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How to Find a Good Nursing Homes

How to find a good nursing home – The best time to shop for a nursing home, is when you do not need one. If you wait until you can no longer safely or comfortably live on your own, you probably will not be in a position to do a lot of legwork to investigate facilities. Do your research well ahead of time, so you know the nursing homes in your area that provide high-quality care and, more importantly, the ones that have significant problems.

As you evaluate and compare facilities, you need to know how to spot problems at nursing homes. The marketing brochure, website and lobby might be lovely, but you should base your decision about a long-term care facility on much more data than those things. Here are some tips on how to dig for possible problems at nursing homes:

  • Online search. Check out the nursing home’s website to get an overview of the services it offers and the industry affiliations or certifications it has. Look at the daily menus to see if the meals are nutritious and have enough variety. Most people would not enjoy eating the same main course two or three times a week. Look at the activities calendar to see if you would be happy with the planned social events. On some websites, you can view the floor plans of the resident rooms.
  • Ask your primary care doctor to name a few facilities he would recommend for his parents, and those where he would not want them to live.
  • Local Office on Aging location. Every state has an Office on Aging. Contact them to get as much information as you can about safety records, injuries, deaths, regulation violations and complaints about local nursing homes.
  • Your state’s Long-term Care Ombudsman (LCO). Every state also has an Ombudsman who investigates allegations against nursing homes and advocates for the residents. Your state LCO should have a wealth of information about the facilities in your area.
  • State Online Database or Reporting System. Some states have online databases or collect reports about nursing homes.
  • Medicare’s Nursing Home Compare website. Medicare maintains an online tool, Nursing Home Compare, that provides detailed information on nursing homes. Every nursing home that gets any funding from Medicare or Medicaid is in this database. You can enter the name of a specific nursing home or search for all the facilities in a city or zip code. The tool includes information about abuse at long-term care facilities. On the webpage, you can explore the Special Focus Facility section to find nursing homes with a history of problems.
  • Word of mouth. Ask your friends, relatives and neighbors to recommend a quality nursing home. Personal experience can be extremely valuable.
  • Make a short list of the top candidates. After you collect as much information as you reasonably can, narrow your options down to four or five facilities that best meet your needs and preferences.
  • Visit your top choices. There is no substitute for going to a nursing home and checking it out in person. Pay attention to the cleanliness of the place throughout, not just in the lobby. Give the facility the “sniff” test. Determine whether they use products to mask unpleasant odors, instead of cleaning thoroughly. See whether the residents are well-groomed and wearing fresh, clean clothes. Observe the interaction of the staff with the residents. Notice whether people who need assistance at mealtime, get the help they need without having to wait.
  • Take online reviews with a grain of salt. Fake reviews are all over the internet. If you see a nursing home with only a few reviews, and they are all five stars, be skeptical.

Once you gather this information, you will be ready in the event you need to stay in a nursing home for a short recuperation from surgery or longer term.


AARP. “Finding a Nursing Home: Don’t Wait Until You Need One to Do the Research.” (accessed December 5, 2019)

CMS. “Find a nursing home.” (accessed December 5, 2019)


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Top 6 Questions (and Answers) about Conservatorships and Guardianships

Note in New York the Conservatorship is called the Guardian of the Property.

What is a guardian?

When someone becomes incapacitated due to illness, injury or disability, the court appoints a guardian to handle healthcare and certain non-financial decisions for that person. A guardian can be anyone over the age of 18, but must also be able to show that they are qualified to make these decisions for their loved one.  A guardian is not necessarily the person who is the caregiver over the incapacitated individual.

What is a conservator?

A conservator is appointed by the court to make financial decisions for an incapacitated person. In some states, those who are appointed “conservator of the estate” are those who make financial decisions. Those who are appointed “conservator of the person” handle the same issues as a “guardian.” Conservators can be expensive, as is the process to obtain one. There is also the potential that the incapacitated individual may be taken advantage of. To avoid a conservatorship, designate a power of attorney for your financial and medical care.

Does my elderly loved one need a guardian?

If your family member is unable to make healthcare decisions on her own, due to an injury following an accident, an illness, or disability, and she has not designated a healthcare power of attorney, she will need a guardian.

