Below average — CMS composite of the measures below.
The next survey window likely opens around April 2027
Estimate from public CMS data, current as of August 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Clement Manor Health Care Center during CMS and state inspections, most recent first.
A resident with full code status was found pulseless and non-breathing, but CPR was not initiated immediately and was performed while the resident remained in a recliner, making it ineffective. Interviews and records showed conflicting timelines for the code response, delayed overhead paging, and a late-entry RN note that did not match the EMT report. The resident had significant cardiac, renal, and respiratory diagnoses and had documented wishes for CPR.
A resident with severe cognitive impairment had repeated falls, and the care plan was not consistently updated with interventions that matched the circumstances of the falls, including attempts to toilet, self-transfer, and unsafe movement from a wheelchair or recliner; the resident later sustained a clavicle fracture and a patella fracture. Another resident with dementia and repeated falls had a fall with skin tears, but the facility could not produce the completed fall investigation or neuro checks, and staff could not verify the root cause or whether appropriate interventions were in place.
Food service sanitation was not maintained when surveyors observed heavy grease, dried food, crumbs, and dirty surfaces on kitchen equipment, a dirty wall behind the dish machine, a spill in a refrigerator, and a scoop left in a ready-to-use flour bin with dirty lids. During meal service, a server handled ready-to-eat buns and other food with gloved hands after touching contaminated surfaces, and also placed part of a hamburger on the steam table surface. The server stated tongs should have been used, and the NHA agreed the food should not have been touched.
Incomplete COVID Outbreak Investigation: The facility did not complete and document a thorough outbreak investigation for a COVID outbreak affecting residents. The outbreak line list showed multiple residents developed respiratory symptoms and tested positive, but there was no documented summary of the investigation and no documentation of whether staff had respiratory symptoms during the outbreak period. The IC RN was unsure if the investigation had been completed, and another RN stated it was not completed.
Antibiotics and an antifungal medication were prescribed for residents even though their symptoms did not meet the facility’s McGeer’s Criteria for infection. Review of the infection line list and McGeer’s Criteria forms showed that several residents with suspected UTI, pneumonia, cellulitis, or fungal skin infection lacked the required signs and symptoms, yet the former Medical Director still prescribed treatment after being informed the cases did not meet the facility’s standard of practice.
Incomplete Investigation of Alleged Misappropriation: A cognitively intact resident reported fraudulent charges on a bank account, and the resident’s family suspected possible staff involvement. The facility interviewed staff and contacted police, but the investigation did not include resident interviews to determine whether other residents had missing credit cards or money, and no documentation showed staff education related to misappropriation after the allegation.
A resident with Parkinson's disease and documented moderate hearing difficulty did not have a comprehensive person-centered care plan addressing being hard of hearing. Although staff said they knew to speak louder, face the resident, and repeat conversation as needed, the communication care plan had blank sections and no pertinent interventions, and the DON acknowledged no hearing-related care plan was found.
Incomplete post-fall neurological monitoring documentation: The facility did not maintain evidence that required neuro checks were completed after falls for two residents with significant cognitive impairment and multiple fall-related events. One resident had several unwitnessed or head-injury falls with only limited charted neuro checks, while the other resident’s fall record and neuro monitoring documentation could not be produced when requested by surveyors.
A resident with diagnoses including Parkinson’s Disease and hydronephrosis had significant weight gains documented, but the EMR did not show notification to the provider or RD, and no reweigh was documented to verify the accuracy of the weights. Staff interviews showed weights were taken on shower days and entered verbally, while the RD questioned the accuracy of the weights and had no documentation requesting a reweigh.
A resident on hospice had repeated monthly pharmacy review recommendations that were not acted on in a timely manner. The pharmacist identified concerns about overdue vital sign checks, possible deprescribing to reduce pill burden, and a Senna order that did not match what was being administered, but the record showed delayed or unclear facility response and no evidence that the recommendations were promptly shared with the provider; the DON could not explain the delay.
Inaccurate Daily Nursing Staffing Postings: The facility’s daily nursing staffing post did not match the actual RN, LPN, and CNA schedules on multiple dates. Surveyors observed the required staffing post and then reviewed the posted staffing against actual night shift schedules, finding repeated discrepancies. The ISS stated the scheduler was responsible for the postings, but the facility was not updating them to reflect actual staffing changes.
