Above average — CMS composite of the measures below.
The next survey window likely opens around June 2027
Estimate from public CMS data, current as of October 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Alpine Nursing Home Inc during CMS and state inspections, most recent first.
A facility failed to inform multiple residents or their representatives in advance about psychotropic medication starts and dose changes, including the risks, benefits, side effects, and treatment alternatives. Records for residents with diagnoses such as depression, anxiety, Alzheimer’s disease, and Parkinson’s disease showed new orders and dose adjustments for meds like Ativan, quetiapine, sertraline, mirtazapine, duloxetine, trazodone, Seroquel, and lorazepam without evidence of advance informed consent. Staff said consent was obtained on admission, but could not produce documentation showing the required discussions occurred before the medication changes.
Missing Hospice Documentation in Resident Care Plans: The facility failed to include the most recent hospice POC and a description of LTC services in the written care plans for three residents receiving hospice. Record review found missing hospice certification, hospice election, and/or most recent hospice POC for residents with diagnoses including follicular lymphoma, COPD, adult failure to thrive, and Parkinson's disease. The Charge Nurse and DON acknowledged the hospice documents were not in the EMR.
Failure to Monitor Antibiotic Use and Complete Antibiotic Time-Outs: The facility did not have an effective antibiotic stewardship program with a system to monitor antibiotic use or complete antibiotic time-outs. Five residents received antibiotics for pneumonia or other infections, including levofloxacin, doxycycline hyclate, Augmentin, and clindamycin, but the record did not show evidence of an antibiotic review process to reassess whether the antibiotics remained indicated or needed adjustment. The DON was unable to provide evidence that the time-outs were completed.
Missing Documentation for Pneumococcal Vaccinations: The facility failed to document that 3 residents who had signed consent forms actually received the pneumococcal vaccine or had a documented reason for not receiving it. Record review showed signed consents for each resident, but no evidence in the medical record that the vaccine was administered. The IP acknowledged the consents were signed and the residents should receive the vaccine, and the DON could not provide proof that it had been given.
Late MDS Assessments After Readmission: The facility failed to complete required MDS assessments within the required timeframe for two residents after hospital-related readmissions. One resident had COPD and adult failure to thrive and was on hospice, while another resident was readmitted with pneumonia; in both cases, the assessments were not completed or submitted on time, and the RAC and DON acknowledged the delay.
A facility failed to complete timely SCSAs for two residents after hospice enrollment, leaving both assessments in progress beyond the required timeframe. One resident had follicular lymphoma and the other had Parkinson's disease; the RAC acknowledged the assessments were not completed, and the DON stated hospice admission was the significant change date and the SCSAs should have been finished within the required period.
A resident with atrial fibrillation had a physician order for oxygen at 2-4 LPM via NC for SOB PRN, but surveyors observed the resident receiving 1 to 1.5 LPM instead. An RN acknowledged the oxygen flow did not match the order, and the MAR documented repeated administration of oxygen outside the ordered range across multiple shifts.
Failure to provide prorated interest for resident funds held in a pooled interest-bearing account. Record review showed two residents did not have evidence of receiving prorated interest on their Personal Needs Statements, and the Administrator was unable to provide proof that the interest had been prorated for either resident.
The facility failed to meet the nutritional needs of residents as its diet manual did not include national guidelines or current Dietary Reference Intakes. Additionally, the menu served lacked standardized recipes, and the Food Service Director confirmed the absence of recipes with caloric and nutrient content.
The facility was cited for several deficiencies in food service safety, including improperly labeled spray bottles, accumulation of grease on kitchen surfaces, uncovered trash receptacles, and improper cooling of food. These issues were observed during a survey and acknowledged by the Food Service Director.
A facility failed to follow a physician's order for a resident with bradycardia by measuring the radial pulse instead of the apical pulse. The Medication Technician documented the radial pulse as the apical pulse on the MAR for multiple days, which was acknowledged by the Director of Nursing Services.
The facility failed to provide trauma-informed care for five residents by not completing trauma assessments or developing care plans that accounted for their traumatic experiences and preferences. The Director of Nursing Services confirmed the lack of completed assessments, despite the facility's policy emphasizing the importance of addressing past trauma.
