regarding the nurse's absence and the delay in medication administration. The DON was not informed that the nurse would be unavailable for an extended period and was unaware that medications had not been administered to all assigned residents. The delay in medication administration was only addressed after direct intervention by other staff and surveyors, highlighting a breakdown in communication and oversight that led to the deficiency.
Failure to Provide a Urinal
Penalty
Summary
The facility failed to treat 1 of 1 sampled resident with dignity by not providing Resident #37 with a urinal. Resident #37 was admitted to the facility and had a quarterly assessment dated 05/18/25 documenting a BIMS score of 03 on a 0-15 scale, indicating severe cognitive impairment. During an observation on 08/04/25 at 10:29 AM, a medium-size clear bowl containing amber-colored urine was found under the resident’s bed. When asked what was in the bowl, the resident stated it was pee and said, "That's what I have to pee in" and "I don't have one" when asked why he was not using a urinal. Photographic evidence was obtained. On 08/05/25 at 11:45 AM, the resident was again observed lying in bed, and an empty clear bowl similar to the one previously observed was on the nightstand near the bed; no urinal was observed in the room. A CNA stated that the resident sometimes uses a urinal but most of the time goes in his brief and that she helps him use the urinal. The care plan dated 05/28/25 documented an ADL self-care deficit related to the resident’s disease process and chronic medical conditions. On 08/07/25, the DON, Risk Manager, and Regional Nurse were informed of the bowl of urine under the bed, and the DON questioned why the resident did not have a urinal before stating, "I gave the resident a urinal."
Failure to Provide Ordered Wound Care for Sacral Pressure Ulcer
Penalty
Summary
Failure to provide treatment to promote wound healing was identified for one resident with a non-healed stage 3 pressure ulcer on the sacrum. The resident had a BIMS score of 13 and was documented as at risk for skin breakdown due to weakness and incontinence, with a care plan addressing preventative skin treatments and recent IV antibiotic treatment for ESBL in the urine. A wound care note documented the sacral ulcer measured 3 cm by 2.5 cm by 0.6 cm, and a physician order active as of 08/02/25 directed staff to cleanse the wound, apply skin prep, Silvadene, calcium alginate, and cover with a silicone super absorbent dressing daily and as needed. During wound care observation, the wound care nurse stated the order had been changed to leave the sacral wound open to air after applying Silvadene, and no dressing was covering the wound when the resident was turned. The nurse stated she had requested the change that morning because the buttocks area was red from moisture, but the wound care doctor had not seen the resident that day. The regional nurse observed the wound and stated it needed a dressing, then obtained a verbal order to cleanse the wound, apply Silvadene, pack with calcium alginate, and cover with a foam dressing every other day. In interview the next day, the wound care nurse was unable to find documentation of wound care provided on 08/05/25 and stated she did not perform the ordered wound care because she did not see any wound care orders in the record.
Failure to Secure Foley Catheter and Timely Assess Removal
Penalty
Summary
The facility failed to ensure proper care and assessment for two residents with indwelling Foley catheters. Resident #117 was admitted with a Foley catheter and had a BIMS score of 15, indicating no cognitive impairment. Although an order dated 07/31/25 directed staff on every shift to use or apply a catheter tube securing device, the resident stated staff did not seem to know she had a Foley and that they pulled on it. During interview and observation, a statlock was present on her left thigh, but the Foley catheter was not secured to it. The time-stamped MAR showed staff signed for use of the securing device on 08/05/25 and 08/06/25 for every shift, yet the record contained no documentation that the resident was assessed for possible Foley removal before 08/07/25. Resident #123 was admitted with a urinary drainage device, and the record showed no attempt to discontinue it until 08/06/25. A progress note by the Nurse Practitioner on 07/29/25 documented a plan to remove the urinary drainage device and complete a voiding trial pending urinalysis results. The urinalysis was negative on 07/30/25, but the catheter remained in place for one week after those results were available, and the record lacked any rationale for the delay. The spouse stated she had asked about removing the catheter and was told the nurse would speak with the physician. The Unit Manager later reviewed the note and urinalysis and agreed there was a delay in services.