When is a conservator more appropriate than a guardian?

In some cases, someone may be perfectly capable of making her own healthcare decisions, but are unable to manage her finances. In this case, a conservator would be more appropriate. If an individual cannot make financial or healthcare decisions, both may be appropriate.

Who does the court appoint as guardian or conservator?

A court will appoint the person it deems most competent to fill the role of conservator or guardian. In general, the person must be over the age of 18. The court’s first choice is a spouse, or other close family member. If none of those is available or is unwilling to serve, then they may consider extended family or friends. If those are unwilling or unavailable, then the court will appoint a neutral third party, such as an attorney, to act as conservator or guardian.

How do I relinquish guardianship over my wife?

To relinquish guardianship over any loved one, you must go to court and petition to do so. It is best if you have someone else in mind to take over when you submit your petition, to ensure your loved one’s needs are met.


ElderLawAnswers. (Accessed November 29, 2019) (Accessed November 29, 2019)


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Donor-Advised Funds – What are Some Smart Ways to Give to Charities During the Holidays?

Donor-Advised Funds – The Tax Cuts and Jobs Act nearly doubled the standard deduction, so fewer people are itemizing their taxes. However, there still are ways to donate to charity and get a reward.

Donor-advised funds. Your contributions are invested and grow tax-free, until you elect to donate to a qualified charity. Many of them have minimums to set up, as well as minimums on subsequent donations. Donations made to donor-advised funds are irrevocable. Depending on your situation, a donor-advised fund could help you exceed the standard deduction, which is $12,200 for single filers or $24,400 for married couples filing jointly. This would let you itemize your deductions at tax time.

Rather than giving to charity each year, you can save your donations and give twice as much every other year. It’s called bunching. For instance, say that you donate $10,000 to charity every year. If you started bunching this holiday season, you’d wait a year to make that donation and take the standard deduction on your 2019 taxes. But in 2020, you’d donate $20,000 ($10,000 for 2019 and $10,000 for 2020) and itemize your taxes that year. You can also think about front-loading two years’ worth of donations and contributing to a donor-advised fund this year. Try to take as many itemized deductions as you can this year and take the standard deduction next year.

Even if you’re not thinking of itemizing, you can reduce your taxable income by using your Required Minimum Distributions (RMDs) to give to others. If you’re over 70½, your deadline to take distributions from your tax-deferred retirement accounts is likely the end of the year. You can transfer untaxed money directly from your IRA to a qualifying charity. Transfer the money directly to avoid paying taxes on the withdrawal.

Donating stocks, bonds, mutual funds or real estate can also be a beneficial tax strategy. You can donate appreciated investments, provided you’ve owned them for more than a year. When you donate appreciated investments directly to a charity, you avoid having to report the gains as taxable income.

It’s a wise idea to think about charitable giving all year round, because it’s a useful tax strategy in retirement. Donating to local charities also helps your community.

Create a comprehensive written retirement plan that details all your expenses, including charitable giving. Lastly, stress test your nest egg before you make charitable donations to make certain that you’re not at risk of running out of money. You should also speak with your estate planning attorney to be sure that your charitable giving strategy complements your estate plan.

Reference: Kiplinger (November 25, 2019) “Strategies for Charitable Giving this Holiday Season”


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Hipaa Authorization – What Estate Planning Documents Does My Child Need Now That She’s an Adult?

Hipaa Authorization – Your child may graduate from high school and head off to college or start a full-time job or vocational training program.

Although they’re still your children, the law sees them as are adults. As a result, parents’ “rights” to protect their adult children or make decisions for them immediately becomes quite limited.

