Total health inspections
4
Tennessee average 3.5
Last Health inspection on Feb 2025
Mix of rehab and long-term care
This home supports both short-term rehab and long-term care, with residents staying for a wide range of durations.
The Waters of Gainesboro
CMS overall rating
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
The Waters of Gainesboro
CMS overall rating
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
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The Waters of Gainesboro accepts Medicaid, Medicare, and private pay.
Serving residents across Jackson County, The Waters of Gainesboro provides skilled nursing care, memory care, short-term rehabilitation, and respite care in a rural Tennessee setting. The facility is an 83-bed nursing home in Gainesboro, operated by The Waters of Gainesboro, LLC, under the administration of Rita Crabtree. Medicare and Medicaid are both accepted.
The CMS 3-star overall rating reflects a marked split across sub-ratings. Health Inspection performance is 37% above the Tennessee average, a meaningful positive signal for families weighing recent compliance history. However, staffing is the counterweight. Total nurse staffing averages 2 hours and 57 minutes per resident per day, compared with a state average of 3 hours and 40 minutes, placing the facility 150th out of 172 Tennessee SNFs on that measure.
Over five inspections since 2017, the facility has received 16 citations. A 2019 annual survey produced an Immediate Jeopardy finding related to elopement prevention. A February 2023 complaint investigation substantiated a failure to report an allegation of abuse within the required two-hour window. No fines or enforcement actions appear in the available reports.
Occupancy sits at 54%, well below the Tennessee average of 73%, which typically indicates current availability. Clinical programs include Comprehensive Wound Care and Respiratory Services, as well as the Living Well and In Motion activity and wellness tracks.
The facility serves residents requiring post-acute rehabilitation, long-term skilled nursing, or memory care support in rural Jackson County, Tennessee.
Quality ratings
The Overall CMS Rating combines results from health inspections, staffing levels and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
Based on the results of the facility's three most recent standard inspections and any complaint investigations. CMS reviews the number, scope, and severity of deficiencies, with more recent findings weighted more heavily.
Measures average nursing staff hours per resident per day, including Registered Nurses (RNs) and total nursing staff. Ratings are adjusted based on the level of care residents require and are compared to state and national benchmarks.
Based on clinical and physical health indicators reported to CMS, such as hospital readmissions, falls, pressure ulcers, and improvements in mobility. These measures reflect how well residents' health needs are being managed.
Staffing hours breakdown
Daily nursing hours per resident by staff type, reported to CMS. Higher is generally better — compare this facility to state and national averages to see where staffing stands.
Total nursing care / resident
This home is ranked 150th out of 172 homes in Tennessee for nurse hours. Total adjusted nursing hours per resident per day, combining RN, LPN, and aide time. CMS adjusts this for case-mix so facilities can be fairly compared.
This home is ranked 150th out of 172 homes in Tennessee for nurse hours. Total adjusted nursing hours per resident per day, combining RN, LPN, and aide time. CMS adjusts this for case-mix so facilities can be fairly compared.
2h 57m per day
Rank #150 / 172Nurse hours — State benchmarkedThis home is ranked 150th out of 172 homes in Tennessee for nurse hours. Shows adjusted nurse hours per resident per day benchmarked to the Tennessee average, with a ranking across 172 Tennessee SNFs. More hours mean more direct care. The national average is about 3.5 hrs; below 3.0 is a red flag.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
vs Tennessee avg
-19%
Standout metric
LPN / LVN is +6% above state avg
| Staff type | Hours / Day / Resident | vs state avg |
|---|---|---|
|
Registered Nurse (RN)
RNs hold the highest nursing license and can assess residents, interpret test results, and direct care plans. More RN hours per day often signals stronger clinical oversight and faster response to health changes.
| 21m per day | ▼ 39% State avg: 35m per day · National avg: 41m per day |
|
LPN / LVN
Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs) deliver routine hands-on care — medication administration, wound dressing, and monitoring vital signs. They work under RN supervision and make up a large share of daily bedside care.
| 1h 8m per day | ▲ 6% State avg: 1h 5m per day · National avg: 52m per day |
|
Nurse Aide
Certified Nurse Aides (CNAs) provide the most direct day-to-day assistance: bathing, dressing, feeding, and mobility. Nurse aide hours are typically the largest staffing category and directly affect residents' quality of life.
