Below average — CMS composite of the measures below.
The next survey window likely opens around March 2027
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 Hidalgo Nursing And Rehabilitation Center during CMS and state inspections, most recent first.
A resident with moderate dementia and severe cognitive impairment was started on Zyprexa after a MH NP changed her medication regimen, and physician orders documented its use for depression and later unspecified psychosis. Progress notes showed that the responsible party (RP) was informed of psychiatric recommendations and was later contacted multiple times regarding a pending consent form, and also requested discontinuation of Zyprexa while the consent remained unsigned. Despite this, the MAR showed that Zyprexa was administered on two occasions before any written consent was obtained, contrary to staff statements and facility policy requiring a signed antipsychotic consent from the resident or RP and the prescriber, and prior disclosure of risks, benefits, and alternatives.
A resident with moderate dementia and severe cognitive impairment, but no documented psychosis or behavioral symptoms, was started on Zyprexa (olanzapine) 10 mg at bedtime after a mental health NP changed her medication regimen. Physician orders listed varying indications for the antipsychotic, including depression, unspecified psychosis, anxiety, and bipolar disorder, despite the clinical record and MDS lacking corresponding documented diagnoses at the time. Nursing staff reported that they were responsible for entering and clarifying antipsychotic orders and recognized that inappropriate indications for dementia residents could constitute a chemical restraint. The DON could not locate documentation supporting a stated history of schizophrenia, and the facility’s own psychotropic drug policy required a specific, diagnosed, and documented condition for such medications, leading surveyors to find that the antipsychotic was used without an adequate indication.
Failure to Notify LTC Ombudsman of Resident Discharges: The facility failed to send discharge notices to the LTC Ombudsman for most resident discharges, sending only AMA discharges instead of all discharges. The SW said she was instructed by the Administrator to report only AMA cases and did not know all discharges had to be sent, while the ADON and Administrator also stated they were unaware of the requirement and that the facility did not follow its Transfer and Discharge policy.
Food service safety deficiencies were observed in the kitchen and dining area. Two dietary employees were not wearing beard restraints properly, scratched non-stick pans were hanging in the dishwash room, the cook prepared raw ground beef without gloves, and the can opener had a black substance on the working side. In the dining area, a CNA touched a resident’s glass, dessert cup, and peaches while serving food. Surveyors also observed uncovered dinner rolls on top of the oven and ceiling vents with black substance and condensation dripping to the floor.
A resident with an indwelling Foley catheter and severe cognitive impairment was observed with the catheter bag/tubing laying on the floor beside the bed. An LVN stated it should not touch the floor because it could pick up bacteria, and the ADON confirmed the catheter should be secured on the bed frame side and not on the floor; the facility procedure also stated the catheter must be properly secured.
A resident receiving O2 via nasal cannula was observed with the tubing touching the floor and no oxygen sign posted outside the room. The resident had acute respiratory failure with hypercapnia and HF, and staff confirmed the missing sign and the tubing issue during interview.
Loose Tablets Found in Medication Carts: The facility failed to keep meds in proper labeled packaging when five loose tablets were found in one med cart and eight loose tablets/capsules were found in another med cart among residents’ blister packs. An MA said she was responsible for one cart and cleaned it at the end of her shift, while the ADON stated the cart should be cleaned once per shift with no loose pills, expired items, or disorganized supplies; the facility policy also required med carts and supplies to be clean and orderly.
A resident with an indwelling Foley catheter and diagnoses including bladder dysfunction and HF was observed receiving incontinent and catheter care by two CNAs who used gloves but did not wear gowns as required for EBP. Both CNAs stated they forgot the gowns, and the ADON confirmed that EBP required gown and glove use for residents with catheters, feeding tubes, or wounds.
A resident with intact cognition and multiple comorbidities, including DM and bilateral below-knee amputations, kept his wallet and debit card in a safe in the business office. He routinely requested his debit card to buy snacks, handing it to the assistant business office manager (ABOM) to purchase items from an employee lounge vending machine. On one such occasion, the ABOM retained the card instead of returning it to the business office manager (BOM), and there was no system in place to verify the card’s return to the safe. When the BOM later attempted to collect the resident’s applied income, the transaction was declined, and a bank review revealed numerous unauthorized transactions totaling over $1,300. The resident denied authorizing these charges, and facility interviews and document review, including a receipt from a local vendor bearing the ABOM’s name and the resident’s card number, showed that the ABOM had used the resident’s debit card without consent, constituting misappropriation of the resident’s funds.