The Tewksbury Town Crier’s recent article, “Is your child turning 18? Here’s what you need to know,” explains that people often have an estate planning attorney draft the appropriate documents, so they will be legal and binding. Let’s look at a list of documents to consider and discuss with your young adult:

  • HIPAA Authorization: if your 18-year-old has a job in another state or will be attending college and needs medical records or assistance making appointments, ask her to go to the doctor’s and dentist’s office and sign forms that designate agents to act on her behalf. Due to HIPAA laws, information can’t be released without the adult child’s permission.
  • Healthcare Proxy: Have your 18-year old complete this document, make a copy, put a copy on each parent or guardian’s phone and put a copy on your child’s phone. This is for an emergency, like when the child can’t speak for herself. However, don’t wait for an emergency. If your child is at college, the school will only contact you as the emergency contact, but the proxy is between you and the hospital and includes mental health issues. A healthcare proxy lets you to participate in life and death decisions, should your child not be able to advocate for herself.
  • Durable Power of Attorney: A general durable power of attorney or financial power of attorney must also be signed by the 18-year old, designating his parents, guardians, or others as agents authorized to act on his behalf. This allows the agent access to financial information, so that he can participate in the financial issues with a university or business in the event that the child cannot.
  • FERPA: This is an educational records release, which allows the educational institution to share grades, transcripts and other related materials with parents or designated agents. Without it, the school will not provide you with access to any information.

Finally, encourage your young adult family member to register to vote.

Reference: Tewksbury Town Crier (December 8, 2019) “Is your child turning 18? Here’s what you need to know”


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Dynasty Trust – How Much Control from the Grave Can Parents Have?

Parents who want to protect their home from being sold by heirs can do so by way of a dynasty trust, but it gets complicated, explains the Santa Cruz Sentinel’s article “Not a good idea to keep home in ‘dynasty trust.’” Every situation is different, so every family considering this strategy should meet with an estate planning attorney to learn if this is a solution or an added complication.

Why would the parents want to make their children’s lives complicated? Perhaps they think the children are likely to end up in a bad situation, and they are attempting to provide a safe landing for what they believe is inevitable. Or they simply cannot manage the idea, that one day the house won’t be part of the family.

The house can be protected from a sale, through the use of a revocable trust. Instead of distributing the home in equal shares among their children, along with all of their other assets, the house can be put in the trust and their trust can continue after their deaths. The trust can include any restrictions they want, with respect to how they want the home to be maintained after their deaths.

They can even put their home into a dynasty trust. Done correctly, a dynasty trust can hold the property for the children, grandchildren and great-grandchildren. However, there are some issues.

First, if the home is held in trust, it means that the trust must be funded, since there will be expenses for the home, including maintenance and upkeep. Unless the home is used as a rental property, there won’t be any income to pay for these expenses. The parents will need to leave a significant amount of assets in the trust, so that big and small items can be paid for, or the children may be charged with paying for the expenses.

Next is the problem of capital gains taxes. When the parents pass, the home receives a stepped-up cost basis. That means that when the property is eventually sold, the amount of capital gains tax and in this case, California income tax due, will be based on the increase of the value of the property since the surviving spouses’ date of death.

If the home is held in trust until all of the siblings have died, the value of the house will likely have increased dramatically. Where is the money to pay the taxes coming from? Will the house need to be sold to pay the tax?

What if one of the children decides to move into the house and lets it get run down? The other two siblings may never receive their inheritance. There are so many different ways that this could lead to an endless series of family disputes.

Keeping a “spare” house may not be realistic. It may force the children to become rental property managers when they don’t want to. It may exhaust their finances. In other words, it may become a family burden, and not a place of refuge.

Talk with an estate planning attorney. It may be far better to distribute the home outright to the children along with other assets and let them decide what the best way forward will be.

Reference: Santa Cruz Sentinel (December 1, 2019) “Not a good idea to keep home in ‘dynasty trust.’”


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How to Protect Your Retirement From Spendthrift Parents

Spendthrift Parents – Denise Clark was flabbergasted and not without reason. Her mother wanted her children to buy her a brand new car and expensive birthday gifts for extended members of the family. Her mother thought nothing of asking for several hundreds of dollars each month from each of them to maintain her lifestyle. The Clarks are not the only family facing this issue, as reported in “How to Support Your Retired Parents Without Sinking Your Own Retirement Plans” from Money. A study from TD Ameritrade found that 13% of Americans are supporting a parent, including 19% of millennials.