The facility failed to ensure that nursing staff had the necessary competencies to provide safe and effective care. Five Medication Technicians were found to lack the skills to obtain an apical pulse, impacting the care of a resident with bradycardia. The Director of Nursing Services confirmed the absence of competency assessments for these staff members.
The facility failed to provide respiratory care consistent with professional standards for two residents. One resident's oxygen tubing was not changed as ordered, and another resident received an incorrect oxygen flow rate. Both discrepancies were acknowledged by nursing staff and the Director of Nursing Services.
The facility failed to maintain accurate medical records for two residents receiving oxygen therapy. One resident's oxygen tubing was not changed as documented, and another resident's PRN oxygen administration was not recorded in the Treatment Administration Record.
The facility failed to conduct appropriate infection control practices for two staff members during the care of COVID-19 positive residents. Staff D administered eye drops without gloves and did not perform hand hygiene, while Staff E performed nail care without gloves and brushed nail clippings onto the floor. Both staff members admitted to not following proper PPE protocols.
The facility failed to ensure accurate assessments for a resident with hand contractures. Despite OT evaluations documenting contractures in both hands, the MDS Assessments did not reflect these findings on multiple dates. The Therapy Manager and DON confirmed the oversight, acknowledging the inaccuracy in the assessments.
Failure to Inform Residents and Representatives Before Psychotropic Medication Changes
Penalty
Summary
The facility failed to inform residents or their appointed representatives, in advance, of the care to be furnished by the physician or other provider, including the risks and benefits of proposed care or treatment alternatives, before initiating or changing psychotropic medications for multiple residents. The deficiency involved Resident ID #1, #3, #4, #5, #28, and #30, all of whom had clinical records showing psychotropic medication use or changes without evidence that advance notification and informed discussion occurred before therapy began. Resident ID #1 was readmitted with diagnoses including adjustment disorder and major depressive disorder and was identified as using high-risk medications, including anti-anxiety medications. The resident was prescribed Ativan 0.5 mg once daily as needed from 6/3/2026 through 8/3/2026, but the record did not show that the resident or representative was informed in advance of the new psychotropic medication, or of its risks, benefits, side effects, or treatment alternatives before it was started. Resident ID #3 had diagnoses including generalized anxiety disorder, delusional disorders, and major depressive disorder, and was receiving psychotropic medications with risk for side effects, adverse drug reactions, and oversedation. The resident received quetiapine, sertraline, and mirtazapine, including medication additions and dose changes. Although a psychotropic consent form signed by the representative was present, it did not identify any of the resident’s psychotropic medications, and the record did not show advance notification for the additions or dose increases, or evidence that risks, benefits, side effects, and alternatives were discussed before therapy changes. Resident ID #4, #5, #28, and #30 also had records showing psychotropic medication use without evidence of advance informed notification. Resident ID #4 received duloxetine 90 mg daily; Resident ID #5, who had Alzheimer’s disease, received Ativan with multiple changes in dose and frequency; Resident ID #28, who had Alzheimer’s disease with late onset, received trazodone and sertraline; and Resident ID #30, who had Parkinson’s disease, received Seroquel, trazodone, and lorazepam with multiple additions and dosage changes. For each of these residents, the record failed to show that the resident or representative was informed in advance of the medication changes or that the risks, benefits, side effects, and treatment alternatives were discussed before psychotropic therapy was initiated or adjusted. Staff interviews confirmed that psychotropic consent was obtained on admission, but the Charge Nurse and DON were unable to provide evidence of psychotropic consents for the residents for the listed medications or evidence that advance informed consent occurred for the medication changes.
Missing Hospice Documentation in Resident Care Plans
Penalty
Summary
The facility failed to ensure that each resident's written plan of care included the most recent hospice plan of care and a description of the services furnished by the facility for residents receiving hospice services. Clinical record review showed that Resident ID #2, admitted with diagnoses including follicular lymphoma and adult failure to thrive, was admitted to hospice, but the electronic and paper medical record did not contain a signed hospice election form or the resident's hospice certification and plan of care. Record review also showed that Resident ID #6, with diagnoses including COPD and adult failure to thrive, and Resident ID #30, with a diagnosis including Parkinson's disease, were both admitted to hospice, but their records did not contain the hospice certification and most recent plan of care. During interviews, the Charge Nurse stated that hospice documents should be scanned into the electronic medical record and acknowledged they were not, and the DON stated that hospice certifications and plans of care were sent to her email but had not been uploaded into the residents' electronic medical records until the surveyor brought it to her attention.
