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 Magnolia Crossing Nursing And Rehabilitation Cente during CMS and state inspections, most recent first.
Incomplete care plans failed to reflect key resident needs, including bowel and bladder incontinence, MDS-triggered areas such as pain, dehydration, and psychosocial wellbeing, and pressure ulcers/injuries. One resident with moderate cognitive impairment was always incontinent, another resident with Alzheimer’s disease had triggered CAA areas not included in the care plan, and two residents with wound orders and pressure injuries had no corresponding wound focus in their comprehensive care plans. Interviews with the DON, MDS nurse, and MDS Coordinator confirmed the omissions.
Inaccurate PASRR Level 1 Screening for Resident with PTSD: A resident with PTSD and severe cognitive impairment had a PASRR PL-1 coded as no evidence of mental illness even though PTSD was documented in the chart and care plan. The MDS nurse stated the diagnosis was missed during review of admission clinicals, and the Administrator stated the facility followed the Texas HHS PL-1 guide but had no specific policy for PL-screening submissions.
Care plans were not reviewed and revised by the IDT after falls for two residents with significant cognitive impairment and multiple diagnoses, including dementia, TBI, seizures, and reduced mobility. One resident was found on the floor and said he hit his head, and another resident reported being in bed and then on the floor; both events were assessed by staff, but the falls were not documented in the comprehensive care plans. The MDS nurse, DON, and Administrator stated the falls should have been included in the care plans.
Improper wound cleansing technique during pressure ulcer care: A wound care nurse used the same gauze to cleanse both the wound bed and peri-wound area for one resident with multiple wounds, and for another resident with a stage 4 pressure injury she cleansed only the wound bed before applying treatment. The nurse, IP, and DON all stated that accepted practice was to use separate clean gauze for the wound bed and peri-wound area, and the facility did not have a policy addressing care according to accepted professional standards.
Surveyors found that a CMA left multiple medications, including Aspirin, Zyrtec, Iron, Vitamin B-12, Cyanocobalamin, Eliquis, Metformin HCl, Hydroxyzine, Lisinopril, and Protonix, on top of a medication cart while the cart was unattended in a resident care area. The CMA reported being in a resident’s room at the time and acknowledged that medications should have been placed back inside the locked cart. Other staff, including another CMA, the ADM, the DON, and the NP, confirmed that facility policy requires all medications to remain secured in a locked cart when not in immediate use and that the cart must not be left unlocked or unattended.
A resident with severe cognitive impairment, Parkinson’s disease, epilepsy, and ID/DD was identified as receiving PASRR services, including a customized wheelchair and planned habilitation coordination, but the facility failed to submit the required NFSS request after an IDT meeting where OT for self-feeding and seating was recommended. The resident’s PCSP indicated specialized OT was not needed, while an OT evaluation documented skilled OT services focused on restoration and compensation, billed to Managed Care Part B rather than PASRR. An OT discharge summary noted the resident was not on PASRR as originally thought and that OT was held after benefits were exhausted. Interviews with the MDS nurse, DON, Regional MDS nurse, and administrator confirmed there was no evidence of an NFSS submission, and leadership acknowledged relying on non-PASRR-funded OT instead of requesting PASRR NFSS, contrary to regulatory requirements.
A resident with dementia, severe cognitive impairment, a history of falls, gait abnormalities, muscle weakness, and poor coordination required substantial/maximal assistance and one-person assist for transfers per the MDS and care plan. Video evidence showed a CNA repeatedly transferring the resident between bed and wheelchair without a gait belt, pulling the resident up by the hand without back support, failing to lock the bed, and abruptly seating the resident while the resident screamed, cried, and appeared to grimace. During one transfer from the restroom, the resident’s private area was exposed and the CNA again transferred the resident without a gait belt. The DON and therapy director stated gait belts should be used for transfers and that not using them could result in falls or injury, and facility policy required compliance with safe handling/transfer practices.
A resident with severe cognitive impairment and multiple medical diagnoses reported difficulty breathing to staff. Despite care plan requirements, an LVN failed to assess the resident's respiratory status or check vital signs when the concern was first raised, instead instructing staff to leave the room. The deficiency was confirmed through interviews, record review, and video evidence, showing a lack of immediate clinical assessment in response to the resident's reported symptoms.
