Astoria Place of Cincinnati

Inspectors wroteBased on review of the survey results notebook in the main receptionist area, review of the Certification and Licensure System (CALS), review of facility policy, and staff interview, the facility failed to ensure the most recent survey of the facility conducted by Federal or State surveyors and any plan of corrections was maintained in a readily accessible. This affected all 84 residents in the facility. Review of the survey results notebook in the main receptionist area revealed the last facility survey results were dated 08/16/23. Review of the CALS survey history for the facility revealed the facility had surveys on 08/31/23, 09/21/23, 10/24/23, 11/08/23, 12/26/23, 01/23/24, 02/22/24, 03/13/24, 04/09/24, 04/18/24, 06/12/24, 08/12/24, 09/19/24, 10/02/24, 10/22/24, 12/24/24, 05/19/25, 07/10/25, 07/18/25, 08/12/25, 10/22/25, 12/09/25, and 01/22/26. [...]

Inspectors wroteBased on observation, staff interviews, record review and policy review, the facility failed to ensure meals delivered to the residents matched the residents ' meal tickets and the daily menu. This affected all residents in the facility as the facility identified all 84 residents received food from the kitchen. The facility census was 84.1) Review of medical record of Resident #37 revealed an admission date of 12/10/25. Diagnoses included chronic obstructive pulmonary disease (COPD), unspecified, personal history of transient ischemic attack (TIA), and cerebral infarction without residual deficits, left bundle-branch block, unspecified, unspecified mood disorder, acute kidney failure, unspecified, other toxic encephalopathy, and cocaine abuse. Review of admission Minimum Data Set (MDS) assessment dated [DATE], revealed Resident #37's cognitive status was not assessed. [...]

Inspectors wroteBased on observation, interview, and policy review the facility failed to ensure food served was palatable and at an appetizing temperature. This had the potential to affect all 84 residents as the facility identified all residents received food from the kitchen. The facility census was 84.

Inspectors wroteBased on observations, record review, staff interviews and policy review, the facility failed to ensure foods were made to the correct consistency for residents with a puree and mechanical soft diet order. This affected seventeen Residents (#08, #34, #75, #05, #06, #17, #25, #27, #32, #46, #53, #54, #56, #73, #79, #81, and #95) who the facility identified as receiving a puree or mechanical soft diet order. The facility census was 84. Review of the medical records revealed three Residents (#08, #34, and #75) had physician orders for a puree diet. Further review revealed fourteen Residents (#05, #06, #17, #25, #27, #32, #46, #53, #54, #56, #73, #79, #81, and #95) had physician orders for a mechanical soft diet. Review of the lunch menu for 02/18/26 revealed the residents would be served lemon zest broccoli, chocolate cake with icing, chicken patty on bun, and rice. [...]

Inspectors wroteBased on observation, staff interview, and review of the facility policy, the facility failed to store and prepare food in a sanitary manner to prevent foodborne illness. This had the potential to affect all residents residing in the facility. The facility census was 84 residents.

Inspectors wroteBased on review of facility documents, staff interview, and review of the facility policy, the facility failed to complete the facility assessment. This affected all residents in the facility. The facility census was 84 residents.

Inspectors wroteBased on record review, staff interview, and review of the facility policy, the facility failed to develop, implement, and maintain an effective Quality Assurance Performance Improvement (QAPI) program that identified and addressed systemic noncompliance. This affected all residents in the facility. The facility census was 84 residents.

Inspectors wroteBased on record review, staff interview, and review of the facility policy, the facility's Quality Assurance and Performance Improvement (QAPI) committee failed to perform any QAPI activities for the entirety of 2025. This affected all residents in the facility. The facility census was 84 residents.

Inspectors wroteBased on record review, staff interview, and review of the facility policy, the facility failed to ensure Quality Assurance and Performance Improvement (QAPI) meetings were conducted on a quarterly basis. This affected all residents in the facility. The facility census was 84 residents.

Inspectors wroteBased on record review, staff interview, review of the facility policy, and review of online resources from the Centers for Disease Control and Prevention (CDC), the facility failed to ensure a comprehensive water management plan was implemented to minimize the risk of waterborne pathogens including Legionella. This had the potential to affect all residents living in the facility. The facility census was 84 residents.