A resident with multiple respiratory diagnoses did not receive BIPAP therapy as ordered when the primary machine malfunctioned and the RT on duty was unaware of the backup device, resulting in the resident being placed on supplemental oxygen for the night despite facility protocols and staff training regarding backup equipment.
A resident with mobility issues and a history of falls required a mechanical lift for transfers, but this was not documented in the care plan. CNAs used the lift for safety, but the LVN and DON were unaware, leading to a discrepancy between care provided and documented. The facility's policy requires comprehensive care plans, but this was not met for the resident.
A facility failed to document a resident's assessment after a CNA reported redness on the resident's leg. The LVN assessed the resident for flu symptoms instead and did not document the findings or inform the oncoming nurse. The resident, with dementia and other health issues, was unable to communicate effectively. Despite staff training on documentation, the LVN cited being busy as the reason for the oversight.
A resident with dementia and hemiplegia was verbally abused by a CNA during a transfer attempt. The resident attempted to hit the CNA, who responded with inappropriate language. The incident was overheard by an LVN, who intervened and reported the event to the administration. The resident was assessed and found to have no injuries.
Antipsychotic Administered Without Prior Informed Consent
Penalty
Summary
The deficiency involves the facility’s failure to obtain and document informed consent for an antipsychotic medication prior to administration. A female resident with moderate dementia, anxiety, and depression, and a BIMS score of 02 indicating severe cognitive impairment, was admitted with no documented psychiatric or mood disorders, no indicators of psychosis, and no behavioral symptoms. Her care plan, however, included a focus on the use of the antipsychotic medication Zyprexa related to psychosis, initiated and revised in mid-April 2026. On 03/18/2026, a mental health nurse practitioner evaluated the resident and ordered discontinuation of Keppra, Buspar, and melatonin, and initiation of Zyprexa 10 mg at bedtime and Topamax 100 mg twice daily. Physician orders documented Zyprexa 10 mg at bedtime first for depression and then for unspecified psychosis. Progress notes indicated that the resident’s responsible party (RP) understood the psychiatric recommendations, and later notes documented calls to the RP regarding a pending signature for consent and that discontinuation of Zyprexa was requested by the RP while the consent signature was still pending. The MAR showed that Zyprexa 10 mg was administered on two evenings in early April without a signed consent from the RP. Interviews with nursing staff confirmed that facility practice and policy required a signed consent form from the resident or RP and the physician/NP before administering antipsychotic medications, and that verbal consent alone was not sufficient. Staff acknowledged that administering an antipsychotic without a signed consent could mean the RP or resident was not informed of side effects or other information about the medication. The DON confirmed that the resident received Zyprexa on two occasions without a consent form signed by the RP, despite the facility’s written policy stating that, prior to initiating or increasing psychotropic medications, the resident or representative must be informed of benefits, risks, alternatives, and have the opportunity to accept or decline, with documentation of this information in a format chosen by the facility.