Failure to Reweigh Resident After Significant Weight Variance
Penalty
Summary
The facility failed to follow its weight assessment policy for one of four sampled residents by not reweighing a resident after a significant, undesired weight change. The policy stated that weight variance changes that are undesired or unplanned since the last weight assessment would be retaken as soon as practical for confirmation, and if verified, nursing would communicate with the Dietician and/or physician. Resident #68 was admitted to the facility, had a BIMS score of 14 indicating mild cognitive impairment, and was care planned as at risk for alteration in nutrition/hydration related to depression and MS. During interview, the resident stated his food was good and that he had gained weight, estimating his weight at 180 pounds. Record review showed the resident’s documented weight increased from 150.5 pounds to 180 pounds, a 30-pound gain, and the RD noted that weight clarification was needed because of the significant gain. The RD documented that the resident said his usual weight was 175 to 180 pounds and that he would be reweighed weekly, but the record did not show a reweigh by 08/06/25. The report also identified a prior pattern in which the resident had a documented 14-pound weight loss between 10/08/24 and 11/08/24 without a confirming reweigh, and he was not reweighed until 12/30/24, when the documented weight showed a 13.2-pound gain. Interviews with the RD and DON confirmed that CNA staff were responsible for weighing residents and that the RD entered the weights into the system after reviewing them.
Respiratory Care Deficiencies
Penalty
Summary
Respiratory services were not adequately provided for a resident with chronic respiratory failure and tracheostomy status when the facility failed to deliver oxygen at the physician-ordered rate. Resident #91 was admitted with diagnoses including chronic respiratory failure and tracheostomy status, had a BIMS score of 8 indicating moderate cognitive impairment, and was documented to receive oxygen during the MDS lookback period. The care plan directed staff to administer oxygen as ordered, and the physician order dated 07/25/25 specified oxygen via trach collar at 3 liters per minute. During observations on 08/04/25, 08/05/25, and 08/06/25, the oxygen concentrator tubing was attached to the trach collar, but the oxygen was set at approximately 5.8 liters per minute rather than the ordered 3 liters per minute. An RN later confirmed the order was for 3 liters per minute and stated the concentrator was set on 6 liters per minute. Respiratory care was also not adequately provided during a nebulizer treatment for another resident when required assessment was not performed as described in the facility's nebulizer process. The facility policy referenced reporting information in accordance with facility policy and professional standards of practice, and the facility provided a nebulizer document stating that approximately five minutes after treatment begins, or sooner if clinical judgment indicates, the resident's pulse should be obtained. During a medication pass observation with an LPN/unit manager, ipratropium bromide nebulizer treatment was prepared for Resident #105, delayed for lunch, and then administered after lunch. The LPN checked the resident's pulse and oxygen saturation before the treatment and again after the treatment was completed, but during interview the LPN stated she was unaware of the need to assess the resident's pulse during the nebulizer treatment.
Inaccurate MDS Documentation for Medications and Falls
Penalty
Summary
The facility failed to ensure accurate MDS assessments for 2 of 27 sampled residents. For Resident #2, the current MDS documented that the resident was receiving a hypoglycemic medication used for diabetes or high blood sugar levels, but the corresponding MAR for the seven-day look-back period did not show any documented administration of a hypoglycemic medication. During a side-by-side record review and interview, the MDS Coordinator agreed the assessment was inaccurate. For Resident #57, the MDS documented a BIMS score of 14, indicating the resident was cognitively intact, and stated the resident had no falls since admission or the last entry, reentry, or prior assessment. However, the record showed the resident had two falls between the prior assessment and the current assessment, including one event where the resident was observed lying on the floor and another where the resident stated she fell in her room while walking to her wheelchair and got herself up off the floor. During interview, the resident stated she had had multiple falls at the facility, and the MDS Coordinator agreed the assessment was inaccurate.