This particular mother may have to find another money tree to shake. Clark doesn’t want to turn over the funds that she has saved over time, by careful budgeting to spendthrift parents who has a history of living beyond her means. All of the siblings have worked hard to attain financial security, devoting decades to building healthy nest eggs.

How can this family and others help aging parents, without sacrificing their own retirement or financial security?

Set boundaries, and stick to them. The role reversal of a child setting limits with spendthrift parents makes this a challenging set up, but it’s critical for the child to say no. The last thing you want is to go broke helping an elderly parent, and then finding yourself in the same situation with your own children years from now.

Address harmful money habits straight on. Spending as a hobby may be a symptom of depression or boredom. If that’s the situation, discuss it and consider getting the help of a professional counselor.

Don’t give cash directly to the person. If you can help out with small expenses and don’t want the money to be lost, pay a bill for them. The bill will be paid and the money won’t go elsewhere.

Try an approach of collaboration. Ask for their help in figuring out their financial future. Be encouraging, without scolding. If you’ve never talked about money, then be patient. It may take a while for them to accept your input, even if they are all too eager to accept financial gifts.

Check out government support programs. The Medicare Savings Program can help low-income seniors, who also qualify for Medicaid, afford a Medicare prescription plan. HUD runs a number of housing plans, although wait lists are often long.

If housing costs are a problem, look to alternatives. Are they willing to take on a roommate or two? The added rent money and socialization could alleviate some issues, although you have to be careful about who lives with your parent. A “Golden Girls” living situation might work.

Don’t overlook filing for bankruptcy. If their credit card debt, medical bills or underwater mortgage are overwhelming, bankruptcy might be a welcome relief.

Finally, if your own financial situation permits, consider setting up a trust with an estate planning attorney to benefit your aging parents. Inside a revocable living trust, a certain percentage of money or a set dollar amount can be distributed on a controlled basis, with a trustee who can be given the discretion to decide when assets should be distributed. If there are gambling or other abuse problems, restrictions should be built into the trust.

Reference: Money (December 3, 2019) “How to Support Your Retired Parents Without Sinking Your Own Retirement Plans”


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What Do I Need to Know About Owning Property with Someone Other than My Spouse?

Have you ever considered owning property jointly with a family member, friend, or a business associate? Inside Indiana Business’ recent article, “Risky: Property Owned with a Non-Spouse,” says that you should think about the negatives, such as loss of control, unknown creditor issues and tax consequences.

Loss of Control. When you choose to co-own an asset with another person, you can enter into a legal ownership agreement known as “joint tenants with rights of survivorship” or “JTWROS.” When one of the owners dies, the surviving owner automatically becomes sole owner of the property. However, you give up some control of ownership, when you own property in this way. For example, you can’t direct your portion to go to a spouse or a child after your death in your will or other estate planning documents. OK, you can, but your co-owner’s ownership title takes precedence over your estate documents. As a result, she will become the sole owner. You can also lose some control over the property, if the non-spouse co-owner transfers her interest in the property to another individual without your consent. It’s also tough to remove a co-owner from the property title without his or her full cooperation.

Creditors. Another issue with jointly held property is that it’s subject to creditors’ claims against both owners. If your brother, as a co-owner of your cabin, has financial troubles and files for bankruptcy, his ownership in the cabin could possibly be claimed by a creditor. He could also be forced to sell it to pay off his debts. So, unless you can buy out his ownership in the cabin, you may now own the property with a stranger.

Potentially Higher Taxes. Adding a non-spouse as co-owner of an asset, allows for a simple property transfer at your passing. However, it could also mean both a gift tax to you and an increased capital gain tax for your heir. By adding a non-spouse to the property title, you’re making a gift to the new joint owner. Therefore, based on the current value of the property being gifted, you could be liable for gift tax. In addition, the heir of the property may have to pay increased capital gain taxes. Property transferred at death receives a step-up in basis. This means the heir’s cost basis is equal to the fair market value of the property at your death, instead of your cost basis (the amount you paid for the property). Receiving a step-up in basis reduces the heir’s capital gain on the appreciation of the property when it’s sold. However, if you add a co-owner, only your interest in the asset has the benefit of stepped-up basis at your death, not the entire property. When the property is sold, this may mean a higher capital gain tax.

