Rowena Arnott: I usually reach out to you know, other owners in the area they're a good resource. You know, they're a competition, but then at the same time, I don't treat them as a competition because we are all here to serve our seniors. So. I reach out to them, letting them know I have a bed available.
I call the hospital. Sometimes I visit them. I just make phone calls and texts hospice. I take hospice residents You know, do a lot of marketing. So when a client from their home starts to kind of needing more assistance, and then that's when I introduce, Hey, you know, would you like to move to our facility?
Charlie Cameron: Welcome to the RAL Room Assisted Living Podcast with your hosts, Charlie Cameron and Alex Schlo. This is your go to show for cutting edge insights from industry leaders in residential assisted living. Whether you're ready to launch your own assisted living business or looking to invest in this fast growing, high impact sector, we are here to equip you with the tools, strategies, and confidence you need to succeed.
Get ready to ride the silver tsunami and change the future of care. Now on to today's show.
Welcome back to today's episode of the RALroom Assisted Living Podcast. I'm your host, Charlie Cameron, and today we're thrilled to have Rowena Arnott as our guest joining us today. How are you, Rowena?
Rowena Arnott: Hi, good morning. Good morning, Charlie. Good morning, everyone. My name is Rowena Arnott. I currently live in Billings, Montana.
I own a home care service agency for about three years now and I have almost a year old assisted living facility, which is an eight bed here in Montana and my profession before owning a business was a registered nurse. I used to live in California and moved to Montana three years ago. It's been a great move for us and grateful for what we have going here.
Charlie Cameron: That's awesome. Thank you for that background. That's exactly what I was going to ask. So you, you got it going already and your background is different than most of our guests. Most of our guests are operating multiple assist living homes. A lot of them were nurses beforehand or physicians. But you actually had a An intermediate step in the middle, which is starting an in home care agency.
So let's walk back to, okay, you're a nurse. You moved to Billings, Montana. What, how did you go from, from W 2 employee to starting a home care agency? So my husband, this is all his idea is to start our own business and then, I don't know, invest our money somewhere else and not to to be working on the long hour shifts.
So, fast forward, we try to buy a couple of businesses here in Montana. I think we try to buy B2B printing that fell through. We try to buy windows, doors, installation that fell through. And the third one would be the home care. Cause, and, anyway, my husband doesn't know anything about. And so when we saw this come up, we, we said we could try it and see what would happen.
I know that I'm a nurse, so I, it would make it easy for. For the, both of us having me and my background as a nurse. And so his background is he's an electrical engineering guy works in the refinery working 12 hour shifts day and night shifts, you know, they, he flip flops and so he was a lot on his body and I work as a, as a nurse. in a night shift in a hospital in Torrance.
Yeah, that sounds tough. A lot of, a lot of conflicting schedules, long hours. And so what, when you. Did you purchase an in home care agency? Did you buy, did you start one? What did that look like?
So this was an established franchise. It's called right at home. So they're everywhere all over.
So it was, it was already established. They, they opened it up from 2016 and it was for sale in 2021. So it had like 15, I think they had like 13 actually, 13 caregivers and their clients, I think they're 20s. So right now we're, our, our caregivers are up to in the forties now going on fifties and our clients have tripled pretty much.
So so how we got started with, with assisted living is a year after our home care. Was running our accountant recommended to invest into real estate just to diversify our portfolio so we try to get into duplexes and backed out because I don't know, it's kind of scary to rent to someone and you know, we're not a, we're not those real estate and so two deals we backed out on and then two weeks later, our realtor told us about this property, which is existing facility, but being used as a foster home.
So they had four residents here in Montana. If you do the foster home, you can only have four in a home, but this used to be, this property was used to be an assisted living, which had 17 rooms. 7, 000 square feet. And so we put an offer and it got accepted. So we said, maybe we'll, we're meant to do this again, you know, just really serving our senior. So, .
So now it's an eight bed senior assisted living facility.
Yes. Yes.
Okay. Now why, if it has 17 bedrooms, why is it only eight bed?
So my husband don't, cause it's a it's a basement, so eight on top. And then I think seven. On the bottom. So he said it's a lot of liability having to put somebody on the basement. And so he didn't want to do that.
Do you have anybody in there? Could you, could you lease rooms out to caregivers or to others?
