Inspection·February 26, 2026

F 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. Based on observations, interviews, and record reviews the facility failed to ensure drugs and biologicals used in the facility were labeled in accordance with currently accepted professional principles, and included the appropriate accessory and cautionary instructions in accordance with professional standards for 4 of 8 medication carts reviewed for medication storage in that: Medication Carts #1, #2, #3 and #4 contained medications that did not have an open date written on the bottles. The failure to date opened medications placed residents at risk for receiving expired, contaminated, or ineffective medications which could result in medication errors, infection, delayed treatment or adverse drug outcome.Findings:On 2/25/2026 at 10:20 a.m., during a medication storage observation of Medication Cart #1 located on the 400 Hall, in the presence of the DON and RN I, the following medications were observed without a documented date indicating when the medications were opened: Valproic acid solution 250/5ml. (used to treat various types of seizure disorders). Dayquil, Severe Cold and flu (used to treat nose stuffiness, relieve coughing, and ease pain and fever). Nystatin powder 1,000,000iu. (it is used to treat skin infections caused by yeast). Zinc oxide pastes skin protectant with menthol. (is used to protect, soothe and heal the skin, also used in the prevention and treatment of skin breakdown). Triple antibiotic ointment (it is used to help prevent bacterial infection in minor skin injuries). Prevent Silicone cream. (skin protectant that temporarily protects and helps relieve chapped or cracked skin) On 2/25/2026 at 10:51 a.m., during a medication storage observation of Medication Cart #2 located on the 300 Hall, in the presence of the DON and LVN J, the following medications were observed without a documented date indicating when the medication was opened: Two Albuterol Sulfate Inhalation Aerosol 90mcg per activation (used to treat or prevent bronchospasm, or narrowing of the airways in the lungs, relaxes muscles in the airways and increases air flow to the lungs). Valproic acid solution 250/5ml (used to treat various types of seizure disorders). All day Allergy, Cetirizine Hydrochloride (used to treat cold or allergy symptoms such as sneezing, itching, watery eyes, or runny nose). Promethazine/Codeine solution (is a combination medicine used to treat cold or allergy symptoms such as runny nose, sneezing, and cough). ConvaTec Stomahesive Paste 2-ounce tube (used in filling uneven skin surface around the stoma to create a secure seal, preventing leakage and irritation). On 2/25/2026 at 11:03 a.m., during a medication storage observation of Medication Cart #3 located on the 500 Hall, in the presence of the DON and MA L, the following medications were observed without a documented date indicating when the medication was opened: Collagenase Santyl ointments 250 units/30g (is used to treat severe burns or skin ulcers in adults. Santyl helps remove dead skin tissue and aid in wound healing). Silver sulfadiazine cream, USP 1% (is commonly used to treat and prevent wound infections in people with severe burns). Albuterol sulfate inhalation solution 2.5mg/3ml (used to treat or prevent bronchospasm, or narrowing of the airways in the lungs, relaxes muscles in the airways and increases air flow to the lungs). Ammonium Lactate cream 12% (is used to treat dry, scaly, itchy skin). Zinc Oxide 20% cream. (is used primarily to protect, soothe and heal the skin, also used in the prevention and treatment of skin breakdown). Fluticasone Propionate Nasal spray, USP. 50mcg per spray (is used to treat nasal congestion, sneezing, runny nose, and itchy or watery eyes caused by seasonal or year-round allergies). Miebo drops 1.3gm/ml (is a prescription eye drop used to treat the signs and symptoms of dry disease). Nitroglycerin 0.4mg/hr. (skin patch) is used to prevent attacks of chest pain). Pantoprazole Sodium 40mg delayed release oral suspension. (used to treat certain stomach and esophagus problems (such as acid reflux). It works by decreasing the amount of acid your stomach makes. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455643 If continuation sheet Page 2 of 9 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 455643 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/26/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avir at Bay City 700 12th St Bay City, TX 77414 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Famotidine tablet 10mg (is used to prevent and relieve heartburn due to acid indigestion). Two packets of Alendronate sodium tablets, USP 70mg (is a medication that strengthens bones and reduces the risk of fractures by slowing bone loss). Mucus relief, Guaifenesin 400mg (is used as an expectorant to relieve chest congestion by thinning and loosening mucus, making it easier to cough up). Brimonidine tartrate/Timolol Maleate ophthalmic solution 0.2%/0.5% 5ml (is an eye drop used to treat increase pressure in the eye). Two packets of Linzess capsules (is used to treat certain types of constipation. Constipation is a condition in which you may have fewer bowel movements than expected, or you may have stools that are hard, dry, lumpy, or painful or difficult to pass). Bisacodyl 5mg, stimulant laxative enteric coated tablets (is a laxative that stimulates bowel movements). Cyclosporine ophthalmic emulsion, 0.05% (is used to treat chronic dry eye syndrome by increasing tear production and reducing inflammation in the eyes). On 