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← WAUPUN MEMORIAL HOSPITAL

Form 990 for tax year 2023

Filed by WAUPUN MEMORIAL HOSPITAL.

Totals

Total revenue
$59,986,891
Total expenses
$49,404,360
Contributions and grants received
$60,292
Grants paid
$65,373
Program service revenue
$59,588,022
Investment income
-$4,487
Other revenue
$343,064
Total assets, end of year
$93,064,323
Total liabilities, end of year
$441,196
Net assets or fund balances, end of year
$92,623,127
Program services expenses (Part IX)
$44,721,180
Management and general expenses
$4,683,180
Fundraising expenses
$0
Program service expenses (Part III)
$44,721,180

Program services were 90.5% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1d · Related organizations

    $1,000

  • 1e · Government grants (contributions)

    $34,579

  • 1f · All other contributions, gifts and grants

    $24,713

  • 2a · Program service revenue: NET PATIENT SERVICE RE

    total $59,397,961 · related or exempt $59,397,961

  • 2b · Program service revenue: 340B PHARMACY REVENUE

    total $21,110 · related or exempt $21,110

  • 2f · All other program service revenue

    total $168,951 · related or exempt $168,951

  • 3 · Investment income

    total -$4,487 · excluded -$4,487

  • 6a · Gross rents

    real property $187,855

  • 6b · Less rental expenses

    real property $0

  • 6c · Rental income or loss

    real property $187,855

  • 6d · Net rental income or loss

    total $187,855 · excluded $187,855

  • 11a · Other revenue: CAFETERIA REVENUE

    total $135,314 · excluded $135,314

  • 11b · Other revenue: MOBILE MEALS

    total $19,895 · unrelated business $19,895

  • 11e · Other revenue, total

    $155,209

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $65,373 · program services $65,373

  • 7 · Other salaries and wages

    total $19,240,734 · program services $18,790,243 · management and general $450,491

  • 8 · Pension plan contributions

    total $955,453 · program services $933,083 · management and general $22,370

  • 9 · Other employee benefits

    total $2,732,396 · program services $2,668,421 · management and general $63,975

  • 10 · Payroll taxes

    total $1,296,401 · program services $1,266,048 · management and general $30,353

  • 11a · Fees: management

    total $29,282 · program services $29,282

  • 11b · Fees: legal

    total $16,160 · program services $36 · management and general $16,124

  • 11g · Fees: other

    total $3,500,839 · program services $3,500,839

  • 13 · Office expenses

    total $754,970 · program services $740,889 · management and general $14,081

  • 14 · Information technology

    total $1,446,234 · program services $1,446,234

  • 16 · Occupancy

    total $1,188,632 · program services $1,188,632

  • 17 · Travel

    total $56,366 · program services $49,747 · management and general $6,619

  • 19 · Conferences, conventions and meetings

    total $4,143 · program services $3,338 · management and general $805

  • 21 · Payments to affiliates

    total $6,757,451 · program services $2,872,413 · management and general $3,885,038

  • 22 · Depreciation, depletion and amortization

    total $2,749,711 · program services $2,749,711

  • 23 · Insurance

    total $238,240 · program services $118,229 · management and general $120,011

  • 24a · Other expenses: MEDICAL SUPPLIES & EQUI

    total $8,121,476 · program services $8,119,313 · management and general $2,163

  • 24b · Other expenses: LICENSES, DUES & SUBSCR

    total $94,400 · program services $72,737 · management and general $21,663

  • 24c · Other expenses: BANK FEES

    total $51,296 · program services $770 · management and general $50,526

  • 24e · All other expenses

    total $104,803 · program services $105,842 · management and general -$1,039

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $337,154 · end of year $355,906