So no, right now we're using we're using it for our home care agency office.
Oh, nice.
Yeah. So the, the business is renting to us.
Nice.
Yeah. So.
That's, that's a great use of space.
I love that. And I want to back up for just a minute because I started in real estate and then transitioned to assisted living. Because I kind of knew about, well, I learned about a lot of the benefits. I didn't know about them from the start. I learned about them in my late twenties and went, Oh wow, real estate's really great from a tax perspective.
A lot of folks don't know about these advantages. So, you know, if you start making some money, especially from a business, you know, a lot of CPAs, the smart ones are going to come and tell you, Hey, you need to buy real estate because you want to be able to, to have some losses that offset a good cash flowing business or even a W2 income if your income isn't above a certain threshold.
So a lot of folks don't realize some of the benefits of, of real estate that may not come from the stock market, such as book losses. So the best way to explain this is, Hey, the government lets you write off the entire structure. When you buy real estate, not the land, but the structure. So if the structure is worth 500, 000, the government's going to let you write off that entire 500, 000.
Either linearly, if you don't do a cost segregation study, or if you do a cost segregation study, you'll be able to take all of that. A lot of that upfront which means on your, on your K one, on your, on your statements for taxes, it's going to show a loss when actually you took money home, potentially.
So that loss can count against other businesses or other real estate kind of depends on your total financial situation, how that shakes out. But I know we, for one, have done a lot of cost segregation studies, and that's allowed us to accelerate growth by paying a lot fewer taxes, especially if you count as a real estate professional.
So for those listening surely go on our Facebook group and ask more questions. If you have questions about that, that's something that Like I, I don't enjoy doing taxes, but I really, really like saving money. So you have to get smart on these things, especially as a business owner, like yourself.
Right. And so so this property is really, it's really great. Because. It's sitting in a 2. 3 acres. It's a commercial. Oh, actually it's a mixed use. So 2. 3 acres, 7, 000 square feet. So now we are working with our architect in building our 16 units, memory memory home facility. So it's almost done.
We're, we're going to submit it. Pretty soon, hopefully by end of this month to our lenders and get the funding.
Awesome. On the same lot right next door.
On the same lot. So actually the architect have it set where I can, I can build three 16 units facility in that lot.
On how many acres?
2. 3.
Wow. That's a, that's a lot of stuff on, on 2. 3 acres. That's awesome. More power to you.
Yeah. we'll see. Let's start with one first.
Wow. That's, that's awesome. So you mentioned something before we got on the podcast that I want to bring up, which is home. The home care agency is harder than the assisted living home. Can you kind of explain what you mean by that?
Yeah. So with the home care I mean, you have to serve, you know, how many clients, you know, 50, 60 clients on top of that, your, your caregivers. So I think the issues we're having is finding good caregivers that are reliable, which we do, we do have them, but sometimes you get the bad apples.
But, you know, it's just a lot of stress because if one caregiver calls in, then you have to find replacement, which if that caregiver has three or four or five clients, then you have to, you know, make the calls and let them know you're getting a different caregivers or you don't have a caregiver today compared to the assisted Transcribed I have about, I have for the eight residents, I have two caregivers during the day and then one at night.
So, and they're on a set schedule and it's seven to seven and so far so good. You know, I've, they, I don't like caregivers sleeping at night to make sure so I've let go a couple of them because they sleep in .
You know, yeah, they need to be awake.
Yeah. So anyway, so home care is a lot of stress stress for us.
My husband and I have a plan so that when our 16 units opens up, we're gonna probably sell our home care.
Interesting. So, let me ask you this. One of the advantages that, that we think of having a home care agency as well as assisted living in the same area is being able to You know, cross staff, like, let's say one of your caregivers at the home calls in sick.
You could pull one from your agency that may not have had a shift that day. Is that something you've been able to take advantage of? Is that even a good benefit or does it not really work like that?
Yes. You know what? So, so, okay. So having a home care agency in the facility is, is. Because so let's say you don't have enough hours for your caregiver.
Cause you know, with the home care, it's kinda, you know, you never know when you're going to get your clients. And so other caregivers have already established schedule. So when you hire somebody for full time, there's, they're, they're working on getting their clients established, their hours established, and so.
