Health inspection·December 21, 2023

F 0641 Ensure each resident receives an accurate assessment. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record reviews, the facility failed to accurately assess the residents' status for 4 (Resident #4, Resident #30, Resident #54, and Resident #324) of 6 residents reviewed for assessment accuracy. Residents Affected - Some The facility did not accurately indicate on Resident #4, Resident #30, or Resident #54's MDS (Minimum Data Set) the results of a Brief Interview for Mental Status evaluation. The facility did not accurately indicate on Resident #324's MDS a urinary tract infection. These failures could place residents at risk for receiving inadequate or inappropriate care and services . Findings included: Review of Resident #4's face sheet revealed a [AGE] year-old male who was admitted to the facility on [DATE] with medical diagnoses of major depression, bipolar disorder (a serious mental illness that causes extreme shifts in mood), schizoaffective disorder (a mental illness similar to schizophrenia but with added features that affect mood), and a history of traumatic brain injury. Review of the Brief Interview for Mental Status evaluation dated 08/16/2023, revealed a score of 9 out of 15 indicating moderate cognitive impairment. Resident #4's Quarterly MDS dated [DATE] Section C 0500 BIMS Summary Score revealed a BIMS score of 5 out of 15 indicating severe cognitive impairment. Review of Resident #30's face sheet revealed a [AGE] year-old male who was admitted to the facility on [DATE] with medical diagnoses of dementia, bipolar disorder, neurosyphilis (an infection of the central nervous system) and altered mental status. Review of the Brief Interview for Mental Status evaluation dated 08/16/2023 revealed a score of 3 out of 15 indicating severe cognitive impairment. Resident #30's Quarterly MDS dated [DATE] Section C 0500 BIMS Summary Score revealed a BIMS score of 4 out of 15. Review of Resident #54's face sheet revealed a 73-year-ole male who was admitted to the facility on [DATE] with medical diagnoses of dementia, psychotic disturbance, and anxiety. Review of the Brief Interview for Mental Status evaluation dated 11/01/2023 revealed a score of 13 out of 15 indicating cognitively intact. Resident #54's Quarterly MDS dated [DATE] Section C 0500 BIMS Summary Score revealed a BIMS score of 7 out of 15 indicating severe cognitive impairment. Review of Resident #324's electronic health record revealed Resident #324 was an [AGE] year-old female who was admitted to the facility on [DATE] and discharged from the facility on 08/21/2023. Resident #324's diagnoses included Sepsis (blood infection), dehydration, and urinary tract infection. Review of Resident #324's comprehensive quarterly assessment dated [DATE] revealed resident was severely cognitively impaired with BIMS of Zero. Review of facility infection tracker revealed Resident #324 had urinary tract infection on (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675746 If continuation sheet Page 2 of 29 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 675746 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/21/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avir at Coronado 1751 N 15th St Abilene, TX 79603 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 0641 06/12/2023 and 08/15/2023. Level of Harm - Minimal harm or potential for actual harm Review of Resident #324's physician orders revealed Resident #324 was prescribed cefuroxime axetil (antibiotic used to treat wide variety of bacterial infections) 500mg twice a day from 07/31/2023 to 08/02/2023 for urinary tract infection, Macrobid (antibiotic used to treat urinary tract infections) 100mg twice a day from 11/22/2022 to 07/24/2023 for urinary tract infection, Macrobid 100mg twice a day from 08/02/2023 to 08/08/2023 for urinary tract infection. Residents Affected - Some Review of Resident #324's hospital records revealed resident was diagnosed with urinary tract infection on 07/24/2023, 07/30/2023, and 08/21/2023. Review of Resident #324's comprehensive discharge assessment dated [DATE] revealed resident did not have a urinary tract infection in the last 30 days. Review of Resident #324's comprehensive significant change assessment dated [DATE] revealed resident did have a urinary tract infection in the last 30 days. Review of Resident #324's comprehensive discharge assessment dated [DATE] revealed resident did not have a urinary tract infection in the last 30 days. During an interview on 12/20/23 at 1:40 PM, the DON stated her expectations were for the data entered into the MDS to accurately reflect the resident's status. During an interview on 12/21/2023 at 2:22 PM, the MDS Coordinator stated she conducted the BIMS evaluations. She was not able to explain the discrepancies identified between the BIMS electronic evaluation and the BIMS data entered in the MDS. Facility policy Certifying Accuracy of the Resident Assessment revised November 2019 under Policy Interpretation and Implementation item 3. The information captured on the assessment reflects the status of the resident during the observation period for that assessment. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675746 If continuation sheet Page 3 of 29 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 675746 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/21/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avir at Coronado 1751 N 15th St Abilene, TX 79603 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 0656 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interviews and record reviews, the facility failed to develop and implement a comprehensive person-centered care plan based on assessed needs with measurable objectives that have the ability to be evaluated or quantified to attain or maintain the resident's highest practicable physical, mental, and psychosocial well-being for 4 (Resident #5, Resident #30, Resident #54, and Resident #65) of 7 residents reviewed for comprehensive person-centered care plans. 1. The facility failed to develop care plans based on assessed needs with measurable objectives and timeframes in areas such as bathing, impaired decision making related to insulin dosage, skin breakdown, adverse consequences related to antipsychotic medications, adverse consequences related to antianxiety medication, disruptive behaviors, keeping food and dirty dishes in her room, cognitive loss, compliance with medications and self-care, medication administration time preference, non-participation in activities, communication, elopement risk, PASRR positive status, code status, plan to remain in facility, risk for pressure ulcers, risk for pain, risk for falls, aggressive behaviors, self-care deficit, and tasks documented in the plan of care for Resident #5. 2. The facility failed to develop care plans based on assessed needs with measurable objectives and timeframes in areas such as behavior management, keeping food and dirty dishes in his room, risk for dehydration and/or malnutrition, communication, facts he would like caregivers to know, managing anxiety, plans to remain in the facility, complications of viral hepatitis, impaired decision making, code status, wandering, fall prevention, resisting care, injury related to diagnosis of epilepsy, and ADL assistance for Resident #30. 3. The facility failed to develop care plans based on assessed needs with measurable objectives and timeframes in areas such as fall prevention, regular diet, risk for pain, risk for skin breakdown, bladder and bowel incontinence, communication, disruptive behavior management, facts he would like caregivers to know, managing anxiety, cognitive loss, lack of participating in activities, tasks/data recorded in the plan of care, ADL assistance, and code status for Resident #54. 4. The facility failed to develop care plans based on assessed needs with measurable objectives and timeframes in areas such as fall prevention, risk for adverse effects of antipsychotic medication, cognitive loss, facts he would like caregivers to know, tasks recorded in the plan of care, plan to remain in the facility, need for psychiatric services, at risk for skin breakdown, ADL assistance, boot related to fracture of left lower leg, nutritional status/diet, and code status for Resident #65. These failures could affect the residents by placing them at risk for not receiving care and services to meet their needs. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675746 If continuation sheet Page 4 of 29 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 675746 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/21/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avir at Coronado 1751 N 15th St Abilene, TX 79603 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 0656 Findings include: Level of Harm - Minimal harm or potential for actual harm Review of Resident #5's face sheet revealed a [AGE] year-old female who was admitted to the facility on [DATE] with medical diagnoses of bipolar disorder, mild intellectual disabilities, autistic disorder, dementia, and psychotic disorder with delusions. Residents Affected - Some Review of Resident #5's Quarterly MDS dated [DATE] revealed in Section C 0500 BIMS Score Summary a score of 15 out of 15 indicating the resident was cognitively intact. Review of Resident #5's Comprehensive Care Plan reviewed and revised on 12/11/2023 revealed the lack of measuable objectives to be evaluated or quantified were in the order of the problems listed above: Resident continues to show non compliancy with care but agreed to shower twice a week, This patient will allow nursing staff to inject ordered insulin, Resident's open lesion(s) will heal without complications, I will not exhibit signs of drug related side effects or adverse drug reaction, Resident will not exhibit signs of drug related side effects or adverse drug reaction, I will reduce the amount of times I tend to fixate on verbalizations of going to group home, I will allow staff to redirect my fixation of keeping items, dirty dishes, and food in my room and I will be compliant with Life Safety guidelines ., I will be as alert and oriented as possible, I will verbalize to staff reason for not taking meds and/or participating in ADL care needs, To take medication, without refusal, I will not exhibit boredom or isolation, I will be able to express calmly my needs ., Resident will not elope ., [Resident] will maintain highest level of practicable well-being ., The Resident and/or Responsible party will communicate their wishes regarding Advanced Directives/Advanced Care Planning and facility staff will honor their stated preferences, My needs will be met while residing at this nursing center, Prevent pressure sores and skin breakdown, I will be as comfortable as possible, I will have no falls with major injury ., I will have fewer episodes of verbal outbursts ., Resident will achieve maximum functional mobility, and I will perform the following tasks at their highest practicable level. Review of Resident #30's face sheet revealed a [AGE] year-old male who was admitted to the facility on [DATE] with medical diagnoses of dementia, bipolar, neurosyphilis, and altered mental status. Review of Resident #30's Quarterly MDS dated [DATE] revealed in Section C 0500 BIMS Score Summary a score of 05 out of 15 indicating the resident had severe cognitive impairment. Review of Resident #30's Comprehensive Care Plan reviewed and revised on 12/05/2023 revealed the lack of measurable objectives to be evaluated or quantified were in the order of the problems listed above: I will allow staff to redirect my fixation of keeping items, dirty dishes, and food in my room and I will be compliant with Life Safety guidelines ., Resident will consume adequate fluids, Resident's needs/wants will be met at all times, To increase the knowledge of my caregivers about who I am, my interests and past accomplishments, My episodes of anxiety will be reduced without complications ., My needs will be met while am a resident at this nursing home, I will not exhibit signs and symptoms of infection, I will have positive experiences in daily routine without overly demanding tasks and without becoming overly stressed, My wishes and my families' wishes will be respected ., My dignity will be maintained and I will wander about the Secure Unit without occurrence of Significant Injury ., I will be free of falls with major injury, I will not harm self or others secondary to resistance to care, My safety will be maintained with the occurrence of any Epileptic activity ., and My ADL needs will be anticipated and met; I will be clean, dry, and dignity will be maintained without injury . (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675746 If continuation sheet Page 5 of 29 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 675746 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/21/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avir at Coronado 1751 N 15th St Abilene, TX 79603 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 0656 Level of Harm - Minimal harm or potential for actual harm Resident #54's face sheet revealed a [AGE] year-old male who was admitted to the facility on [DATE] with medical diagnoses of dementia, psychotic disturbance, and anxiety. Review of Resident #54's Quarterly MDS dated [DATE] revealed in Section C 0500 BIMS Score Summary a score of 07 out of 15 indicating the resident had severe cognitive impairment. Residents Affected - Some Review of Resident #54's Comprehensive Care Plan reviewed and revised on 12/13/2023 revealed the lack of measurable objectives to be evaluated or quantified were in the order of the problems listed above: Resident will remain free from injury, Maintain Stable Weight, I will be as comfortable as possible, Prevent/heal pressure sores and skin breakdown, I will have fewer episode of incontinence, I will be able to communicate his/her wants, needs, Resident will not exhibit socially inappropriate/disruptive behavior, To increase the knowledge of my caregivers about who I am, my interests and past accomplishments, Resident will not exhibit socially inappropriate/disruptive behavior, Resident will express contentment with quality of life, Resident will express satisfaction with daily routine and leisure activities, The Resident will perform the following tasks at their highest practicable level, I will achieve maximum functional mobility, and The resident and/or responsibly party will communicate their wishes regarding code status. Facility staff will honor their stated preferences. Resident #65's face sheet revealed a [AGE] year-old male admitted [DATE] with medical diagnoses of stroke, schizophrenia, and bipolar disorder. Review of Resident #65's Quarterly MDS dated [DATE] revealed in Section C 0500 BIMS Score Summary a score of 11 out of 15 indicating the resident had moderate cognitive impairment. Review of Resident #65's Comprehensive Care Plan reviewed and revised on 12/15/2023 revealed the lack of measurable objectives to be evaluated or quantified were in the order of the problems listed above: I will remain free of injuries related to falls and will remain in a safe environment, Benefit without side effects, I will be as alert and oriented as possible, To increase the knowledge of my caregivers about who I am, my interests and past accomplishments, The Resident will perform the following tasks at their highest practicable level, My needs will be met while residing at this nursing center, Refer to {third party provider] for psychiatric services, Prevent/heal pressure sores and skin breakdown, I will achieve maximum functional mobility, Resident's mobility status will return to pre-fracture status, Maintain Stable Weight, The resident and/or responsibly party will communicate their wishes regarding code status. Facility staff will honor their stated preferences. During an interview on 12/20/23 at 1:40 PM, the DON stated the importance of measurable objectives in an accurate care plans were for residents to receive the care needed. Comprehensive care plans were necessary for the staff to know the residents. Care plans that were not resident centered and lack of measurable objectives could be detrimental to the resident's health and well-being. The DON stated she expected care plans to address each resident's problems with measurable objectives and have a way to determine when the problem was resolved or needed to be re-evaluated. The facility policy titled Care Plans, Comprehensive Patient-Centered revised December 2020, revealed in item 8. The comprehensive, person-centered care plan will: a. Include measurable objectives and time frames; FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675746 If continuation sheet Page 6 of 29 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 675746 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/21/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avir at Coronado 1751 N 15th St Abilene, TX 79603 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 0657 Level of Harm - Potential for minimal harm Residents Affected - Many Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interviews and record reviews, the facility failed to make sure that the comprehensive care plan is prepared by a team that included the attending physician and a nurse aide with responsibility for the resident for 16 of 16 residents (Resident #26, #6, #10, #34, # 28, #4, #54, #13, #32, #57, #30, #65, #7, #14, #29, #18) reviewed for care plans. The facility failed to ensure the attending physicians and nurse aides with responsibility for the residents were invited and attended the resident care plan conferences. These failures could place the residents at risk for not receiving the care and services to meet their needs Findings include: Resident #26 Review of Resident #26's electronic facesheet revealed resident was [AGE] year-old male who was admitted to the facility on [DATE] with diagnosis of quadriplegia. Review of Resident #26's comprehensive quarterly assessment dated [DATE] revealed the resident had a BIMS of 15 which indicated no cognitive impairment. Review of Resident #26's care plan conference revealed no evidence of attendance by attending physician and nurse aide with responsibility for the resident on 07/26/2023, 09/20/2023, and 11/08/2023. Resident #6 Review of Resident #6's electronic facesheet revealed resident was [AGE] year-old female who was admitted to the facility on [DATE] with diagnosis of depression, cognitive communication deficit, dementia, dependent on care providers, and reduced mobility. Review of Resident #6's comprehensive quarterly assessment dated [DATE] revealed the resident had a BIMS of 04 which indicated severe cognitive impairment. Review of Resident #6's care plan conference report revealed no evidence of attendance by attending physician and nurse aide with responsibility for the resident on 07/19/2023, 08/09/2023, and 11/08/2023. Resident #10 Review of Resident #10's electronic facesheet revealed resident was [AGE] year-old male who was admitted to the facility on [DATE] with diagnosis of severe intellectual disabilities. Review of Resident #10's comprehensive quarterly assessment dated [DATE] revealed the resident had a BIMS of 09 which indicated moderate cognitive impairment. