Nursing Homes in New York
Whether seniors are looking for the bustle of a big city or the close-knit community of country living, they can find the perfect location in New York. The state is home to around 19.5 million people, and almost 17% are aged 65 and over. The state provides its older adults with many resources to help them age comfortably. New York has some of the best hospitals in the country, including a number that are highly rated for geriatric specialties.
There are also approximately 620 nursing homes across the state, which offer long-term care that can include skilled nursing, medical monitoring and treatments. This is in addition to meals, activities and personal care. The average cost of a semi-private nursing home room in New York is $12,319 per month, while a private room comes to $12,927.
This page provides data on the cost of nursing home care in New York to help seniors and their families make informed decisions about their future care. There’s also information about financial assistance and other resources available to seniors, as well as rules and regulations that cover nursing home care in the state.
The Cost of Nursing Home Care in New York
Genworth Financial’s Cost of Care 2020 Survey shows that the average monthly cost of nursing home care in New York is $12,319. This is $4,563 higher than the national average. New York is also more expensive than many of its neighbors. Seniors in Vermont pay just $9,779 per month and those in Pennsylvania pay $10,038. Costs are a little higher in New Jersey, but still less expensive than New York at $11,254 per month. Connecticut is slightly less affordable, with a cost of $12,927, $608 more than New York.
New York is a large state and the cost of nursing home care can vary widely depending on the location. In the state’s largest city, New York, the cost is $11,771. Binghamton and Utica are more affordable, with costs of $11,543 and $9,581 respectively. In Rochester, the cost is $12,380 and in Buffalo it’s $12,669, while seniors in Syracuse pay $12,890. The state’s capital, Albany, is one of the more expensive cities, with a cost of $12,973, and seniors in New City pay $13,748.
New York City
$11771
Buffalo
$12669
Rochester
$12380
Syracuse
$12890
Albany
$12973
Utica
$9581
Binghamton
$11543
New City
$13748
At $12,319 per month, nursing home care is the most expensive senior care option, due to the skilled nursing and medical care it provides. Adult day care is the most affordable option at $1,945 per month. This provides care in a group setting to seniors who live at home. Assisted living provides room, board and personal care and costs an average of $4,800 per month. In-home care provides non-medical services in the home and costs $4,814 per month. Home health care also offers care in the home, but can include medical and skilled nursing services, and costs $4,957. It may be an option for seniors that require a nursing home level of care but want to stay living in the community.
In-Home Care
$4814
Home Health Care
$4957
Adult Day Care
$1945
Assisted Living Facility
$4800
Nursing Home Care
$12319
Does Medicaid Cover Nursing Home Care in New York?
Of the more than 19,835,000 people residing in New York, at least 7,386,139 of them are enrolled in the state’s Medicaid program. New York seniors aged 65 and over account for approximately 11% of those enrollments. For enrollees living in nursing homes, the program pays for the facility’s room and board in addition to standard health care services. Community-based long-term care services are also available to Medicaid recipients.
There are around 615 nursing homes in New York, all of which accept Medicaid. Together, these facilities have up to 121,077 certified nursing home beds and provide residents with around-the-clock hospital-like care. New York Medicaid pays for a wide range of services including nursing home care, hospital inpatient and outpatient services, lab tests, physician and dental care, medical equipment and supplies. Seniors who need nursing care but prefer to remain living at home or within the community may be eligible for Medicaid Managed Care, which offers health care plans certified by the New York State Department of Health.
Medicaid Eligibility in New York
An applicant must meet specific financial and medical criteria to be eligible for Medicaid in New York. To meet the basic eligibility requirements, you must:
- Need health care assistance
- Have a low income
- Live with a medical disability and/or be 65 years of age or older
- Be a resident of New York State
- Be a United States citizen, permanent resident or legal alien
The financial eligibility requirements consist of income and asset limits for applicants. Assets or resources include cash, investments, second homes, savings and checking accounts. Burial funds or a life insurance policy with up to a $1,500 cash value, a car and pre-paid funeral trusts are exempt. If the applicant owns and intends to return to their primary home, that is exempt if the home equity interest is below $955,000. Â
For a single applicant, monthly income must not exceed $1,677 and countable liquid assets are limited to $30,182. The non-applicant’s income limit is the same, but that person’s asset limit is higher at $148,620 because of the financial protection provided by the Spousal Impoverishment Act. This Congressional Act protects the assets for non-applicant spouses of Medicaid applicants seeking long-term care. It helps prevent one spouse from becoming poverty-stricken so the applicant spouse can become eligible for Medicaid. If both spouses are applying for nursing home Medicaid, the monthly income limit is increased to $2,268 with $40,821 in allowable assets.