Inadequate Indication for Antipsychotic Use Resulting in Chemical Restraint
Penalty
Summary
Surveyors identified a deficiency related to the facility’s failure to prevent the use of unnecessary psychotropic medications and chemical restraints for one resident. The resident was an elderly female with moderate dementia, anxiety, and depression, admitted with severe cognitive impairment as evidenced by a BIMS score of 02. Her MDS showed no psychiatric or mood disorders, no indicators of psychosis such as hallucinations or delusions, and no behavioral symptoms. She required extensive assistance with ADLs, including showers, toileting, and personal hygiene. Her routine medications included antidepressants, an antibiotic, hypoglycemics (including insulin), and anticonvulsants. The clinical record showed that on a specific date, a mental health NP evaluated the resident and issued new orders to discontinue Keppra, Buspar, and melatonin, and to start Zyprexa (olanzapine) 10 mg at bedtime and Topamax 100 mg twice daily. Progress notes documented that these orders were carried out and the responsible party was notified. Subsequent physician orders listed multiple and changing indications for Zyprexa 10 mg at bedtime, including depression, unspecified psychosis, anxiety, and bipolar disorder, despite the resident’s MDS and record lacking documented psychosis, mood disorder, or bipolar diagnosis at that time. The Zyprexa order also carried a black box warning for increased mortality in elderly patients with dementia-related psychosis, and the medication was administered on multiple days during the month per the MAR. Interviews with nursing staff and the DON revealed that nurses were responsible for entering NP or physician antipsychotic orders into the computer and were expected to clarify any unclear or inappropriate indications, particularly for residents with Alzheimer’s or dementia. LVNs interviewed acknowledged that antipsychotics for dementia residents required a specific, accurate indication and that vague indications such as altered mental status would be inappropriate, potentially constituting a chemical restraint. The DON stated that the NP had written the Zyprexa order for psychosis and later referenced a history of schizophrenia and bipolar disorder, but the DON could not locate documentation of schizophrenia in the record. The facility’s psychotropic drug use policy required that psychotropic medications only be used to treat a specific, diagnosed, and documented condition and not as a chemical restraint, and defined chemical restraint as any drug used for discipline or staff convenience and not required to treat medical symptoms. The lack of an adequate, documented indication for Zyprexa prior to its administration constituted the identified deficiency.
Failure to Notify LTC Ombudsman of Resident Discharges
Penalty
Summary
The facility failed to send a copy of residents’ discharge notices, prior to discharge, to the representative of the Office of State Long-Term Care Ombudsman for 77 of 81 residents discharged during the first 3 months of 2026. Record review of the monthly discharge report dated 04/14/2026 showed that only 4 discharges, all Against Medical Advice (AMA), were sent to the LTC Ombudsman for January, February, and March 2026. The facility policy for Transfer and Discharge stated that the facility would maintain evidence that the notice was sent to the Ombudsman. During interview, the Social Worker stated she had been instructed by the Administrator to send only AMA discharges to the LTC Ombudsman and said she did not know she was supposed to send all resident discharges monthly or bi-monthly. The ADON stated she was not aware the Ombudsman was to receive notice of all discharges every month, and the Administrator stated the facility failed to follow its policy and procedure for notifying the LTC Ombudsman of monthly discharges. The Administrator also stated the Social Worker had not brought the failure to his attention and acknowledged that only AMA discharges had been reported for the first three months of 2026.
Food Service Safety and Infection Control Deficiencies
Penalty
Summary
The facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety in the kitchen and dining area. During an initial kitchen tour, surveyors observed two male dietary employees not wearing beard restraints properly, a set of 11 non-stick pans with scratched or peeling coating hanging in the dishwash room, the cook preparing raw ground beef without gloves, and a can opener with a black substance coating the working side. The facility’s policies stated that food was to be prepared and handled according to state and US Food Codes and that beard coverings and other hair restraints must be worn. During a dining observation, CNA C was observed serving A resident and touching the rim of the drinking glass and dessert cups after removing protective covering, then touching the peaches with her finger as she placed the cup on the resident’s table. The resident had diagnoses including Alzheimer’s disease, dementia, contracture, and cognitive communication deficit, and was unable to answer surveyor questions during interview. The observation documented improper infection control during food service and direct contact with the resident’s food while serving it. In a later kitchen observation, two cookie sheets of dinner rolls were seen uncovered and sitting on top of the self-standing oven, and the oven doors were observed open while the rolls were being removed and not closed immediately afterward. Surveyors also observed 7 of 9 ceiling air conditioning vents with a black substance around the edges and condensation dripping onto the floor. Interviews with staff and management confirmed awareness of the beard restraint issue, scratched pans, can opener cleaning, uncovered rolls, glove use with raw meat, and the condensation around the vents, and the facility’s food storage policy required FIFO rotation and storage of food according to state, federal, and US Food Codes.