Inspectors wroteBased on observation, staff interview, and review of the facility policy, the facility failed to maintain the building in a safe and sanitary manner for residents, staff, and the public. This had the potential to affect all residents in the facility. The facility census was 84 residents.

Inspectors wroteBased on record reviews, interviews, and policy review, the facility failed to conduct quarterly care conferences. This affected five Residents (#03, #06, #07, #61 and #49) of five residents reviewed for care conferences. The facility census was 84. 1) Review of the medical record revealed Resident #03 was admitted to the facility on [DATE] with diagnoses of congestive heart failure, hypertension, atrial fibrillation, bipolar disorder and anxiety disorder. Review of the Minimum Data Set (MDS) Quarterly assessment dated [DATE] revealed Resident #03 had intact cognition. Review of care conferences for Resident #03, as provided by the facility, revealed the only documented care conference for Resident #03 was in the third quarter of 2025. There were no documented care conferences at admission and fourth quarter of 2025. During an interview on 02/19/26 at 11:50 A.M. [...]

Inspectors wroteBased on observation, staff interview, record review and policy review, the facility failed to dispose of expired vaccines. This had the potential to affect the forty-six Residents (#01,#02, #03, #06, #07, #09, #10, #11, #15, #16, #20, #22, #25, #28, #29, #30, #33, #34, #35, #37, #38, #39, #40, #41,#47, #49, #50, #52, #54, #57, #58, #59, #61, #62, #64, #69, #71, #73, #74, #77, #78, #80, #85, #94, #95, and #96) housed in the 100 and 300 halls who the facility identified as receiving vaccines. The census was 84. During a medication storage observation on [DATE] at 4:01 P.M., three 0.5 milliliter (mL) single dose Influenza Vaccine Afluria were found to be expired (expiration date [DATE]). Four boxes each containing ten Pneumococcal Vaccine Polyvalent Pneumovax - 23, single dose 0.5 mL syringes were found to be expired (expiration date [DATE]). [...]

Inspectors wroteBased on observation, staff interview, and review of the facility policy, the facility failed to provide privacy curtains in resident rooms. This affected five (Residents #30, #96, #10, #80 and #18) of five residents reviewed for privacy. The facility census was 84 residents.

Inspectors wroteBased on observations, staff interviews, record reviews and policy review, the facility failed to provide residents with regular utensils during meals. This directly affected three Residents (#37, #03 and #61) but had the potential to all affect all 84 residents as the facility identified all residents received Meals from the kitchen. The facility census was 84.

Inspectors wroteBased on observation, staff interview and policy review, the facility failed to ensure a safe, functional and homelike environment for the residents. This affected three Residents (#10, #49 and #80) of four resident rooms reviewed for a safe, functional and homelike environment. The facility census was 84. 1) Review of the medical record of Resident #10 revealed an admission date of 12/28/25. Diagnoses included acute kidney failure with tubular necrosis, rhabdomyolysis, encephalopathy, abnormal levels of other serum enzymes, and cocaine abuse. Review of the admission Minimum Data Set (MDS) Quarterly assessment dated [DATE] revealed Resident #10 was cognitively intact. Observation of Resident #10's room on 02/17/26 at 12:39 P.M. [...]

Inspectors wroteBased on review of Minimum Data Set (MDS) assessments, review of medical record, and staff interview, the facility failed to ensure a significant change assessment was completed for one (Resident #02) of one resident reviewed for significant change assessments. The facility census was 84.

Inspectors wroteBased on observation, staff interviews, and facility policy review, the facility failed to provide a discreet cover for a resident's catheter bag and ensure appropriate placement of catheter bag. This affected one (Resident #94) of two residents reviewed for catheter care. The facility census was 84. Review of the medical record of Resident #94 revealed an admission date of 02/16/26. Diagnoses included acute hematogenous osteomyelitis, left ankle and foot, complete lesion at T1 level of thoracic spinal cord, neuromuscular dysfunction of bladder, borderline personality disorder, antisocial personality disorder, paraplegia, schizoaffective disorder, and acquired absence of right leg above knee. The admission Minimum Data Set (MDS) assessment for Resident #94 was still in progress. A Brief Interview for Mental Status (BIMS) revealed Resident #94 was cognitively intact. [...]