2022 Basic Medicaid Income Limits for Seniors in New York
Household Size | Number of Applicants | Income Limits Per Year* | Asset Limits: Applicant(s) | Asset Limits: Non-Applicants |
---|---|---|---|---|
One Person | 1 | $20,124 | $30,182 | |
Two Person | 1 | $20,124** | $30,182 | $148,620 |
Two Person | 2 | $27,216 | $40,821 |
*Except for a $50/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient's monthly income must be put toward the cost of nursing home care.
**Income limit is for applicant only.
How to Apply for Medicaid in New York
Seniors can apply for Medicaid in New York through their local New York State Department of Social Services. Each county houses at least one social services office. You can either apply by going to an office in person, submitting a written application or calling the social services office in your area. A person can also apply for Medicaid online at the New York State Department of Health website. The health department has a help line to call for more information at 1-855-355-5777.
Information You Will Need
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- Copy of birth certificateÂ
- Social Security card
- Proof of U.S. citizenship or lawful residence (e.g., passport, driver’s license, green card)
- Proof of income (e.g., Social Security award letter, retirement benefit statements)
- All bank statements that cover the last 60 months preceding your application date
- Life insurance documents
- Property deeds or proof of residence
- Medicare card
- Any other insurance cards or policy papers
- Automobile registration or title
- Preneed burial contracts
- Irrevocable trust documentation for funeral expenses
- If applicable, power of attorney papers
Additional Medicaid Support & Resources in New York
The list below contains contact details and a brief explanation of resources available to seniors and their families in New York State who are navigating the complicated process of applying for Medicaid assistance.Â
Resource | Contact | Service |
---|---|---|
NY Connects | (800) 342-9871 | This statewide system provides New Yorkers with information about long-term services and supports available to older adults and people with disabilities. Help is available for finding various types of health services and legal assistance and assisting with Medicaid applications and getting information about the eligibility process. Seniors can obtain help and information either by telephone, online or in person at a local NY Connects office location. |
Long-Term Care Ombudsman Program | (855) 582-6769 | This program is a resource for nursing homes and other long-term care residents in New York who need an advocate to resolve problems affecting their quality of life and care needs. Volunteers act as representatives to educate the elderly and act as mediators to protect their rights. |
American Council on Aging | Online Only | The American Council on Aging has state-specific information concerning Medicaid eligibility for long-term care, such as income and asset limits. The website also provides an online Medicaid eligibility test for seniors and information on ways to qualify for Medicaid if you're over the income or asset limits. |
New York State Office for the Aging | Local office phone numbers and locations available online | The Area Agency on Aging in New York has an office in every county. Seniors and their families can obtain assistance with Medicaid information, health insurance counseling and a variety of other services through this agency. |
Medicaid Hotlines | (800) 541-2831 | New York State has a toll-free Medicaid Helpline to help people with general queries about Medicaid as well as specific numbers to call for reporting Medicaid fraud and for those living in New York City. |
Does Medicare Cover Nursing Home Care in New York?
Medicare provides limited coverage for short-term stays in a skilled nursing facility following a hospital stay, but seniors must meet a number of specific requirements. This benefit is available to beneficiaries who have been hospitalized for at least three days, excluding the date of discharge, so it’s most valuable for those who are recovering from an injury, illness or surgery.
Once seniors meet the hospitalization requirement, Medicare will pay for up to 100 days of skilled nursing per benefit period. The first 20 days are covered in full. Starting on day 21, beneficiaries must pay a daily coinsurance rate. After day 100, seniors are responsible for the entire cost.
What Does Medicare Cover?