The facility did not promptly report suspected abuse, neglect, or theft, nor did it report the results of its investigation to the appropriate authorities as required.
Staff failed to follow infection control and hand hygiene procedures during care for two residents, including not washing hands after handling soiled linen and using gloves that had fallen on the floor. These actions were not consistent with facility policy and were confirmed by staff and leadership interviews.
A resident who was fully dependent on staff for care had soiled linens with dried fecal matter and food crumbs that were not changed for 8 days, despite repeated requests to CNAs. Staff interviews confirmed that linen changes were expected on shower or bed bath days, but this was not consistently performed, and observations confirmed the ongoing issue. Nursing and administrative staff acknowledged the requirement for clean linens and the facility's policy on resident rights to a clean environment.
A resident with severe cognitive impairment and total dependence for ADLs did not consistently receive scheduled bed baths as required by her care plan. Documentation showed missed bed baths on multiple scheduled days, and staff interviews revealed confusion about responsibilities and documentation procedures. The resident’s family reported that hygiene care was often only provided after their requests, and facility leadership confirmed that care was not consistently delivered or documented according to policy.
A CNA was observed sleeping while assisting a resident with severe cognitive impairment and dysphagia risk during a meal. The resident began coughing and signaled distress, but the CNA did not respond or provide supervision as required by the care plan. Other staff and a roommate confirmed the CNA's inattention, and video evidence showed the CNA repeatedly asleep during the feeding process.
Incomplete Care Plans for Incontinence, Triggered CAA Areas, and Pressure Injuries
Penalty
Summary
The facility failed to develop and implement comprehensive person-centered care plans with measurable objectives and time frames for multiple residents whose assessments identified specific care needs. For one resident, the comprehensive care plan did not include a focus for bladder and bowel incontinence even though the MDS showed the resident was always incontinent of both bowel and bladder and had a BIMS score of 8 indicating moderate cognitive impairment. The resident was observed lying in bed watching TV, was oriented to person and place only, and stated she wore a brief. Staff interviews confirmed the resident was incontinent and wore a brief, and the MDS nurse stated the incontinence should have been reflected in the care plan. A second resident’s care plan did not include diagnoses and triggered care areas identified on the admission assessment. The resident had diagnoses including Alzheimer’s disease, anxiety disorder, depression, and pain, and the MDS triggered care areas for pain, dehydration, and psychosocial wellbeing. The care plan reviewed for this resident did not include those triggered areas and did not address Alzheimer’s disease. The DON and MDS Coordinator both reviewed the care plan and stated that all CAA areas should be care planned to properly care for the resident. Two additional residents had pressure ulcers or injuries that were not incorporated into their comprehensive care plans. One resident had physician orders for wound care to multiple skin shear wounds, including the sacrum, left upper back, and left buttocks, and the MDS CAA summary indicated pressure ulcer care planning was triggered, but the care plan did not address pressure ulcer/injury as a focus of care. Another resident had physician orders for a stage 4 pressure injury to the upper left posterior calf and a skin tear to the left lateral leg, the MDS indicated the resident was at risk for pressure ulcers/injuries, and the care plan did not address the stage 4 pressure injury. Interviews with the DON, LVN, and MDS Coordinator confirmed the omissions in the care plans.
Inaccurate PASRR Level 1 Screening for Resident with PTSD
Penalty
Summary
The facility failed to ensure that the preadmission PASRR Level 1 screening for Resident #4 accurately reflected her status. Resident #4 was originally admitted on 7/12/2025 and later readmitted, and her record showed a diagnosis of PTSD on the face sheet. Her MDS quarterly assessment also showed a BIMS score of 7, indicating severe cognitive impairment, and the care plan identified a mood problem related to PTSD with interventions addressing mood, sleep, and symptoms of depression and anxiety. The PASRR Level 1 screening dated 7/10/2025 coded Resident #4 as 0, indicating no evidence or indicator of mental illness, even though PTSD was present on admission and documented in the record. During interview, the resident stated she had a history of trauma and used Bible Study in the facility as a coping method. The MDS nurse stated she was responsible for reviewing and submitting PASRR screenings, that she did not receive many admission clinicals for Resident #4 because the resident came directly from home, and that the PTSD diagnosis was not caught. The Administrator stated the facility followed the Texas HHS guide for completing the PL-1 screening form and did not have a specific policy regarding PL-screening submissions.