| 2h 7m per day | ■ Avg State avg: 2h 8m per day · National avg: 2h 20m per day |
|
Weekend Total Nursing
Combined nursing hours (RN + LPN + Nurse Aide) per resident per day on weekends. Staffing often drops on weekends — this figure reveals whether the facility maintains adequate coverage outside of weekday hours.
| 3h 28m per day | ▲ 3% State avg: 3h 21m per day · National avg: 3h 27m per day |
|
Physical Therapist
Hours per resident per day provided by licensed Physical Therapists (PTs) or PT Assistants. PT services help residents recover mobility after injury or illness and are especially important for post-acute (short-stay) rehabilitation.
| 2m per day | ▼ 58% State avg: 5m per day · National avg: 4m per day |
|
Weekend RN
Registered nurse hours specifically on weekends. Facilities sometimes reduce RN presence on Saturdays and Sundays — a low weekend RN figure compared to weekday hours can indicate reduced clinical oversight when most administrative staff are absent.
| 17m per day | ▼ 27% State avg: 23m per day · National avg: 29m per day |
Capacity and availability
This home usually has availability
Occupancy rate
54.4%
Rank #254 / 303Occupancy rate — State benchmarkedThis home is ranked 254th out of 303 homes in Tennessee for occupancy rate. Shows this facility's occupancy rate versus the Tennessee average, with its Statewide rank out of 303. Higher occupancy signals strong local demand and financial stability.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Avg. Length of Stay
175 days
83-bed community Rank #199 / 427Bed count — State benchmarkedThis home is ranked 199th out of 427 homes in Tennessee for bed count. Shows this facility's certified or reported bed count compared to other Tennessee SNFs. Larger communities may offer more amenities, programs, and on-site services for residents and families.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
A larger shared setting that may offer more common spaces and organized community services.
33 years in operation Rank #67 / 385Years in operation — State benchmarkedThis home is ranked 67th out of 385 homes in Tennessee for years in operation. Shows how long this facility has been in operation compared to other Tennessee SNFs. Longer operating histories may benefit residents, families, and staff.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
A longer operating history, which may indicate experience navigating regulations and delivering ongoing care.
Walk Score: 41 / 100 Rank #216 / 554Walk Score — State benchmarkedThis home is ranked 216th out of 554 homes in Tennessee for walk score. Shows how walkable this facility's neighborhood is compared to the average Walk Score across Tennessee SNFs. Higher scores benefit residents, families, and staff.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Somewhat walkable. A few nearby services may be reachable on foot, but most trips require transportation.
About this community
Facility TypeNursing Home
StatusLicensed
IssuanceJuly 1, 1992
License Number00000136
CMS Certification Number445171
The Waters of Gainesboro is administrated by Rita Crabtree.
Owner NameThe Waters Of Gainesboro, LLC
Accept Medicaid
Accept Medicare
Rehabilitation Services
Respite Care
Specific ProgramsLiving Well, In Motion, Comprehensive Wound Care, Respiratory Services
Operating Hours24 hours - 7 days a week
Inspection History
In Tennessee, the Department of Health, Division of Health Care Facilities performs unannounced inspections and investigations to ensure facilities provide high-quality resident care.
Since 2017 · 9 years of data
16 citations
Inspection Scorecard
This scorecard compares key inspection, citation, and complaint metrics at this facility against the Tennessee state average. Metrics rated ≥15% worse than average are highlighted in red; those ≥15% better are highlighted in green.
Since 2017 vs. Tennessee state average
Overall vs. TN average
2 Worse
Metrics worse than Tennessee average:
• Total citations (300% above)
• Citations per year (350% above) 0 Better No metrics in this bucket.
• Total citations (300% above)
• Citations per year (350% above) 0 Better No metrics in this bucket.
Latest Inspection
March 18, 2020
Citations
| This Facility | TN Average | vs. TN Avg |
|---|---|---|---|
|
Total citations
Formal regulatory issues recorded by inspectors across all inspection types.
| 16 | 4 | This facility has 300% more total citations than a typical Tennessee nursing home (16 vs. TN avg 4).↑ 300% worse |
|
Citations per year
Average citations per year since 2017.
| 1.8 | 0.4 | This facility has 350% more citations per year than a typical Tennessee nursing home (1.8 vs. TN avg 0.4).↑ 350% worse |
Inspection Reports Summary
An editor-reviewed summary of the themes and findings across this facility's recent inspection reports.