  • 4 · Accounts receivable

    beginning of year $5,074,383 · end of year $6,669,268

  • 8 · Inventories for sale or use

    beginning of year $11,903 · end of year $31,712

  • 9 · Prepaid expenses and deferred charges

    beginning of year $2,353

  • 10a · Land, buildings and equipment: cost or other basis

    $51,432,426

  • 10b · Land, buildings and equipment: accumulated depreciation

    $18,369,051

  • 10c · Land, buildings and equipment, net

    beginning of year $32,643,374 · end of year $33,063,375

  • 13 · Investments: program-related

    beginning of year $305,454 · end of year $375,013

  • 15 · Other assets

    beginning of year $48,722,992 · end of year $52,569,049

  • 17 · Accounts payable and accrued expenses

    beginning of year $4,137,326 · end of year $296,492

  • 25 · Other liabilities

    beginning of year $974,447 · end of year $144,704

  • 27 · Net assets without donor restrictions

    beginning of year $81,680,386 · end of year $92,248,114

  • 28 · Net assets with donor restrictions

    beginning of year $305,454 · end of year $375,013

Mission and programs · 2023

Mission

THE MISSION OF WAUPUN MEMORIAL HOSPITAL IS TO PROVIDE COMPASSIONATE CARE THAT BRINGS HOPE, HEALTH, AND WHOLENESS TO THOSE WE SERVE BY HONORING THE SACREDNESS AND DIGNITY OF ALL PERSONS AT EVERY STAGE OF LIFE. WE ARE ROOTED IN THE HEALING MINISTRY OF THE CATHOLIC CHURCH.

  • SINCE IT WAS FOUNDED IN 1872 BY CATHOLIC SISTERS, SSM HEALTH (SSMH) HAS EXISTED TO MEET THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES. SSMH IS A CATHOLIC, NOT-FOR-PROFIT HEALTH SYSTEM SERVING THE COMPREHENSIVE HEALTH NEEDS OF COMMUNITIES ACROSS THE MIDWEST THROUGH ONE OF THE LARGEST INTEGRATED DELIVERY SYSTEMS IN THE NATION. WITH CARE DELIVERY SITES IN ILLINOIS, MISSOURI, OKLAHOMA, AND WISCONSIN, SSMH INCLUDES 23 ACUTE CARE HOSPITALS, ONE CHILDREN'S HOSPITAL, MORE THAN 650 PHYSICIAN OFFICES AND OTHER OUTPATIENT AND VIRTUAL CARE SERVICES, 12 POST-ACUTE FACILITIES, COMPREHENSIVE HOME CARE AND HOSPICE SERVICES, A PHARMACY BENEFIT COMPANY, AND AN ACCOUNTABLE CARE ORGANIZATION. THE HEALTH SYSTEM EMPLOYS NEARLY 40,000 PEOPLE AND IS AFFILIATED WITH 13,900 PHYSICIANS MAKING IT ONE OF THE LARGEST EMPLOYERS IN EVERY COMMUNITY IT SERVES. IN THE TRADITION OF ITS FOUNDING SISTERS, SSMH STRIVES TO FULFILL ITS MISSION BY PROVIDING EXCEPTIONAL HEALTH CARE TO EVERYONE WHO COMES TO ITS HOSPITALS, REGARDLESS OF THEIR ABILITY TO PAY. ABOUT WAUPUN MEMORIAL HOSPITAL:WAUPUN MEMORIAL HOSPITAL IS A CRITICAL ACCESS HOSPITAL LOCATED IN WAUPUN, WISCONSIN, AND PROVIDES A FULL RANGE OF INPATIENT AND OUTPATIENT SERVICES TO WAUPUN AND THE SURROUNDING RURAL AREAS. WAUPUN MEMORIAL HOSPITAL FEATURES A TWO-STORY PROVIDER CLINIC, CONSOLIDATING ALL ITS PROVIDER SERVICES INTO ONE FACILITY WITH A DIRECT CONNECTION TO THE LARGER RESOURCES OF THE HOSPITAL. A STATE-OF-THE-ART SURGERY AREA FEATURES THREE HIGH-TECH OPERATING ROOMS, AN ENDOSCOPY PROCEDURE ROOM, 11 PRE/POSTOPERATIVE PATIENT ROOMS, FOUR POST ANESTHESIA RECOVERY ROOMS AND CENTRALIZED STERILE PROCESSING AREA. THE HOSPITAL'S STAFF OF ASSOCIATES AND VOLUNTEERS IS DEDICATED TO PROVIDING SERVICES IN THE AREAS OF LABORATORY, CARDIOPULMONARY, REHABILITATION, RADIOLOGY, ULTRASOUND, MRI, SURGICAL, EMERGENCY, OUTPATIENT DIALYSIS, MEDICAL/SURGICAL SERVICES, INTENSIVE CARE AND OBSTETRICS.IN 2018, WAUPUN MEMORIAL HOSPITAL RECEIVED CERTIFICATION OF ITS CARDIAC REHAB PROGRAM BY THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION (AACVPR). WMH WAS RECOGNIZED FOR ITS COMMITMENT TO IMPROVING THE QUALITY OF LIFE BY ENHANCING STANDARDS OF CARE. AACVPR PROGRAM CERTIFICATION IS THE ONLY PEER-REVIEW ACCREDITATION PROCESS DESIGNED TO REVIEW INDIVIDUAL PROGRAMS FOR ADHERENCE TO STANDARDS AND GUIDELINES DEVELOPED AND PUBLISHED BY AACVPR AND OTHER PROFESSIONAL SOCIETIES. EACH PROGRAM IS REVIEWED BY THE AACVPR PROGRAM CERTIFICATION COMMITTEE AND CERTIFICATION IS AWARDED BY THE AACVPR BOARD OF DIRECTORS. AACVPR-CERTIFIED PROGRAMS ARE RECOGNIZED AS LEADERS IN THE FIELD OF CARDIOVASCULAR AND PULMONARY REHABILITATION BECAUSE THEY OFFER THE MOST ADVANCED PRACTICES AVAILABLE. WAUPUN MEMORIAL HOSPITAL ALSO FURTHERS ITS EXEMPT PURPOSE WITH THE FOLLOWING ACTIVITIES: OPERATES AN EMERGENCY ROOM THAT IS OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA ENGAGES IN THE TRAINING AND EDUCATION OF HEALTH CARE PROFESSIONALS, PARTICIPATES IN MEDICAID, MEDICARE, CHAMPUS, TRICARE, AND/OR OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS ALL SURPLUS FUNDS GENERATED BY SSMH ENTITIES ARE REINVESTED IN IMPROVING OUR PATIENT CARE DELIVERY SYSTEM QUANTIFIABLE UNCOMPENSATED CARE:THIS SECTION INCLUDES A LIST OF THE TYPES OF PROGRAMS AND SERVICES THAT COULD BE QUANTIFIED AS UNCOMPENSATED CARE:TRADITIONAL CHARITY CARE $782,903UNPAID COST OF MEDICAID $154,150TOTAL QUANTIFIABLE UNCOMPENSATED CARE $937,054