Failure to Monitor Antibiotic Use and Complete Antibiotic Time-Outs
Penalty
Summary
The facility failed to establish an Infection Prevention and Control Program that included an antibiotic stewardship program with antibiotic use protocols and a system to monitor antibiotic use. Record review showed that the facility policy titled Antibiotic Stewardship required an ongoing program to promote appropriate antibiotic use and included an antibiotic time-out 48 to 72 hours after initiation to consider colonization versus infection and possible early discontinuation. The Centers for Disease Control and Prevention guidance cited in the report also described the need for standardized practices, antibiotic review processes, and tracking antibiotic use patterns. Clinical record review found that five residents received antibiotics for pneumonia or other infections, including levofloxacin, doxycycline hyclate, Augmentin, and clindamycin. Resident ID #6 had levofloxacin ordered for pneumonia, Resident ID #19 had doxycycline hyclate ordered for pneumonia, Resident ID #29 had levofloxacin ordered for pneumonia, Resident ID #42 had Augmentin ordered for a surgical site infection and pneumonia, and Resident ID #44 had clindamycin ordered for pneumonia. For each of these five residents, the record failed to show evidence that the facility completed an antibiotic review process or antibiotic time-out to determine whether the antibiotic remained indicated or needed adjustment. During interview, the DON was unable to provide evidence that the antibiotic time-outs had been completed for these residents.
Missing Documentation for Pneumococcal Vaccinations
Penalty
Summary
The facility failed to ensure that residents' medical records included documentation showing that the pneumococcal vaccine was administered or that it was not given because of a medical contraindication or refusal for 3 of 3 residents reviewed who had consented to vaccination. Review of the facility's pneumococcal vaccination policy showed that the vaccine history of all residents is to be established on admission, the vaccine is to be offered to eligible residents within 5 days of admission depending on prior vaccine history, and residents or their designated family members are to receive the vaccine information statement and sign a consent form before administration. Record review showed that Resident ID #39, readmitted in August 2025, signed a consent form on 9/11/2025 for pneumococcal vaccination. Resident ID #42, admitted in January 2026, had a consent form dated 1/21/2026 signed by the responsible party for pneumococcal vaccination. Resident ID #44, admitted in August 2025, had a consent form dated 10/8/2025 signed by the responsible party for pneumococcal vaccination. Despite these signed consents, the record review did not reveal evidence that the pneumococcal vaccine was administered to any of the three residents. During interview, the Infection Preventionist acknowledged that the consents were signed and the residents should receive the pneumococcal vaccine, and the DON was unable to provide evidence that the vaccine had been given.
Late MDS Assessments After Readmission
Penalty
Summary
The facility failed to complete comprehensive assessments within 14 calendar days after admission for 2 residents readmitted after hospitalization. Resident ID #6 was readmitted in January 2026 with diagnoses including chronic obstructive pulmonary disease and adult failure to thrive, and was admitted to hospice on 1/23/2026; the admission MDS assessment was not completed until 2/8/2026, 18 days after admission. Resident ID #29 was readmitted in June 2026 with a diagnosis including pneumonia; the resident was discharged on 6/25/2026 and readmitted on [DATE], but the discharge MDS assessment remained incomplete as of 7/13/2026, 18 days after discharge. During interviews, the Resident Assessment Coordinator acknowledged the MDS assessments were not completed and submitted within the required timeframes, and the DON stated she would expect the assessments to be completed within the required timeframes.