JTWROS vs. Tenants in Common. When deciding to co-own an asset with another person, you can also enter into an ownership agreement known as “tenants in common.” Here’s a key difference: holding property JTWROS with another person means that when one owner dies, the other owner receives the property outright and automatically. When owning property as tenants in common with another person, when one owner dies, the owner’s heirs receive his share in the property. A co-owner can again transfer his interest in the property without approval as the other co-owner. This loss of control may place you in a difficult position.

When considering property ownership with another party, look at the pros and cons of both JTWROS and tenants in common. The cons usually outweigh the pros. However, if owning property with a non-spouse is what you want, discuss this with a qualified estate planning attorney.

Reference: Inside Indiana Business (December 1, 2019) “Risky: Property Owned with a Non-Spouse”

Suggested Key Terms: Estate Planning Lawyer, Wills, Inheritance, Asset Protection, Probate Attorney, Tenancy in Common, Joint Tenancy, JTWROS, Estate Tax, Capital Gains Tax

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Share Your Estate Plan Now to Protect Your Family When You Are Gone

If one child will receive more than his siblings, even though his need is obviously greater, will that shared info create fighting between the children? And should children even have advance knowledge that they are going to receive an inheritance? These are some of the questions examined in the article “Disclosing estate plans in advance can save strife later” from The Indiana Lawyer. In most situations, advance discussions between family members are better to ensure family harmony.

Many estate planning attorneys have the “fair does not always mean equal” discussion with their clients. For some families, there is one child who is in dire need, while the others have prospered and don’t really need help. Maybe one child has special needs, or just hasn’t been as successful in life. In other cases, one child has already received substantial property from the parents, so no portion of the estate will be left to them. Regardless of the circumstances, which vary widely, having a frank discussion with all of the children is better than a series of surprises.

Research from the Federal Reserve Board shows that more than half of any given inheritance equals $50,000 or less, and more than 80% of all inheritances are less than $250,000.

With only half of what most people inherit being generally used to invest or pay down debt, most of these inheritances are spent, invested, or donated.

Regardless of the size of the inheritance, most parents expect that the beneficiaries of their estate will protect and preserve their legacy and use the money wisely. That is not always the case. If the parents want heirs to be careful with inheritances, they need to have a plan that will prepare heirs to act as stewards of their inheritances. The plan may be as simple as a series of conversations about saving and investing, or making charitable donations. It might also be complex, like meeting with the parent’s financial advisor and estate planning attorney and discussing wealth transfer and the potential to grow the wealth for another generation.

Families with larger estates often involve their children in annual gifting to get them used to the experience of receiving significant assets and learning how to manage these gifts. This has the added impact of allowing the parents to see how their children will respond to windfalls, which may guide how they distribute wealth in their estate plan. If one child is a repeat spendthrift, for instance, a trust may be a better way to pass the wealth to the child, with a trustee who can determine when they receive assets.

Families who have worked hard to leave their children with an inheritance, regardless of the size, should prepare their children by teaching them, through the parent’s actions, how their values impact their wealth, and how to manage it for themselves and future generations.

Reference: The Indiana Lawyer (October 16, 2019) “Disclosing estate plans in advance can save strife later”

Suggested Key Terms: Inheritance, Legacy, Wealth Transfer, Gifting

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Financial Considerations Before Marrying Again

With increased longevity comes more time for romance, which is a happy event for seniors. However, what can you expect if you decide to go ahead and marry again? It’s a little more complicated this time around, says Delco Times in the article that asks “Does it make financial sense to marry a second time?”

There may be issues from religious or personal beliefs. There may be challenges from family members, and concerns about the financial realities of a later-in-life marriage. There are definitely legal issues that need to be considered. Make sure to have good legal and financial advice, so that both members of the couple are making an informed decision.

Before making a decision about marriage, have a thorough discussion about finances. Are you financial equals, or does one of you have far more assets than the other? Is one of you mired in debt? Be extremely clear and honest about assets, liabilities credit card debt, outstanding loans and any financial obligations.