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675746 If continuation sheet Page 7 of 29 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 675746 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/21/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avir at Coronado 1751 N 15th St Abilene, TX 79603 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 0657 Level of Harm - Potential for minimal harm Residents Affected - Many Review of Resident #10's care plan conference revealed no evidence of attendance by attending physician and nurse aide with responsibility for the resident on 07/26/2023, 08/23/2023, and 11/22/2023. Resident #34 Review of Resident #34's electronic facesheet revealed resident was [AGE] year-old female who was admitted to the facility on [DATE] with diagnosis of heart disease and diabetes. Review of Resident #34's comprehensive quarterly assessment dated [DATE] revealed the resident had a BIMS of 15 which indicated no cognitive impairment. Review of Resident #'s care plan conference revealed no evidence of attendance by attending physician and nurse aide with responsibility for the resident on 10/11/2023 and 11/01/2023. Resident #28 Review of Resident #28's electronic facesheet revealed resident was [AGE] year-old female who was admitted to the facility on [DATE] with diagnosis of coronary artery disease and dementia. Review of Resident #28's comprehensive quarterly assessment dated [DATE] revealed the resident had a BIMS of 07 which indicated severe cognitive impairment. Review of Resident #28's care plan conference revealed no evidence of attendance by attending physician and nurse aide with responsibility for the resident on 10/11/2023. Resident #4 Review of Resident #4's electronic facesheet revealed resident was [AGE] year-old male who was admitted to the facility on [DATE] with diagnosis of dementia. Review of Resident #4's comprehensive quarterly assessment dated [DATE] revealed the resident had a BIMS of 04 which indicated severe cognitive impairment. Review of Resident #4's care plan conference revealed no evidence of attendance by attending physician and nurse aide with responsibility for the resident on 07/26/2023, 09/20/2023, and 12/06/2023. Resident #54 Review of Resident #54's electronic facesheet revealed resident was [AGE] year-old male/female who was admitted to the facility on [DATE] with diagnosis of diabetes, high blood pressure, high cholesterol, dementia, and seizures. Review of Resident #54's comprehensive quarterly assessment dated [DATE] revealed the resident had a BIMS of 07 which indicated severe cognitive impairment. Review of Resident #54's care plan conference revealed no evidence of attendance by attending physician and nurse aide with responsibility for the resident on 08/30/2023 and 12/06/2023. Resident #13 (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675746 If continuation sheet Page 8 of 29 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 675746 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/21/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avir at Coronado 1751 N 15th St Abilene, TX 79603 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 0657 Level of Harm - Potential for minimal harm Residents Affected - Many Review of Resident #13's electronic facesheet revealed resident was [AGE] year-old female who was admitted to the facility on [DATE] with diagnosis of high blood pressure, obstructive uropathy (obstruction of urinary flow), depression, and post-traumatic stress disorder. Review of Resident #13's comprehensive quarterly assessment dated [DATE] revealed the resident had a BIMS of 08 which indicated moderate cognitive impairment. Review of Resident #13's care plan conference revealed no evidence of attendance by attending physician and nurse aide with responsibility for the resident on 09/20/2023 and 11/22/2023. Resident #32 Review of Resident #32's electronic facesheet revealed resident was [AGE] year-old male who was admitted to the facility on [DATE] with diagnosis of high blood pressure, wound infection, and diabetes. Review of Resident #32's comprehensive admission assessment dated [DATE] revealed the resident had a BIMS of 11 which indicated moderate cognitive impairment. Review of Resident #32's care plan conference revealed no evidence of attendance by attending physician and nurse aide with responsibility for the resident on 09/27/2023. Resident #57 Review of Resident #57's electronic facesheet revealed resident was [AGE] year-old male who was admitted to the facility on [DATE] with diagnosis of Alzheimer's Disease and dementia. Review of Resident #57's comprehensive quarterly assessment dated [DATE] revealed the resident had a BIMS of 03 which indicated severe cognitive impairment. Review of Resident #57's care plan conference revealed no evidence of attendance by attending physician and nurse aide with responsibility for the resident on 09/27/2023. Resident #30 Review of Resident #30's electronic facesheet revealed resident was [AGE] year-old female who was admitted to the facility on [DATE] with diagnosis of dementia and seizures. Review of Resident #30's comprehensive quarterly assessment dated [DATE] revealed the resident had a BIMS of 05 which indicated severe cognitive impairment. Review of Resident #30's care plan conference revealed no evidence of attendance by attending physician and nurse aide with responsibility for the resident on 08/30/2023 and 11/14/2023. Resident #65 Review of Resident #65's electronic facesheet revealed resident was [AGE] year-old male who was admitted to the facility on [DATE] with diagnosis of high blood pressure, depression, and Schizophrenia. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675746 If continuation sheet Page 9 of 29 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 675746 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/21/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avir at Coronado 1751 N 15th St Abilene, TX 79603 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 0657 Level of Harm - Potential for minimal harm Review of Resident #65's comprehensive admission assessment dated [DATE] revealed the resident had a BIMS of 11 which indicated moderate cognitive impairment. Review of Resident #65's care plan conference revealed no evidence of attendance by attending physician and nurse aide with responsibility for the resident 09/06/2023. Residents Affected - Many Resident #7 Review of Resident #7's electronic facesheet revealed resident was [AGE] year-old female who was admitted to the facility on [DATE] with diagnosis of cancer, high blood pressure, Parkinson's disease, seizures, and depression. Review of Resident #7's comprehensive quarterly assessment dated [DATE] revealed the resident had a BIMS of 14 which indicated no cognitive impairment. Review of Resident #7's care plan conference revealed no evidence of attendance by attending physician and nurse aide with responsibility for the resident on 07/19/2023, 08/30/2023, and 11/15/2023. Resident #14 Review of Resident #14's electronic facesheet revealed resident was [AGE] year-old female who was admitted to the facility on [DATE] with diagnosis of heart failures, high blood pressure, vascular disease, high cholesterol, and depression. Review of Resident #14's comprehensive quarterly assessment dated [DATE] revealed the resident had a BIMS of 12 which indicated moderate cognitive impairment. Review of Resident #14's care plan conference revealed no evidence of attendance by attending physician and nurse aide with responsibility for the resident on 07/26/2023, 11/01/2023, and 11/29/2023. Resident #29 Review of Resident #29's electronic facesheet revealed resident was [AGE] year-old male who was admitted to the facility on [DATE] with diagnosis of heart failure, high blood pressure, high cholesterol, and dementia. Review of Resident #29's comprehensive significant change assessment dated [DATE] revealed the resident had a BIMS of 09 which indicated moderate cognitive impairment. Review of Resident #29's care plan conference revealed no evidence of attendance by attending physician and nurse aide with responsibility for the resident on 07/27/2023, 09/06/2023, and 10/20/2023. Resident #18 Review of Resident #18's electronic facesheet revealed resident was [AGE] year-old male who was admitted to the facility on [DATE] with diagnosis of heart failure, high blood pressure, vascular disease, high cholesterol, and respiratory failure. Review of Resident #18's comprehensive quarterly assessment dated [DATE] revealed the resident had (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675746 