Improper Foley Catheter Placement
Penalty
Summary
The facility failed to ensure appropriate care for a resident with an indwelling urinary catheter when the catheter tubing/bag was observed touching the floor. Resident #19 was a female admitted with a diagnosis of neuromuscular dysfunction of the bladder and had severe impaired cognition with a BIMS score of 1. Her care plan identified that she had a Foley catheter for neuromuscular dysfunction of the bladder, with the catheter bag and tubing to be kept below the level of the bladder and away from the entrance room door. The order summary also listed a Foley catheter with an 18 French, 30 milliliter balloon. During an observation, Resident #19's indwelling catheter bag was noted laying on the floor on the left side of her bed. When informed of this, an LVN stated the bag should not be touching the floor and explained that if it was on the floor it would not drain well and could pick up bacteria from the floor. The ADON later stated the catheter should be on the side of the bed, not on the moving part of the bed frame, so it would not fall, and confirmed it should not be touching the floor because residents could be at risk of infection. The facility's nursing procedure for indwelling urinary catheter care and removal stated to make sure the catheter is properly secured.
Oxygen tubing on floor and missing oxygen sign
Penalty
Summary
Resident #20, a [AGE]-year-old male admitted on 4/8/2026 with diagnoses including Acute Respiratory Failure with Hypercapnia and Heart Failure, was observed on 4/12/2026 lying in bed wearing a nasal cannula and receiving oxygen at 2 liters per minute. During that observation, the oxygen tubing was touching the floor without a protective sleeve, and there was no oxygen sign posted outside his room. His record showed he was on oxygen therapy while a resident, with a care plan noting oxygen therapy PRN for shortness of breath and physician orders started 4/12/2026 for oxygen at 2 liters per minute every shift for hypoxia. During interview, the LVN stated all staff were responsible for posting the oxygen sign outside residents' rooms and verified that Resident #20 did not have one posted. She also stated that oxygen tubing should not touch the floor because it could become contaminated and cause infection, and that the sign was important so people entering the facility would know oxygen was in use for safety. The ADON stated floor nurses were responsible for verifying the tubing was not touching the floor every shift because of infection risk, and said the admitting nurse was responsible for posting the oxygen sign, while also noting that the sign was important for everyone to know oxygen was in use in that room.
Loose Tablets Found in Medication Carts
Penalty
Summary
The facility failed to ensure drugs and biologicals used in the facility were labeled in accordance with currently accepted professional principles, including the appropriate accessory and cautionary instructions and expiration date when applicable. During observation of the 100/200 hall medication cart at 2:37 PM on 04/13/26, five assorted tablets were found loose in the second drawer from the top among blister packs of medications for residents on the 100 and 200 halls. During observation of the 300/400 hall medication cart at 2:54 PM on 04/13/26, eight assorted tablets were found loose in the second drawer from the top among blister packs of medications for residents on the 300 and 400 halls. In interview, MA A stated she was responsible for the 100/200 hall medication cart when the loose pills were found and said she always cleaned out her cart at the end of her shift, including looking for expired medications and loose tablets. MA A stated she had found loose tablets in her cart before when cleaning it and that keeping the cart clean and organized was important to help prevent contamination and protect residents' property. The ADON stated it was nursing best practice for the person responsible for the medication cart to ensure it was cleaned appropriately once per shift, with no loose pills, properly sealed liquids, no expired items, and a clean, organized cart. The facility policy titled Medication Carts and Supplies for Administering Meds, last revised 10/01/19, stated the licensed nurse or medication aide should maintain a clean top surface on the medication cart while passing medications and clean and replenish the medication cart after each use, and that equipment and supplies relating to medication administration are clean and orderly.
Failure to Follow Enhanced Barrier Precautions During Catheter Care
Penalty
Summary
The facility failed to maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment to help prevent the development and transmission of communicable diseases and infections for 1 of 5 residents reviewed for infection control. Resident #20 was a [AGE]-year-old male admitted on 4/8/2026 with diagnoses including neuromuscular dysfunction of the bladder and heart failure. His MDS assessment indicated he had an indwelling catheter, and his care plan identified a need for Enhanced Barrier Precautions due to the Foley catheter. During an incontinent care observation, CNA B and CNA C entered the resident’s room, performed hand hygiene, donned gloves, and prepared supplies. They later discarded the gloves, used hand sanitizer, and put on new gloves, but did not use gowns during incontinent care and catheter care. CNA B stated she should have worn a gown and had overlooked it, and CNA C stated she forgot to use the gown. The ADON stated EBP required staff to wear a gown and gloves for residents with a catheter, feeding tube, or wounds, and the facility’s policy stated EBP included targeted gown and glove use during high-contact resident care activities for residents with urinary catheters.