2/25/2026 at 11:18 a.m., during a medication storage observation of Medication Cart #4 located on the 500 Hall, in the presence of the DON and LVN K, the following medications were observed without a documented date indicating when the medication was opened: Collagenase Santyl ointments 250 units/30g (is used to treat severe burns or skin ulcers in adults, also used to help remove dead skin tissue and aid in wound healing). Albuterol sulphate inhalation sodium, 0.083% 3ml (is used to treat or prevent narrowing of the airways in the lungs, relaxes muscles in the airways and increases air flow to the lungs). Antimicrobial skin and wound gel. Triple antibiotic ointment (is used to help prevent bacterial infection in minor skin injuries). Triad Hydrophilic wound dressing (is used to manage moisture-prone wounds and protect peri wound skin from irritation and maceration). Dakin's solution (is a diluted sodium hypochlorite solution, is primarily used for cleaning and disinfecting wounds to prevent or treat infections).Therahoney gel (is used to help wound heal, helps debride - remove dead tissue) naturally. Antidiarrheal - Loperamide HCL tablets 2mg (used to treat loose stool or to reduce the amount of stool). On 2/25/2026 at 10:25 a.m., an interview was conducted with RN I. RN I stated that she did not know which staff member opened the medications without documenting an opened date. When asked about the potential consequences of failing to document an opened date, RN I stated that without an opened date, it may result in the administration of an expired medication. RN I further stated that administration of an expired medication could negatively affect a resident's health condition. On 2/25/2026 at 10:51 a.m., an interview was conducted with LVN J. LVN J acknowledged that, in accordance with facility policy and safe medication administration practices, all medications were required to be dated upon opening. LVN J stated she did not know which staff member opened the medications without documenting the opened date. She stated that she discovered the medications had already been opened without a date and indicated there was no way to determine when they were opened. LVN J stated she would discard the medications and ensure that replacement medications were dated at the time of opening. When asked about the potential risk to residents if medications were opened and not dated, she stated that without an opened date, staff would not be able to determine when the medication has expired. LVN J further stated that administering expired medications could cause residents to become ill. She explained that once medications expire, their strength and effectiveness may be reduced, which could result in harm to residents. On 2/25/2026 at 11:03 a.m., an interview was conducted with MA L. MA L Acknowledged responsibility for not ensuring that opened medications contain a documented date open. She confirmed that facility policy required staff to document the dates when medications were opened. MA L stated she did not know which staff member opened the medications without documenting the opened date. MA L further stated that if medications were not dated upon opening, there was a risk that residents could receive medications that were expired or contaminated. She acknowledged that administration of expired or (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455643 If continuation sheet Page 3 of 9 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 455643 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/26/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avir at Bay City 700 12th St Bay City, TX 77414 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0761 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete contaminated medications could negatively impact or complicate a resident health condition. On 2/25/2026 at 11:18 a.m., an interview was conducted with LVN K. LVN K stated that she did not know which staff member opened the medications without documenting an opened date. She confirmed that staff were expected to know that medications must be dated at the time they were opened, in accordance with facility policy and the standard medication administration practices. LVN K stated that when medications were not dated upon opening, there was a risk that medication could become contaminated or exceed the recommended timeframe for use. She further stated that if such medication was administered to a resident, it may not be effective and could delay the resident's healing or recovery. On 2/25/2026 at 11:20 a.m., an interview was conducted with DON. The DON confirmed that in accordance with CMS regulations and the facility policy, all medications were required to be dated at the time of opening. The DON stated that all licensed nursing staff and the medication aides were expected to be aware of this requirement. The DON further stated she would initiate in- service education for nursing staff and medication aides to address the identified concerns and reinforce proper medication labeling and handling procedures. Review of the facility policy and procedure titled Medication Labeling and Storage revised February 2023 revealed: Labeling of medications and biologicals dispensed by the pharmacy is consistent with applicable federal and state requirements and currently accepted pharmaceutical practices. The medication label includes, at a minimum: . expiration date, when applicable. Event ID: Facility ID: 455643 If continuation sheet Page 4 of 9 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 455643 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/26/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avir at Bay City 700 12th St Bay City, TX 77414 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0883 Develop and implement policies and procedures for flu and pneumonia vaccinations. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interviews and record review, the facility failed to document evidence of receiving or refusal of influenza or pneumococcal immunization for 5 of 5 residents reviewed for immunizations (Resident#12, Resident #2, Resident #39, Resident #7, and Resident #5). The facility failed to document evidence in the electronic medical record the offering or the refusal of the influenza and pneumococcal immunization status for Resident #12 and Resident #2. The facility failed to document evidence in the electronic medical record the offering or the refusal of the pneumococcal immunization status for Resident #7, Resident #39, and Resident #5. The failures could place residents at risk of contracting viral illness, influenza or pneumococcal disease, or of not being informed of the benefits and risk which could cause respiratory complications and lead to potential adverse health outcomes. Record review of Resident #12's face sheet dated 2/26/2026 revealed a [AGE] year-old female admitted into the facility on 2/12/2026 with diagnoses that included Unspecified Atrial Fibrillation (irregular heart beat), Type 2 diabetes mellitus (a condition where the body's cells do not respond properly to insulin leading to high blood sugar levels), Hypertensive Heart Disease with heart failure (a condition where the pressure inside the blood vessels is too high leading to heart strain and the heart can't pump blood effectively). Record review of Resident #12's electronic record revealed no documented evidence of the facility offering or the refusal of influenza or pneumococcal vaccines. Record review of Resident #2's face sheet dated 2/26/2026 revealed a [AGE] year-old male admitted to the facility on [DATE] with diagnoses that included Chronic Obstructive Pulmonary Disease (a group of diseases affecting the lungs), Essential Hypertension (a type of high blood pressure that does not have a known cause), and Type 2 Diabetes Mellitus (a condition where the body's cells do not respond properly to insulin leading to high blood sugar levels). Record review of Resident #2's Comprehensive MDS dated [DATE] revealed a BIMS score of 3 which indicated severe cognitive impairment. Section O of Resident #2's Comprehensive MDS dated [DATE] indicated that he was not up to date with both influenza and pneumococcal vaccinations and had declined the offer of both the influenza and pneumococcal vaccines. Record review of Resident #2's electronic record did not reveal documented evidence of Resident #2's refusal of the influenza or pneumococcal vaccines. Record review of Resident #7's face sheet dated 2/26/2026 revealed a [AGE] year-old male was originally admitted into the facility on 6/24/2025 and readmitted on [DATE] with diagnoses that included Paraplegia (a condition where the legs are unable to move due to damage to the spinal cord), Heart Failure (a condition where the heart is unable to pump enough blood to meet the body's needs, leading to fatigue and shortness of breath), Type 2 Diabetes Mellitus (a condition where the body's cells do not respond properly to insulin leading to high blood sugar levels), and Essential Hypertension (a type of high blood pressure that does not have a known cause). Record review of Resident #7s quarterly MDS dated [DATE] revealed a BIMS score of 12 which indicated moderate cognitive impairment. Section O of Resident #7's quarterly MDS indicated that Resident #7 was not up to date with pneumococcal vaccination and declined the offer of the pneumococcal vaccination. Record review of Resident #7's electronic record did not reveal documented evidence of Resident #7's refusal of the pneumococcal vaccine. Record review of Resident #39's face sheet dated 2/26/2026 revealed a [AGE] year-old female originally admitted into the facility on 1/20/2021 and readmitted on [DATE] with diagnoses that included Polyneuropathy (a condition involving damage to the peripheral nervous system affecting sensory and motor functions), Dementia (a general term for a range of conditions affecting memory, thinking, and social abilities), and Heart Failure (a condition where the heart is unable to pump enough blood to meet the body's needs, leading to fatigue and shortness of breath). Record Residents Affected - Some (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455643 If continuation sheet Page 5 of 9 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 455643 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/26/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avir at Bay City 700 12th St Bay City, TX 77414 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0883 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some review of Resident #39's quarterly MDS dated [DATE] revealed a BIMS score of 7 which indicated severe cognitive impairment. Section O of Resident #39's quarterly MDS dated [DATE] indicated Resident #39 was not up to date on her pneumococcal vaccination and had declined the pneumococcal vaccine. Record review of Resident #39's electronic medical record did not reveal documented evidence of Resident #39's refusal of the pneumococcal vaccine. Record review of Resident #5's face sheet dated 2/26/2026 revealed a [AGE] year-old female admitted to the facility originally on 10/14/2025 and readmitted on [DATE] with