Care plans not revised after resident falls
Penalty
Summary
The facility failed to review and revise the comprehensive care plan by the interdisciplinary team after changes in condition for 2 of 21 residents reviewed. Resident #42 had diagnoses including dementia, depression, hypertension, anxiety disorder, history of falling, neoplasm of the brain, and reduced mobility. Her annual MDS showed severely impaired cognition, supervision needed for eating, hygiene, and dressing, maximum assistance needed for toileting and bathing, and frequent bowel and bladder incontinence. Her care plan identified high fall risk related to confusion, gait and balance problems, and incontinence, but it did not document the fall event that occurred when she stepped into the hallway, reported that she had been in bed and then on the floor, and was assessed by staff after the incident. Resident #7 had diagnoses including traumatic brain injury, pancytopenia, psychological disorder, seizures, dementia, and depression. His MDS showed severely impaired cognitive skills, need for supervision/set-up for eating, total dependence for hygiene, toileting, showering, and dressing, and constant bowel and bladder incontinence. His care plan identified high fall risk related to confusion and incontinence and a separate fall care plan related to unsteady gait and poor safety awareness, but it did not document the fall when he was found sitting on the floor mat, stated he hit his head, and was sent to the ER after staff assessed him. The MDS nurse, DON, and Administrator stated the care plans should have documented the falls, and the facility policy stated comprehensive care plans would be reviewed and revised by the interdisciplinary team after each comprehensive and quarterly MDS assessment.
Improper wound cleansing technique during pressure ulcer care
Penalty
Summary
The facility failed to ensure that wound care for two residents with pressure ulcers/injuries was provided using accepted aseptic technique. Resident #13 was a severely cognitively impaired male with diagnoses including nontraumatic intracerebral hemorrhage, congestive heart failure, end stage renal disease, and hypertension. Although his assessment and care plan did not identify pressure ulcers/injuries as a focus of care, physician orders dated 07/10/2026 directed wound care for skin shear to the sacrum, left upper back, and left buttocks. During observation, the wound care nurse saturated one piece of gauze with wound cleanser and used the same gauze to clean both the wound bed and the peri-wound area, repeating this process two times before applying the ordered treatments and dressings. Resident #22 was a severely cognitively impaired female with diagnoses including encephalopathy, congestive heart failure, type 2 diabetes, and hypertension. Her quarterly assessment identified her as at risk for pressure ulcers/injuries, and physician orders directed treatment for a stage 4 pressure injury to the upper left posterior calf and a skin tear to the left lateral leg. During observation, the wound care nurse performed wound care to the stage 4 pressure injury, prepared supplies, removed the old dressing, and cleansed the wound bed with one piece of gauze. After cleansing the wound bed, the nurse discarded the gauze and applied the ordered ointment and dressing. During interview, the wound care nurse stated that accepted wound care practice was to cleanse the wound bed with one piece of gauze, discard it, and then use a separate clean piece of gauze to cleanse the peri-wound area. She stated that using the same piece of gauze for the wound bed and peri-wound, or failing to cleanse the peri-wound with a separate clean gauze, was not performed according to accepted professional standards. The Corporate Clinical Specialist/Infection Preventionist and the DON both confirmed that the expected practice was to use separate clean gauze for the wound bed and peri-wound area and stated that the observed care did not follow accepted standards. The facility also did not have a policy addressing provision of care according to accepted professional standards.
