Below average — CMS composite of the measures below.
A standard survey is most likely before around December 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 Gold City Health And Rehab during CMS and state inspections, most recent first.
A resident with severe cognitive impairment but intact limb function, care planned to use a wheelchair and not to have restraints, was observed early one morning by two dietary staff seated or reclined in a Broda chair near the nurses’ station, appearing unable to move arms or legs and verbally expressing distress. One dietary aide believed the resident’s wrists were secured with Velcro, while the other reported the resident’s apparent immobility to nursing staff but did not escalate the concern to administration. Later that morning, an Infection Control LPN saw the resident reclined in a Broda chair, recognized it could function as a restraint, and directed transfer to a regular wheelchair, but did not identify or report an abuse allegation at that time. The dietary staff did not report their observations to their supervisor until two days later, at which point administration was notified and the incident was reported to the State Agency, contrary to facility policy and staff expectations that all suspected abuse or restraint use be reported immediately.
A resident with multiple chronic conditions, severe cognitive impairment, and documented use of a manual wheelchair was placed in a Broda chair without a prior PT assessment, despite facility expectations that such devices be evaluated through a therapy referral. The resident’s MDS and care plan reflected wheelchair use, limited mobility with supervision, and no use of restraints or chairs that prevent rising. An LPN admitted the resident had not been assessed for the Broda chair, a restorative CNA was unaware of its use and reported the resident used a regular wheelchair and could stand, and a PTA confirmed there was no PT referral and no observed Broda chair use. Leadership staff acknowledged that, even when used for comfort and positioning, a therapy assessment should have been completed before using the Broda chair.
A resident with severe cognitive impairment and a history of inappropriate sexual behavior was able to have unsupervised access to another resident, resulting in inappropriate physical contact and attempted kissing. The incident occurred when no staff were present at the nurses' station, and the affected resident was unable to disengage without staff intervention. This reflects a failure to prevent resident-to-resident abuse as required by facility policy.
A resident with multiple mental health diagnoses and a history of suicidal ideation did not have a comprehensive, person-centered care plan with specific interventions to ensure psychosocial well-being and safety. Despite documented incidents of self-harm and a care plan outlining certain precautions, observations revealed that potentially harmful items, such as clear trash liners, were accessible, and staff interviews showed inconsistent understanding of safety measures.
A resident with multiple medical and psychiatric diagnoses was provided with a bed rail without documented assessment, attempts at alternative interventions, or informed consent. Staff and administration confirmed that the required evaluation and interdisciplinary review were not completed prior to the installation of the bed rail.
The facility failed to maintain RN coverage for eight consecutive hours daily on specific dates, as revealed by staff interviews and Daily Nursing Staff Reports. The interim Administrator confirmed the requirement for RN coverage and acknowledged the potential for negative outcomes due to the absence of RNs, potentially affecting all 68 residents.
The facility failed to maintain the chemical level of the low temperature dishwasher, resulting in zero parts per million (PPM) concentration of chlorine, potentially affecting all 68 residents. A dietary aide continued to wash dishes without notifying anyone about the issue, and the dishwasher log was incomplete for several days. The Dietary Manager confirmed the sanitizer should have been at 50 PPM.
The facility failed to protect residents from mental, verbal, and physical abuse. A resident with no cognitive decline verbally harassed others, leading to a physical altercation, while another resident made inappropriate comments and was involved in verbal abuse incidents. Despite these issues, care plans were not updated with new interventions. Additionally, a resident with severe cognitive impairment struck another resident, highlighting the facility's failure to prevent abuse.
A resident with severe dementia and aggressive behaviors was involved in multiple altercations with other residents due to inadequate supervision and monitoring. Despite incidents of aggression, the facility failed to update the resident's care plan with new interventions, leading to repeated conflicts. Staff interviews confirmed insufficient monitoring, contributing to the deficiency.
A facility failed to accurately reflect a resident's Do Not Resuscitate (DNR) status in her medical records. Although the resident's paper chart clearly indicated a DNR order, her electronic medical record (EMR) and admission record incorrectly listed her as a full code, meaning CPR should be attempted. The resident was cognitively intact and had signed documents confirming her DNR status, but these were not accurately reflected in the EMR. The Assistant Director of Nursing confirmed the discrepancies during an interview.