Deficiencies in Gastrostomy Tube Care and Skin Assessments
Penalty
Summary
The facility staff failed to provide necessary care and services for two residents, particularly concerning gastrostomy tube management and skin assessments. For one resident, there was no evidence of daily care for the PEG tube, including checking residuals or providing water flushes, as prescribed by physician orders. The resident experienced nausea and vomiting, leading to hospitalization, where it was discovered that the PEG tube had migrated, causing a partial obstruction. Upon the resident's return to the facility, there was inadequate documentation and assessment of the PEG tube site, and the staff did not complete weekly skin assessments as required. Another resident, admitted with a diagnosis of osteomyelitis and a Stage IV pressure ulcer, also did not receive consistent weekly skin assessments. The facility's records showed a lack of documentation for skin assessments over a seven-week period following the resident's readmission. This oversight in monitoring and documenting the resident's skin condition could potentially exacerbate existing pressure ulcers or lead to new skin impairments. Interviews with facility staff, including a Licensed Practical Nurse and an Advanced Registered Nurse Practitioner, revealed a lack of clarity and adherence to protocols regarding the care of gastrostomy tubes and skin assessments. The staff admitted to not having specific physician orders for the PEG tube care and acknowledged the failure to conduct thorough assessments and documentation. This lack of proper care and documentation highlights significant deficiencies in the facility's ability to provide adequate care for residents with complex medical needs.
Infection Control and EBP Deficiencies
Penalty
Summary
The facility failed to ensure proper disinfecting of glucometers for two residents. During a medication observation pass, an LPN used an alcohol pad instead of an approved disinfectant wipe to clean the glucometer and did not allow the proper wet time for disinfection. The Director of Nursing (DON) confirmed the improper disinfecting practices. Additionally, another LPN disposed of a used lancet in a resident's trash can instead of a sharps container, which was also acknowledged by the DON as improper disposal practice. The facility did not have a policy for Enhanced Barrier Precautions (EBP) and failed to implement them according to CDC guidelines. Observations revealed that rooms identified as needing EBP lacked proper signage and readily accessible personal protective equipment (PPE), specifically gowns. Multiple rooms on both floors were found without the necessary gowns, and the linen carts were inadequately stocked. The DON was made aware of these deficiencies during the survey. Hand hygiene practices were also found to be inadequate during meal tray distribution. A CNA was observed not performing hand hygiene between handling meal trays and entering different resident rooms, including a transmission-based precaution room. Additionally, two residents with conditions requiring transmission-based precautions did not have these precautions in place, as evidenced by the lack of PPE and proper signage in their rooms. The DON was informed of these issues, which were confirmed through multiple observations and interviews.
Failure to Ensure Timely Smoking Privileges
Penalty
Summary
The facility failed to ensure timely smoking privileges as per resident choice and schedule for two residents who smoke. Observations revealed that the scheduled smoking times were not consistently adhered to, with staff often being late. For instance, on one occasion, the CNA assigned to the smoking area was not present at the scheduled time, and the Unit Manager had to cover the duty. Residents expressed frustration over the inconsistency, particularly noting that the last smoking time of the day was frequently delayed by 30 minutes or more. Staff interviews confirmed these delays, with one CNA admitting to covering the smoking area to ensure residents received their smoke breaks on time. Resident #159, who was alert and oriented, and Resident #259, who had a BIMS score indicating cognitive intactness, both reported issues with the timeliness of the smoking breaks. The Assistant Director of Nursing (ADON) acknowledged the problem but downplayed the extent of the delays. Despite the ADON's claim of being vigilant about the smoking schedule, the issue persisted, particularly during the 6:30 PM smoking time, which was often delayed by the second-floor staff.
Inaccurate MDS Assessments for Three Residents
Penalty
Summary
The facility failed to ensure accurate Minimum Data Set (MDS) assessments for three residents. Resident #43, who was non-verbal and immobile, was incorrectly documented with a Brief Interview for Mental Status (BIMS) score of 6. Observations and interviews confirmed that the resident could only communicate by blinking, and the Social Services Director acknowledged the error in the BIMS assessment. Resident #3's Quarterly MDS assessment inaccurately documented antibiotic use, which was not supported by the Medication Administration Record (MAR) or corresponding orders. The MDS Director confirmed this discrepancy during an interview. Resident #108's discharge location was incorrectly recorded in the MDS assessment. Although the progress notes and discharge orders indicated that the resident was discharged home, the MDS assessment erroneously documented a discharge to the hospital. The MDS Coordinator admitted to the error, attributing it to a possible miss-click while entering the data. These inaccuracies in the MDS assessments highlight the facility's failure to ensure accurate and reliable documentation for its residents.