Medicare covers a number of specific services, including:
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- Meals
- A semiprivate room
- Medications
- Skilled nursing
- Physical therapy
- Occupational therapy
- Speech therapy
- Audiologist care
- Medical supplies
- Medical social services
- Nutritional counseling
- Ambulance transportation
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What Isn’t Covered by Medicare?
Medicare does not cover long-term custodial care that addresses seniors’ day-to-day needs. This includes help with daily activities, such as bathing, dressing and using medical equipment.
For more information about Medicare and when it covers Nursing Home Care, read our Guide to Nursing Homes.
Medicare Support & Resources in New York
When considering nursing home care for a loved one, families may wonder whether Medicare will cover some or all the costs involved. While it’s true that Medicare health insurance may be of some assistance initially, it is not a resource for covering long-term care costs. Trained staff associated with the organizations listed below may be able to provide information and help with your individual circumstances.
Program | Contact | Service |
---|---|---|
Health Insurance Information, Counseling and Assistance Program | (800) 701-0501 | HICAP counselors are available in local offices throughout the state to answer residents' questions about Medicare, managed Medicare programs, prescription drug plans, Medigap and long-term care insurance issues. The helpline telephone number is open from Monday through Friday, 8:30 a.m. to 5 p.m. |
Livanta | (866) 815-5440 | Livanta is a Beneficiary and Family Centered Care Quality Improvement Organization that performs medical case reviews and advocates for the rights of Medicare recipients. Counselors can address complaints, answer questions about Medicare claims and appeal a discharge from a health care facility. |
Medicare.gov | (800) 633-4227 | The federal Medicare website provides information on costs, how to apply for Medicare, what this insurance covers and much more, including links to various other government websites. The site has a live chat function that's available 24 hours a day, 7 days a week, excluding some federal holidays. Phone numbers and websites for Medicare organizations and services in New York can also be obtained by selecting your state from the drop-down menu. |
Other Financial Assistance Options for Nursing Home Care in New York
While Medicaid and Medicare are two of the most common programs used to pay for Nursing Home Care, there are other financial assistance options available, depending on your unique situation.
How To Apply | How It Works | |
---|---|---|
Aid and Attendance | Learn more and apply online at va.gov. | Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for skilled nursing care. |
Reverse Mortgages | Learn more about your options and how to apply at ftc.gov | If you own a home, you may be able to use a reverse mortgage to help pay for nursing care. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan. |
Long-Term Care (LTC) Insurance | Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov. | Seniors who already have long-term care insurance may be able to use it to pay for skilled nursing care. Most policies cover at least a portion of the cost, but it depends on the specific policy terms. Note that older adults who are already in need of skilled nursing care will not typically be eligible to sign up for a LTC insurance policy. |
Free and Low-Cost Resources for Seniors in New York
There are many resources in New York that assist seniors in their retirement. Caring.com has compiled information on local organizations, programs and agencies and categorized them into care types for easy reference.
Area Agency on Aging
Retirees can find support and advice on various senior-related issues from their local Area Agency on Aging. The agency provides advice on topics such as financial assistance programs, in-home care and long-term care planning. It also connects seniors and caregivers with community-based resources.
Program Name | Phone Number | Description |
---|---|---|
New York Area Agencies on Aging | New York State has 59 Area Agencies on Aging, and they offer services to seniors that include legal services, home-delivered meals, transportation, social adult day services and case management. Seniors can also learn more about volunteer opportunities, get help with their insurance and receive advice about proper nutrition. Support is available to caregivers who need guidance or information about resources. |
Cash Assistance Programs
Cash assistance programs in New York provide financial support to help low-income retirees remain in their own homes for as long as possible. Seniors and caregivers can apply for tax rebates and reductions, discounts on vital services and help covering the cost of heating and cooling their home.