The facility failed to report an abuse allegation within the required timeframe. A resident with severe cognitive impairments entered another resident's room, touched her inappropriately, and yelled at her. The incident was reported to a CNA and then to an LPN, but it was not communicated to the abuse coordinator until several hours later, as confirmed by the Administrator.
A resident reported being treated roughly by a CNA, including being pushed and having her wheelchair moved out of reach. The resident had scratches and bruises, but the facility's investigation did not document inquiries into these injuries. The CNA was suspended and later quit, but the investigation concluded that abuse could not be substantiated. The administrator acknowledged that the resident should have been asked about the injuries.
A facility failed to provide a resident and their responsible party with a written notice of transfer to a hospital, as required by policy. The resident, who had moderately impaired cognition, was hospitalized for medical reasons but did not receive the necessary documentation. The Business Office Manager acknowledged the omission, although the ombudsman was informed.
A facility failed to monitor a resident for adverse effects and behaviors related to the use of an antidepressant medication, as required by their policy. The resident, who was cognitively intact and diagnosed with bipolar and generalized anxiety disorders, was prescribed sertraline for depression. Despite the care plan's requirement to monitor for adverse reactions, no documentation was found in the resident's records. The ADON confirmed the lack of monitoring documentation.
A medication cart on the B Hall was left unattended and unlocked, allowing potential unauthorized access to medications. The cart contained residents' liquid medications and insulin vials and was out of the nurse's sight for about 17 minutes. An LPN admitted to forgetting to lock the cart, and the DON confirmed that staff had been educated on the importance of securing medication carts.
The facility did not fill in the daily census on the Daily Nursing Staff Report(s) from late July to late August 2024. This omission was confirmed by the interim Administrator and could cause uncertainty for visitors about the staff-to-resident ratio. The facility census was 68 residents.
Failure to Timely Report Suspected Restraint Use as Possible Abuse
Penalty
Summary
The deficiency involves the facility’s failure to timely report an allegation of possible abuse involving the use of restraints on a resident to the State Survey Agency, as required by facility policy and regulation. The resident involved had multiple diagnoses, including Down syndrome, cerebral palsy, type 2 diabetes mellitus, congestive heart failure, chronic atrial fibrillation, epilepsy, chronic kidney disease stage 3, anxiety, restlessness and agitation, lumbar compression fractures, abdominal distension, obstructive uropathy, and urogenital implants. The resident’s MDS showed severely impaired memory and decision-making but no impairment in upper or lower extremity function, and indicated that no restraints or chairs that prevent rising were in use. The care plan documented limited mobility, use of a wheelchair, and need for staff supervision for short ambulation. On the early morning in question, two dietary staff members arriving for day shift observed the resident seated or reclined in a Broda (medical) chair near the nurses’ station. One dietary staff member reported that the resident asked for tea and appeared to have immobile arms, and believed the resident’s wrists were secured with Velcro, though she was uncertain due to dim lighting. She also observed the resident in disposable underwear with a sheet over his waist. The other dietary staff member observed the resident reclined, covered with a white blanket, appearing unable to move his arms or legs, with only his head moving forward, and heard the resident say, “I am done, I am done.” This staff member stated she reported her observations to nursing staff, who told her the resident had been awake all night and would remain in the chair for a while. Neither dietary staff member reported their observations to administration at that time. Later that morning, an Infection Control LPN observed the resident reclined in a Broda chair with feet elevated and recognized that the reclined Broda chair could be considered a restraint, instructing another LPN to transfer the resident to his regular wheelchair. She stated she did not see restraints or distress. The two dietary staff did not bring their concerns to their supervisor until two days later during a morning meeting, at which time they were asked for written statements and the concern was then reported to administration. The Administrator was not notified until that point, and the Facility-Reported Incident was submitted to the State Agency only after this delayed internal reporting. Facility policies required all allegations of abuse, neglect, or exploitation, including potential restraint use, to be reported immediately to the Administrator and appropriate agencies, and staff interviews confirmed that all staff, including non-nursing staff, were expected to immediately report suspected abuse or restraint use, even if uncertain. The delay from the initial observations to notification of administration and reporting to the State Agency constituted the failure to timely report the suspected abuse.