Two severely cognitively impaired residents engaged in separate resident-to-resident physical abuse incidents in a dining area. In one event, a resident verbally threatened harm toward another, then kicked the other resident’s wheelchair and pulled her hair until staff intervened. In a later event, the other resident intentionally pinched the first resident’s hand and attempted to run over her feet with a wheelchair, causing the resident to cry. Staff, social services, and the Administrator acknowledged these intentional acts as abuse, contrary to the facility’s abuse-prevention policy.
A resident with a history of DVT was receiving Eliquis 5 mg BID when the Medical Director ordered Paxlovid, prompting a pharmacist-identified drug interaction and a new order to reduce Eliquis to 2.5 mg BID for several days. Due to communication failures between the prescriber, pharmacy, and nursing staff, and confusion over the new Eliquis dose, nursing staff inconsistently held and administered the 5 mg dose while also giving the 2.5 mg dose. As a result, the resident received overlapping Eliquis doses totaling 7.5 mg on multiple days during Paxlovid therapy, contrary to the physician’s dose reduction order and the facility’s policy for accurate dispensing and interaction screening.
Delayed CPR for a Full Code Resident
Penalty
Summary
The facility failed to ensure that a resident with full code status received basic life support, including CPR, in a timely and effective manner after the resident was found pulseless and non-breathing. The resident had been admitted with acute hypoxemic respiratory failure due to acute on chronic heart failure with preserved ejection fraction, severe mitral valve regurgitation with volume overload, pulmonary hypertension, chronic kidney disease stage IV/V requiring temporary dialysis, and anemia. The resident’s MDS documented cognitive intactness with a BIMS score of 15, no activated POA, and full code status, and the care plan also documented the resident’s choice to receive CPR if pulseless and non-breathing. According to the record and interviews, the resident returned from dialysis, was awake and alert, and later ate supper while seated in a recliner. A CNA later observed the resident gray in color and not breathing, and RN-M found the resident breathless and pulseless, gray, and cool to the touch. RN-M documented calling 911 and later documented that chest compressions were started, but the EMT report showed the 911 call was received earlier than the nurse’s late-entry note reflected. The EMT narrative stated staff were performing CPR on arrival, but also documented that facility staff reported only about 3 minutes of CPR had been performed without ventilations and that the resident was still in a recliner when EMS arrived. Interviews showed conflicting accounts of who responded and when CPR began. One nurse stated the code page was heard after EMTs were already arriving, and that CPR was started just before EMTs entered the room. Another staff member stated the code page was overhead and that RN-M started compressions while the resident remained reclined in the chair, requiring staff to lean the resident forward to place a backboard behind them. The resident’s family member stated RN-M called to say the resident was gone and asked, "Oh, you want that?" when the family questioned why CPR was not being done. The surveyor determined from documentation and interviews that there was a delay between the resident being found unresponsive and the initiation of effective CPR, and that compressions were performed while the resident was still in a recliner rather than on a firm surface.
Inadequate fall supervision and missing fall investigation documentation
Penalty
Summary
The facility did not ensure adequate supervision and fall prevention for residents with repeated falls, including a resident with dementia and severe cognitive impairment who experienced numerous falls during the stay. For one resident, the record showed multiple falls beginning shortly after admission, with the resident assessed as severely cognitively impaired and later sustaining a right clavicle fracture and a left patella fracture after a fall that led to hospitalization. The resident’s falls care plan was repeatedly revised after incidents, but the documented interventions often did not match the circumstances of the falls, were added days after the events, or did not address the identified causes such as attempts to toilet, self-transfer from a wheelchair or recliner, or unsafe movement without assistance. After several falls, nursing documentation and incident reports showed interventions such as gripper socks, floor mats, Dycem, call light reminders, and increased rounding, but the surveyor noted that these interventions were not consistently added to the care plan or were not appropriate to the resident’s condition and behavior. The resident was documented as non-ambulatory in one care plan, yet was repeatedly found attempting to transfer, getting up from a recliner, or going to the bathroom. The record also showed that some interventions were implemented days after the falls, and one fall resulted in a hospital admission where imaging identified the clavicle and patella fractures. Facility staff interviews confirmed that falls were supposed to be assessed, investigated, and incorporated into the care plan, but the DON stated that no further information could be found for some care plan revisions and that staff would need in-service education. A second resident with dementia, anxiety, sleep disorder, repeated falls, and bilateral hearing loss had a documented fall with skin tears, but the facility could not produce the completed fall investigation or neurological checks for that event. The resident’s fall risk assessment indicated significant fall risk, and the care plan contained general safety measures, but surveyors could not verify that any new interventions were added after the fall. The NHA stated the fall report was missing and believed it may have been taken by the physician, while the DON said the facility was still trying to locate the information. Because the documentation was missing, surveyors could not verify the root cause of the fall or whether fall interventions were in place before the event.