- November 29, 2023 inspection found 2 deficiencies involving improper oxygen administration and unsafe respiratory equipment storage for Residents #3 and #4.
- February 8, 2023 complaint investigation confirmed failure to report abuse allegations within the required 2-hour timeframe for Resident #3.
- November 6, 2019 annual inspection cited immediate jeopardy for failure to prevent elopement and multiple care and food safety deficiencies.
Health Inspection History
Inspections
Total health citations
7
Rank #31 / 176Health citations — State benchmarkedThis home is ranked 31st out of 176 homes in Tennessee for health citations. Shows this facility's total health deficiency citations benchmarked to the Tennessee State average, with a ranking across all 176 TN SNFs. Lower citation counts earn a better rank.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Tennessee average 15.4
Citations per inspection
1.75
Rank #11 / 176Citations per inspection — State benchmarkedThis home is ranked 11th out of 176 homes in Tennessee for citations per inspection. Shows average deficiency citations per CMS inspection for this facility versus the Tennessee mean across 176 SNFs with citation data. Lower is better.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Tennessee average 4.39
Health citations are formal notices following inspections when they fail to comply with safety and care standards.
6 of 7 citations resulted from standard inspections; and 1 of 7 resulted from complaint investigations.
Breakdown of citation severity (last 7 years)
Critical health citations
0
100% better than Tennessee averageTennessee average: 1.1
Serious health citations
0
100% better than Tennessee averageTennessee average: 0.6
Citations history (last 7 years)
Nutrition moderate citation
Feb 05, 2025
Corrected
Pharmacy moderate citation
Feb 05, 2025
Corrected
Quality of Care moderate citation
Feb 05, 2025
Corrected
Care Planning moderate citation
Sep 01, 2023
Corrected
Staffing Data
Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.
Total staff
77
Employees
63
Contractors
14
Staff to resident ratio
1.48 : 1
15% fewer staff per resident than Tennessee average
Avg staff/day
31
Average shift
8.7 hours
5% better than Tennessee average
Total staff hours (quarter)
24,695
Nursing staff breakdown
Q4 2025 · Oct 1 – Dec 31
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Registered Nurse
Manages medical care and health needs.
RN Staff
All 2 RN Staff are full-time employees. No contractors work on this role.
2
All 2 RN Staff are full-time employees. No contractors work on this role.
2
Average shift length
Average shift length. Calculated as total hours divided by days worked and average staff per day.
11.3 hours
Average shift length. Calculated as total hours divided by days worked and average staff per day.
11.3 hoursLicensed Practical Nurse
Assists with medical care and medications.
LPN Staff
All 17 LPN Staff are full-time employees. No contractors work on this role.
17
All 17 LPN Staff are full-time employees. No contractors work on this role.
17
Average shift length
Average shift length. Calculated as total hours divided by days worked and average staff per day.
9.5 hours
Average shift length. Calculated as total hours divided by days worked and average staff per day.
9.5 hoursCertified Nursing Assistant
Helps with daily care and mobility.
CNA Staff
All 34 CNA Staff are full-time employees. No contractors work on this role.
34
All 34 CNA Staff are full-time employees. No contractors work on this role.
34
Average shift length
Average shift length. Calculated as total hours divided by days worked and average staff per day.
9.2 hours
Average shift length. Calculated as total hours divided by days worked and average staff per day.