Failure to Assess Resident Prior to Use of Broda Chair
Penalty
Summary
The deficiency involves the facility’s failure to ensure that a resident received an appropriate assessment before the use of a Broda chair, a specialized seating device. The facility could not provide a policy specific to assessment prior to use of mobility devices, and the existing Functional Impairment – Clinical Protocol only generally addressed assessment upon admission, with significant change, and periodically, including use of consultations and therapy evaluations to guide care planning. The resident involved had multiple diagnoses, including Down syndrome, unspecified cerebral palsy, type 2 diabetes mellitus, congestive heart failure, chronic atrial fibrillation, epilepsy, benign prostatic hyperplasia, chronic kidney disease stage 3, anxiety, restlessness and agitation, lumbar compression fractures, abdominal distension, obstructive uropathy, and urogenital implants. The most recent MDS showed severely impaired memory and cognitive skills for daily decision-making, but no impairment in upper or lower extremity function, use of a manual wheelchair for mobility, and no use of restraints, bed rails, bed alarms, or chairs that prevent rising. The care plan documented limited mobility with supervision for short ambulation distances and wheelchair use, and addressed fall risk and safety with interventions such as staff supervision and environmental safety measures. Staff interviews revealed that the Broda chair was used for the resident without a prior therapy assessment or documented PT referral. An LPN acknowledged that the resident had not been assessed for use of the Broda chair before it was used. A restorative CNA reported being unaware of the resident using a Broda chair and stated the resident used a regular wheelchair and was able and preferred to stand. A PTA explained that when a Broda chair is considered, nursing is expected to submit a PT referral for an assistive device evaluation, after which PT determines appropriateness and provides recommendations; she confirmed there was no PT referral for this resident and that she had never seen the resident in a Broda chair. During a joint interview with leadership staff, the LPN stated the Broda chair was used for comfort rather than mobility but acknowledged a PT referral should have been initiated, and the RN and Administrator agreed that an assessment should have been completed in accordance with policy. These findings show the resident used a Broda chair without the required assessment to determine appropriateness, need, and safe use.
Failure to Prevent Resident-to-Resident Abuse Due to Lack of Supervision
Penalty
Summary
The facility failed to prevent resident-to-resident abuse when one resident with a history of inappropriate sexual behavior and severe cognitive impairment was able to have unsupervised access to another resident. The resident with high-risk heterosexual behavior and a BIMS score indicating severe cognitive impairment was care planned for behavioral problems, including inappropriate sexual behavior, with interventions to protect others. Despite these interventions, the resident was observed by an LPN holding another resident's hand, attempting to kiss his hands and arms, and pulling on his arm while the other resident tried unsuccessfully to pull away. No staff were present at the nurses' station at the time, as CNAs were making rounds, allowing the incident to occur without immediate intervention. The second resident involved had diagnoses including Alzheimer's disease, dementia, and impaired cognitive function, and was care planned for self-care deficits, aggression, wandering, and resistive behaviors. The incident was witnessed by an LPN, who intervened to separate the residents and was assisted by another staff member. The lack of supervision and failure to implement effective interventions allowed the opportunity for the inappropriate contact to occur, constituting a failure to protect residents from abuse as required by facility policy.
Failure to Develop and Implement Comprehensive Care Plan for Resident with Suicidal Ideation
Penalty
Summary
The facility failed to develop and implement a comprehensive, person-centered care plan with specific interventions to ensure the psychosocial well-being and safety of a resident with multiple mental health diagnoses, including schizoaffective disorder, bipolar disorder, major depressive disorder, anxiety disorder, and a history of suicidal ideation and attempts. Despite the resident being cognitively intact and having a care plan that included interventions such as 15-minute safety checks, use of only plastic silverware, placement in a room with a roommate, and removal of potentially harmful items, there were lapses in the execution and specificity of these interventions. Documentation revealed that the resident had recent incidents of self-harm, including drinking hand sanitizer and attempting to suffocate herself with a plastic bag. Observations showed that clear trash liners, which could pose a risk, were accessible in both the resident's and roommate's trash cans. Staff interviews indicated a lack of consistent understanding regarding the appropriateness of trash liners in the resident's environment. The facility's policy required comprehensive care plans with measurable objectives and timeframes, but the care plan for this resident did not adequately address all identified risks or ensure staff were fully informed and consistent in implementing interventions.