Food Service Sanitation and Cross-Contamination During Meal Prep
Penalty
Summary
The facility did not ensure food was stored, prepared, distributed, and served in accordance with professional food safety standards. During an initial kitchen tour, surveyors observed multiple pieces of equipment with grease buildup, dried food, crumbs, and splattered food on the front and back of prep stations, the heater, the temp fryer, the stove, the convection oven, and the fryer. The ready-to-use flour bin had a scoop left inside it, and the lids to the flour and sea salt containers were dirty and sticky. The wall behind the dish machine was also observed to be splattered with dried food and dirty. Record review showed the facility had policies requiring food service areas and equipment to be cleaned on a schedule, including cleaning of cabinets, drawers, ovens, fryers, and other appliances. The Dining Services Manager stated the fryer oil was cleaned according to the log, but the surveyor noted the oil had last been cleaned on 5/4/26. The Dining Services Manager also stated the equipment should have been cleaned and agreed the observed condition was dirty. The manager was unable to provide completed scheduled cleaning logs to verify regular cleaning of the equipment. A refrigerator on the north unit was also observed with a large dried spill under the drawers, and the Dining Services Manager stated kitchen staff were responsible for keeping it clean. During meal service in the South Unit dining room, a server was observed handling ready-to-eat buns and meal items with gloved hands while also touching contaminated surfaces, including lids, meal tickets, the warming cart, and the steam table. The server removed buns from bags, opened them with gloved hands, placed hamburger patties and Polish sausage into the buns, and at one point set half of a hamburger on the server surface of the steam table. The server later removed gloves, blew their nose, washed hands, and resumed service. The server stated tongs should have been used for the buns and was unsure whether they should have been used throughout the service. The Nursing Home Administrator agreed the server should not have been touching the food.
Incomplete COVID Outbreak Investigation
Penalty
Summary
The facility did not ensure a thorough investigation was completed for a COVID outbreak that began on 2/7/26. The outbreak line list documented that by 2/7/26, three residents had been diagnosed with COVID. Additional residents later developed respiratory symptoms and tested positive for COVID, including R61 on 2/15/26, R39 on 2/16/26, and R40 on 2/17/26. The facility documented interventions such as signage, staff communication, family emails, notification of the medical director, health department updates, contact tracing, PPE rounding, increased cleaning, and symptom monitoring for residents on the affected units. The facility did not document an investigation summary for the outbreak and did not document whether any staff had respiratory symptoms during the outbreak period. During interview, the Infection Control RN stated she was new to the role and unsure whether a summary of the outbreak investigation had been completed or whether staff illness had been tracked. Another RN who had been assisting with infection control stated that an outbreak investigation was not completed. The surveyor discussed this concern with the DON and NHA during the daily exit meeting.
Antibiotics Prescribed Without Meeting Infection Criteria
Penalty
Summary
The facility did not ensure that antibiotics and an antifungal medication were used only when residents met the facility’s infection criteria. Based on interview and record review, 6 of 6 residents reviewed for antibiotic use did not have indications for infection under the facility’s McGeer’s Criteria, including residents with documented concerns for UTI, fungal skin infection, pneumonia, and cellulitis. The infection line list and McGeer’s Criteria forms showed that R60, R39, R1, R40, R37, and R33 were prescribed antibiotics or an antifungal cream even though their symptoms did not meet the criteria for infection. The facility’s Infection Control RN stated that the residents were monitored and kept on the line list even when they did not meet McGeer’s Criteria, and that former Medical Director-K had been educated that the symptoms did not meet the facility’s standard of practice for infection. According to the RN, former Medical Director-K still insisted on prescribing antibiotics for those residents. The Infection Control RN also stated that she was new and that RN-V had been responsible for infection control during that time period, and that the former Medical Director had since retired and been replaced by a new Medical Director.