Program Name | Phone Number | Description |
---|---|---|
New York Department of Social Services | New York's Department of Social Services plays a significant role in providing financial assistance for senior care. Through various programs and initiatives, the office offers support for seniors who require long-term care services. The department administers benefits such as Medicaid and Supplemental Security Income (SSI), which can help cover care costs for assisted living and nursing homes. It also offers a Home Care Services program, which gives seniors a number of in-home options should they choose to age in place. | |
New York Lifeline Program | 800-234-9473 | The LifeLine Program offers a discount on landline or mobile telephone service, ensuring that participants can stay in contact with loved ones. |
Financial Assistance for Senior Care and Senior Living
Whether living in their own home or in a senior living community, New York seniors can find financial assistance from numerous local resources. These organizations help residents cover some of the costs associated with in-home or long-term care and connect them with other helpful community-based resources.
Program Name | Phone Number | Description |
---|---|---|
New York BenefitsCheckUp | 800-794-6559 | Benefits Checkup is a nationwide service that helps seniors understand their eligibility for benefits such as financial assistance to pay for food, medicines, health care and utilities. The service can outline what benefits are available locally and assist seniors with the application process. |
New York NY Connects | NY Connects is a state government website that directs New Yorkers to an array of useful services available in their communities. Visitors can use the site's search facilities to find a local provider loaning durable medical equipment free of charge. | |
New York Program for All-Inclusive Care for the Elderly (PACE) | The PACE provider manages all medical and non-medical services in the senior's home or in an adult day care facility or nursing home. PACE combines Medicaid and Medicare services, with the organization responsible for all aspects of care, including the choice of physicians. |
Food Assistance Programs
Local organizations help ensure elderly citizens have a balanced diet and receive essential vitamins and minerals to remain healthy. Through nutrition programs, congregate meals, home-delivered meals and food pantries, these programs help New York seniors afford the nutritious food they need.
Program Name | Phone Number | Description |
---|---|---|
New York Meals on Wheels | New York Meals on Wheels helps connect seniors to food pantries, shared meal sites and home delivery options in their area. MOW volunteers can deliver hot lunches to homebound seniors who are unable to make their own meals, with the food delivery doubling as a welfare check. While program participants are encouraged to support the program with optional donations, there's no financial requirement to participate |
Financial Assistance for Senior Living
Low-income elderly individuals in senior living communities can access financial assistance through local-run programs. These New York resources offer advice, guidance and support to help older adults pay for the services offered by long-term care providers.
Program Name | Phone Number | Description |
---|---|---|
New York Special Needs Assisted Living Voucher Demonstration Program for Persons with Dementia | The SNALR Voucher Program is a demonstration program that helps adults with Alzheimer's disease or dementia pay for care in an assisted living setting. It's designed to prevent enrollment in Medicaid and isn't available to those who are Medicaid-eligible. The vouchers subsidize up to 75% of the average monthly cost for care in the region. Because it's a demonstration program, there is a waitlist for new applicants. |
Free Used Medical Equipment
Due to the high cost of purchasing new medical equipment, several organizations in New York collect lightly used medical devices such as wheelchairs, ramps and walkers and distribute them to local seniors and residents in need.
Program Name | Phone Number | Description |
---|---|---|
New York Technology-Related Assistance for Individuals with Disabilities (TRAID) | TRAID is a federally-sponsored program designed to help New Yorkers with disabilities get the equipment they need to live as independently as possible. Local TRAID centers can also refer visitors to other disability related services available in the area. |
Health Insurance & Prescription Drug Coverage for Seniors
New York seniors who meet certain income criteria can apply to local resources to help them pay for prescription drugs. Eligible residents can also receive assistance through health insurance and other programs to access free or discounted medical services.
Program Name | Phone Number | Description |
---|---|---|
New York Elderly Pharmaceutical Insurance Coverage (EPIC) Program | 800-332-3742 | The New York Elderly Pharmaceutical Insurance Coverage Program provides secondary coverage for drugs included in Medicare Part D and other approved medications, including prescription vitamins. Additionally, it helps with Medicare Part D premiums for individuals earning under $23,000 annually. To qualify for EPIC, New York residents must be 65+ and not receiving full Medicaid benefits. They must be enrolled in or eligible for Medicare Part D and have income below $75,000. For married couples, the limit is $100,000. |
Home Repair and Modifications
Seniors and those with disabilities can access a variety of local resources to help them pay for home repairs and modifications. Programs in New York have different eligibility criteria and often assist retirees by providing grants or loans.