9.2 hoursContractor staffing
Q4 2025 · Oct 1 – Dec 31
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Total hours from contractors
4.8%
1,180 contractor hours this quarter
Physical Therapy Aide: 5
Physical Therapy Assistant: 4
Speech Language Pathologist: 2
Respiratory Therapy Technician: 2
Qualified Social Worker: 1
Staff by category
Q4 2025 · Oct 1 – Dec 31
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
| Certified Nursing Assistant | 34 | 0 | 34 | 12,560 | 92 | 100% | 9.2 |
| Licensed Practical Nurse | 17 | 0 | 17 | 6,763 | 92 | 100% | 9.5 |
| Clinical Nurse Specialist | 3 | 0 | 3 | 1,061 | 74 | 80% | 7.7 |
| Other Dietary Services Staff | 3 | 0 | 3 | 756 | 80 | 87% | 6.6 |
| Dietitian | 1 | 0 | 1 | 545 | 68 | 74% | 8 |
| Nurse Practitioner | 1 | 0 | 1 | 542 | 64 | 70% | 8.5 |
| Registered Nurse | 2 | 0 | 2 | 516 | 37 | 40% | 11.3 |
| Mental Health Service Worker | 1 | 0 | 1 | 420 | 56 | 61% | 7.5 |
| Speech Language Pathologist | 0 | 2 | 2 | 383 | 61 | 66% | 6.1 |
| Administrator | 1 | 0 | 1 | 353 | 45 | 49% | 7.8 |
| Physical Therapy Aide | 0 | 5 | 5 | 306 | 49 | 53% | 6.3 |
| Physical Therapy Assistant | 0 | 4 | 4 | 252 | 50 | 54% | 4.9 |
| Respiratory Therapy Technician | 0 | 2 | 2 | 193 | 54 | 59% | 3.6 |
| Qualified Social Worker | 0 | 1 | 1 | 47 | 19 | 21% | 2.5 |
34 Certified Nursing Assistant
% of Days
100%
17 Licensed Practical Nurse
% of Days
100%
3 Clinical Nurse Specialist
% of Days
80%
3 Other Dietary Services Staff
% of Days
87%
1 Dietitian
% of Days
74%
1 Nurse Practitioner
% of Days
70%
2 Registered Nurse
% of Days
40%
1 Mental Health Service Worker
% of Days
61%
2 Speech Language Pathologist
% of Days
66%
1 Administrator
% of Days
49%
5 Physical Therapy Aide
% of Days
53%
4 Physical Therapy Assistant
% of Days
54%
2 Respiratory Therapy Technician
% of Days
59%
1 Qualified Social Worker
% of Days
21%
Penalties and fines
Federal penalties imposed by CMS for regulatory violations, including civil money penalties (fines) and denials of payment for new Medicare/Medicaid admissions.
Source: CMS Penalties Database
No penalties in the past 3 years
No civil money penalties or payment denials were reported in the last 3 years.
Quality of care over time
These measures show how residents usually do over time at this home, based on health outcomes and preventive care.
High-risk clinical events score
A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline.
11.5
A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline.
11.5
10% worse than Tennessee averageTennessee average: 10.5
Functional decline score
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
17.2
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
17.2
12% better than Tennessee averageTennessee average: 19.5
Long-stay resident measures
Need for Help with Daily Activities Increased
Percent of long-stay residents whose need for help with daily activities has increased
10.2%
Percent of long-stay residents whose need for help with daily activities has increased
10.2%
36% better than Tennessee averageTennessee average: 16.0%
Walking Ability Worsened
Percent of long-stay residents whose ability to move independently worsened
18.4%
Percent of long-stay residents whose ability to move independently worsened
18.4%
15% better than Tennessee averageTennessee average: 21.7%
Low Risk Residents with Bowel/Bladder Incontinence
Percent of low risk long-stay residents who lose control of their bowels or bladder
23.1%
Percent of low risk long-stay residents who lose control of their bowels or bladder
23.1%
11% worse than Tennessee averageTennessee average: 20.7%
Falls with Major Injury
Percent of long-stay residents experiencing one or more falls with major injury
9.2%
Percent of long-stay residents experiencing one or more falls with major injury
9.2%
150% worse than Tennessee averageTennessee average: 3.7%
High Risk Residents with Pressure Ulcers
Percent of long-stay high risk residents with pressure ulcers
5.4%
Percent of long-stay high risk residents with pressure ulcers
5.4%
In line with Tennessee averageTennessee average: 5.4%
Urinary Tract Infection
Percent of long-stay residents with a urinary tract infection
1.3%
Percent of long-stay residents with a urinary tract infection
1.3%
35% better than Tennessee averageTennessee average: 2.1%
Lost Too Much Weight
Percent of long-stay residents who lose too much weight
14.3%
Percent of long-stay residents who lose too much weight
14.3%
127% worse than Tennessee averageTennessee average: 6.3%
Depressive Symptoms
Percent of long-stay residents who have depressive symptoms
27.0%
Percent of long-stay residents who have depressive symptoms
27.0%
145% worse than Tennessee averageTennessee average: 11.0%
Antipsychotic Use
Percent of long-stay residents who received an antipsychotic medication
18.5%
Percent of long-stay residents who received an antipsychotic medication
18.5%
12% worse than Tennessee averageTennessee average: 16.5%
Pneumococcal Vaccine
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
96.7%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
96.7%
8% better than Tennessee averageTennessee average: 89.9%
Influenza Vaccine
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
100.0%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
100.0%
6% better than Tennessee averageTennessee average: 94.5%
Short-stay resident measures
Pneumococcal Vaccine
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
91.1%
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
91.1%
14% better than Tennessee averageTennessee average: 79.7%
Antipsychotic medication increase
Percent of short-stay residents who newly received an antipsychotic medication
0.9%
Percent of short-stay residents who newly received an antipsychotic medication
0.9%
48% better than Tennessee averageTennessee average: 1.7%
Influenza Vaccine
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
79.0%
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
79.0%
In line with Tennessee averageTennessee average: 79.8%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
Breakdown by payment type
Medicare
49% of new residents, usually for short-term rehab.