Incomplete Investigation of Alleged Misappropriation
Penalty
Summary
The facility did not ensure that an allegation of misappropriation involving a cognitively intact resident was thoroughly investigated. R33, who had diagnoses including Parkinson’s disease and Type 2 diabetes, reported being overwhelmed after learning that fraudulent charges had been made on the resident’s bank account. The resident’s admission MDS documented cognitive intactness. The allegation involved suspected unauthorized transactions on R33’s credit card, with the resident’s family expressing concern that a staff member may have been involved. The facility’s incident documentation stated that the bank notified the COO of suspected misappropriation and that law enforcement was contacted. Facility staff interviewed staff members who worked during the relevant shifts and reviewed names provided by the bank through HR and Scheduling, but the investigation did not include resident interviews. Surveyor review found no interviews with other residents to determine whether any other resident had a missing credit card or missing money. The facility also did not document staff education to prevent misappropriation after the allegation. During interviews, the SW, DOSW, and CA each confirmed that the investigation was handled by Social Work and administration, and that police were involved. The SW stated resident interviews were typically completed but could not confirm them for this case. The DOSW stated she was not asked to complete resident interviews, and the CA acknowledged the concern when informed that other residents had not been interviewed. The surveyor determined the investigation was not thorough because it did not include resident interviews to identify the potential scope of the concern.
Incomplete Care Plan for Resident With Hearing Difficulty
Penalty
Summary
The facility did not develop and implement a comprehensive person-centered care plan to meet the medical and psychosocial needs of a resident who was hard of hearing. The resident was admitted with diagnoses including Parkinson's disease, and the Quarterly MDS dated 2/26/2026 indicated the resident was cognitively intact, had adequate hearing, did not use hearing aids, and was understood and understood others. However, the resident's Activities assessment documented moderate difficulty hearing, with notes that when staff spoke louder at eye level and sometimes repeated conversation, the resident was able to interpret conversation. Survey observations and interviews showed the resident needed staff to move closer and speak up to be heard, and staff confirmed the resident was hard of hearing. A CNA stated staff knew to speak up, and an LPN stated CNAs knew how to interact and to talk up and make sure the resident could see lips. The resident stated being hard of hearing did not impact activities and that they could interpret what was said. The DON acknowledged there was no care plan found for the resident's hard of hearing status and stated it should have started on admission. The resident's communication care plan contained blank sections and no pertinent interventions, and the surveyor was unable to locate a comprehensive care plan addressing the resident's hearing needs.
Incomplete post-fall neurological monitoring documentation
Penalty
Summary
The facility did not ensure residents received care in accordance with professional standards of practice following falls for 2 residents, R9 and R23. Facility policy required neurological checks after unwitnessed falls, falls with head injury, or for residents with significant cognitive impairment, and the neurological evaluation sheet specified the frequency of checks based on the resident’s condition and injury status. Survey review found that the facility could not consistently provide documentation showing these checks were completed after the falls in question. R9 had diagnoses including dementia, emphysema, diabetes, and chronic kidney disease, and the admission MDS documented severe cognitive impairment with a BIMS score of 4. The record showed multiple falls, including an unwitnessed fall onto the knees, a fall with a developing forehead bruise after dizziness, a fall from a recliner, and a fall in which R9 hit the left side of the forehead and had a raised area. For several of these events, nursing notes documented only limited neurological checks or stated they were negative, but the facility could not produce complete neurological check flow sheets or other documentation showing the required post-fall monitoring was completed. R23 had diagnoses including dementia, anxiety disorder, sleep disorder, repeated falls, and bilateral hearing loss, and the quarterly MDS documented severe cognitive impairment with a BIMS score of 2. After a fall found with the resident on the side of the bed and skin tears to the left arm, the progress note stated the resident did not recall why she fell or what she was trying to get. When surveyors requested the fall investigation packet and neurological checks, the facility could not provide the missing fall report or additional documentation, and staff stated they were still trying to locate the information. No additional information was provided to show neurological checks were completed or to identify the root cause of the fall.
