Health inspection·May 5, 2025

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to provide a safe, functional, sanitary, and comfortable environment for 3 of 4 residents (Resident #1, Resident #2, Resident #3). The facility failed to ensure the environment was clean, sanitary and homelike for 3 of 4 residents (Resident #1, Resident #2, Resident #3) reviewed for environment, in that:. 1. There was a strong smell of urine throughout the facility. These failures could place residents at risk for not living in a comfortable and homelike environment, affecting their rights. Findings include: On 05/05/2025 beginning at 10:00AM an observation was conducted of the facility that revealed a strong urine odor in the front of the building and throughout the halls of the facility. Record review of Resident #3's face sheet indicated that Resident #3 is a [AGE] year-old woman who was admitted to the facility on [DATE]. Resident #3 has a diagnosis of Hepatitis A without Hepatic Coma (viral hepatitis that does not result in a coma) , Bipolar disorder and depression. On 05/05/2025 at 12:30PM an interview was conducted with Resident #3 who reported that the facility has a strong odor that makes you feel sick. Resident #3 stated that the facility had been notified of the smell. Record review of Resident #3's MDS record dated 04/14/2025 indicated that Resident #3 has a BIMS score of 15 which indicated no cognitive impairment. Record review of Resident #3's care plan dated 07/05/2025, indicated that Resident #3 has a communication problem. Resident #3's task section in the care plan stated the following anticipate and meet needs. Notify RN of change of condition. Record review of Resident #1's face sheet indicated that Resident #1 is an [AGE] year-old female Page 1 of 3 455799 455799 05/05/2025 Austin Wellness & Rehabilitation 11406 Rustic Rock Drive Austin, TX 78750

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some who was admitted to the facility on [DATE]. Resident #1 has a diagnosis of other sequelae of cerebral infarction (long term affects of a stroke), reduced mobility, and muscle weakness. On 05/05/2025 at 12:45PM an interview was conducted with Resident #1, who reported that the facility has a foul odor that smells rotten. Resident #1 stated that residents tend to talk about it to Resident #1 and to the facility often but could not state how long . Record review of Resident #1's MDS record dated 03/03/2025, indicated that Resident #1 had a BIMS of 12, which indicated mild cognitive impairment. Record review of Resident #1's care plan dated 06/02/2023 indicated that Resident #1 has an ADL self-care performance deficit. Record review of Resident #2's face sheet indicated that Resident #2 is a [AGE] year-old female who was admitted to the facility on [DATE]. Resident #2 has a diagnosis of epilepsy (recurring seizures), protein-calorie malnutrition, and polyneuropathy (damage that affects the nerves outside of the brain and spinal cord). On 05/05/2025 at 1:15PM an interview was conducted with Resident #2, who reported that the facility smells like urine all of the time. Resident #2 stated that they will find staff if there is a smell. Record review of Resident #2's MDS dated [DATE] record indicated that Resident #2 had a BIMS of 15 which indicated no cognitive impairment. Record review of Resident #2's care plan dated 11/09/2022 indicated that Resident #2 will communicate their needs and perform ADL care with support from staff members. On 05/05/2025 beginning at 1:30PM an observation was made of the 2200 hall and the 2100 hall. These halls both had a strong urine odor that radiated the hallways. On 05/05/2025 at 1:45PM an interview was conducted with CNA A who reported working at the facility for 4 months. CNA A stated they have received trainings on Resident Rights this year which included training for all rights that residents have while living in the facility. CNA A reported that they have received complaints from residents about foul odors of urine throughout the building. CNA A reported that they smell urine in the building and will notify housekeeping. CNA A reported this could negatively impact residents by them potentially feeling uncomfortable in their home. On 05/05/2025 at 2:00PM an interview was conducted with CNA B who reported working at the facility for 1 year. CNA B stated they have received training on resident rights this year which included training for all rights that residents have while living in the facility. CNA B reported that they have received complaints from residents inside the facility, that there is a strong urine odor. CNA B reported that they also could smell urine throughout the building. CNA B reported this could negatively impact the resident by causing them to get sick. On 05/05/2025 at 2:15PM an interview was conducted with the DON who reported working at the facility for almost 3 weeks. The DON stated that they have received training on resident rights which included residents have the right to live in a clean and dignified environment. The DON stated that there has have been a urine odor on the 2200 hall due to residents who refuse to shower. The DON stated 455799 Page 2 of 3 455799 05/05/2025 Austin Wellness & Rehabilitation 11406 Rustic Rock Drive Austin, TX 78750

F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some that the facility provides cleaning from housekeeping any time there is a foul odor smell. The DON reported that this could negatively impact the residents by not providing them with a safe and clean environment, as well as the potential for the smell to cause depression for the residents. On 05/05/2025 beginning at 2:30PM another observation was conducted through the facility with the DON. During this observation, there was a foul odor in the halls, as indicated before. The observation also revealed that the smell was still present. Record review of an undated document provided by the facility labeled as Infection Prevention and Control Program indicated the following: 1. The infection control policies and procedures are intended to facilitate maintaining a safe, sanitary and comfortable environment and to help prevent and manage transmission of diseases and infections. 2. Maintain a safe, sanitary and comfortable environment for personnel, residents, visitors and the general public. 455799 Page 3 of 3