Failure to Provide Appropriate Catheter Care
Penalty
Summary
The facility failed to provide appropriate treatment and services for a resident with a clinically justified indwelling urinary catheter. Resident #42, who was admitted with chronic kidney disease and was severely cognitively impaired, had orders for catheter care every shift and to irrigate the catheter as needed for blockage, leakage, increased sediment, or decreased output. Additionally, there was an order to change and date the catheter securement device weekly. However, observations revealed that the catheter was not properly anchored, and the urine in the tubing was red-tinged, indicating potential issues that were not addressed in a timely manner. On multiple occasions, staff failed to use an anchoring device for the catheter, and the catheter tubing was observed hanging freely between the resident's thighs. The April 2024 Treatment Administration Record documented that the catheter was changed on 04/06/24, but the observed catheter was dated 03/31/24, indicating a discrepancy. The Unit Manager confirmed the inconsistency and acknowledged that the catheter should have been irrigated or changed based on the observations. These failures in catheter care and documentation led to the deficiency noted in the report.
Failure to Change PICC Line Dressing as Ordered
Penalty
Summary
The facility failed to ensure that the PICC line dressing for a resident was changed as ordered. The resident, who was admitted with septicemia and had a PICC line inserted for intravenous antibiotic administration, had physician orders for the dressing to be changed every 7 days and within 24 hours of admission, insertion, or reinsertion. However, the clinical records and treatment administration records indicated that the dressing was only changed on four occasions, which did not comply with the physician's orders. An observation on 04/08/24 revealed that the dressing had a date of 3/23, and the resident confirmed that the dressing had not been changed by the facility staff since admission. During an interview on 04/11/24, the Director of Nursing (DON) was made aware of the discrepancy and acknowledged the finding after a side-by-side review of the resident's record. The failure to change the PICC line dressing as ordered was confirmed, indicating a lapse in following the prescribed treatment plan for the resident, who was cognitively intact and had no mood or behavior issues as per the admission MDS assessment.
Failure to Ensure Proper Oxygen and Respiratory Care
Penalty
Summary
The facility failed to ensure proper care and services for oxygen use for two residents. Resident #59 had an order for continuous oxygen at 2 liters per minute via nasal cannula due to shortness of breath. However, multiple observations revealed that the oxygen tubing was not attached to the concentrator, and the nasal cannula was found on the floor or lying on the bed. Despite the oxygen concentrator running, the tubing was not connected, and staff members denied responsibility for the improper handling of the oxygen equipment. The resident did not report shortness of breath during these observations, but the equipment was not used as ordered by the physician. Resident #55 had orders for nebulizer treatments and the use of respiratory medications for COPD. Observations revealed that the nebulizer mask was not stored properly in a plastic bag and the nebulizer machine was dirty with debris. The mask was repeatedly found lying on top of the machine or nightstand instead of being stored hygienically. Staff acknowledged the need for cleaning or replacing the nebulizer machine and properly storing the tubing. These deficiencies indicate a failure to follow the facility's policy on oxygen administration and proper storage of respiratory equipment.
Failure to Monitor Blood Pressure as Ordered
Penalty
Summary
The facility failed to implement physician-ordered blood pressure monitoring parameters for a resident diagnosed with Essential Primary Hypertension. The resident had an order to take Lisinopril 20 mg daily, with instructions to hold the medication if the systolic blood pressure (SBP) was below 130. However, the Medication Administration Record (MAR) for January, February, March, and April 2024 showed inconsistent and insufficient documentation of blood pressure readings. Specifically, blood pressure was recorded only on a few days each month, and there were no documented readings for April until after surveyor intervention. Additionally, Lisinopril was administered on two occasions in December 2023 when the SBP was below 130. The Unit Manager confirmed that the blood pressure should have been recorded on the MAR as per the physician's order.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near West Palm Beach
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Colonial Skilled Nursing Facility Llc | 0.3 mi | ★★★★★ | 0 | 0 |
| Darcy Hall Of Life Care | 1.3 mi | ★★★★★ | 4 | 2 |
| Palm Garden Of West Palm Beach | 1.5 mi | ★★★★★ | 4 | 0 |
| Joseph L Morse Health Center Inc The | 1.6 mi | ★★★★★ | 1 | 0 |
| Lakeside Health Center | 1.8 mi | ★★★★★ | 2 | 0 |
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