Failure to Assess and Document Alternatives Prior to Bed Rail Installation
Penalty
Summary
The facility failed to ensure that a resident was properly evaluated for bed rail use and that alternative measures were attempted prior to the installation of bed rails. According to the facility's policy, the use of bed rails is prohibited unless specific criteria are met, including the use of alternatives, an interdisciplinary evaluation, a resident assessment, and informed consent. For one resident with diagnoses including cerebral palsy, schizoaffective disorder, bipolar disorder, major depressive disorder, anxiety disorder, suicidal ideations, and paraplegia, there was no documentation of an initial bed rail assessment, alternatives tried, or consent for bed rail use. The resident was noted to be cognitively intact based on a Brief Interview for Mental Status (BIM) score of 15. Observations revealed a bed rail in the lowered position on the right side of the resident's bed, with the bed pushed against the wall on the left side. Staff interviews confirmed the presence of the bed rail and acknowledged that the required assessment, documentation of alternatives, and informed consent were not completed prior to installation. The Administrator and DON were unable to explain how the required documentation and interdisciplinary review were missed.
Failure to Maintain RN Coverage
Penalty
Summary
The facility failed to maintain Registered Nurse (RN) coverage for eight consecutive hours seven days a week on specific dates, namely 8/10/2024, 8/11/2024, 8/24/2024, and 8/25/2024. This deficiency was identified through staff interviews and a review of the facility's Daily Nursing Staff Reports, which indicated the absence of RN coverage during each shift on the mentioned dates. The Administrator, who has been interim since July 2024, confirmed the requirement for RN coverage and acknowledged the potential for negative outcomes due to the lack of RN presence. This failure had the potential to leave all 68 residents without necessary medical assistance that only an RN could provide.
Failure to Maintain Dishwasher Sanitizer Levels
Penalty
Summary
The facility failed to maintain the chemical level of the low temperature dishwasher at a level that would sanitize soiled dishes, potentially affecting all 68 residents. During an observation, a dietary aide was seen running dishes through the dishwasher, which was not dispensing any sanitizer into the rinse cycle. The test strip used to check the sanitizer level did not change color, indicating a zero parts per million (PPM) concentration of chlorine. Despite this, the aide continued to wash dishes without notifying anyone about the issue. The facility's policy required the sanitizer level to be between 50 and 100 PPM, and the dishwasher log should have been completed three times daily to ensure proper maintenance. Further investigation revealed that the sanitizer level had not been checked since the morning, and the dishwasher log was incomplete for several days. The dietary aide admitted that she was supposed to inform the Dietary Manager if the sanitizer was not at the correct level but planned to do so only after the manager arrived the next morning. The Dietary Manager later confirmed that the sanitizer should have been at 50 PPM and acknowledged that the staff should not have used the dishwasher when the sanitizer level was zero.
Failure to Protect Residents from Abuse
Penalty
Summary
The facility failed to protect residents from mental and verbal abuse, as evidenced by incidents involving several residents. Resident R19, who had no cognitive decline, was involved in multiple incidents of verbal harassment. R19 accused R53 of stealing, leading to a physical altercation where R53 struck R19 with magazines. Additionally, R19 made inappropriate remarks about R11's body, which were overheard by a staff member. Despite these incidents, R19's care plan was not updated with new interventions to address his behaviors. Resident R16, who was cognitively intact, also displayed verbally aggressive behaviors. R16 was reported to have asked R53 if she wanted to be raped, a statement that was overheard by a nurse. R16 admitted to making the inappropriate comment and apologized. Furthermore, R16 was accused of verbally abusing residents R122 and R71 by calling them derogatory names. Despite these incidents, R16's care plan did not include new interventions to manage her behaviors. The facility also failed to protect a resident from physical abuse. R53, who had severe cognitive impairment, struck R48 with a plastic plate during a disagreement over bingo prizes. R48, who had moderate cognitive decline, was not injured but the incident highlighted the facility's inability to prevent physical altercations. The facility's policies on abuse prevention were not effectively implemented, as evidenced by the lack of updated care plans and interventions for residents involved in these incidents.