If continuation sheet Page 10 of 29 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 675746 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/21/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avir at Coronado 1751 N 15th St Abilene, TX 79603 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 0657 a BIMS of 14 which indicated no cognitive impairment. Level of Harm - Potential for minimal harm Review of Resident #18's care plan conference revealed no evidence of attendance by attending physician and nurse aide with responsibility for the resident on 08/09/2023, 10/04/2023, and 11/15/2023. Residents Affected - Many During an interview at 12/19/2023 at 9:06 am, CNA-A stated that she was never invited nor attended care plan conferences. She stated that the care plan conferences were for the residents to attend. During an interview on 12/21/2023 at 2:22pm, the Corporate RN stated that the only staff to attend the care plan conferences were the dietary department, activities department, MDS Cordinator, and the residents if they wanted to attend. The Corporate RN in conjunction with the DON and MDS Coordinator shook their heads no when asked if nurse aides familiar with the resident and the attending physician attended the care plan conferences. Review of facility policy titled Care Plans, Comprehensive Person-Centered revised December 2020 revealed: 1. The Interdisciplinary Team (IDT), in conjunction with the resident and his/ her family or legal representative, develops and implements A comprehensive, person- centered care plan for each resident 3. The IDT may include but not limited to: a. the attending physician; c. a nurse aide who has responsibility for the resident. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675746 If continuation sheet Page 11 of 29 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 675746 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/21/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avir at Coronado 1751 N 15th St Abilene, TX 79603 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 0700 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and record review the facility failed to attempt to use alternatives prior to installing a side or bed rail and assess the resident for risk of entrapment from bed rails prior to installation for 3 of 3 residents (Resident #7, Resident #10, and Resident #13) reviewed for bed rails. The facility failed to assess residents for entrapment risks and attempt less restrictive measures prior to installing bed rails. These failures could place residents at risk for injury. The findings include: Resident #7 Record review of Resident #7's undated electronic face sheet revealed a [AGE] year-old female who was admitted to the facility on [DATE] with diagnoses which included Parkinson's disease (a brain disorder that causes unintended and uncontrollable body movements), left shoulder pain, lack of coordination, and weakness. Record review of Resident #7's quarterly MDS assessment dated [DATE] revealed: Section C (Cognitive Patterns) BIMS assessment revealed a score of 14 meaning cognitively intact; Section GG (Functional Abilities) revealed Resident #7 needed partial to moderate assistance to roll left to right; and Section P (Restraints and Alarms) revealed physical restraints bed rail not used. Record review of Resident #7's comprehensive care plan reviewed on 12/21/2023 revealed the resident was at risk for falls due to unsteady gait (walking), decreased balance, medications, poor safety awareness, and suffered a recent fall which resulted in a broken hip. Resident #7's care plan noted the resident required extensive assistance with bed mobility. There was no evidence of interventions for placement and/or use of bed rails. Record review of Resident #7's electronic physician orders revealed no order for the use of bed rails. Record review of Resident #7's electronic records on 12/21/2023 revealed no evidence of an attempt to use alternatives to bed rails or assessment for the risk of entrapment. During an observation and interview on 12/18/2023 at 2:47 p.m., Resident #7's bed had quarter rails on both sides. Resident #7 stated that the rails help her with bed mobility. Resident #10 Record review of Resident #10's undated electronic face sheet revealed a [AGE] year-old male who was originally admitted to the facility on [DATE] and most recently admitted to the facility on [DATE] with diagnoses which included intellectual disabilities, dementia, atrophy (muscle loss), unsteadiness on feet, and reduced mobility. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675746 If continuation sheet Page 12 of 29 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 675746 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/21/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avir at Coronado 1751 N 15th St Abilene, TX 79603 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 0700 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Record review of Resident #10's quarterly MDS dated [DATE] Section C (Cognitive Patterns) BIMS assessment revealed a score of 9 indicated moderately impaired and Section G (Functional Status) revealed Resident #10 needed extensive assistance with bed mobility. Record review of Resident #10's comprehensive care plan reviewed on 12/21/2023 revealed the resident preferred to have grab bars on both sides of bed to increase mobility on 12/21/2023 and resident at risk for falls related to history of fall with major injury on 03/06/2019. Record review of Resident #10's electronic physician orders revealed order for left and right positioning bars for increased mobility with start date of 12/21/2023. Record review of Resident #10's electronic records on 12/21/2023 revealed no evidence of an attempt to use alternatives to bed rails or assessment for the risk of entrapment. During an observation of Resident #10's room on 12/18/23 at 2:17 p.m., Resident #10 had quarter rails present to the head of bed. Resident #13 Record review of Resident #13's undated electronic face sheet revealed an [AGE] year-old female was originally admitted to the facility on [DATE] and most recently admitted to the facility on [DATE] with diagnoses which included unsteadiness on feet, mild cognitive impairment, lack of coordination, abnormalities of gait and mobility, atrophy (muscle wasting) and muscle weakness. Record review of Resident #13's quarterly MDS dated [DATE] Section C (Cognitive Patterns) BIMS assessment revealed a score of 8 meaning moderately impaired and Section GG (Functional Abilities) revealed Resident #13 needed partial to moderate assistance with rolling left to right. Record review of Resident #13's comprehensive care plan reviewed on 12/21/2023 revealed the resident preferred to have grab bars to bilateral sides of the bed to increase mobility starting on 12/21/2023 and resident at risk for falls related to poor safety awareness, weakness, and medications starting on 11/22/2020 with interventions listed not including placement and/or use of bed rails. Record review of Resident #13's electronic physician orders revealed order for grab bars to bilateral upper sides of bed with start date of 12/21/2023. Record review of Resident #13's electronic records on 12/21/2023 revealed no evidence of an attempt to use alternatives to bed rails or assessment for the risk of entrapment. During an observation of Resident #13's room on 12/18/23 at 2:29 p.m., Resident #13 had quarter rails present on bed. During an interview on 12/21/2023 at 10:50 a.m., DON stated her expectation would be that entrapment risk assessment be performed, order received from physician, consent be signed by resident or responsible party, and care plan be updated prior to bed rails being installed on a resident's bed. DON stated that she was unsure what led to entrapment risk assessment not being performed, order not received, consent not signed, and care plan not updated prior to bed rails being installed for the 3 residents listed above and charts are being audited at this time to correct any missed steps. DON could not provide any documentation at this time that entrapment risk assessment had been performed. She (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675746 If continuation sheet Page 13 of 29 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 675746 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/21/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avir at Coronado 1751 N 15th St Abilene, TX 79603 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 0700 Level of Harm - Minimal harm or potential for actual harm stated that it was her responsibility for making sure assessments were performed, orders were obtained, and consents were signed prior to bed rail installation. During an interview on 12/21/2023 at 11:00 a.m., CNA E stated that bed rails are used to help residents be mobile and for fall prevention. CNA E stated that facility does not use bed rails to keep residents in bed. Residents Affected - Some During an interview on 12/21/2023 at 11:03 a.m., LVN F stated that physician's order needed to be obtained and DON notified prior to bed rails being installed on a resident's bed. LVN F stated that she did not know who was responsible for completing entrapment risk assessment. LVN F stated