Inspectors wroteBased on medical record review, resident interview, staff interview, and review of the facility policy, the facility failed to implement nutritional recommendations made by the Registered Dietitian (RD) for a resident with weight loss. This affected one (Resident #03) of three residents reviewed for nutrition. The facility census was 84.

Inspectors wroteBased on review of the medical record, staff interviews, review of Self-Reported Incidents (SRI), review of staff time punches, and policy review, the facility failed to follow abuse policy relating to alleged abuse by staff. This affected one (Resident #15) of three reviewed for abuse. The facility census was 78.

Inspectors wroteBased on review of the medical record, review of Self-Reported Incidents (SRI), review of emergency room (ER) records, staff interviews, and review of facility policy, the facility failed to report an allegation of abuse to the state agency. This affected one (Resident #79) of three residents reviewed for abuse. The facility census was 78.

Inspectors wroteBased on review of the medical record, review of Self-Reported Incidents (SRI), review of emergency room (ER) records, staff interviews, and review of facility policy, the facility failed to complete a thorough investigation for an alleged sexual abuse allegation. This affected one (Resident #79) of three residents reviewed for abuse. The facility census was 78Findings include: Review of the medical record for Resident #79 revealed an admission date of 06/12/25 with a discharge date of 10/06/25. Diagnoses included dementia, type II diabetes mellitus (DM II), and bipolar disorder. Review of the ER records dated 08/28/25 at 7:01 P.M., revealed Resident #79 was admitted to the ER related to a reported sexual assault. The ER notes indicated Emergency Medical Services (EMS) were called to the facility for a hyperglycemic related incident. [...]

Inspectors wroteBased on review of the medical record, observations, staff interviews, and policy review, the facility failed to ensure infection control measures were followed during incontinence care. This affected one (Resident #46) of three reviewed for incontinence care. The facility census was 78.

Inspectors wroteBased on observation and staff interview, the facility failed to ensure medications were properly stored. This had the potential to affect all 18 residents residing on the 200 unit (Residents #17, #25, #30, #101, #102, #103, #104, #105, #106, #107,#108, #109, #110, #112, #113, #114, #115, #116). The facility census was 75 residents.

Inspectors wroteBased on medical record review, staff interview, review of facility Self-Reported Incidents (SRIs), and review of the facility policy, the facility failed to report an allegation of sexual abuse to the Ohio Department of Health (ODH) in a timely manner. This affected one resident (Resident #45) of three residents reviewed for abuse. The facility census was 75 residents.

Inspectors wroteBased on medical record review, staff interview, resident interview, and review of the facility policy, the facility failed to prevent misappropriation of residents' personal property. This affected two (Residents #12 and #13) of three residents reviewed for residents' rights. The facility census was 75 residents.

Inspectors wroteBased on medical record review, review of personnel records, review of staff statements, resident interview, staff interview, review of facility Self-Reported Incidents, and review of the facility policy, the facility failed to report allegations of verbal abuse to the state agency. This affected one (Resident #10) of three residents reviewed for abuse. The facility census was 75 residents.

Inspectors wroteBased on medical record review, review of personnel records, review of staff statements, resident interview, staff interview, review of facility Self-Reported Incidents, and review of the facility policy, the facility failed to thoroughly investigate allegations of abuse/mistreatment of residents. This affected one (Resident #10) of three residents reviewed for abuse. The facility census was 75 residents.

Inspectors wroteBased on medical record review, review of facility Self-Reported Incidents (SRIs), review of staff witness statements, review of hospital records, staff interview, resident interview, and review of the facility policy, the facility failed to ensure residents were free from resident-to-resident abuse. This resulted in Actual Harm on 07/01/25 to Resident #38 when Resident #43, a resident with a known history of aggressive behaviors towards other residents, struck Resident #38 in the face causing a nasal fracture. This affected one (Resident #38) of three residents reviewed for abuse. The facility census was 71 residents.

Inspectors wroteBased on medical record review, observation, review of maintenance orders, resident interview, staff interview, and review of the facility policy, the facility failed to ensure a safe and homelike environment for the residents. This affected Residents #20 and #21, the following 18 residents residing on the 100- unit (#1, #2, #3, #4, #5, #6, #7, #8, #9, #10, #11, #12, #13, #14, #15, #16, #17, #18), and the following 14 residents residing on the 400-unit (#58, #59, #60, #61, #62, #63, #64, #65, #66, #67, #68, #69, #70, #71) and had the potential to affect all of the residents residing in the facility . The facility census was 71 residents.