Are both people open to having a pre or post-nuptial agreement? If you have established a business or accumulated assets in your own name, you’ll want to be very clear about who will own what in the event of a divorce or when death occurs. If you have children from a prior marriage, how will you protect them, if you should die before your new spouse?

Note that marriage does not signal an end to written agreements, which can be revised as the need arises. However, if someone refuses to sign a pre-nup, don’t count on your powers of persuasion to be convince them to sign a post-nup. By then, it may be too late.

As for health care costs, that is a real consideration for later-in-life marriages. The government does not recognize a pre- or post-nup agreement, when it comes to Medicaid rules. There are some protections for spouses, but once you marry, one of you needing to apply for Medicaid has to be considered.

There are some advantages to being married, if one of the spouses has healthcare insurance through work or through a retirement plan. If a new spouse has benefits through their service, the new spouse may have access to veteran’s benefits. Transferring a 401(k) or IRA to a spouse is also much preferred than to a non-spousal beneficiary.

Bear in mind though that if you have benefits from a prior marriage, like alimony or pension payments, you may lose those by remarriage. Social Security benefits under a deceased spouse’s benefit may end, if you remarry before age 60. Remarriage after age 60 does not impact surviving spouse benefits.

Talk to your estate planning attorney before getting married about protecting yourself and your children. It will be time well spent. If all goes well, there won’t be any drama.  If there is drama, iti is better to know about it before you say “I do.”

Reference: Delco Times (October 16, 2019) “Does it make financial sense to marry a second time?”

Suggested Key Terms: Remarriage, Later-in-Life Marriage, Medicaid, Social Security, Pre-Nuptial, Post Nuptial, Veterans Benefits, Alimony, Pensions, Surviving Spouse

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Can My Estate Plan Include Illiquid Assets, Like Real Property and Ownership Interests?

Many people are focused on their traditional assets that generate monthly statements, like bank and investment accounts, stocks and mutual funds. However, those assets, which are called “liquid” because they can be readily converted to cash, are often less than half of their entire portfolio. Wilmington Biz advises readers not to ignore their illiquid accounts in the article “Don’t Overlook Those Harder-To-Sell Assets When Making An Estate Plan.”

First, let’s see what assets fall into the illiquid category. Commonly, they include:

  • Real estate, collectibles, artwork, cars, livestock, mineral rights and timber, as well as
  • Financial instruments that don’t have a ready market: hedge funds, options, stock in non-public corporations and some types of debt securities.

The biggest consequences of leaving these assets out of an estate plan isn’t felt, until after the owner dies. First, estate taxes must be paid which are levied on the value of all inheritable assets transferable to heirs. Those taxes are due in a matter of months. However, if a good chunk of those assets are illiquid, they may need to be sold in a hurry to raise the cash needed to pay the taxes or debts of the estate.

That presents a real problem for heirs.

Many illiquid assets can’t be sold, or have to be sold below their market value, if they have to be sold within a tight nine-month window or a reasonable estate administration time frame. If the decedent owned real estate in a region were prices are in a slump, the sale price will be lower than if there were enough assets to pay the taxes and wait for prices to return to normal or even become robust.

A will often divides the estate in a way that has nothing to do with the actual value of the assets. Let’s say three children are left a third of an estate, two-thirds of which are real estate and one-third of which is cash or liquid assets. The real estate may need to be sold, if the heirs don’t want to own an undivided interest in the real estate property together.

Here’s a more common situation: If the amount of cash needed to settle the estate is far less than the actual value of an illiquid asset, but the only way to get cash is to sell the asset, something that might have been hoped to be passed on to the next generation may be lost. That includes family farms, a family business or an heirloom.

Careful planning with an experienced estate planning attorney well in advance can avoid this and similar situations, where illiquid assets are concerned. It may mean setting up and funding a trust or using life insurance. An estate planning lawyer will be able to guide the family through the process to protect assets, but it must be done well in advance of the person’s death.

Reference: Wilmington Biz (November 27, 2019) “Don’t Overlook Those Harder-To-Sell Assets When Making An Estate Plan”

Suggested Key Terms: Liquid Assets, Illiquid, Estate Planning Attorney, Real Estate, Heirs, Family Farms, Estate Plan, Market Value

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