    Expenses $44,721,180 · Grants $65,373 · Revenue $59,588,022

As filed on the 2023 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • DOUG CRONIN

    PT YR DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • KATHY DUCHAC

    PT YR DIRECTOR, VICE CHAIR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • SCOTT HANSFIELD

    PT YR DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • JAN HARMSEN

    PT YR DIRECTOR, CHAIR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • KATHLEEN HENDRICKS

    PT YR DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • DAVID HOPP

    PT YR DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • AMY MOHR

    PT YR DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • BREANNA NAGEL

    PT YR DIRECTOR, CHIEF OF STAFF REPRESENTATIVE

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • ROBERT NAGLE

    PT YR DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • BRITTANY PAGE

    PT YR DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • KAREN REYNOLDS

    PT YR DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • RHEA EMMER

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 4 related

  • PENG HER

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 4 related

  • MARK HOLZMAN

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 4 related

  • JOAN KARSTON

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 4 related

  • KATIE KENNEDY

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 4 related

  • PATTI LEITZEN FYE

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 4 related

  • JENNIFER MASKEL

    DIRECTOR, PHYSICIAN

    Total calculated
    $156,819
    From this org
    $0
    From related orgs
    $142,795
    Other
    $14,024
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $142,370 related
    Bonus
    $0
    Other
    $0 + $425 related
    Deferred
    $0 + $10,628 related
    Nontaxable benefits
    $0 + $3,396 related
    Filer's total
    $0 + $156,819 related