Inadequate Supervision Leads to Resident Altercations
Penalty
Summary
The facility failed to provide adequate supervision to prevent accidents involving a resident with severe dementia, delusions, and paranoid schizophrenia, who exhibited aggressive behaviors towards other residents. The resident, identified as R6, had a history of negative behaviors and was involved in multiple altercations with other residents, including hitting another resident with a tray lid and striking another resident in the face. Despite these incidents, the facility did not implement new interventions in R6's care plan to address these behaviors. In one incident, R6 was involved in an altercation with another resident, R23, after being run into by R23's wheelchair. The facility's Activities Director witnessed the incident but was unable to prevent it. Another altercation occurred when R6 entered the wrong room and began touching another resident, R36, due to confusion after a room change. The facility did not provide adequate monitoring or redirection for R6, which contributed to these incidents. The facility's failure to provide continuous monitoring and appropriate interventions for R6's aggressive behaviors resulted in repeated altercations with other residents. Staff interviews confirmed that monitoring was insufficient, and the facility did not maintain the necessary supervision to prevent these incidents. The lack of timely psychiatric consultation and failure to update care plans further contributed to the deficiency.
Failure to Accurately Reflect DNR Status in Medical Records
Penalty
Summary
The facility failed to ensure that a resident's medical record accurately reflected her request to not have cardiopulmonary resuscitation (CPR) in the event of cardiopulmonary failure. The resident, who was cognitively intact with a Brief Interview for Mental Status (BIMS) score of 15 out of 15, had a documented Do Not Resuscitate (DNR) order in her paper chart. However, her electronic medical record (EMR) and admission record inaccurately indicated she was a full code, meaning CPR should be attempted. The resident's paper chart contained a sticker indicating DNR and a signed document titled "Do Not Resuscitate for Resident with Decision Making Capacity," which clearly stated that CPR was not to be initiated. Additionally, the Advanced Directive Checklist signed by the resident also had the DNR order check marked. Despite these clear indications in the paper record, the EMR and admission record failed to reflect the resident's wishes accurately. The Assistant Director of Nursing (ADON) confirmed the inaccuracies in the EMR and paper chart during an interview.
Delayed Reporting of Abuse Incident
Penalty
Summary
The facility failed to report an allegation of abuse within the required two-hour timeframe for two residents, R6 and R36, as per their policy on Abuse, Neglect, and Exploitation. R6, who has severe cognitive impairments including Alzheimer's disease and schizophrenia, allegedly entered R36's room early in the morning, touched her inappropriately, and yelled at her. R36, also severely cognitively impaired, reported the incident to a CNA, who then informed an LPN. However, the incident was not reported to the abuse coordinator until five and a half hours later, which was confirmed by the facility's Administrator. The incident occurred when R6, in a wheelchair, entered R36's room and began touching her and pulling off her blankets. The CNA who witnessed the event removed R6 from the room and later reported the incident to the charge nurse. However, the report was not clearly communicated, leading to a delay in notifying the appropriate authorities. The facility's investigation included a handwritten statement from the CNA, who admitted to not ensuring the nurses heard the report. The Administrator acknowledged the delay in reporting the incident, which was not in compliance with the facility's policy.
Failure to Investigate Resident Abuse Allegation Thoroughly
Penalty
Summary
The facility failed to thoroughly investigate an allegation of staff-to-resident abuse involving a resident who reported being treated roughly by a CNA. The resident, who was cognitively intact, reported that the CNA was rude, pushed her wheelchair out of reach, and made her lie in her own urine. The resident also reported being shoved, which was immediately reported to the abuse coordinator, and a police report was made. The resident was assessed for injuries, with scratches on her wrists and bruising on her shins noted. However, the investigation did not document any inquiry into these injuries. The facility's investigation concluded that abuse could not be substantiated, and the CNA involved was suspended but quit shortly after. Despite a follow-up interview with the resident, there was still no documentation that the resident was asked about the scratches and bruises. The administrator, who was not employed during the investigation, acknowledged that the resident should have been asked about these injuries. The lack of thorough investigation into the resident's reported injuries represents a deficiency in the facility's handling of the abuse allegation.