Unsecured Medications Left Unattended on Medication Cart
Penalty
Summary
Surveyors identified a deficiency related to medication security and storage involving Medication Cart #1 on Hall A. During a complaint and incident investigation, observation of the cart at 9:38 a.m. showed four medication bottles and five blister packs left on top of the cart unsupervised, rather than secured inside the locked cart as required. The medications observed included Aspirin 81 mg chewable tablets, Zyrtec 10 mg tablets, Iron 325 mg tablets, Vitamin B-12 1,000 mg, Cyanocobalamin 500 mcg tablets, Eliquis 2.5 mg tablets, Metformin HCl 1,000 mg tablets, Hydroxyzine 25 mg tablets, Lisinopril 10 mg tablets, and Protonix 20 mg delayed-release tablets. These medications were not under direct supervision and were not stored in locked compartments as required by facility policy and professional standards. In an interview, CMA B acknowledged that she had been informed a picture was taken of her medication cart and, upon viewing it, stated she had been "moving too fast" and confirmed that medications should be placed inside the cart and locked before leaving it unattended. She reported that she had been in a resident’s room while the cart, with medications on top, was left unattended. Additional interviews with another CMA, the ADM, the DON, and the NP confirmed that medications are expected to be kept inside a locked cart when not in immediate use and that leaving medications on top of the cart unsupervised is contrary to facility policy dated 10/01/19, which states that the mobile medication cart is to ensure appropriate control and surveillance of medications and must not be left unlocked or unattended in resident care areas.
Failure to Submit NFSS and Implement PASRR-Recommended OT Services
Penalty
Summary
The deficiency involves the facility’s failure to coordinate PASRR-recommended services and to submit a Nursing Facility Specialized Services (NFSS) request within the required timeframe for a resident with significant cognitive and neurological impairments. The resident, an older female with Parkinson’s disease, epilepsy, cognitive communication deficit, and unspecified intellectual disabilities, had a BIMS score of 6 indicating severe cognitive impairment and was identified as receiving PASRR services related to ID/DD. Her care plan noted that a customized manual wheelchair was acquired through PASRR and that she would participate in habilitation coordination to establish a PASRR plan. A PASRR program spreadsheet showed that an IDT meeting occurred for this resident, but the PASRR department did not receive an NFSS service request for an OT assessment and OT services, despite the PASRR meeting resulting in a request for OT to address self-feeding and seating. The resident’s PCSP form indicated that specialized OT was not needed, while an OT evaluation and plan of treatment documented that she was receiving skilled OT services with a focus on restoration and compensation, paid by Managed Care Part B rather than PASRR funds. An OT discharge summary stated that the resident was not on PASRR as originally thought, so OT would be held, and listed the reason for discharge as exhausted benefits. Interviews with the MDS nurse, DON, Regional MDS nurse, and administrator revealed that no documentation of an NFSS submission could be produced, and the Regional MDS nurse acknowledged that OT services were provided under another payor source and that he did not see an NFSS request in the record. The DON stated the NFSS was not filed because the resident was already receiving OT services, which she believed were through PASRR. This failure to submit a complete and accurate NFSS request within 20 business days after the IDT meeting, as required by 26 TAC §554.2704(i)(7), and to incorporate PASRR recommendations into the assessment, care plan, and transition of care, constituted the cited deficiency.
Improper Transfer Techniques and Lack of Gait Belt Use During Resident Transfers
Penalty
Summary
The deficiency involves the facility’s failure to provide safe transfers and adequate supervision for a cognitively impaired resident with a history of falls, gait abnormalities, muscle weakness, and lack of coordination. The resident’s MDS dated 01/25/2026 documented severe cognitive impairment with a BIMS score of 4/15 and a need for substantial/maximal assistance for bed mobility, sit-to-stand, and transfers to a wheelchair. The care plan dated 03/29/2025 indicated the resident required one-person assistance for transfers. Video and photo evidence from 02/14/2026 showed CNA A transferring the resident without a gait belt on multiple occasions. At approximately 5:01 p.m., CNA A placed the wheelchair at the bedside, pulled back the covers, and used her right hand to grab the resident’s left hand to pull her up to a sitting position without supporting the resident’s back, during which the resident screamed and appeared to grimace. The bed was not locked and rolled slightly during this process. The same video sequence showed CNA A grasping the resident’s upper right arm by the bicep area, adjusting the resident’s blouse, and then transferring the resident from the bed to the wheelchair without a gait belt, with both appearing to struggle and the resident being assisted into the wheelchair abruptly and appearing to cry. Later, around 5:12 p.m., the video showed CNA A returning the resident from the restroom to the bedside with the resident’s upper body covered but without a brief, leaving the resident’s private area exposed. CNA A then transferred the resident from the wheelchair back to the bed without using a gait belt. Interviews with the Director of Therapy and the DON confirmed that staff were expected to use gait belts for transfers and that failure to do so could result in falls or injury. The facility’s “Safe Resident Handling/Transfers” policy dated 02/19/2025 stated that all residents require safe handling when transferred and that handling aids may include gait belts, and that staff are expected to maintain compliance with safe handling/transfer practices, which was not followed in this case.