Inspectors wroteBased on medical record review, observation, staff interview, and review of the facility policy, the facility failed to implement Enhanced Barrier Precautions (EBP) while providing incontinence and wound care and failed to change gloves and perform appropriate hand hygiene during incontinence care. This affected one (Resident #10) of three residents reviewed for infection control. The facility census was 71 residents.

Inspectors wroteBased on resident interviews, staff interviews, an Ombudsman interview, police interviews, medical record review, and policy review, the facility failed to provide a safe discharge for Resident #19. This resulted in Immediate Jeopardy on 04/10/25 when Resident #19 was placed at risk for potential serious life-threatening harm, injuries, negative health outcomes and/or death when the facility discharged Resident #19 without providing a safe discharge location or provisions for a wound treatment. This affected one (Resident #19) of three residents reviewed for discharge. The facility census was 69. On 04/23/25 at 1:07 P.M., the Administrator, Director of Nursing (DON), and Regional Director of Operations (RDO) #200 were notified that Immediate Jeopardy began on 04/10/25 at 3:00 P.M. [...]

Inspectors wroteBased on record review, review of hospital records, staff interviews, and policy review, the facility failed to ensure adequate supervision was in place to prevent one resident, identified as an elopement risk and who was assessed with purposeful exit seeking behaviors, from eloping from the facility unknown to staff. This resulted in Immediate Jeopardy and serious physical harm and injuries on 04/26/25 when Resident #75 was removed from one-on-one supervision and was subsequently found on the ground outside of the facility after removing a windowpane from the window in his room and dropping two stories to the pavement below, sustaining bilateral ankle fractures which required surgery. This affected one (Resident #75) of three residents reviewed for elopement risk. The facility census was 69. On 05/02/25, the Administrator was notified that Immediate Jeopardy began on 04/26/25 at 7:50 A. [...]

Inspectors wroteBased on observation, record review, interview and policy review, the facility failed to notify residents of changes to the menu in a timely manner. This all residents who accepted food from the kitchen. The facility identified two (Residents ##10 and #18) residents who did not receive food form the kitchen. The facility census was 69.

Inspectors wroteBased on observations and staff interviews the facility failed to ensure residents were able to control room temperature and failed to maintain sanitary shower rooms. This affected one (Resident #73) of six residents sampled for appropriate room temperature controls. This had the potential to affect all residents on the first floor and in the Women's Secured Unit who used the shower rooms. The facility census was 69.

Inspectors wroteBased on record review, interview, and policy review, the facility failed to ensure the physician was notified of diagnostic results in a timely manner. This affected one (Resident #60) of six residents reviewed for falls. The facility census was 69.

Inspectors wroteBased on record review, staff interviews, and policy review, the facility failed to report allegations of abuse to the State Agency in a timely manner. This affected two (Residents #64 and #51) of six residents sampled for abuse. The facility census was 69.

Inspectors wroteBased on record review, interview and policy review, the facility failed to ensure residents received appropriate screening for pre-admission screening and resident review (PASRR) prior to admission. This affected one (Resident #43) of six residents reviewed for PASRR. The facility census was 69.

Inspectors wroteBased on record review, interview, and policy review, the facility failed to ensure residents were reassessed for pre-admission screening and resident review (PASRR) after new mental health diagnoses and new psychotropic medications were ordered. This affected one (Resident #36) of six residents reviewed for PASRR. The facility census was 69.

Inspectors wroteBased on medical record review, interview, and policy review, the facility failed to ensure residents received quarterly conferences attended by members of the clinical team. This affected three (Residents #36, #51, and #60) of five residents reviewed for care conferences. The facility census was 69.

Inspectors wroteBased on record review, interview and policy review, the facility failed to timely treat residents with displaced joints. This affected one (Resident #60) of five residents reviewed for falls. The facility census was 69.

Inspectors wroteBased on record review, interview and policy review, the facility failed to ensure residents attended mental heath appointments as scheduled. This affected one (Resident #75) of seven residents reviewed for mental health services. The facility census was 69.

Inspectors wroteBased on record review, interview and policy review, the facility failed to ensure medications were given as prescribed. This affected three (Residents #38, #45, and #73) of eight residents reviewed for medication administration. The facility census was 69.