that if no assessment were performed, resident could be at risk for getting entangled in bed rail and staff unaware. LVN F stated that she had no residents with half or full bed rails and that facility uses rails to help with mobility and not as a restraint. During an interview and record review on 12/21/2023 at 1:54 p.m., DON stated that all entrapment risk assessments had been performed for the residents requiring bed rails. She provided what assessment had been performed titled Physical Restraint/Adaptive Equipment Consent for Resident #7. Surveyor reviewed form provided by DON for Resident #7's assessment and no documentation was observed of an attempt to use alternatives to bed rails or assessment for the risk of entrapment on the form. DON stated that she would reach out to corporate to see if they had another assessment form available. During an interview on 12/21/2023 at 2:38 p.m., DON stated that if entrapment risk assessments were not performed, bed rails being used inappropriately would put residents at risk of injury or harm from becoming trapped in bed rails. Record review of the facility's policy titled Proper Use of Side Rails revision date of December 2016 revealed Purpose: The purposes of these guidelines are to ensure the safe use of side rails as resident mobility aids and to prohibit the use of side rails as restraints unless necessary to treat a resident's medical symptoms .General Guidelines: 1. Side rails are considered a restraint when they are used to limit the resident's freedom of movement (prevent the resident from leaving his/her bed). (Note: The side rails may have the effect of restraining one individual but not another, depending on the individual resident's condition and circumstances.) 2. Side rails are only permissible if they are used to treat a resident's medical symptoms or to assist with mobility and transfer of residents. 3. An assessment will be made to determine the resident's symptoms, risk of entrapment and reason for using side rails. When used for mobility or transfer, an assessment will include a review of the resident's: a. Bed mobility; b. Ability to change positions, transfer to and from bed or chair, and to stand and toilet; c. Risk of entrapment from the use of side rails; and d. That the bed's dimensions are appropriate for the resident's size and weight. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675746 If continuation sheet Page 14 of 29 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 675746 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/21/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avir at Coronado 1751 N 15th St Abilene, TX 79603 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 0700 4. The use of side rails as an assistive device will be addressed in the resident care plan. Level of Harm - Minimal harm or potential for actual harm 5. Consent for using restrictive devices will be obtained from the resident or legal representative per facility protocol. Residents Affected - Some 6. Less restrictive interventions that will be incorporated in care planning include: a. Providing restorative care to enhance abilities to stand safely and to walk; b. Providing a trapeze to increase bed mobility; c. Placing the bed lower to the floor and surrounding the bed with a soft mat; d. Equipping the resident with a device that monitors attempts to arise; e. Providing staff monitoring at night with periodic assisted toileting for residents attempting to arise to use the bathroom; and/or f. Furnishing visual and verbal reminders to use the call bell for residents who can comprehend this information. 7. Documentation will indicate if less restrictive approaches are not successful, prior to considering the use of side rails. 8. The risks and benefits of side rails will be considered for each resident. 9. Consent for side rail use will be obtained from the resident or legal representative, after presenting potential benefits and risks. (Note: Federal regulations do not require written consent for using restraints. Signed consent forms do not relieve the facility from meeting the requirements for restraint use, including 10. Manufacturer instructions for the operation of side rails will be adhered to. 11. The resident will be checked periodically for safety relative to side rail use. 12. If side rail use is associated with symptoms of distress, such as screaming or agitation, the resident's needs, and use of side rails will be reassessed. 13. When side rail usage is appropriate, the facility will assess the space between the mattress and side rails to reduce the risk for entrapment (the amount of safe space may vary, depending on the type of bed and mattress being used). 14. Side rails with padding may be used to prevent resident injury in situations of uncontrollable movement disorders but are still restraints if they meet the definition of a restraint. 15. Facility staff, in conjunction with the Attending Physician, will assess and document the resident's risk for injury due to neurological disorders or other medical conditions. Record review of the facility's policy titled Bed Safety revision date of October 2023 revealed (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675746 If continuation sheet Page 15 of 29 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 675746 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/21/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avir at Coronado 1751 N 15th St Abilene, TX 79603 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 0700 Purpose: Level of Harm - Minimal harm or potential for actual harm It is the policy of this facility to utilize a person-centered approach when determining the use of bed rails. Appropriate alternative approaches are attempted prior to installing or using bed rails. If bed rails are used, the facility ensures correct installation, use, and maintenance of the rails . Residents Affected - Some Resident Assessment: 1. If side rails are used, there shall be an interdisciplinary assessment of the resident, consultation with the Attending Physician, and input from the resident and/or legal representative. 2. As part of the resident's comprehensive assessment, the following components will be considered when determining the resident's needs, and whether or not the use of bed rails meets those needs: a. Medical diagnosis, conditions, symptoms, and/or behavioral symptoms b. Size and weight c. Sleep habits d. Medication(s) e. Acute medical or surgical interventions f. Underlying medical conditions g. Existence of delirium h. Ability to toilet self safely i. Cognition j. Communication k. Mobility (in and out of bed) l. Risk of falling 3. The resident assessment must include an evaluation of the alternatives that were attempted prior to the installation or use of a bed rail and how these alternatives failed to meet the resident's assessed needs. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675746 If continuation sheet Page 16 of 29 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 675746 B. Wing (X3) DATE SURVEY COMPLETED A. Building 12/21/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avir at Coronado 1751 N 15th St Abilene, TX 79603 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 0700 4. The resident assessment must also assess the resident's risk from using bed rails. Examples of the Level of Harm - Minimal harm or potential for actual harm potential risks with the use of bed rails include: a. Accident hazards (e.g., falls, entrapment, and other injuries sustained from attempts to climb Residents Affected - Some over, around, between, or through the rails, or over the footboard) b. Barrier to residents from safely getting out of bed c. Physical restraint (e.g., hinders residents from independently getting out of bed or performing routine activities) d. Decline in resident function, such as muscle functioning/balance e. Skin integrity issues f. Decline in other areas of activities of daily living such as using the bathroom, continence, eating, hydration, walking and mobility g. Other potential negative psychosocial outcomes such as an undignified self-image, altered self esteem, feelings of isolation, or agitation/anxiety. 5. The resident assessment should assess the resident's risk of entrapment between the mattress and bed rail or in the bed rail itself. 6. The facility will assess to determine if the bed rail meets the definition of a restraint. A bed rail is a restraint if the bed rail keeps a resident from voluntarily getting out of bed in a safe manner due to his/her physical or cognitive inability to lower the bed rail independently. If it is determined to be a restraint, the facility will follow their procedures related to physical restraints . Informed Consent 7. Informed consent from the resident or resident representative must be obtained after appropriate alternatives have been attempted prior to installation and use of bed rails. This information should (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675746 If continuation sheet Page 17 of 29 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 675746 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/21/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avir at Coronado 1751 N 15th St Abilene, TX 79603 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 0700 be presented in an understandable manner, and consent given voluntarily, free from coercion. Level of Harm - Minimal harm or potential for actual harm 8. The information that the facility should provide to the resident, or resident representative includes, but is not limited to: Residents Affected - Some a. What assessed medical needs would be addressed by the use of bed rails; b. The resident's benefits from the use of bed rails and the likelihood of these benefits; c. The resident's risks from the use of bed rails and how these risks will be mitigated; and d. Alternatives attempted that failed to meet the resident's needs and alternatives considered but not attempted because they were considered to be inappropriate. 