By having an assisted living facility, you're, we're able to use that caregiver to get, to give them hours at the same time, you know, like while hiring for the home care, I also hire for the. facility in case like, Hey, are you able to work night shift in case I need somebody up there? Can you help?
So I mean, it's easy. I mean, I like for this Saturday my caregiver for my night shift requested an off. And so I already have people lined up to work. So yeah, I mean, it makes it easier having a home care, but yeah, it's just. You know, when they call in, it's the issue when they're doing, they're out in the field, then it's a lot more stressful that way.
The thing that makes me the most nervous about an in home care agency, because as I mentioned, we've been looking at, Hey what, what, you know, additional businesses can we buy that aligned well with assisted living homes in the same areas in home care just pops up first. And I've looked at a lot of the data and.
It doesn't look as good on paper when you look at like the big reports is in home care agencies and the profit margins and difficulty with staffing and difficulty with finding enough staff. There's just not enough caregivers out there. Period. It seems like getting, getting caregivers enough hours to be trained.
So in You know, in your experience, what is the toughest part you know, that, well, okay, the thing that makes me the most nervous is a caregiver calling in sick and now you don't have shifts covered in your experience, how, how much does that come up and, and what are some ways you've been able to overcome that?
So, okay, so so we have hired somebody a caregiver before that will be the on call person. So, that, that's a way you can solve this. It's been working, actually. We did have a Do you pay them? Like, are they being paid to be on call? Or how does that work? Yes, so, so what we do is hey, you know, you'll be our on call.
We'll pay you for Full time hours, 40 hours, and just be ready to be, you know, on the go when we need you. So last week my on call person worked about 20 hours but she's getting paid 40 hours. Yeah. So I, you know, we like it that way. And I mean, we did have one before, but she got burnt out because she's getting calls all over all the time.
Then she quit and then we have a new one again. So hopefully this will be a good one. But yeah, of course she likes it.
So that's interesting. Tell me what, can you tell me a little bit about your hiring process and where, and how you go about finding caregivers?
So since it's a franchise you know, there's like this third party, like we, we have a ploy, we have indeed and then.
So we do, we, we also have another, a third party that will be scheduling the interviews. And so, so, so before when we started, we didn't have all this, you know, third party that's calling to schedule the interview. It's like an automatic text, you know, schedule your interview now, blah, blah, blah. We had trouble finding people to get to the door.
They will they won't answer their calls, so it was tough in the first year, year and a half. But we invested into this third party. Where they could text them and set up the interview automatically. So it's been, it's been great addition. So yeah. Is that part of the franchise or is that a different service?
It's a different service. So yeah. So if. We, we franchises is, you know, you have to pay the fees royalty, and then you have the brand fund. And then, you know, it's a lot more expenses to having a home care.
Yeah. Yeah. It seems like the profit margin is tough and and caregivers, it really comes down to staffing, which I think is what makes us nervous about operating our own home care agency.
So the gross it's, it's really good. But, you know, for all the amount of stress, I don't, I don't know if it's worth it, you know, I like the the facility better because you don't have a lot of turnaround with the, you know, caregivers I mean, as you know, we treat our caregivers really well, and that's why we're able to increase the amount of caregivers We have now compared to when we bought it.
They only had 13 Caregivers, so we're maybe close to 50 now.
Yeah, you know, that's great growth.
We offered health insurance 401k, you know the PTO everything.
Wow.
And then you know, pay them well, of course.
Yeah. No, that's awesome. Thank you for indulging my, my questions about an in home care agency.
That's, that's very, very interesting that you had that kind of leapfrog into an assisted living home. And now congratulations on the 16 bed memory care. That's very exciting. So it sounds like you're going to be in the permitting stage. Building stage pretty soon, right?
Yeah. So hopefully break ground in May.
Awesome. Okay. So one of the biggest challenges that a lot of folks have when getting started on their first assisted living home is financing it. So can you talk about how you financed that home?
Okay. So how we did was so when we live in California, of course, you know, the, the, when we sold our house, we got some good equity there and that's why we're able to.
By the home care agency. And then we still have some leftovers plus, you know, whatever we made from our home care. And so that's how we were able to purchase the property. Now my husband uses 401k, you know, they called robs, R O B S. Have you heard about that? It's ROBS. Rollover something.
I can't remember. Oh, pulling money out for, for real estate from here.