Failure to Complete Timely Significant Change Assessments for Hospice Enrollment
Penalty
Summary
The facility failed to complete a Significant Change in Status Assessment (SCSA) within 14 days after a significant change in condition for 2 of 3 residents reviewed for hospice services. Resident ID #2 was admitted to the facility with a diagnosis including follicular lymphoma and was admitted to hospice services on 6/24/2026. An SCSA was created with an ARD date of 7/7/2026, but as of 7/13/2026 it was still listed as in progress, and Section Z did not show a RN Assessment Coordinator signature and date, indicating the assessment remained incomplete 19 days after the significant change was determined. Resident ID #30 was readmitted to the facility with a diagnosis including Parkinson's disease and was admitted to hospice services on 6/18/2026. An SCSA was created with an ARD date of 7/2/2026, but as of 7/13/2026 it was still listed as in progress, and Section Z did not show a RN Assessment Coordinator signature and date, indicating the assessment remained incomplete 25 days after the significant change was determined. During interview, the Resident Assessment Coordinator acknowledged both SCSAs were still in progress and not completed, and the DON stated that hospice admission is considered the date of the significant change in status and that the SCSAs should have been completed within the required time frame.
Oxygen Therapy Not Provided as Ordered
Penalty
Summary
The facility failed to provide respiratory care consistent with professional standards of practice for a resident receiving oxygen therapy. The resident was readmitted in January 2026 with diagnoses including atrial fibrillation, and had a physician order dated 12/18/2025 for oxygen at 2-4 LPM via nasal cannula for shortness of breath every shift as needed. Surveyor observations showed the resident receiving oxygen outside the ordered range on multiple occasions, including 1.5 LPM on 7/8/2026 and 1 LPM on 7/9/2026. During a simultaneous observation and interview on 7/9/2026, an RN acknowledged the resident was receiving 1 LPM and confirmed it did not match the physician's order. Review of the July 2026 MAR showed documentation that the resident had been receiving 1.5 LPM across numerous shifts from 7/1/2026 through 7/9/2026, and the DON stated she would expect the amount of oxygen administered to match the physician's order.
Failure to Provide Prorated Interest on Resident Funds
Penalty
Summary
The facility failed to provide prorated interest for residents whose personal funds were held in a single interest-bearing account. Record review showed that Resident ID #15, admitted in August 2019, did not have evidence of receiving prorated interest from 3/31/2025 through 2/28/2026 on the Personal Needs Statement. Record review also showed that Resident ID #46, admitted in April 2018, did not have evidence of receiving prorated interest from 8/31/2025 through 2/28/2026 on the Personal Needs Statement. During an interview on 7/13/2026 at approximately 1:06 PM, the Administrator was unable to provide evidence that either resident received prorated interest.
Failure to Meet Nutritional Needs Due to Lack of Standardized Recipes
Penalty
Summary
The facility failed to provide a dietary menu that meets the nutritional needs of residents in accordance with established national guidelines. The facility's diet manual, titled Alpine Nursing Home LLC Dietary Manual 2024-2025, did not include the established national guidelines for developing regular and therapeutic diet menus. Additionally, the manual lacked the current Dietary Reference Intakes, which are necessary to ensure the nutritional adequacy of the menu served to the resident population. A review of the menu served from March 24, 2025, through March 27, 2025, showed no evidence of standardized recipes being on file. During an interview with the Food Service Director, in the presence of the Director of Nursing Services, it was revealed that the facility does not have standardized recipes with caloric and nutrient content.
Deficiencies in Food Service Safety and Labeling
Penalty
Summary
The facility was found to have several deficiencies in food service safety during a survey. Observations revealed that spray bottles in the main kitchen were improperly labeled, lacking necessary information such as a signal word or a statement indicating that full label information was available on the outside package. This was in violation of the State Operations Manual Appendix PP-Guidance to Surveyors for Long Term Care Facilities and the Occupational Safety and Health Administration Standard. Additionally, the kitchen hood over the stove was noted to have an accumulation of grease, which was acknowledged by the Food Service Director (FSD) as needing cleaning, contravening the Rhode Island Food Code requirement for nonfood contact surfaces to be free of dirt and debris. Further observations identified that trash receptacles in the kitchen were uncovered and not in continuous use, which is against the Rhode Island Food Code. Moreover, the facility failed to properly cool cooked time/temperature control for safety food, as evidenced by the split pea soup not reaching the required temperature within the specified time frame. The FSD was unaware of this issue until it was pointed out by the surveyor. These findings indicate a failure to adhere to professional standards for food service safety, as required by relevant regulations.