  • WAYNE MATZKE

    DIRECTOR, VICE CHAIR

    Total calculated
    $0
    Hours/week
    1 + 4 related

  • THEODORE MILLER

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 4 related

  • OLIVIA OTTE

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 4 related

  • MATTHEW POGODZINSKI

    DIRECTOR, PHYSICIAN

    Total calculated
    $817,434
    From this org
    $0
    From related orgs
    $755,367
    Other
    $62,067
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $753,607 related
    Bonus
    $0
    Other
    $0 + $1,760 related
    Deferred
    $0 + $19,050 related
    Nontaxable benefits
    $0 + $43,017 related
    Filer's total
    $0 + $817,434 related

  • WESLEY SPARKMAN

    DIRECTOR, CHAIR

    Total calculated
    $0
    Hours/week
    1 + 4 related

  • SUE ANDERSON

    DIRECTOR, REGIONAL PRESIDENT

    Total calculated
    $1,969,236
    From this org
    $0
    From related orgs
    $1,428,914
    Other
    $540,322
    Hours/week
    1 + 55 related

    Schedule J breakdown matched by us

    Base
    $0 + $765,767 related
    Bonus
    $0 + $330,759 related
    Other
    $0 + $332,388 related
    Deferred
    $0 + $520,449 related
    Nontaxable benefits
    $0 + $19,873 related
    Filer's total
    $0 + $1,969,236 related

  • DEANN THURMER

    PT YR DIRECTOR, PRESIDENT/CNO-WAUPUN MEMORIAL HOSP

    Total calculated
    $544,562
    From this org
    $0
    From related orgs
    $407,420
    Other
    $137,142
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $317,834 related
    Bonus
    $0 + $58,132 related
    Other
    $0 + $31,454 related
    Deferred
    $0 + $111,051 related
    Nontaxable benefits
    $0 + $26,091 related
    Filer's total
    $0 + $544,562 related

  • RANDY COMBS

    TREASURER, CFO AT SSM HEALTH

    Total calculated
    $3,420,428
    From this org
    $0
    From related orgs
    $2,182,354
    Other
    $1,238,074
    Hours/week
    1 + 55 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,242,308 related
    Bonus
    $0 + $669,269 related
    Other
    $0 + $270,777 related
    Deferred
    $0 + $1,203,989 related
    Nontaxable benefits
    $0 + $34,085 related
    Filer's total
    $0 + $3,420,428 related

  • DOUGLAS LONG

    SECRETARY, CHIEF LEGAL OFFICER AT SSM HEALTH

    Total calculated
    $2,202,252
    From this org
    $0
    From related orgs
    $1,425,239
    Other
    $777,013
    Hours/week
    1 + 55 related

    Schedule J breakdown matched by us

    Base
    $0 + $759,270 related
    Bonus
    $0 + $495,539 related
    Other
    $0 + $170,430 related
    Deferred
    $0 + $753,634 related
    Nontaxable benefits
    $0 + $23,379 related
    Filer's total
    $0 + $2,202,252 related

  • STEVE SMOOT

    VICE PRESIDENT, COO AT SSM HEALTH

    Total calculated
    $3,258,847
    From this org
    $0
    From related orgs
    $2,054,358
    Other
    $1,204,489
    Hours/week
    1 + 55 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,173,646 related
    Bonus
    $0 + $737,192 related
    Other
    $0 + $143,520 related
    Deferred
    $0 + $1,164,125 related
    Nontaxable benefits
    $0 + $40,364 related
    Filer's total
    $0 + $3,258,847 related

  • THOMAS KIRSCHBAUM

    ASSISTANT SECRETARY

    Total calculated
    $742,649
    From this org
    $0
    From related orgs
    $532,265
    Other
    $210,384
    Hours/week
    1 + 45 related