Yeah. So we use that to do some renovations and stuff like that.
Okay. What, what has been your biggest key to success for keeping the home fully occupied and getting, getting it occupied and then keeping it fully occupied.
So so what I do is if I know if I have a bed that's.
I usually reach out to you know, other owners in the area you know, they're, they're a good, they're a good resource. You know, they're, they're a competition, but then at the same time, I don't treat them as a competition because we are all here to serve our seniors. So. I reach out to them, letting them know I have a bed available.
I call the hospital. Sometimes I visit them. I just make phone calls and texts hospice. I take hospice residents You know, do a lot of marketing I don't, the good thing about having a home care agency also is there's a continuity of care. So when a client from their home starts to kind of needing more assistance, and then that's when I introduce, Hey, you know, would you like to move to our facility?
And so I've had about three of them that have moved into my facility. And so yeah, just, just, just letting people know, and you know, having a good reputation having your, you know, your residents well cared for, the family sees it. And so they refer you, people, Billings is very small town. And so people talk about each other.
And so they, I always. You know, here, you know, good, good things when you actually take care, take care of your residents. Well.
Yeah, yeah, you know, you do, you do the number one thing, right. And everybody will talk about it, not just the families, but also the staff. Right.
Yeah.
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And I think it's cool. Something you said that I've not heard on the podcast before, which is you call up the other assisted living homes. And say, Hey, I have some vacancies. That's, that's brilliant because there's, there's more business to go around than there are beds and homes.
Right there.
There's way more demand. Then there, then there is supply.
So why not right? Call another home. Hey, yes, we have someone. We can't put them in the home. We're totally full. Here you go. And it's kind of like a return the favor thing, right? I'm sure if you had a wait list and another home called and said, Hey, we have a vacancy that you would refer back. I think that's beautiful because it saves in placement fees. Right?
Doing it that way versus always going to a placement agent. Do you leverage placement agents at all?
I, I do. I'm okay with it, but I don't, I don't need it because I have private most of my residents are private. I have a couple of Medicaid but you know, but you choose who you want to take in.
But if, If I was not, if I'm not picky, I mean, it's always going to be full because there's just a lot of residents, a lot of seniors that are needing home.
Now you said, if you're not picky.
Yeah. If you're not picky.
Yeah. Now I assume you do have some criteria and what does that look like for you and your home?
So depends, you know, the level of care, you know, are there any family involved and, you know, of course, finance, you know, you need that that money to keep going. And so you know, and Depends also like if the residents don't have any power of attorney person, you know, it's going to be hard. They're, what is it called past medical history that, you know, the level of care. I think I pretty much look and how much care do they need? You know, I do have two caregivers during the day. But at the same time, you know you, you got to know, you got to be picky a little bit.
Yeah. Well, let's go ahead. Go ahead.
Because I don't know, it's just, it's just better for everybody, you know, to make sure that the, you know, the client that you're taking in is not it matches with the other residents, you know?
Yeah. I've heard horror stories of, of Owners, you know, that aren't doing memory care specifically, you know, the family not being totally forthcoming about a resident placing the resident without doing any sort of screening and then learning that, oh, they, they really do have dementia really bad. And it's, it's, we're not designed for that, right?
We're not even potentially certified for it because usually that's an extra level. And yeah, you could end up in kind of a, a tough spot where you'd have to then. Turn that family and that resident away, which would be much worse than just saying no from the beginning, right?
Yeah, so i've had that, you know, I am not perfect. So nobody's perfect. So i've taken clients that You know, you don't get to know them until about two or three weeks Once, after you take them in you know, you just, there's a honeymoon phase, so everything is good, they seem easy, and then like two weeks after that, you see the, the real. The real them.
Also when you get residents from hospital or some other facilities, they, they don't always tell you the, the truth. So yeah I've had to I did get one from a placement agency, which had advanced you know, dementia. And it came from, she came from another facility over here and said, Oh yeah, she's good.
Blah, blah, blah. But after about two weeks, I mean, she really needs a lockdown facility. So I had to transfer her out.
Wow.
Yeah, it's not, not fun for the family and it's just not, you know, the placement agency should have been forthcoming about, you know, what she really needs. So it could have avoided the transfer here, moving from places to places, you know?