Typical stay
9 - 10 months
Private pay
5% of new residents, often for short stays.
Typical stay
1 - 2 years
Medicaid
45% of new residents, often for long-term daily care.
Typical stay
2 - 3 months
Facility Characteristics
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
52
Medicare
7
13.5% of residents
Medicaid
31
59.6% of residents
Private pay or other
14
26.9% of residents
Programs & Services
Residents Group
Residents meet regularly to discuss policies, care quality, and activities
Nurse Aide Training
State-approved Nurse Aide Training and Competency Evaluation Program on-site
Active Resident Council
Organized group of residents that meets regularly to discuss facility policies, quality of life, and activities.
Data sourced from CMS Long-Term Care Facility Characteristics quarterly report. Payer mix reflects the current resident census by primary payment source.
Financial Trends
Historical financial and operational data for The Waters of Gainesboro based on CMS SNF Cost Reports.
Occupancy Rate
63.2%
↑ 10.2pp vs 2021
Net Income
-$446.8K
↑ ~$52.2K vs 2021
Total Payroll
$3.3M
↑ ~$112.3K vs 2021
Profit Margin
-7.9%
↑ 2.5pp vs 2021
Finances and operations
Privately-owned community
Operated by a single business entity.
Home revenue
$6.4M
Operating loss
-$446.8K
Privately-owned community
Operated by a single business entity.
Home revenue
$6.4M Rank #161 / 176Revenue — State benchmarkedThis home is ranked 161st out of 176 homes in Tennessee for revenue. Shows this facility's annual revenue compared to the Tennessee SNF average. Higher revenue generally means more resources for staffing and capital — read alongside Payroll %.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Operating loss
-$446.8K
Payroll costs
The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
Rank #149 / 176Payroll — State benchmarkedThis home is ranked 149th out of 176 homes in Tennessee for payroll. Shows total annual staff payroll benchmarked to the Tennessee average. Higher payroll investment relative to peers often signals better staffing and less reliance on cheaper contract labor.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
$3.3M
The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
Rank #149 / 176Payroll — State benchmarkedThis home is ranked 149th out of 176 homes in Tennessee for payroll. Shows total annual staff payroll benchmarked to the Tennessee average. Higher payroll investment relative to peers often signals better staffing and less reliance on cheaper contract labor.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Other operating costs
All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
$3.5M
All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
Total costs
$6.8M
Who this home usually serves
Show admissions and discharges
TYPE OF STAY
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Financial Assistance for
Nursing Home in Tennessee
The Waters of Gainesboro is located in Gainesboro, Tennessee.
Here are the financial assistance programs available to residents in Tennessee.
Frequently Asked Questions about The Waters of Gainesboro
Is The Waters of Gainesboro in a walkable area?
The Waters of Gainesboro has a walk score of 41. Somewhat walkable. A few nearby services may be reachable on foot, but most trips require transportation.
What is the license number of The Waters of Gainesboro?
According to TN state health department records, The Waters of Gainesboro's license number is 00000136.
Who is the administrator of The Waters of Gainesboro?
Rita Crabtree is the administrator of The Waters of Gainesboro.
How many beds does The Waters of Gainesboro have?
The Waters of Gainesboro has 83 beds.
What is the address of The Waters of Gainesboro?
The Waters of Gainesboro is located at 1340 North Grundy Quarles Highway.
What is the phone number of The Waters of Gainesboro?
(931) 268-0291 will put you in contact with the team at The Waters of Gainesboro.
Is The Waters of Gainesboro Medicare or Medicaid certified?
Yes — The Waters of Gainesboro is a CMS-certified provider of Medicare and Medicaid.
Guides for Better Senior Living
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