    Schedule J breakdown matched by us

    Base
    $0 + $388,964 related
    Bonus
    $0 + $99,618 related
    Other
    $0 + $43,683 related
    Deferred
    $0 + $172,359 related
    Nontaxable benefits
    $0 + $38,025 related
    Filer's total
    $0 + $742,649 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 1a · Tax indemnification and gross-up payments
  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 1b · Written policy on the line-1a expenses
  • 2 · Substantiation required before reimbursing expenses
  • 4a · Severance or change-of-control payment
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 1A
AN INDIVIDUAL LISTED ON PART VII, SECTION A, RECEIVED TAX INDEMNIFICATION/GROSS UP PAYMENTS IN 2023, WHICH WAS INCLUDED IN TAXABLE COMPENSATION.
PART I, LINE 3
THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL, PRESIDENT, IS COMPENSATED BY A RELATED ORGANIZATION THAT UTILIZED THE FOLLOWING TO DETERMINE COMPENSATION: (1) INDEPENDENT COMPENSATION CONSULTANT; (2) COMPENSATION SURVEY OR STUDY; AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
PART I, LINE 4B
PENSION RESTORATION PLAN: SSM HEALTH (SSMH) PROVIDES THIS SUPPLEMENTAL DEFINED BENEFIT NONQUALIFIED RETIREMENT PLAN TO ANY EMPLOYEE WHO IS A PARTICIPANT IN THE SSMH QUALIFIED DEFINED BENEFIT PLAN WHO EARNS OVER THE INTERNAL REVENUE SERVICE COMPENSATION LIMIT. THE PLAN "RESTORES" THE BENEFITS TO THESE EMPLOYEES THAT WOULD HAVE BEEN PROVIDED UNDER THE SSMH QUALIFIED PLAN IF THE REGULATIONS DID NOT IMPOSE COMPENSATION LIMITS. AN INDIVIDUAL CAN TAKE A DISTRIBUTION FROM THE PLAN AT (1) AGE 65 OR OLDER IF THE INDIVIDUAL IS STILL EMPLOYED BY SSMH OR (2) AGE 55 OR OLDER IF THE INDIVIDUAL IS NO LONGER EMPLOYED BY SSMH. NO INDIVIDUALS LISTED ON PART VII OF FORM 990 RECEIVED DISTRIBUTIONS FROM THE PLAN IN 2023. CAPITAL ACCUMULATION PLAN: SSMH PROVIDES THIS SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN TO EXECUTIVE LEVEL EMPLOYEES. THE ORGANIZATION CONTRIBUTED A PERCENTAGE OF THE EMPLOYEE'S BASE SALARY INTO THEIR CHOICE OF A SELECT LIST OF INVESTMENTS. THE DEPOSITS AND EARNINGS OF THE PLAN ARE OWNED BY SSMH AND ARE TAX-DEFERRED UNTIL A DISTRIBUTION IS MADE TO THE EMPLOYEE. IN ADDITION, THE PLAN HAS SPECIAL SAFEGUARDS IN PLACE TO PROTECT THE FUNDS FROM CONTINGENCIES, OTHER THAN INSOLVENCY. FOR CONTRIBUTIONS MADE TO THE PLAN IN 2014 OR AFTER, THE DISTRIBUTION WILL OCCUR AFTER THE COMPLETION OF FOUR PLAN YEARS FOR ALL EXECUTIVES THAT ARE STILL ACTIVELY EMPLOYED ON THE DISTRIBUTION DATE. ANY ACTIVE PARTICIPANT 65 YEARS OR OLDER WILL RECEIVE THE CONTRIBUTION IN THE CURRENT YEAR. THE FOLLOWING INDIVIDUALS LISTED ON PART VII OF THE FORM 990 RECEIVED DEFERRALS FROM THIS PLAN IN 2023: DEANN THURMER - $29,866 JENNIFER MASKEL - $2,131 RANDY COMBS - $261,633 DOUGLAS LONG - $161,287 STEVE SMOOT $249,972 SUE ANDERSON - $153,458 THOMAS KIRSCHBAUM - $37,511 THE FOLLOWING INDIVIDUALS LISTED ON PART VII OF THE FORM 990 RECEIVED DISTRIBUTIONS FROM THIS PLAN IN 2023. ALL DISTRIBUTIONS RECEIVED FROM THE PLAN IN THE CURRENT YEAR WERE INCLUDED IN THE INDIVIDUAL'S TAXABLE COMPENSATION. DEANN THURMER - $26,741 STEVE SMOOT - $140,898 SUE ANDERSON - $132,843

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

Provenance

Return type
form_990
Tax year
2023
Filed
15 November 2024
IRS schema version
2023v5.1
Source object
202423209349318787

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