Health inspection·May 2, 2025

F 0584 the right (Southwest). Level of Harm - Minimal harm or potential for actual harm Record review of Maintenance room/air temperature logs revealed: -Room temperatures had been taken between 4/25/2025-5/1/2025 Residents Affected - Few 4/25/2025 -Temperatures taken at 1pm and 3pm 1:00pm- Rooms 403, 404, 405 and 406 had temperatures of 82 degrees Fahrenheit. 3:00pm- Only room # 403 and 406 had temperatures of 81.9 and rooms [ROOM NUMBERS] had temperatures of 81.9 degrees Fahrenheit. 4/26/2025 and 4/27/2025- None of the rooms were documented with temperatures over 81 degrees Fahrenheit. 4/29/2025- Room temperatures were taken at 8:30am, 11:30am, 1:30pm, 3:30pm, and 5:30pm- room [ROOM NUMBER] room temperature rose to 82 degrees Fahrenheit at 3:30pm. 5/1/2025- Room temperatures were taken at 8:30 and 10am- At 10:00am room# 404 and 406 rose to 82 degrees Fahrenheit. Record review of invoice from a local HVAC company revealed the scope of their work on 4/25/2025 was the following: -Pull permit for removal of old chiller -Remove attic unit and haul away debris -Provide and install (2) 5-ton condensers, (2) air handlers, (2) heat kits, (2) drain pans, (4) float switches, (1) furnace switches, and flush copper lines -Electricians to install dedicated electrical wiring and breakers for (2) air handler units. Record review of TULIP on 5/1/2025 revealed no incidents had been called into CII. Further, the facility was on initially certified on 1/26/1998. An interview with the Maintenance Director on 5/1/2025 at 10:20 am, revealed the HVAC system started having cooling issues on 4/25/2025. He stated that the chillers had to be replaced for two units. He said that 2 units had been ordered but they were waiting on an electrician to come and complete the work. He said the electricians were on their way to the facility and after they completed the electrical work, the system should be up and running. Observation rounds ensued with him. He said portables were installed immediately, but Hall D only had one return for hot air to circulate. He said the portables were immediately placed down Hall D with room numbers 401-407 were located; and two portables were placed on the other part of Hall D where 408-415 because this part of the hall had two return vents. He stated the facility had about 5 fans and they had been disbursed to residents requesting one. He said upper management were aware of not all the residents having a fan in their rooms. He stated (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675612 If continuation sheet Page 2 of 5 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 675612 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/02/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Paradigm at Westbury 5201 S Willow Dr Houston, TX 77035 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 that the wall thermometer between rooms #403 and #404 controlled the temperatures in rooms 401-407. Level of Harm - Minimal harm or potential for actual harm An observation and interview with Resident #1 at 10:38am, he stated that the air had been down, and his room was hot for about 6-8 days. Observation of his room revealed he had no fans, and it was warm in this room. He said he did not ask for a fan. He said management knew the air conditioning was down. He said he was doing fine despite the heat. He said he did not want to change rooms. Residents Affected - Few Observation and Interview with Resident #2 on 5/1/2025 at 11:13am, he had been a resident for about one year he stated the air conditioner had been out before but for only two days. He stated the problem with the air conditioner not cooling this time started on last Wednesday (4/24/2025) or Thursday (4/25/2025). He stated staff did bring him a fan after he requested one. Observation of a floor oscillating fan at his bedside another fan was observed on the dresser near the TV and one standing fan facing his roommate. Resident #2 did not have a shirt on. He was covered by a sheet. He stated he was hot and preferred not to have clothing on. An interview with RN A on 5/1/2025 at 11:35am, she stated she worked at the facility part-time and had been an employee for three to four years. She stated most times she worked Hall D and stated that she had been out for about a month and returned to work on April 30th she stated that she did have a few complaints from residents in room [ROOM NUMBER] and 404 but no residents have been sent out to the hospital due to the heat. She said the nurses worked 12-hour shifts and her shift was 6:00 AM until 6:00 PM. She stated that she is constantly rounding and checking for comfort and stated that rooms 404, 403,406 were all located on the [NAME] side of the building where the sun hit. She stated that she offered the residents to come out of the rooms during the day and sit in the dining area and other places that were a little bit cooler. Some residents preferred this, while others wanted to remain in their rooms. She said she none of the residents asked her for a fan. She said the heat could have caused a heat stroke, or hyperthermia. She stated they did not have any residents that were hospitalized due to air conditioning issue. An interview with CNA A on 5/1/2025 at 11:48am, she had worked on hall D for almost a month. She said she normally