Failure to Notify Provider and RD of Significant Weight Gain
Penalty
Summary
The facility did not ensure a resident with documented nutritional risk maintained acceptable nutritional status because significant weight gains were not documented as being reported to the provider or the Registered Dietician (RD). The resident had diagnoses including hydronephrosis, constipation, and Parkinson’s Disease, and the care plan identified risk for nutritional decline and included monitoring weights, intake, and notifying the physician, family, and RD/DTR of significant change. The facility policy required reweighing and provider notification for a fluctuation of 5 pounds or more within one month. The resident’s recorded weights showed a change from 139 pounds to 154.2 pounds and then to 182 pounds, with the surveyor noting a 10.94% gain in one week and later a 20.53% gain in one week. The surveyor found no documentation in the EMR that the provider or RD was notified of the significant weight changes. The EMR also did not document that the resident was reweighed after the significant gains to verify accuracy, despite the facility policy requiring reweights the next morning and nurse verification. During interviews, a CNA stated weights were obtained on shower days using a shower chair or hoyer lift and then verbally reported to the nurse for entry into the computer. An LPN stated that if a resident over 100 pounds had a 5-pound gain or loss, the resident would be reweighed the following day and placed on the 24-hour board, with notification if still out of parameters. The consulting RD stated she was aware of the weight changes but questioned the accuracy of the weights and had no documentation requesting a reweigh. The admissions coordinator stated she requested a reweigh due to inaccurate weights, and the DON was notified of the concern, but the surveyor found no documentation that the provider or RD had been notified of the significant weight fluctuations.
Delayed Response to Monthly Pharmacy Review Recommendations
Penalty
Summary
The facility did not ensure that a licensed pharmacist’s monthly drug regimen review recommendations were acted upon in a timely manner for one resident, R7, who was on hospice. Survey review of R7’s monthly pharmacy reviews from January 2026 through May 2026 showed repeated pharmacist recommendations that were not promptly addressed. On 1/19/26, the pharmacist noted an insignificant irregularity and recommended verifying the frequency of vital sign checks because the last BP and pulse were documented on 12/10/25, over one month earlier. On 2/16/26, the pharmacist again identified an insignificant irregularity and recommended considering a medication list evaluation and discontinuing Eliquis, Amiodarone, Ferrous Sulfate, Pantoprazole, and a probiotic to decrease pill burden. On 3/16/26, the pharmacist documented another insignificant irregularity regarding Senna 8.6 mg in Matrix, noting that pharmacy had an order for Senna S with docusate every day and as needed and that the order should be updated to match what was being administered. On 4/17/26, the pharmacist issued a second request for the Senna order correction and the hospice medication list evaluation, but the surveyor found the nurse practitioner’s response on 5/11/26 stating the issue would be addressed at the next visit. The surveyor noted this response was over one month overdue from the 3/16/26 recommendation and that there was no evidence showing when the facility responded or whether the information was shared with the physician for recommendations or response. The DON stated the facility forwards pharmacy recommendations to the provider but could not explain why the recommendations had not been addressed in a timely manner.
Inaccurate Daily Nursing Staffing Postings
Penalty
Summary
The facility did not ensure that the daily nursing staff posting contained accurate information. Surveyors observed the required nursing posting displayed for two days and were informed that the Nursing Scheduler was responsible for completing the nursing schedules and daily postings. During record review, surveyors compared the facility’s nursing postings with the actual working schedules for RN, LPN, and CNA staff for March through early May 2026 and found multiple dates where the posted staffing did not match the actual night shift schedules. The discrepancies were identified on numerous dates in March and April 2026, as well as on two dates in May 2026. The Information Systems Specialist stated that the scheduler was supposed to make changes to the nursing hours postings by the end of the day, remove the prior day’s posting the next morning, and post the next day’s schedule, but there were no staff assigned to update the postings based on the actual night shift schedule. The Information Systems Specialist also stated that the issue had been brought to the Nursing Home Administrator’s attention and that the facility was “good at posting but not updating.”