diagnoses that included non-traumatic intracerebral hemorrhage (a condition where bleeding occurs directly into the brain tissues not due to external injury), End Stage Renal Disease (refers to the most severe stage of kidney disease where the kidneys can no longer filter waste effectively), Type 2 Diabetes Mellitus (a condition where the body's cells do not respond properly to insulin leading to high blood sugar levels), and Epilepsy (brain disorder caused by abnormal electrical activity in the brain). Record review of Resident #5's Comprehensive MDS dated [DATE] indicated a BIMS score of 11 which indicated moderate cognitive impairment. Section O of Resident #5's Comprehensive MDS dated [DATE] indicated that Resident #5 was not up to date with the pneumococcal vaccination and had declined the offer of the Pneumococcal vaccine. Record review of Resident #5's electronic medical record did not reveal documented evidence of Resident #5's refusal of the pneumococcal vaccine Interview with the ADON on 2/26/2026 at 9:32 am revealed she was the infection preventionist for the facility and was responsible for immunization compliance along with the DON. The ADON stated that a resident's immunization status should be listed in the immunization tab of the electronic record but sometimes it was in the notes section. The ADON stated that all residents were offered immunizations for influenza, pneumococcal, and covid on admission. The ADON stated that the facility had an influenza vaccination event that ran from October 2025 to November 2025. The ADON stated that she was working on a pneumococcal vaccination event for the residents. The ADON states the events were done because the facility didn't stock the influenza or pneumococcal vaccines, but the facility could order the vaccines as needed. When asked if there was a specific number that was needed to have a vaccination event occur, the ADON did not provide a number. The ADON was asked to provide documentation of offering, administration or refusal of the influenza and pneumococcal vaccines for Residents#12, Resident #7, Resident #39, Resident #2, and Resident# 5, but stated she was unable to locate the information. The ADON stated the facility went through a change of software in April of 2025 and resident data crossed over completely. When asked how she monitored immunization compliance for the residents, the ADON did not have an answer. The ADON stated she knew this was an area that needed attention. When asked what the risk was associated with not assessing immunization compliance, the ADON stated the resident could be vaccinated twice for the same illness, the residents could get sick with a preventable disease, or the resident could receive vaccinations that were contraindicated. Interview with the DON on 2/26/2026 at 11:41 am revealed the DON stated there was a facility wide influenza event in October and November of 2025. The DON stated that not all the influenza immunization records had been uploaded into Point Click Care {PCC.} which is the facility's electronic record software system. The DON stated that she was aware that some residents needed pneumococcal vaccinations and there was a plan to get a mass vaccination event conducted at the facility. The DON stated immunization documentation was an area that she was aware of that needed attention and was working on getting immunizations uploaded and updated. The DON stated she was in the process of getting a pneumococcal vaccination event scheduled. The DON stated that the facility began using a new software program and it had affected how immunization dates and refusals were placed into the new system. The DON stated the risk of not having up to date immunization records for residents could possibly lead to (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455643 If continuation sheet Page 6 of 9 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 455643 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/26/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avir at Bay City 700 12th St Bay City, TX 77414 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0883 Level of Harm - Minimal harm or potential for actual harm preventable illness, or unnecessary vaccinations. Record review of facility policy statement, undated and titled Influenza, Prevention and Control of Seasonal revealed in part. all residents and staff are offered the vaccine prior to the onset of the influenza season. Record review of facility policy titled Pneumococcal Vaccine dated 2001 revealed in part. all residents are offered pneumococcal vaccines to aid in the preventing pneumonia/pneumococcal infections. Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455643 If continuation sheet Page 7 of 9 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 455643 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/26/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avir at Bay City 700 12th St Bay City, TX 77414 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0887 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record reviews, the facility failed to implement their policy to ensure residents were offered, received, or refused Covid-19 immunization, for 3 of 5 residents who were reviewed for immunization compliance. (Resident #12, Resident #7, and Resident#2). The facility failed to document in Resident #12, Resident #7, and Resident #2's electronic medical records for having received or having had not received the Covid-19 immunization due to medical contraindication or refusal.This failure could place residents at risk of not