Program Name | Phone Number | Description |
---|---|---|
New York Residential Emergency Services to Offer (Home) Repairs to the Elderly (RESTORE) | New York's Residential Emergency Services To Offer Repairs to the Elderly, known as RESTORE, provides financial assistance to help low-income seniors repair their home. Participants must be at least 60 years of age and meet the income eligibility requirements. They must also own their home, which may be up to a four-unit residence, and reside in the home. RESTORE covers a wide variety of repairs, including structural, plumbing and heating repairs. It also covers modifications to make the home more accessible, such as ramps and grab bars. | |
New York Weatherization Assistance Program | 800-342-3009 | For approved applicants, the program can cover the costs of preparing their homes for changes in season, reducing their energy costs and increasing safety. |
Legal Resources
Many organizations offer free or low-cost legal services to New York seniors. Older adults can access advice on issues such as estate planning, living wills and power of attorney. Some firms also act as long-term care ombudsmen, advocating for the rights of seniors in senior living communities.
Program Name | Phone Number | Description |
---|---|---|
New York Office of the State Long Term Care Ombudsman | 855-582-6769 | The Office of the State Long Term Care Ombudsman advocates for the rights of Albany's seniors residing in assisted living, memory care, nursing homes and other senior living communities. It acts as a mediator, working with residents, families and care facilities to find mutually beneficial solutions to any issues that arise. The office also provides information and educates seniors and their families on their rights to ensure they live with dignity and a high quality of life. |
Senior Centers
Senior centers in New York bring together residents through recreational activities and events. Many also offer advice and support on senior issues, run wellness and nutrition programs, and connect older adults with other resources in the local area.
Program Name | Phone Number | Description |
---|---|---|
New York State Department of Health | The New York State Department of Health offers health insurance information and senior advocacy. The department also has free programs for seniors, such as the EISEP program, which allows individuals to access home care services such as personal care at reduced or no cost, depending on their income. |
Medicaid Resources
Navigating the Medicaid system is often difficult and confusing. Several New York resources help older adults by providing advice on Medicaid options, waiver programs and eligibility criteria to help seniors receive the right health care benefits.
Program Name | Phone Number | Description |
---|---|---|
New York Managed Long Term Care (MLTC) | 866-881-2809 | MLTC is for existing Medicare beneficiaries, enabling them to continue using services they already receive under that program while covering other home care costs, such as skilled nursing, personal care and home-delivered meals. |
New York Assisted Living Program (ALP) | 518-565-3300 | New York seniors who are eligible for Medicaid and in need of support in an assisted living setting can apply for the Assisted Living Waiver. For successful applicants, it can cover the costs of some or all of their room and board, emergency response services, occupational therapies and medical supplies and equipment. To qualify, the senior must be able to provide medical evidence that assisted living care is the best option for their needs and that they don't require nursing home levels of support 24/7. The program is limited to 85% of Medicaid recipients, resulting in strict interpretations of the eligibility requirements. |
Social Security Offices
Social Security offices in New York help seniors and disabled people access the benefits they're entitled to. Older adults can contact their local office for information about receiving retirement benefits, disability allowance and Supplemental Security Income.
Program Name | Phone Number | Description |
---|---|---|
New York Social Security | Social Security is a source of income available to retirees and people who can no longer work because of a disability. The money for Social Security comes from a payroll tax levied on employers, employees and self-employed individuals. When you retire, you'll receive monthly payments based on how much you earned when you were working. |
Tax Assistance
Seniors can apply for tax assistance from several New York resources. Elderly residents and those with disabilities could be eligible for tax exemptions on medical expenses, reductions on property tax and other tax assistance programs.
Program Name | Phone Number | Description |
---|---|---|
New York Senior Citizen Homeowners' Exemption (SCHE) | 212-639-9675 | The exemption reduces the taxable assessment of the qualifying senior's home from anywhere between 5% and 50%, depending on how their local government and school district apply it. Maximum income limits also vary due to location. |
Utility & Energy Bill Assistance
Low-income seniors who are struggling to meet the costs of maintaining their homes can find support from organizations that offer assistance with utility and energy bills. New York retirees could also qualify for emergency funding programs if they're in danger of losing utility services due to unpaid invoices.