Inspectors wroteBased on record review, interview and policy review, the facility failed to ensure information documented in the medical record was accurate. This affected three (Residents #19, #60, and #75) of six residents reviewed for accurate documentation. The facility census was 69.

Inspectors wroteBased on observation, staff interview and review of the facility policy, the facility failed to store foods safely, and maintain a sanitary kitchen to ensure food service safety. This had the potential to affect 60 of 60 residents who received food from the kitchen. The facility identified two residents (#21, #49) who received nothing by mouth. The facility census was 62 residents.

Inspectors wroteBased on observation, medical record reveiw, policy review and interview the facility failed to provide a safe, comfortable and clean environment for all residents. This affected 13 residents (#3, #5, #6, #8, #14, #30, #31, 34, #38, #44, #48, #52 and #56) of 19 residing on the women's secured unit. The facility census was 62 residents.

Inspectors wroteBased on observation, medical record review, facility policy review and interview, the facility failed to ensure resident bedrooms provided visual privacy for the residents. This affected eight residents (#3, #5, #6, #24, #30, #31, #52, and #56) of 19 women residing on the secured women's unit. The facility census was 62 residents.

Inspectors wroteBased on observation, facility policy review the facility failed to provide a safe, functional, sanitary and comfortable environment. This affected 19 residents (#3, #5, #6, #8, #9, #14, #20, #24, #28, #29, #30, #31, 34, #38, #40, #44, #48, #52 and #56) of 19 residing on the women's secured unit. The facility census was 62 residents. Findings Include: 1. Observation on 08/05/24 at 2:32 P.M. revealed the women's secure unit shower room had a blackened substance, consistent with appearance of mold, at base of shower stall and adjacent walls. The shower exhaust fan did operate and had a gray fuzzy layer covering the surface. There was a shower privacy curtain which was torn three feet from the top and was not attached to the track and was hanging which prevented complete privacy around the shower area from the door entrance. Interview on 08/05/24 at 2:32 P.M. [...]

Inspectors wroteBased on observation, medical record review and interview the facility failed to ensure Resident #23 received proper treatment and assistive devices to maintain vision. This affected one resident (#23) of six residents reviewed for vision services. The facility census was 62 residents.

Inspectors wroteBased on record review and staff interview, the facility failed to submit complete and accurate staffing information for the Payroll-Based Journal (PBJ) staffing report to the Centers for Medicare and Medicaid Services (CMS). This had the potential to affect all 62 residents residing in the facility.

Inspectors wroteBased on record review, review of facility policy, and interview, the facility failed to ensure Resident #11's physician and guardian were notified timely following a fall with injury. This affected one resident (#11) of five residents reviewed for falls. The facility census was 63. Findings Include: Review of the medical record for Resident #11 revealed admission date of 09/12/11 with diagnoses including cerebral palsy (CP), schizophrenia, convulsion, moderate intellectual disabilities (ID), borderline personality disorder, type two diabetes mellitus, seizures, psychosis, dementia, peripheral vascular disease, impulse disorder, post-traumatic stress disorder (PTSD), and intermittent explosive disorder. Review of the Minimum Data Set (MDS) assessment dated [DATE], revealed Resident #11 was rarely understood and was dependent on staff for transfers and mobility. [...]

Inspectors wroteBased on record review, review of facility policy, and interview, the facility failed to ensure adequate assessment and timely care and treatment were provided to Resident #11 following an unwitnessed fall with injury. This affected one resident (#11) of five residents reviewed for falls. The facility census was 63. Findings Include: Review of the medical record for Resident #11 revealed admission date of 09/12/11 with diagnoses including cerebral palsy (CP), schizophrenia, convulsion, moderate intellectual disabilities (ID), borderline personality disorder, type two diabetes mellitus, seizures, psychosis, dementia, peripheral vascular disease, impulse disorder, post-traumatic stress disorder (PTSD), and intermittent explosive disorder. Review of a fall risk assessment dated [DATE] revealed Resident #11 was a high risk for falls. [...]