Failure to Safeguard Resident Debit Card Resulting in Misappropriation of Funds
Penalty
Summary
The deficiency involves the facility’s failure to protect a resident’s personal funds and belongings, specifically the resident’s debit card, from misappropriation. The resident was a 58-year-old male with bilateral below-knee amputations, morbid obesity, diabetes, and a need for assistance with personal care. His quarterly MDS showed a BIMS score of 13, indicating intact cognition. The resident kept his wallet, containing his driver’s license, insurance cards, Social Security card, and debit card, in a safe in the Business Office Manager’s (BOM) office at his own request. He reported that he would request his wallet or debit card from the BOM when he needed to make purchases and that he had never allowed anyone to use his debit card or loaned money to staff. According to the resident, the last time he requested his debit card was in late November, when he wanted a cinnamon roll from a vending machine located in the employee lounge. The BOM gave him his debit card, and he then handed it to the Assistant Business Office Manager (ABOM) to purchase the snack. After receiving the cinnamon roll, the resident returned to his room while the ABOM retained possession of the debit card, telling him she would return it to the BOM. The resident stated that in early January, the BOM informed him that his bank account had been drained and that he had a negative balance, leaving him without funds to pay his applied income for that month. The resident questioned how this could have occurred if only the BOM and ABOM had access to his debit card and suspected the ABOM had used it without his permission. The BOM confirmed that the resident’s wallet was stored in a safe in her office and that the resident regularly requested his debit card to buy cinnamon rolls from the employee lounge vending machine, typically asking the ABOM to make the purchase. She recalled that at the end of November the resident requested his debit card and gave it to the ABOM, but she did not remember whether the ABOM returned the card. The BOM acknowledged that prior to December there was no system in place to ensure the resident’s debit card was returned to the safe, and she did not track the card’s return because she trusted the ABOM and was busy. In early January, when the BOM attempted to collect the resident’s applied income, the transaction was declined, prompting a review of the resident’s bank account. Bank records showed multiple unauthorized transactions in December totaling $1,340.16, and the resident disputed all but three of them. The facility’s internal investigation, including review of a receipt from a local oil change company bearing the ABOM’s name, her vehicle information, the amount charged, and the resident’s debit card number, led the Administrator to substantiate that the ABOM had used the resident’s debit card without consent, resulting in misappropriation of the resident’s funds.
Failure to Provide BIPAP as Ordered Due to Staff Unawareness of Backup Equipment
Penalty
Summary
The facility failed to ensure that a resident who required respiratory care was provided with a BIPAP machine as ordered by the physician. The resident, a male with diagnoses including acute and chronic respiratory failure with hypercapnia, COPD, dependence on supplemental oxygen, obstructive sleep apnea, and pulmonary hypertension, had a physician's order for BIPAP use at night and as needed. On the night in question, the resident's BIPAP machine malfunctioned after being removed for medication administration, and the respiratory therapist (RT) on duty was unable to restore its function. Despite the existence of a backup BIPAP machine in the facility, the RT stated he was not aware of its availability until several hours later, by which time the resident was already asleep. The resident was placed on supplemental oxygen for the remainder of the night. Interviews with other staff, including another RT, a registered nurse, the DON, and the administrator, confirmed that a backup BIPAP machine was available and that staff had been in-serviced on its location and use. Documentation also indicated that the BIPAP machine and backup equipment were to be checked at the beginning and end of each shift, with a sign-off sheet for accountability. The resident did not experience any immediate negative outcomes during the incident, as his oxygen saturation levels remained stable and he did not exhibit shortness of breath. However, the failure to provide the BIPAP machine as ordered constituted a deficiency in following physician orders and ensuring respiratory care consistent with professional standards of practice. The facility's policy required notification and action in circumstances requiring alteration of treatment, such as equipment malfunction, but this was not followed in this instance.