Yeah, that's heartbreaking. It did. What ended up happening with the placement agency? Did you have to pay a fee or what?
So what she does is so her deal is. She gets the first month. And then, yeah, she gets the first month. And then, so what happened was after about two weeks, I already have warned the family and her that like, she doesn't fit here.
I didn't have to pay her because it was not a good.
I'm glad to hear that. Yeah.
Yeah.
So something that you said earlier, which I think is super important and, and a lot of people aren't thinking about this in, in the care industry because they're thinking about care and it's all about taking care of people, which I totally understand, but you also have to be profitable in order to take good care of people because if you're negative, you now, you know, the tendency is to cut corners and then things go downhill really quickly.
If you can't pay your staff, you're in trouble. So you talked about screening financially and we do this with tenants for long term rentals. And you know, a lot of people aren't thinking about that when it comes to placing residents. So can you talk about. You know, what are some of the things you look at when you do a financial screening for that family?
Yeah. So here, you know, I just, honestly, I don't, I mean, I don't look at their bank statements. I don't, I'm just hoping to God that they, you know, they will be able to, you know, And so far, God is good. I haven't had any issues with that. And so just having, and a lot of times, I don't know, you know, it's gotta be from your heart, you know, with everything that you do, if it comes from your heart, I mean, everything is going to be fine.
So I just, you know, but I did have a one situation where this client. resident came from a nursing home, which is four hours away from me. They told me that. They told me that he has a private funds and that You know, he's got some assets. And so I took their word for it. So I took in the resident and come to find out he owes 80, 000 from that nursing home and he refused to use his He's 401k to pay for his stay in that nursing home because to be able to to be able to be eligible for Medicaid, you have to have an asset of 2, 000 or less or something like that.
But he did have some money which is not very much, but enough to stay for about seven months or something. But with that, you're not. They're not going to approve your Medicaid. So he was refusing to pay the nursing home with his 401k. And so they transferred him out and, you know, they didn't tell me all of this.
And he didn't have any power of attorney. It was a mess. Sounds like it. And so they told me that I should start screening for it. I just don't know. I just can't do it, you know? I don't know. I mean, I just, I just pray to God that, you know we're here, we are here to, to, to, to care for a senior. And so I mean it's everything is going to work out fine, you know, just.
Yeah It is a good question of if you have screening criteria, what should they be?
And I know in every single state there's specific criteria in terms of tenants, you know for for for leasing a place and they're very strict on what you can or can't use in terms of screening criteria due to like fair housing and things like that. So that is a curious question that we'll, we'll have to look at answering as to what's, what's the best way to screen.
Yeah, because they could show that they have this money and then, you know, a week later, the family withdraws the money, you know, so.
Yeah, it's a hundred percent. Yep.
Yeah. I don't know. I'm just, you know, I really just pray to God that everything is going to be fine. And it, it is, it always is, you know, so.
Yeah. Okay. So I got a couple more questions for you. One is if you were to start over on the assisted living home or even the care agency, whichever, whichever one you want to answer, what would you do differently? You know, what advice would you give to someone just starting?
What would I do differently? I don't know that I have anything I would do differently because, you know, it's different every day. You have different residents, different clients, different situation. Just know that you know, before you get into assisted living business do your homework, do the math, you know just do it.
Just do it. Don't overthink it. And let's see. Yeah, I, you know, I didn't know anything about business. Okay. So, but all I know is that, you know, as a nurse, it's going to be fine, you know, and and. What is it called? I called different owners when I started, I don't know anything, how to run the business.
I don't know policy and procedure. Where am I going to get this thing? Do you know? And so I reach out to people, you have, you can't be timid and, you know, just reach out, ask questions and thank God, God showed me You know, one of the owner who owns four facilities in the area and just like you can have my policy and procedure, you know, so he helps me like if I have a question, I call him if I have any situation that I don't know what to do, I call him and just for free.
So I don't know. So just, just ask and you shall receive.
Yeah, yeah. You can't be shy. Can't be timid. And you know. We see the same thing with people who need to raise money, which is most people to get started on this. And they're like, yeah, I don't, well, I just don't want to put it on Facebook that I need money for a deal or an opportunity to get started.