Program Name | Phone Number | Description |
---|---|---|
New York Home Energy Assistance Program | 800-342-3009 | The program pays one benefit per year to low-income New Yorkers struggling to meet energy costs. There's also an emergency fund existing claimants can request if they're in danger of having their home fuel supply cut off. |
Veteran's Services
New York retirees who have served in the U.S. military can find support from local veteran services. These offices and organizations help vets access the benefits they're eligible for and provide advice and information on a variety of issues.
Program Name | Phone Number | Description |
---|---|---|
New York VA Benefits and Health Care | New York VA Benefits and Health Care includes provisions specific to seniors, offering access to medical and mental health services, as well as help social needs, such as housing and in-home personal care. With major health care systems in Buffalo, Montrose and New York, including community living centers and outpatient clinics, seniors who partook in active service and are now aged 65 and older, have access to a wide range of health and wellness services. |
Nursing Home Laws and Regulations in New York
Topic | Rule |
---|---|
Licensing Requirements | Nursing homes in New York must be licensed by the New York State Department of Health, Division of Quality and Surveillance for Nursing Homes and ICF/MR. They are defined as facilities that are subject to New York State Public Health Law that provide lodging for three or more residents who require regular nursing or other professional services. Nursing homes can be part of a larger facility. |
Staffing Requirements | New York nursing homes must have a sufficient number of nursing staff to provide nursing services that maintain the highest practicable physical, mental and psycho-social well-being of each resident. They must also be able to provide all the services detailed in each resident’s care plan. In addition, there must be a charge nurse on duty on each shift who is responsible for supervising all nursing activities. Facilities must also hire a director of nursing on a full-time basis. |
Staff Training Requirements | Staff providing skilled nursing or other medical services, such as physical therapy, must be trained and licensed to provide these services. Nurse aides, who provide non-medical personal care and services, must also be trained and registered with the New York State RHCF Nurse Aide Registry. All personnel must undertake continuing staff development programs that increase their knowledge and skills. |
Admission Restrictions | Residents can only be admitted to New York nursing homes on a physician’s orders. Facilities can only accept a resident if they have the ability to provide adequate care. |
Care Planning Requirements | Residents must be assessed within 14 days of admission to determine their needs and functional capacity. This assessment is used to develop an individualized plan of care to meet the resident’s needs. Professional staff must review the assessment at least every three months and revise the care plan as required. Comprehensive assessments are also conducted at least once every 12 months and after any significant change in a resident’s condition. |
Dietary and Nutritional Services Requirements | Nursing homes must provide residents with nourishing, palatable and well-balanced meals that meet their nutritional needs and any special dietary requirements. To facilitate this, facilities must employ a dietitian on a full-time, part-time or consulting basis. They must also employ sufficient staff to prepare meals. |
Specialized Rehabilitative Services | Nursing homes must provide any specialized rehabilitative services that are detailed in a resident’s plan of care. Facilities can either employ providers themselves or obtain services from an outside resource. All services must be provided by qualified personnel. |
Medication and Pharmaceutical Services | Facilities must provide pharmaceutical services in order to provide drugs and biologicals to residents. They must employ or obtain the services of a registered pharmacist and develop policies and procedures that ensure drugs are accurately administered to residents. |
Activities Requirements | Facilities must have an activities program directed by a qualified professional. The program should be designed to meet the interests of residents, promote their well-being and help make their life more meaningful. Residents should be encouraged to choose their own activities and when they wish to participate. |
Infection Control Requirements | Nursing homes must have an infection control program in place to help prevent the transmission of disease. Facilities must maintain records of incidences of infections and report increased incidences to the Office of Health Systems Management. In addition, people known to have a communicable disease can’t have direct contact with residents or their food, if direct contact can transmit the disease. Before employment, staff must have a tuberculosis assessment and provide immunization certificates for rubella and measles. |
Medicaid Coverage | In New York, Medicaid covers the cost of nursing home care for eligible seniors. In order to qualify, seniors must meet income and asset eligibility requirements, be a citizen or permanent resident of the United States and be assessed as requiring a nursing home level of care. |
Facilities in New York
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