Failure to Document Mechanical Lift Requirement in Care Plan
Penalty
Summary
The facility failed to develop and implement a comprehensive person-centered care plan for a resident, identified as Resident #247, which did not reflect the need for a mechanical lift for transfers. The resident, a male with a history of intervertebral disc degeneration, muscle wasting, abnormalities of gait and mobility, and a history of falling, was admitted with a requirement for substantial assistance in transfers. Despite these needs, the care plan only indicated a two-person assist for transfers without specifying the use of a mechanical lift. Observations and interviews revealed that Certified Nursing Assistants (CNAs) were using a mechanical lift for the resident's transfers to ensure safety due to his size and uncoordinated movements. However, this practice was not documented in the care plan, and there was a lack of communication among staff regarding this requirement. The CNAs were aware of the need for a mechanical lift, but the Licensed Vocational Nurse (LVN) and the Director of Nursing (DON) were not informed, leading to a discrepancy between the care provided and the documented care plan. The facility's policy mandates the development of a comprehensive care plan that includes measurable objectives and timeframes to meet the resident's needs. However, the care plan for Resident #247 did not include the necessary details about the use of a mechanical lift, which could potentially place residents at risk of not receiving the appropriate care. Despite the oversight, the DON confirmed that the resident had not sustained any negative outcomes due to the care plan's omission.
Failure to Document Resident Assessment
Penalty
Summary
The facility failed to maintain clinical records in accordance with accepted professional standards for a resident who was assessed for potential health concerns. Specifically, a Licensed Vocational Nurse (LVN) did not document an assessment after being informed by a Certified Nursing Assistant (CNA) about redness observed on a resident's leg. The resident, an elderly female with multiple diagnoses including unspecified dementia and rheumatoid arthritis, was unable to complete an interview due to cognitive impairments. Despite being alerted to the redness, the LVN assessed the resident for flu symptoms instead and failed to document any findings or communicate the concern to the oncoming nurse. Interviews with staff revealed that the CNA had clearly communicated the specific location of the redness to the LVN, who acknowledged the oversight in documentation due to being preoccupied with other residents. Subsequent assessments by other staff members did not note any redness or bruising, and the Director of Nursing confirmed that staff had been trained on proper documentation procedures. The facility's policy mandates accurate and timely documentation to reflect the resident's experiences and progress, which was not adhered to in this instance.
Verbal Abuse Incident Involving CNA and Resident
Penalty
Summary
The facility failed to ensure that residents were free from verbal abuse, as evidenced by an incident involving a CNA and a resident. The resident, a male with a history of hemiplegia, dementia, and cognitive communication deficit, was involved in an altercation with CNA A. During the incident, the resident attempted to hit the CNA while being assisted to transfer to a wheelchair. In response, CNA A used obscene language in Spanish towards the resident, which was overheard by LVN B, who was nearby. The resident's medical records indicated that he had a potential for physical aggression due to dementia and poor impulse control. On the day of the incident, LVN B heard loud obscene yelling coming from the resident's room and intervened. The CNA was observed deflecting the resident's punches and using inappropriate language. The resident expressed that he did not want to go to the dining room but did not provide a reason for his aggression. After the incident, the resident was assessed and found to have no visible injuries or pain. Interviews and written statements from the staff involved confirmed the occurrence of verbal abuse. CNA A admitted to using inappropriate language during the altercation, citing a loss of temper as the reason. The facility's policy on abuse, neglect, and exploitation defines verbal abuse as the use of disparaging and derogatory terms towards residents. The incident was reported to the facility's administration, and the CNA was instructed to leave the facility immediately after the event.
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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 Edinburg
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Edinburg Nursing And Rehabilitation Center | 0.6 mi | ★★★★★ | 13 | 1 |
| Colonial Manor Advanced Rehab & Healthcare | 1.5 mi | ★★★★★ | 6 | 0 |
| Windsor Nursing And Rehabilitation Center Of Edinb | 2.1 mi | ★★★★★ | 11 | 0 |
| Windsor Arbor View | 2.8 mi | ★★★★★ | 11 | 1 |
| Mcallen Nursing Center | 4.3 mi | ★★★★★ | 4 | 0 |
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