Failure to Assess Resident Reporting Shortness of Breath
Penalty
Summary
A deficiency occurred when a resident with multiple complex medical conditions, including a history of stroke, heart failure, and severe cognitive impairment, reported difficulty breathing to staff. The resident's care plan specifically required monitoring and documentation of changes in breathing patterns and prompt reporting of abnormalities to a physician. On the evening in question, the resident verbally expressed to a Restorative Aide that she could not breathe. The aide notified an LVN, who, along with other staff, entered the room. The LVN questioned the resident about her symptoms and medication but did not perform an assessment or check vital signs, including oxygen saturation, as required by the care plan and professional standards of practice. The LVN then instructed staff to leave the room, and no immediate clinical assessment was performed at that time. Subsequently, a family member, observing the situation remotely, called the facility to express concern about the resident's breathing. Another nurse responded to the call, assessed the resident, and documented normal oxygen saturation levels and no signs of distress. The hospice nurse was also called and confirmed the resident was stable upon her arrival. However, the initial failure to assess the resident when she first reported difficulty breathing was corroborated by interviews with staff, the family member, and review of video footage. The Director of Nursing and the Administrator both acknowledged that the LVN did not follow protocol by failing to assess the resident's respiratory status when the concern was first raised. The facility's policy required staff to assess, evaluate, and respond to residents' needs, including performing necessary clinical assessments when a resident reports symptoms such as shortness of breath. The deficiency was identified based on the lack of immediate assessment and documentation when the resident expressed respiratory distress, despite clear care plan interventions and facility policy. This lapse was confirmed through interviews, record reviews, and video evidence.
Failure to Timely Report Suspected Abuse, Neglect, or Theft
Penalty
Summary
The facility failed to timely report suspected abuse, neglect, or theft and did not report the results of the investigation to the proper authorities. This deficiency was identified based on a review of facility practices and documentation, which showed that when an incident of suspected abuse, neglect, or theft occurred, the required notifications and reporting to authorities were not completed within the mandated timeframe. The report does not provide specific details about the individuals involved or the nature of the incident, but it clearly documents the failure to follow required reporting protocols.
Failure to Follow Infection Control and Hand Hygiene Procedures
Penalty
Summary
The facility failed to maintain an effective infection prevention and control program, as evidenced by staff not following proper hand hygiene and infection control procedures during resident care. In one instance, a CNA entered a resident's room carrying soiled linen and trash from another room, removed her gloves, and did not wash her hands before providing care. The CNA acknowledged that she should have discarded the soiled items and gloves before entering another room and should have performed hand hygiene before and after resident contact. Facility leadership and the CNA both confirmed that these actions were not in line with facility policy and posed a risk of cross-contamination. In another case, an LVN was observed entering a resident's room, picking up gloves that had fallen on the floor, and then donning them to provide care, including administering water and checking blood sugar. The LVN did not discard the contaminated gloves or perform hand hygiene before or after providing care. The LVN later stated that the correct procedure would have been to discard gloves that fell on the floor and to wash hands before and after resident contact. The resident involved had multiple diagnoses, including dementia, diabetes, and mobility issues, and required regular blood sugar checks and assistance with care. Interviews with staff and facility leadership confirmed that the expectation was for all staff to follow hand hygiene protocols and not to use contaminated PPE. Facility policy required hand hygiene before and after resident contact and proper handling of soiled linen. The observed failures by both the CNA and LVN to adhere to these protocols resulted in a deficiency related to infection prevention and control for the residents involved.