Failure to Follow Physician's Order for Apical Pulse Monitoring
Penalty
Summary
The facility failed to ensure that services provided met professional standards of quality by not following a physician's order for a resident diagnosed with bradycardia. The resident had a physician's order to monitor the apical pulse daily, which is the most accurate evaluation of heart rate, especially when an abnormality is detected. However, during a surveyor observation, it was found that a Medication Technician, Staff A, obtained the resident's radial pulse instead of the apical pulse as ordered. Staff A admitted to documenting the radial pulse as if it were the apical pulse on the Medication Administration Record (MAR) for multiple days in April 2024. The Director of Nursing Services acknowledged that Staff A did not follow the physician's order and confirmed that it is the facility's expectation for staff to adhere to such orders. The MAR review for April 2024 showed that Staff A documented obtaining the apical pulse on eight out of twelve days, despite actually measuring the radial pulse. This discrepancy highlights a failure in following professional standards and physician directives, potentially impacting the resident's care and monitoring for bradycardia.
Failure to Provide Trauma-Informed Care
Penalty
Summary
The facility failed to ensure that residents who are trauma survivors received trauma-informed care in accordance with professional standards of practice. Specifically, for five residents, the facility did not complete trauma assessments or develop and implement care plans that accounted for their traumatic experiences and preferences. Resident ID #31, who was admitted with diagnoses including depression, anxiety, and dementia with psychotic disturbance, had a documented history of trauma involving the tragic death of a spouse. Despite this, there was no evidence of a completed trauma assessment or a care plan addressing the trauma. Similarly, residents ID #22, #26, #50, and #51, all admitted with various forms of dementia and anxiety, also lacked documented trauma-informed care assessments. During an interview, the Director of Nursing Services confirmed that trauma assessments were the responsibility of the Social Worker but was unable to provide evidence that these assessments had been completed for the mentioned residents. The facility's policy on Trauma-Informed Care & Compassion Fatigue emphasizes the importance of recognizing and addressing past traumatic experiences to provide a sense of safety and well-being for residents. However, the facility did not adhere to this policy, resulting in a failure to provide appropriate trauma-informed care for the affected residents.
Failure to Ensure Nursing Staff Competency in Obtaining Apical Pulse
Penalty
Summary
The facility failed to ensure that nursing staff possessed the appropriate competencies and skill sets to provide nursing and related services to assure resident safety and maintain the highest practicable physical well-being of each resident. Specifically, five Medication Technicians (MTs) were found to lack the competency to obtain an apical pulse, which is a critical measurement for residents with certain heart conditions. This deficiency was identified through surveyor observations, record reviews, and staff interviews. For instance, Resident ID #8, who was admitted with a diagnosis of bradycardia, had a physician's order to monitor the apical pulse daily. However, during an observation, Staff A was found to be obtaining the radial pulse instead of the apical pulse as ordered. Staff A admitted to documenting the radial pulse as if it were the apical pulse on the Medication Administration Record (MAR). The Director of Nursing Services (DNS) confirmed that there was no evidence that the five MTs had demonstrated the competencies and skill sets for obtaining an apical pulse. The deficiency was further substantiated by the DNS's acknowledgment that the facility lacked evidence of competency assessments for the MTs in question. This lapse in ensuring proper competencies directly impacted the care provided to residents, particularly those with specific medical conditions requiring accurate heart rate monitoring. The report highlights that the facility did not meet the regulatory requirements as outlined in the State Operation Manual Appendix PP, which mandates that all nursing staff possess the necessary competencies to meet residents' needs safely and promote their well-being.
Failure to Provide Appropriate Respiratory Care
Penalty
Summary
The facility failed to provide respiratory care consistent with professional standards of practice for two residents. Resident ID #2, who was readmitted with diagnoses including acute and chronic respiratory failure, obstructive sleep apnea, and pulmonary fibrosis, had a physician's order to change oxygen tubing weekly. However, surveyor observations on multiple dates revealed that the oxygen tubing was not changed as per the order, with the tubing labeled with an outdated date. Both the Licensed Practical Nurse and the Director of Nursing Services acknowledged the discrepancy during interviews. Resident ID #23, admitted with chronic obstructive pulmonary disease and heart failure, had a physician's order for oxygen administration at 2-4 liters per minute as needed for shortness of breath. Surveyor observations found that the resident was receiving only 1.5 liters per minute, contrary to the physician's order. The Registered Nurse and the Director of Nursing Services confirmed that the oxygen was not administered as prescribed. These failures indicate a lack of adherence to physician orders and professional standards of practice in respiratory care.