worked the 6a-2pm shift and Hall A. She stated while working they have been sweating and multiple residents complained about the heat. She said throughout the day, she had been standing in front of the portable to cool off. She said the nurses were doing rounds as well as the CNAs. She said everybody in the building was aware that the air was not working properly. She said it is important for the residents and staff to stay hydrated. She said she had asked the residents if they wanted their doors opened, but opening the doors could have caused privacy issues. She said without air circulating throughout the rooms it was very hot. An interview with RN B on 5/1/2025 at 1:19pm, she said she had been employed for 2 months PRN. She said on Sunday (April 27th) she worked and found it to be hot down Hall D and in the rooms. She said she called Maintenance because he was not usually there on weekends. She said she was told the electrician would be there on the following day to complete the electrical parts for the air conditioning to work. She said her job as a nurse was to ensure that the residents had water and ice to keep cool. She said she offered to open the residents' doors and even to come out during the daytime in cooler areas. She said heat strokes and dehydration could have happened due to the broken air conditioning system. She said the key was keeping the residents hydrated until it was fixed. She stated no residents had been sent out due to the heat. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675612 If continuation sheet Page 3 of 5 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 675612 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/02/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Paradigm at Westbury 5201 S Willow Dr Houston, TX 77035 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 A subsequent observation and interview with the Maintenance Director on 5/1/2025 at 3:03pm, it had been pointed out to him that there was a discrepancy in the temperature logs that were submitted by the Administrator. Observations ensued again and he took temperatures for each of the following rooms: Thermometer located on Hall D now read 87 degrees Fahrenheit near room [ROOM NUMBER]. Residents Affected - Few room [ROOM NUMBER]- 84 degrees room [ROOM NUMBER]- 82.7 degrees room [ROOM NUMBER]- 81.3 degrees room [ROOM NUMBER] - 81.3 degrees He said the vents should be pushing at least 65 degrees from the vents now that the electrical work had been completed. He said it might take longer for the area to cool down. An interview with the DON on 5/2/2025 at 1:08pm, DON, she said she had communicated with the residents, and she was told they were okay and none of them wanted their doors opened for the air to circulate. She said she had no complaints from residents and no requests for fans. She said the air conditioning not working when it was warm outside could have caused residents to have heat exhaustion, and dehydration could have been a concern. She was asked if she would have done anything differently, she said she should have asked the residents about room changes or a fan would be offered in the future even if they say they are ok or do not want to leave the room to go to cooler areas. An interview with the Administrator on 5/2/2025 at 2:04pm, he stated they noticed that the building was getting warm on last week in particular Hall D. He said they had a company come out to charge the system, but it did not hold a charge. He said they immediately ordered the portables. He said the units came in on Monday (4/28/2025) the air conditioning units had to be pulled from the roof and then the new units installed. They had to then schedule the electrician to come out to do all the electrical work. He said the management team did Ambassador rounds and checked to ensure the residents were ok. He said they offered to move them, but no one wanted to be moved. He said he had some rooms they could have gone to, but they preferred to remain in their current rooms. He said the residents that resided in rooms with temperatures over 81 degrees could have suffered from dehydration and other negative results. The facility nurses and staff provided ice and water to the residents. He said he also purchased 20 fans on yesterday (5/1/2025). Record review of the facility's resident rights policy revised on 6/2019 stated it is the policy of this facility that the facility staff will provide the residents with the right to an environment that preserves dignity and contributes to a positive self-image. 7. Create a home-like environment for the residents that included: (e) Proper temperature and ventilation. (h) Comfortable and safe temperature levels. Record review of TULIP on 5/2/2025 revealed there were no incidents called in to HHSC CII to for (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675612 If continuation sheet Page 4 of 5 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 675612 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/02/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Paradigm at Westbury 5201 S Willow Dr Houston, TX 77035 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 this issue. Further, the facility was initially licensed on 1/26/1998. Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675612 If continuation sheet Page 5 of 5