9. Upon receiving informed consent, the facility will obtain a physician's order for the use of the specified bed rail and medical diagnosis, condition, symptom, or functional reason for the use of the bed rail. Appropriate Alternatives 10. The facility will attempt to use appropriate alternatives prior to installing or using bed rails. Alternatives include, but are not limited to: a. Roll guards b. Foam bumpers c. Lowering the bed d. Concave mattresses 11. Alternatives that are attempted should be appropriate for the resident, safe and address the medical conditions, symptoms, or behavioral patterns for which a bed rail was considered. 12. If no appropriate alternatives are identified, the medical record should include evidence of the following: a. Purpose for which the bed rail was intended and evidence that alternatives were tried (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675746 If continuation sheet Page 18 of 29 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 675746 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/21/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avir at Coronado 1751 N 15th St Abilene, TX 79603 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 0700 and were not successful; Level of Harm - Minimal harm or potential for actual harm b. Assessment of the resident, the bed, the mattress, and rail for entrapment risk (which would include ensuring bed dimensions are appropriate for resident size/weight); and Residents Affected - Some c. Risks and benefits were reviewed with the resident or resident representative, and informed consent was given before installation or use. Ongoing Monitoring and Supervision 13. The facility will continue to provide necessary treatment and care to the resident who has bed rails in accordance with professional standards of practice and the resident's choices. This should be evidenced in the resident's records, including their care plan, including, but not limited to, the following information: a. The type of specific direct monitoring and supervision provided during the use of the bed rails, including documentation of the monitoring; b. The identification of how needs will be met during use of the bed rails, such as for repositioning, hydration, meals, use of the bathroom and hygiene; c. Ongoing assessment to assure that the bed rail is used to meet the resident's needs; d. Ongoing evaluation of risks; e. The identification of who may determine when the bed rail will be discontinued; and f. The identification and interventions to address any residual effects of the bed rail (e.g., generalized weakness, skin breakdown). 14. Responsibilities of ongoing monitoring and supervision are specified as follows: b. Direct care staff will be responsible for care and treatment in accordance with the plan of care. c. A nurse assigned to the resident will complete reassessments in accordance with the facility's assessment schedule, but not less than quarterly, upon a significant change in (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675746 If continuation sheet Page 19 of 29 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 675746 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/21/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avir at Coronado 1751 N 15th St Abilene, TX 79603 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 0700 status, or a change in the type of bed/mattress/rail. Level of Harm - Minimal harm or potential for actual harm d. The interdisciplinary team will make decisions regarding when the bed rail will be used or discontinued, or when to revise the care plan to address any residual effects of the bed Residents Affected - Some rail. e. The maintenance director, or designee, is responsible for adhering to a routine maintenance and inspection schedule for all bed frames, mattresses, and bed rails. f. The facility's education and training activities will include instruction about risk factors for resident injury due to beds, and strategies for reducing risk factors for injury, including entrapment. 15. The staff shall report to the Director of Nursing and Administrator any deaths, serious illnesses and/or injuries resulting from a problem associated with a bed and related equipment including the bed frame, bedside rails, and mattresses. The Administrator shall ensure that reports are made to the Food and Drug Administration or other appropriate agencies, in accordance with pertinent laws and regulations including the Safe Medical Devices Act. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675746 If continuation sheet Page 20 of 29 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 675746 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/21/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avir at Coronado 1751 N 15th St Abilene, TX 79603 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 0727 Level of Harm - Potential for minimal harm Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. Based on interview and record review, the facility failed to use the services of a registered nurse for at least 8 consecutive hours a day, seven days a week for 6 of 6 days reviewed for RN Coverage. Residents Affected - Some The facility failed to provide evidence a Registered Nurse (RN) worked 8 consecutive hours a day, seven days a week for 6 days (08/05/23, 08/06/23,08/19/23, 09/02/23, 09/03/23 and 09/30/23) of the FY Quarter 4 2023 (July1- September 30) out of 4 Quarters. This failure could place residents at risk for altered physical, mental, and psychological well-being due to decisions that would have required an RN to make in the management of the residents' healthcare needs and in managing and monitoring the direct care staff. The Findings included: Record review of the facility's Staffing Data Report for FY Quarter 4 2023 revealed no RN coverage on 08/05/23, 08/06/23,08/19/23, 09/02/23, 09/03/23 and 09/30/23. During an interview on 12/21/23 at 10:18 AM the ADMN stated her expectation was to have 8 hours of RN coverage daily. The ADMN stated the DON and ADON were responsible to schedule and ensure there was RN coverage. The ADNM stated she did not feel there was a negative impact on residents , there were staff at facility and able to contact DON if had any issues. The ADMN stated not being able to find RN's that could work led to failure of not having RN coverage on 08/05/23, 08/06/23,08/19/23, 09/02/23, 09/03/23 and 09/30/23. During an interview on 12/21/23 at 10:50 AM the DON stated she was responsible for scheduling RN coverage. The DON stated on 08/05/23, 08/06/23,08/19/23, 09/02/23, 09/03/23 and 09/30/23 there was not 8 hours of RN coverage. The DON stated what led to the failure was she was not able to fill the shifts with her employees or thru agency. During exit conference on 12/21/2023 at 5:00 PM the facility administration did not provide evidence of policies or procedure regarding utilization of RN's for 8 consecutive hours a day/7 days a week. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675746 If continuation sheet Page 21 of 29 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 675746 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/21/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avir at Coronado 1751 N 15th St Abilene, TX 79603 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 0804 Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** During an observation, interview, and record review, the facility failed to provide food prepared by methods that conserve nutritive value, flavor, and appearance as well as failed to provide food and drink that was palatable, attractive, and at a safe and appetizing temperature for 1 of 1 meal observed. Residents Affected - Some The facility failed to provide a lunch meal that was flavorful and palatable. These failures can place residents at risk for weight loss. Findings Include: During an observation on 12/20/2023 at 11:41 AM, test meal arrived at 11:55 am. The meal consisted of Salisbury steak, cauliflower and broccoli vegetable mix, potato wedges, and a roll. The Salisbury steak and the cauliflower and broccoli vegetable mix was not flavorful and palatable. During an interview on 12/20/2023 at 3:30pm, DON stated that the meal was not flavorful and palatable. DON stated that if the food was more palatable, the residents would possibly eat more. DON stated that with the food not being flavorful and palatable, the residents could lose weight. DON stated that the failure was due to the dietary manager not working on 12/20/2023 as the dietary manager was responsible for monitoring