Failure to Maintain Accurate Medical Records for Oxygen Therapy
Penalty
Summary
The facility failed to maintain accurate medical records in accordance with professional standards for two residents receiving oxygen therapy. For Resident ID #2, who was admitted with acute and chronic respiratory failure, obstructive sleep apnea, and pulmonary fibrosis, a physician's order required weekly changes of oxygen tubing. Despite documentation indicating the tubing was changed on 4/6/2024, surveyor observations on 4/10/2024 and 4/11/2024 revealed the tubing was dated 3/31. Both a Licensed Practical Nurse and the Director of Nursing Services confirmed the discrepancy, acknowledging the inaccurate documentation. For Resident ID #23, admitted with chronic obstructive pulmonary disease and heart failure, a physician's order prescribed oxygen via nasal cannula as needed for shortness of breath. Surveyor observations on 4/11/2024 and 4/12/2024 confirmed the resident was receiving oxygen, but the Treatment Administration Record (TAR) was not signed off for these dates. A Registered Nurse admitted to not documenting the administration of oxygen on 4/12/2024, and the Director of Nursing Services confirmed that the expectation was for nursing staff to document PRN oxygen administration on the TAR.
Infection Control Deficiency: PPE and Hand Hygiene Failures
Penalty
Summary
The facility failed to conduct appropriate infection control practices relative to personal protective equipment (PPE) and hand hygiene for two staff members, Staff D and E, during the care of COVID-19 positive residents. Staff D was observed administering eye drops to a resident without wearing gloves and touching the resident's bedside table and drawer without performing hand hygiene. Staff D acknowledged the failure to apply gloves and perform hand hygiene before administering the eye drops. This incident involved a resident diagnosed with Alzheimer's disease who was admitted in April 2022 and was on droplet and contact precautions due to a COVID-19 outbreak in the facility. Similarly, Staff E was observed performing nail care for another COVID-19 positive resident without wearing gloves and brushing nail clippings off the resident's bed onto the floor. Staff E also touched the resident's bedside table without wearing gloves. Staff E admitted to not applying gloves before entering the room. This incident involved a resident diagnosed with type 2 diabetes who was admitted in January 2022 and was also on droplet and contact precautions. The Director of Nursing Services (DNS) confirmed the expectation for staff to follow proper infection control practices but could not explain why Staff D and E failed to do so.
Failure to Accurately Reflect Resident's Hand Contractures in Assessments
Penalty
Summary
The facility failed to ensure that the assessment accurately reflected the resident's status for a resident with hand contractures. The resident was admitted in January 2022 with diagnoses including age-related physical disability, tremors, and contracture of the right hand. Occupational Therapy (OT) evaluations and treatments from April 2023 to November 2023 documented contractures in both hands, which caused functional limitations. However, the Minimum Data Set (MDS) Assessments did not document these contractures on multiple dates from April 2023 to March 2024. During a surveyor observation in April 2024, the resident's hands appeared contracted. Interviews with the Therapy Manager and the Director of Nursing Services confirmed that therapy was provided for the hand contractures and that the MDS Assessments should have reflected these contractures. The Director of Nursing Services acknowledged the inaccuracy in the MDS Assessments and was unable to provide evidence that they were completed accurately for the resident's hand contractures.
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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 Coventry
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Coventry Operations Ri Llc Dba Respiratory And Reh | 3.8 mi | — | 40 | 4 |
| Kingston Center For Rehabilitation And Health Care | 7.4 mi | ★★★★★ | 0 | 0 |
| Riverview Healthcare Community | 7.7 mi | ★★★★★ | 14 | 2 |
| Cra-mar Meadows | 8.1 mi | — | 0 | 0 |
| West View Nursing Home, Inc | 8.5 mi | ★★★★★ | 9 | 2 |
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