Failure to Maintain Clean and Safe Resident Environment
Penalty
Summary
A facility failed to provide a safe, clean, and homelike environment for a resident who was dependent on staff for all activities of daily living due to severe cognitive impairment and functional quadriplegia. The resident's linens had not been changed for 8 days, and observations revealed dried fecal matter and food crumbs on the bedding. The resident reported having requested multiple CNAs to change his sheets, but staff did not return to complete the task after stating they needed assistance. The resident received bed baths on scheduled days, during which linen changes were supposed to occur, but this was not consistently done. Interviews with the resident's family member confirmed ongoing complaints about unchanged linens and unmet care needs. Staff interviews revealed that CNAs were responsible for changing linens, typically on shower or bed bath days, and were expected to document any refusals of care. However, there was a lack of follow-through, and the linen remained soiled despite the resident's requests and scheduled care routines. Observations on consecutive days confirmed that the condition of the linens did not improve. Nursing and administrative staff, including the interim DON and the administrator, acknowledged that linens should be changed on shower days and as needed, and that failure to do so could result in dignity issues and potential health concerns. The facility's resident rights policy emphasized the right to live in safe, decent, and clean conditions, which was not upheld in this instance.
Failure to Provide Scheduled Bed Baths for Dependent Resident
Penalty
Summary
The facility failed to ensure that a resident with severe mental impairment and a need for assistance with personal care received scheduled bed baths as required. Record review showed that the resident, diagnosed with Alzheimer’s disease and always incontinent, was care planned to receive bed baths three times per week on specific days and shifts. Documentation revealed that bed baths were not provided or recorded on several scheduled dates over a 30-day period, despite the resident’s inability to perform activities of daily living independently. Interviews with staff indicated a lack of clarity and communication regarding which staff were responsible for providing and documenting bed baths for the resident. Certified Nursing Assistants (CNAs) expressed uncertainty about why the resident had missed scheduled bed baths, with some staff unaware of the resident’s care needs or relying on outdated shower sheets instead of the electronic Plan of Care (POC) system. The resident’s representative and family members also reported that bed baths were often only provided after they requested them, and they monitored care through a camera in the resident’s room. Facility leadership, including the Clinical Specialist, Interim DON, and Administrator, acknowledged that showers and bed baths should be provided and documented according to the POC. However, discrepancies in documentation and staff communication led to missed care. The facility’s policy required that care and services for activities of daily living, including bathing, be provided based on comprehensive assessment and resident needs, but this was not consistently followed for the resident in question.
CNA Fell Asleep During Feeding, Failing to Supervise Resident with Dysphagia Risk
Penalty
Summary
A deficiency occurred when a certified nursing assistant (CNA) fell asleep while providing feeding assistance to a resident with severe cognitive impairment and multiple medical conditions, including dementia, malnutrition, atrial fibrillation, osteoporosis, diabetes, and hypertension. The resident required supervision or touching assistance for eating and had recently been evaluated for dysphagia, with recommendations for close supervision during oral intake. Despite these needs, the CNA was observed on video footage sleeping in a chair next to the resident during lunch, with her eyes closed and head nodding, while the resident was left unattended. During the incident, the resident began coughing while the CNA remained asleep and did not respond to the resident's distress. The video showed the resident covering her mouth and waving her hand to indicate she did not want more food, but the CNA did not wake up or check on her. Another resident in the room attempted to alert the CNA by calling out, but the CNA only briefly woke up, smiled, and then resumed sleeping. The CNA's inattention persisted throughout the meal period, and she attempted to feed the resident again after waking, despite the resident's refusal. Interviews with staff and residents confirmed that the CNA fell asleep multiple times while assisting with feeding and failed to respond when the resident coughed. The resident's care plan required close supervision during meals, and the facility's policies emphasized the need for necessary services to maintain good nutrition and health. The failure to provide adequate supervision during feeding placed the resident at risk, as documented by the survey findings.
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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 Houston
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Park Manor Of South Belt | 0.8 mi | ★★★★★ | 2 | 0 |
| Oasis At Pearland | 3.9 mi | ★★★★★ | 6 | 0 |
| The Suites Pasadena | 4.9 mi | ★★★★★ | 21 | 1 |
| Hca Houston Healthcare Southeast | 5 mi | ★★★★★ | 0 | 0 |
| Pasadena Post Acute | 5.4 mi | ★★★★★ | 6 | 0 |
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