I'm like, but. Why? You know what? Why not just talk about it? And don't be shy. This is more of just like putting it out there. You know, put yourself out there because you'll be surprised how many people would be interested in partnering with you and investing in you and your future. It's shocking. You know, I'll make one facebook post and a bunch of people from that haven't talked to me in five years reach out and go, wow, that's interesting.
I'd love to be involved. I'm like, wow, if I hadn't put that post, I wouldn't have gotten those opportunities. So yeah.
If I did make those calls, I would not have them. Found you know, my mentor. So and, and buying this property, we don't know. I'm like, I don't know. So now what, you know, it's like, well now what, but you know, you do your research, you do what the rules and regulations, you know, you read about it and reach out to people and there's gotta be, there's, there's solution to everything.
A hundred percent. Okay. So cup, just like two more questions here. In terms of the, the industry, the residential assisted living industry, where it is and where it's evolving, you know, what are some of the biggest trends you're seeing in residential assisted living?
I, I. To me, I think I think it's going to continue. I mean, of the silver tsunami coming. But I know that memory care is going to be a hit for sure, because right now, I mean, you know, my residents, they have, there's more of like the. Memory issues right now and the the memory care here in the area are full. And they would call me and say, we have a couple of room, whatever studio.
And then like few days later, they're full again. And so I think that's where it's going to be. It's the memory here. We need more memory here.
So yeah, there's, there's there's incredible data out there. I'm going to read this to you. I pulled it up. The number of adults age 40 and over living with dementia world worldwide is expected to triple from 57 million in 2019 to 153 million in 2050, which is.
Insane. And it's not just a factor of, hey, yes, the populations are aging and the boomer generation, but also a factor of just the propensity is continuing to increase. So you're, you're absolutely right. Memory care is kind of, I mean, it's hugely needed now, and it's only going to get much, much worse in terms of demand in the future.
Right. So my architect, we originally was just going to build like a regular assisted living and I'm like listening to Brett Chotkevys and all, you know, Yeah. And then, you know, from the area with the memory care being full, I told my architect to just like make it make it memory care ready in case we get into that it's already you know, it's already good to go.
Totally agree. We tell all of our RAU members to design and, you know, design for and plan for memory care, but underwrite for assisted living. So make sure it works at a lower level of acuity, but design it for the higher level. Yeah, that's what we have. Then you open yourself up to that opportunity.
Yeah, and it's sad too because, you know, a lot of family, they can't really what is it called properly care. They don't know. And then, you know, and so us. You know, helping them out, It's gonna be good.
Yeah. Okay, so for anyone who is on the fence about getting into residential assisted living, is there anything you would say to them?
Do it. Don't overthink it.
Yeah.
You know, I don't know what I was getting into, but, you know, somehow I found my way and, and you learn.
Along the way, so I learn every day, you know, there's issues that come up, but, you know, you have all this resources. And so just do it. Don't be scared. Yeah. Yeah. It'll be good. Cause then, you know, you'll do something that is serving. People and it's rewarding and you know.
It's rewarding. It's impactful. It's a way you can take charge of your future and build financial independence, right? Be your own boss, even for one home, which is insane. And, and the thing that I think is just so, so, so cool is that the demand is going to continue to increase way faster than the supply. So literally all of us could go open 10, 10 bed homes in the next.
Five years and it wouldn't even make a dent in a what's needed. So like there's, there's, there's just so much like abundance to go around where we can all win at the same time, which is awesome.
Yeah. So yeah, here in Billings, I mean, I, I don't know, we have a hundred. 20, 000 population just here in Billings.
I mean, the facilities are full, you know? So imagine it's, we're not that big, but you know, we're full.
Yeah. Yeah. So Rowena, this has been absolutely fantastic. Really enjoyed you sharing all of your experiences, including the, the home healthcare agency. I think that's really cool. And a really different transition into assisted living.
So how can our listeners reach out to you and learn more from you?
So I have you can email me at rowena@billingshomecare.com. I also have Facebook for our facility. It's called Right Heart Assisted Living. So our home care is right at home. And so we name our facility right Heart Assisted Living because you have to have the heart to do this, you know?
That's awesome. So. There you go.
Love it. Love it. Well, Rowena, thank you so much for joining us today and sharing your insights. It's been a pleasure and I hope to have you on after you build your, your 16 bed.
Yes. Thank you. God willing. Thank you.
That's right.
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