Inspectors wroteBased on staff interviews, record review, and review of the Payroll-Based Journal (PBJ), the facility failed to submit complete and accurate staffing information for the PBJ report to the Centers for Medicare and Medicaid Services (CMS). This had the potential to affect all 63 residents in the facility. Findings Include: Review of the [NAME] PBJ staffing data report for the third quarter of 2023 revealed the facility triggered for no Registered Nurse (RN) hours and no licensed nursing coverage 24 hours/day for the entire quarter. Interview with the Administrator on 03/13/24 at 9:00 A.M. confirmed inaccurate data was sent in on the PBJ for the third quarter of 2023. The Administrator revealed she collected data for two facilities and sends the information to corporate. The Administrator revealed she had no access to verify the information was received by CMS.

Inspectors wroteBased on medical record review, resident representative interview, staff interview, and review of facility policy, the facility failed to ensure staff made timely notification of changes in resident condition to the physician and resident representative. This affected one (Resident #78) of three residents reviewed for falls. The facility census was 63.

Inspectors wroteBased on medical record review, review of resident banking records, review of review of facility grievance logs, review of facility investigative reports, review of facility Self-Reported Incidents (SRIs), resident representative interview, staff interview, and review of facility policy, the facility failed to ensure residents were free from misappropriation. This affected one (Resident #78) of three residents reviewed for misappropriation. The facility census was 63.

Inspectors wroteBased on medical record review, review of resident banking records, review of review of facility grievance logs, review of facility investigative reports, review of facility Self-Reported Incidents (SRIs), resident representative interview, staff interview, and review of facility policy, the facility failed to ensure allegations of misappropriation were reported to the Ohio Department of Health (ODH) as required. This affected one (Resident #78) of three residents reviewed for misappropriation. The facility census was 63.

Inspectors wroteBased on medical record review, review of resident banking records, review of review of facility grievance logs, review of facility investigative reports, review of facility Self-Reported Incidents (SRIs), resident representative interview, staff interview, and review of facility policy, the facility failed to complete a timely and thorough investigation of misappropriation of resident property. This affected one (Resident #78) of three residents reviewed for misappropriation. The facility census was 63.

Inspectors wroteBased on medical record review, staff interview, and review of facility policy, the facility failed to ensure Resident #78 was timely and adequately assessed and provided timely medical intervention following a fall with major injury. This affected one (Resident #78) of three residents reviewed for falls. The facility census was 63.

Inspectors wroteBased on medical record review, resident representative interview, staff interview, and review of facility policy, the facility failed to ensure resident falls were thoroughly investigated including identification of root cause of the fall, identification of hazards and risks associated with falls and evidence of implementation of appropriate interventions to prevent resident falls. This affected one (Resident #78) of three residents reviewed for falls. The facility census was 63.

Inspectors wroteBased on observation, staff and vendor interviews, review of facility billing/financial information, and review of facility policy, the facility neglected to meet financial obligations for the delivery of care and maintenance to all the residents and to operate in a manner to ensure all bills were being paid in a timely manner to prevent potential interruption in services and to meet the needs of all 67 residents residing in the facility.

Inspectors wroteBased on observation, resident and staff interview and review of facility policy, the facility failed to ensure heating equipment was functional to provide warm temperatures in resident rooms. This affected nine residents (#05, #06, #10, #16, #17, #18, #19, #20 and #26) observed/interviewed related to temperatures in the facility. The lack of preventative/routine maintenance on resident individual room heating units had the potential to affect all 67 residents residing in the facility.

Inspectors wroteBased on observation, resident and staff interview and review of facility policy, the facility failed to provide a comfortable, safe, and homelike environment with (air) temperatures maintained between 71 and 81 degrees Fahrenheit. This affected 30 residents (#01, #05, #06, #07, #08, #09, #10, #11, #12, #15, #16, #17, #18, #19, #20, #21, #22, #23, #24, #25, #26, #27, #28, #29, #43, #52, #53, #57, #58 and #64) of 67 residents residing in the facility.

Inspectors wroteBased on staff interview, observation, and review of the facility policy, the facility failed to ensure resident representatives had reasonable access to communication with residents by telephone. This had the potential to affect all of the residents residing in the facility. The facility census was 71.

Inspectors wroteBased on observations, resident interview, staff interview and review of policy, the facility failed to provide a homelike environment to residents. This affected one resident, (#2), with the potential to affect all 23 of the 100-hall residents (#1, #3, #11, #12, #13, #16, #17, #20, #23, #27, #31, #32, #36, #40, #42, #43, #47, #53, #55, #56, #58, #69). The current census is 71.