Failure to Prevent Resident-to-Resident Physical Abuse
Penalty
Summary
The facility failed to protect two severely cognitively impaired residents from physical abuse by each other on two separate occasions. One resident, admitted in 2021 with a BIMS score of 3/15 and dependent on staff for ADLs, approached another resident in the dining room and asked an LPN to take the other resident outside and kill her. After being verbally redirected and moved away, the resident wheeled herself back, kicked the other resident’s wheelchair, and later pulled the other resident’s hair and would not let go until staff intervened. Staff documented that the resident had no behaviors directed to self or others on the most recent MDS assessment prior to this event. The other resident, admitted in 2022 with a BIMS score of 1/15 and also documented as having no behaviors on the most recent MDS, later initiated a separate altercation in the dining room. During this incident, the resident approached the first resident, intentionally pinched the back of her hand, and attempted to run over her feet with a wheelchair. Staff witnesses, including CNAs, described these actions as intentional and confirmed that the involved resident was crying as a result. Social services staff and the Administrator acknowledged that both resident-to-resident altercations constituted abuse under the facility’s policy, which states that residents will not be subjected to abuse by anyone, including other residents.
Medication Management and Communication Failures with Eliquis Dose Reduction During Paxlovid Therapy
Penalty
Summary
The deficiency involves the facility’s failure to properly manage and communicate physician-ordered changes to an anticoagulant (Eliquis) when an antiviral (Paxlovid) was initiated for a resident with a history of deep vein thrombosis (DVT). The resident was admitted on 04/07/22 and had an existing order for Eliquis 5 mg every 12 hours, with the last dose to be administered on 02/11/26. On 02/02/26, the Medical Director ordered Paxlovid 150 mg-100 mg twice daily for four days. The pharmacy’s receipt of the Paxlovid order generated a level one interaction flag because the resident was also on Eliquis, and the pharmacist contacted the Medical Director, who then ordered a reduction of Eliquis to 2.5 mg twice daily for eight days. Despite this new order, the facility’s medication administration records and staff interviews show that the Eliquis dose reduction and hold parameters were not consistently implemented or communicated. The Medication Record for 02/2026 shows that Eliquis 5 mg doses were variably held and administered: the AM dose was held on multiple days between 02/04/26 and 02/08/26, and the PM dose was held on several days but still administered on 02/06/26 and 02/07/26. A separate Physician Orders document dated 02/03/26 reflects the Eliquis 2.5 mg twice daily order, with administration documented from 02/03/26 to 02/08/26. As a result, the resident received both Eliquis 5 mg and 2.5 mg during overlapping periods, leading to total daily doses of 7.5 mg on some days instead of the intended reduced regimen. Staff interviews further describe communication and process failures contributing to the error. One LPN stated she was unaware of the Eliquis dose reduction, returned the 2.5 mg tablets to the pharmacy upon receipt, and did not place a hold on the 5 mg evening dose, even after later writing the 2.5 mg order for eight days. The nurse supervisor reported that the Medical Director reduced the Eliquis dose due to the resident being placed on Paxlovid and that there was a communication failure regarding this change. The Lead Consultant Pharmacist stated that after the interaction alert and dose reduction, her expectation was that the pharmacist would contact the facility to alert nursing staff of the new order. The DON reported that a new LPN administered Eliquis 7.5 mg on two days, and the facility’s Medication Incident Report documented that three PM doses of Eliquis 5 mg were given when they should have been held, resulting in the resident receiving Eliquis 7.5 mg for three days while on Paxlovid, with the potential for increased risk of severe bleeding noted in the deficiency.
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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 Greenfield
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Maplewood Center | 1.2 mi | ★★★★★ | 3 | 0 |
| Complete Care At Hales Corners | 1.8 mi | ★★★★★ | 5 | 0 |
| Greendale Park Nursing And Rehab | 2.9 mi | ★★★★★ | 43 | 0 |
| Resolve At West Allis Respiratory And Rehab | 3 mi | ★★★★★ | 24 | 0 |
| Complete Care At Southpointe | 3.1 mi | ★★★★★ | 19 | 0 |
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