being informed of complications and potential adverse health outcomes. Record review of Resident #12's face sheet dated 2/26/2026 revealed a [AGE] year-old female admitted into the facility on 2/12/2026 with diagnoses that included Unspecified Atrial Fibrillation (irregular heart beat), Type 2 diabetes mellitus (a condition where the body's cells do not respond properly to insulin leading to high blood sugar levels), Hypertensive Heart Disease with heart failure (a condition where the pressure inside the blood vessels is too high leading to heart strain and the heart can't pump blood effectively). Record review of Resident #12's electronic record revealed no documented evidence that revealed her immunization status for Covid-19.Record review of Resident #7's face sheet dated 2/26/2026 revealed a [AGE] year-old male was originally admitted into the facility on 6/24/2025 and readmitted on [DATE] with diagnoses that included Paraplegia (a condition where the legs are unable to move due to damage to the spinal cord), Heart Failure (a condition where the heart is unable to pump enough blood to meet the body's needs, leading to fatigue and shortness of breath), Type 2 Diabetes Mellitus (a condition where the body's cells do not respond properly to insulin leading to high blood sugar levels), and Essential Hypertension (a type of high blood pressure that does not have a known cause). Record review of Resident #7s quarterly MDS dated [DATE] revealed a BIMS score of 12 which indicated moderate cognitive impairment. Record review of Resident #7's electronic medical record revealed no documented evidence that revealed Resident #7's immunization status Covid-19. Record review of Resident #2's face sheet dated 2/26/2026 revealed a [AGE] year-old male admitted to the facility on [DATE] with diagnoses that included Chronic Obstructive Pulmonary Disease (a group of diseases affecting the lungs), Essential Hypertension (a type of high blood pressure that does not have a known cause), and Type 2 Diabetes Mellitus (a condition where the body's cells do not respond properly to insulin leading to high blood sugar levels). Record review of Resident #2's Comprehensive MDS dated [DATE] revealed a BIMS score of 3 which indicated severe cognitive impairment. Record review of Resident #2's electronic medical record revealed no documentation that revealed Resident #2's immunization status against Covid-19. Interview with the ADON on 2/26/2026 at 9:32 am revealed she was the infection preventionist for the facility and was responsible for immunization compliance along with the DON. The ADON stated that a resident's immunization status should be listed in the immunization tab of the electronic record but sometimes is in the notes section. The ADON stated that all residents are offered immunizations for influenza, pneumococcal, and covid on admission. The ADON stated on 2/26/2026 a Covid Clinic took place at the facility in January 2025. The ADON stated that at that time, the facility used an electronic medical record software called the Matrix system which is no longer being utilized in the facility. The ADON stated that the facility now used a newer electronic medical record software program called Point Click Care {PCC }. The ADON stated that immunizations that were administered or refused were not transferred over into the PCC. The ADON stated that this was still a work in progress. When asked to provide any documentation of covid vaccine administration or refusal of for Resident #12, Resident #7, and Resident #2, the ADON (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455643 If continuation sheet Page 8 of 9 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 455643 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/26/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avir at Bay City 700 12th St Bay City, TX 77414 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0887 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete stated she could not locate the information. The ADON stated that another Covid Clinic would be scheduled but was waiting until there were multiple residents who needed the immunization. When asked what was the number that was needed before a Covid Clinic could take place, the ADON was unable to give a specific number of residents. When asked what the risk were associated with not assessing immunization compliance for Covid, the ADON stated the resident could be vaccinated twice for the same illness, the residents could have gotten sick with a preventable disease, or the resident could have received vaccinations that were contraindicated.Interview with the DON on 2/26/2026 at 1:01 pm revealed that overall immunizations was an area that needed attention for compliance. The DON stated that the system change from Matrix to PCC was causing a problem with documentation of covid vaccine administrations and refusals. The DON stated that sometimes residents were already immunized against Covid prior to admission, and but records were not consistently updated in the electronic medical record. The DON stated it was a work in progress. The DON stated the risk of not having up to date immunization records for residents could possibly lead to preventable illness, or unnecessary vaccinations . Record review of facility policy titled Coronavirus Disease (COVID-19) -Vaccination of Residents dated 2001 revised May 2023, revealed in part.The resident's medical record includes documentation that indicates at a minimum.signed consent.#2 prior vaccination or refusal. Event ID: Facility ID: 455643 If continuation sheet Page 9 of 9