the kitchen staff to present a flavorful and palatable meal. DON stated her expectations were for the food to be fresh, flavorful, and palatable when directly served to the residents. During an interview on 12/21/2023 at 10:55am, the Administrator stated that she was responsible for oversight of the dietary manager and dietician. The Admin stated the kitchen staff were in-serviced on nutritious food and services. The Admin stated when a meal is not flavorful or palatable, the residents may not eat and may experience weight loss. The Admin stated her expectations was for meals to be flavorful, palatable, and if the residents were not happy with the meal, the residents were to be provided substitution meals. During an interview on 12/21/23 at 3:00pm, the Dietician stated she in-services the dietary manager once a month. The in-services included dietary scoop size, infection control practices, food storage with dates and labels, menu extensions, food temperature logs, palatable and presentable food. The Dietician stated that the failure occurred due to the staff not being consistent with flavor and palatability. Record Review of facility Nutritious Lifestyles Food and Nutrition services in-service sign in sheet dated 12/06/2023 revealed: Presenter: Dietician; Topic Summary: Tray Ticket Accuracy: following diets, scoop sizes, menu extensions, honoring allergies and residents rights, palatable, presentation; Date and label all food; when delivered and after opening; Temperature Logging and Thermometer calibration methods. Internal final cooking temps and hot holding foods; Posting menus. Record Review of facility in-service's labeled Plate Observation Summary not dated revealed: Regular Texture Standard; All Foods Are Permitted. No Restrictions. Fresh, Colorful, and Appetizing. Honor Resident Preferences, Cultural Values, & Food Allergies. Mechanical Soft/Chopped Standards - Foods are altered using a blender, food processor, food chopper, grinder, potato masher, or cooked until soft. Foods should not be overly dry, well moistened, and bitesize. Use the following moisturizers (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675746 If continuation sheet Page 22 of 29 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 675746 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/21/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avir at Coronado 1751 N 15th St Abilene, TX 79603 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 0804 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some during preparation/serving to help improve taste, swallowing/chewing ability, and digestion; Gravies, Sauces, Vegetable or fruit juice, Milk/Half-and-Half, Water, Oils/Butters/Salad Dressing; Avoid leaving large chunks and using hard to chew foods during the preparation process. Meats are ground or finely cut to an equal size no bigger than 1 inch. Foods that are already soft & moist don't need to be further altered. Foods To Consume: All dairy products except non-shredded hard cheeses, Ground meats, Flaky fish, Eggs, Tofu, Nut butter, Soft cooked vegetables . no seeds or skins, Anything pureed, Oatmeal, Gravies, and sauces, Soft bread. Foods To Avoid: Nuts & Seeds, Non-Ground/Dry/Tough Meats, Bread w/Hard Crust, Hard Candy, Raw/Crunchy Vegetables, Popcorn / Crackers / Chips, Fresh, Frozen, Dried Fruits, Soups with finely chopped vegetables, Olives/Pickles, Crispy/Fried Foods, Chewy Candy/Desserts. Puree Standards: Cut food into small pieces and place in blender or food processor, Add liquid (broth, gravy, milk, sauces, yogurt, etc). Puree until smooth, Season food to taste. Avoid Making Pureed Items Too Thin or Thick. Add More Food If Too Thin; Add More Liquid If Too Thick; Healthy & balanced with foods from all food groups. Add Seasonings To Make Them Taste Good. Three P's: Plate Your Puree Like A Pro Consistency: Free of Lumps, Bumps, and Never Runny (Pudding Like); Spacing: Keep Each Item Separate/Avoid Running Together. Molds/Piping: Molds to make your foods appear to be original dish/plastic pigging to create an eye-appealing plate. Foods To Choose: Applesauce, Pureed, cooked, or canned vegetables, Pureed, canned or soft fruits, Smoothed Mashed Potatoes, Cooked Cereals, Pureed Pasta/Noodles, Pureed Bread/Pancakes/Muffins, Smooth Yogurt/Pudding/Ice Cream, Pureed Meat, poultry, and fish w/o bones. Foods To Avoid: Tough/Raw/Stringy Vegetables, Tough/Stringy/Pulpy Fruit, Celery/Oranges/Pineapples, Watermelon, Dry Cereal, Grain Products w/seeds, Yogurts w/fruit, seeds, nuts, Hard Cheeses, Sausages/Hot Dogs, Tough Meats w/bones, Tough Meats w/bones, Salad Dressing w/grainy spices. CMS Guidelines: Food should be fresh, colorful, and appetizing. Should be presented beautifully on the plate with colorful garnishes. The facility must make reasonable efforts to provide food that is appetizing to and culturally appropriate for residents. Food prepared by methods that conserve nutritive value, flavor, and appearance. Providing palatable, attractive, and appetizing food and drink to residents can help to encourage residents to increase the amount they eat and drink. Are foods prepared as directed? Expresses Resident's Preferences. Does food have a distinctly appetizing aroma and appearance, which is varied in color and texture? food generally well-seasoned (use of spices, herbs, etc.) and acceptable to residents? food served at a preferable temperature for the resident (hot foods are served hot and cold foods are served cold and in accordance with resident preferences? Garnish Ideas; Pureed (syrups/[NAME]); Parsley spread. Arranged Oranges/Melon Edge slices w/breakfast. Desserts: Frosting, glazes, whipped cream, chocolate syrup/caramel syrups, raspberry spread; Cucumber Crowns w/cottage cheese in the center. Cherry Tomatoes Crowns; Strawberry Fans; Boiled Egg Crown for Chef Salad; Kale/Endive Greenery; Baked Fish w/Lemons; Objectives. Remember: The first Impression Means Everything. Regardless of The Consistency: Providing palatable, attractive, and appetizing food and drink to residents can help to encourage residents to increase the amount they eat and drink. Ensure all consistencies are properly prepared to ensure Resident safety & satisfaction. Encourage staff to try each consistency during Kitchen QA's or have it for lunch one day. Don't Be Extra: Understand the capabilities of your kitchen and respect the basics when concern food appearance/flavor. Probe your Residents for what they like to see on their foods and work with CDM and staff to implement change if possible. Review of Texas food Establishment Rules accessed https://www.fda.gov/media/164194/download 08/16/2023 revealed in annex 3 page 17: the manufacturer's use-by date is its recommendation for using the product while its quality is at its best. Although it is a guide for quality, it could be based on food safety reasons. It is recommended that food (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675746 If continuation sheet Page 23 of 29 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 675746 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/21/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avir at Coronado 1751 N 15th St Abilene, TX 79603 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 0804 Level of Harm - Minimal harm or potential for actual harm establishments consider the manufacturer's information as good guidance to follow to maintain the quality (taste, smell, and appearance) and salability of the product. If the product becomes inferior quality-wise due to time in storage, it is possible that safety concerns are not far behind. Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675746 If continuation sheet Page 24 of 29 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 675746 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/21/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avir at Coronado 1751 N 15th St Abilene, TX 79603 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 0812 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Based on observations, interviews, and record reviews, the facility failed to ensure food was stored, prepared, distributed, and served in accordance with professional standards for food service safety for 1 of 1 kitchen observed. The facility failed to ensure that opened food was labeled and dated with date open. These failures place residents at risk for food borne illness Findings include: During observation on 12/18/2023 at 10:10 AM the facility kitchen revealed: Pantry: 1. One clear gallon bag that contained an opened bag of chips not labeled and no open date. 2. One clear gallon bag that contained an opened bag of what was labeled Tostitos with date received of 11/08 , and no open date. 3. One opened box labeled corn starch had an date received of 10/25, and no open date. Freezer #1: 1. One opened box labeled Homestyle Dinner Rolls had an in date 12/06, and no open date. 2, One opened box labeled Bread sticks had an in date 12/13, and no open date. 3. One opened box labeled Omelets had an in date 12/13, and no open date. Refrigerator #1: 1. One opened 5 lb bag labeled parmesan cheese had an in date dated 09/06, and no open date. 2. One opened 1 lb. gallon container with no open date. During an interview on 12/18/2023 at 10:45 AM, the CDM stated all food products should have an in date and if the bag or box was opened, the open date should be written on it. She stated the negative impact to the resident would be the resident could get sick or contaminated if the product were to be expired or left open to air. She stated the staff being lazy was the failure, with her expectations being for products to have the receive date as well as if opened, the open date. During an interview on 12/21/23 at 11:18 AM, the ADMN stated she and the CDM should be monitoring all food products. She stated the DM performed in-services to the kitchen staff. The ADMN stated there could be possible harm to residents such as spoiled or contaminated food. She stated the failures occur with kitchen staff not doing their job with her expectations. that monitoring kitchen was to be done as a routine duty. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675746 If continuation sheet Page 25 of 29 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 675746 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/21/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avir at Coronado 1751 N 15th St Abilene, TX 79603 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 0812 Level of Harm - Minimal harm or potential for actual harm Record Review of Facility training/in-services labeled Proper Label and Date Review with Nutritious Lifestyles revealed: Item: Common name of the food item. Prep Date: Date food item is opened or prepared. Use By: Date food item must be used by or thrown away. Initials: Identify individual who opened or prepared the food item. Time Stamp: Time opened or prepared accurately determines food expiration Residents Affected - Some Food procurement, store/prepare/serve - sanitary Tips! 1. Clearly label food item 2. Date when received, prepared, or opened 3. Practice FIFO (first in first out) method 4. Routinely check storage for proper labeling and dating 5. Discard expired food promptly Review of Texas food Establishment Rules accessed https://www.fda.gov/media/164194/download 08/16/2023 revealed in annex 3 page 17: the manufacturer's use-by date is its recommendation for using the product while its quality is at its best. Although it is a guide for quality, it could be based on food safety reasons. It is recommended that food establishments consider the manufacturer's information as good guidance to follow to maintain the quality (taste, smell, and appearance) and salability of the product. If the product becomes inferior quality-wise due to time in storage, it is possible that safety concerns are not far behind. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675746 If continuation sheet Page 26 of 29 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 675746 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/21/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avir at Coronado 1751 N 15th St Abilene, TX 79603 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 0850 Hire a qualified full-time social worker in a facility with more than 120 beds. Level of Harm - Potential for minimal harm Based on interview and record review, the facility, with a capacity of more than 120 beds, failed to employ a qualified social worker on a full-time basis. Residents Affected - Many The facility failed to ensure facility had a full-time social worker. This failure could affect all residents of the facility by placing them at increased risk of psychosocial decline and poor quality of life. The findings included: During an interview on 12/20/23 at 03:30 PM the SW stated she was a corporate social worker. The SW stated she worked part time at facility and was only there maybe 20 hours per week. The SW stated she was also responsible for several other facilities. During an interview on 12/21/23 at 10:18 AM the ADMN stated her expectation was to have a full-time social worker but had not been able to hire a social worker. The ADMN stated the corporate SW was in the building weekly. The ADMN stated the facility had not had a full-time social worker since the end of August of 2023. The ADMN stated she did not think there was a negative effect on residents, she felt that the cooperate SW was covering and had filled in the gaps. The ADMN stated she was responsible to ensure the position was filled. The ADMN stated what led to failure was she was not able to find a person with the qualifications to hire. Record review of the facility policy titled, Social Services dated October 2010, revealed no evidence the position was to be full-time. Record review of Form 3740 titled Bed Classification dated 12/20/2023 revealed the facility had a licensed capacity of 188 resident beds. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675746 If continuation sheet Page 27 of 29 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 675746 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/21/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avir at Coronado 1751 N 15th St Abilene, TX 79603 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 0880 Provide and implement an infection prevention and control program. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, interviews, and record reviews, the facility failed to maintain infection control protocols to prevent infections for 1 of 2 resident (Resident #27) observed for catheter care needs. Residents Affected - Few The facility failed to ensure CNA A used a peri-care cleaning wipe and cleaned catheter tubing toward the resident and not away toward catheter bag to clean catheter tubing. These failures place residents at risk for unnecessary infections while in the facility. Findings include: Record Review of Resident #27's undated electronic face sheet revealed she was a [AGE] year-old female, admitted to the facility originally on 02/15/2019 and most recently on 03/06/2023, with a diagnoses of urinary tract infection. Record Review of Resident #27's quarterly MDS assessment dated [DATE] revealed: Section C (Cognitive Patterns) revealed no BIMS score (test to determine cognitive status) and Section H (Bladder and Bowel) revealed resident had an indwelling catheter. Record Review of Resident #27's comprehensive care plan reviewed on 12/20/2023 revealed, Resident #27 had an indwelling catheter and to provide catheter care per orders. Record Review of Resident #27's physician orders reviewed on 12/20/2023 revealed order to provide catheter care every shift and as needed with start date of 05/30/2022. During an observation on 12/19/2023 at 3:21 p.m., CNA A cleaned and wiped the catheter tubing toward Resident #27 during foley catheter care. During an interview on 12/19/2023 at 3:27 p.m., CNA A stated she had wiped the catheter tubing toward Resident #27 after first wiping away. CNA A stated that she was nervous being watched. She also stated that performing catheter care incorrectly could cause infection. During an interview on 12/19/2023 at 3:29 p.m., Corporate Nurse stated her expectation would be for staff to clean catheter tubing away from the resident. Corporate Nurse stated the proper way to clean the catheter tubing was to always wipe away from the resident and never towards. She stated if the staff were to wipe or clean toward the resident, it could cause a possible infection. Corporate Nurse stated that she had only been working at facility for one week but that she felt staff education needed to be provided. Corporate Nurse stated that she was the acting IP and that it was her responsibility to educate staff in preventing infections. Corporate Nurse stated that she felt nerves may have led to CNA A performing catheter care incorrectly. During an interview on 12/20/2023 at 11:27 a.m., CNA D stated that it is appropriate to wipe foley catheter tubing away from residents. She stated that wiping toward resident could cause infections. During an interview on 12/20/23 at 4:23 p.m., DON stated that she started working back at the facility today. She stated that it is her expectation catheter care should be performed by wiping tubing away from resident. DON stated that wiping toward resident could cause infection. She stated that (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675746 If continuation sheet Page 28 of 29 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 675746 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/21/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Avir at Coronado 1751 N 15th St Abilene, TX 79603 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 0880 she felt failure occurred due to staff needing more education. Level of Harm - Minimal harm or potential for actual harm Record Review of CNA A's last clinical skill checkoff dated 09/19/2023 included foley catheter care. Residents Affected - Few Record Review of facility policy titled Perineal Care dated with the revised date of 01/20/2023 revealed: If the resident has an indwelling catheter, gently wash the juncture of the tubing from the urethra down the catheter about 3 inches. Record Review of facility policy titled Catheter Care dated with the revised date of 12/2023 revealed: With a new moistened cloth, starting at the urinary meatus moving out, wipe the catheter making sure to hold the catheter in place so as to not pull on the catheter. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675746 If continuation sheet Page 29 of 29