Failure to Provide Written Transfer Notice
Penalty
Summary
The facility failed to provide a resident and their responsible party with a written notice of transfer and the reasons for the transfer, as required by their policy. This deficiency was identified during a review of the facility's policy titled 'Transfer and Discharge,' which mandates that a transfer notice be provided to the resident and representative when a discharge is initiated by the facility for medical reasons to an acute care setting such as a hospital. The review of the electronic medical record (EMR) and hard chart for one resident revealed no transfer/discharge notices were provided, despite the resident being hospitalized. The resident in question, who had moderately impaired cognition, was readmitted to the facility with multiple diagnoses, including acute respiratory failure and chronic kidney failure. During an interview, the resident confirmed hospitalization but could not recall receiving any written notices. The Business Office Manager admitted that no written transfer/discharge notice was sent to the resident or their responsible party, although the ombudsman was notified. This oversight had the potential to leave the resident and their responsible party unaware of the transfer and its reasons.
Failure to Monitor Adverse Effects of Antidepressant Medication
Penalty
Summary
The facility failed to monitor for adverse consequences and behaviors related to the use of antidepressant medication for one resident, identified as R24, who was part of a sample of 43 residents reviewed for unnecessary medications. The facility's policy on antipsychotic medication use, dated July 2022, requires staff to observe, document, and report any side effects or adverse consequences of such medications to the attending physician. However, a review of R24's records, including the Medication Administration Record (MAR), Treatment Administration Record (TAR), and the TASKS tab, revealed no documentation of monitoring for adverse consequences or behaviors. R24 was admitted with diagnoses including bipolar disorder and generalized anxiety disorder and was prescribed sertraline HCl (Zoloft), an antidepressant, for depression. Despite the care plan's directive to monitor and document any adverse reactions to psychotropic medications, there was no evidence of such monitoring in the resident's records. During an interview, the Assistant Director of Nursing (ADON) confirmed the absence of documentation for monitoring behaviors or adverse consequences, acknowledging that such monitoring should have been documented.
Medication Cart Security Breach
Penalty
Summary
The facility failed to ensure the security of a medication cart on the B Hall, which was left unattended and unlocked, allowing potential unauthorized access to medications. During an observation, the cart was found between rooms B5 and B78, out of the nurse's sight, and unlocked. Inside the cart were residents' liquid medications and insulin vials, easily accessible to anyone passing by. Two residents were noted to be within close proximity to the unlocked cart, which remained unsecured for approximately 17 minutes until the Assistant Director of Nursing locked it. Interviews with staff revealed that an LPN admitted to forgetting to lock the cart due to moving too quickly to another hall. The LPN acknowledged the importance of keeping the cart locked to ensure resident safety. The Director of Nursing confirmed that medication carts are expected to be locked when not in use or out of sight and mentioned that nursing staff had been educated on this requirement, although she was unsure of the last training session.
Failure to Indicate Daily Census on Nursing Staff Reports
Penalty
Summary
The facility failed to indicate the daily census on the Daily Nursing Staff Report(s) from 7/29/2024 through 8/26/2024. This omission was identified during a review of the reports provided by the Administrator. The reports, which are required to be posted daily for nursing homes participating in Medicare and Medicaid programs, contained a space for the facility census, but this information was not filled in. The absence of this information could lead to uncertainty for resident family, friends, or other visitors regarding the ratio of nursing staff to residents. The facility census at the time was 68 residents. During an interview, the interim Administrator, who had been in the role since July 2024, confirmed that the census should have been indicated on the posted reports.
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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 Dahlonega
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Chelsey Park Health And Rehabilitation | 0.8 mi | ★★★★★ | 1 | 0 |
| Friendship Health And Rehab | 12.3 mi | ★★★★★ | 5 | 0 |
| Willowbrooke Court At Lanier Village Estates | 12.3 mi | ★★★★★ | 3 | 0 |
| Gateway Health And Rehab | 13 mi | ★★★★★ | 3 | 0 |
| Pruitthealth - Limestone | 17.2 mi | ★★★★★ | 0 | 0 |
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