Health inspection·May 5, 2025

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 (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455799 If continuation sheet Page 2 of 3 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 455799 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/05/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Austin Wellness & Rehabilitation 11406 Rustic Rock Drive Austin, TX 78750 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 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. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 455799 If continuation sheet Page 3 of 3