Health inspection·October 13, 2024

F 0880 Unit 2, starting 10/12/24 to time of exit, male locked unit was hot. Level of Harm - Immediate jeopardy to resident health or safety During an observation on 10/10/24 at 10:35 AM Side A of the building housed one COVID 19 positive, Resident #18 and eight COVID 19 negative, Residents ##19, #20, #21, #22, #23, #24, #25 and #26. Side B of the building Unit 2 male locked unit had 16 total residents, COVID positive's #1, #2, #3, #5, #7, #8, #9, #10, #11, #12, #13, #14, and #15 and COVID negative #4, #6, #16, and #17 at this time Resident #2 had passed. Residents Affected - Some 1. Record review of Resident #2's quarterly MDS, dated [DATE], reflected an [AGE] year-old male who was admitted to the facility on [DATE]. His diagnosis included Cerebral ischemia, hypertension, and dementia. Record review of the facility resident tracking log, dated 10/3/24 on 10/9/24, titled COVID+ Residents, reflected Resident #2 was COVID-19 tested on [DATE], and positive test results were received on 10/3/24. Record review on 10/9/24 of Resident #2's progress notes reflected on 10/3/24 Resident #2 tested positive for COVID-19. On 10/6/24 Resident #2 was taken to local ER due to low O2 stats/saturation. On 10/7/24 Resident #2 expired associated to COVID-19. During an interview on 10/9/24 at 2:10 PM, the MD stated Resident #2 was sent to the ER on [DATE] because the resident was unresponsive. The MD stated Resident #2 was intubated and moved to the ICU at the local community hospital. The MD stated Resident #2 expired on 10/7/24 with complications associated to COVID-19. 2. Record review of Resident #1's quarterly MDS, dated [DATE], reflected a [AGE] year-old male who was admitted to the facility on [DATE]. His diagnosis included Parkinsonism, schizophrenia, and muscle weakness. Record review of the facility resident tracking log, dated 9/30/24 on 10/9/24, titled COVID+ Residents, reflected Resident #1 was COVID-19 tested on [DATE], and positive test results were received on 9/30/24. 3. Record review of Resident #3's quarterly MDS, dated [DATE], reflected a [AGE] year-old male who was admitted to the facility on [DATE]. His diagnosis included Metabolic encephalopathy, history of falling and altered mental status. Record review of the facility's resident tracking log, dated 10/7/24 on 10/9/24, titled COVID+ Residents, reflected Resident #3 was COVID-19 tested on [DATE], and positive test results were received on 10/7/24. 4. Record review of Resident #4's quarterly MDS, dated [DATE], reflected a [AGE] year-old male who was admitted to the facility on [DATE]. His diagnosis included Dementia, Schizoaffective disorder, and muscle weakness. Record review of the facility's resident tracking log, dated 9/30/24 to 10/11/24, titled COVID- Residents, reflected Resident #4 was COVID-19 tested on [DATE], and negative test results were received on 10/11/24. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675746 If continuation sheet Page 2 of 11 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 10/13/2024 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 Level of Harm - Immediate jeopardy to resident health or safety 5. Record review of Resident #5's quarterly MDS, dated [DATE], reflected a [AGE] year-old male who was admitted to the facility on [DATE]. His diagnosis included Dementia, schizoaffective disorder, and bipolar disorder. Record review of the facility's resident tracking log, dated 10/9/24 on 10/9/24, titled COVID+ Residents, reflected Resident #5 was COVID-19 tested on [DATE], and positive test results were received on 10/9/24. Residents Affected - Some 6. Record review of Resident #6's quarterly MDS, dated [DATE], reflected a [AGE] year-old male who was admitted to the facility on [DATE]. His diagnosis included Dementia, Schizoaffective disorder, and bipolar disorder. Record review of the facility's resident tracking log, dated 9/30/24 to 10/11/24, titled COVID- Residents, reflected Resident #6 was COVID-19 tested on [DATE], and negative test results were received on 10/11/24. 7. Record review of Resident #7's quarterly MDS, dated [DATE], reflected a [AGE] year-old male who was admitted to the facility on [DATE]. His diagnosis included Alzheimer's Disease, type 2 diabetes mellitus and hypertension. Record review of the facility's resident tracking log, dated 10/2/24 on 10/9/24, titled COVID+ Residents, reflected Resident #7 was COVID-19 tested on [DATE], and positive test results were received on 10/2/24. 8. Record review of Resident #8's quarterly MDS, dated [DATE], reflected a [AGE] year-old male who was admitted to the facility on [DATE]. His diagnosis included Dementia, anxiety, and alcohol abuse. Record review of the facility's resident tracking log, dated 10/3/24 on 10/9/24, titled COVID+ Residents reflected Resident #8 was COVID-19 tested on [DATE], and positive test results were received on 10/3/24. 9. Record review of Resident #9's quarterly MDS, dated [DATE], reflected a [AGE] year-old male who was admitted to the facility on [DATE]. His diagnosis included Parkinsonism, type 2 diabetes mellitus and muscle weakness. Record review of the facility's resident tracking log, dated 10/3/24 on 10/9/24, titled COVID+ Residents reflected Resident #9 was COVID-19 tested on [DATE], and positive test results were received on 10/3/24. 10. Record review of Resident #10's quarterly MDS, dated [DATE], reflected a [AGE] year-old male who was admitted to the facility on [DATE]. His diagnosis included traumatic subdural hemorrhage, muscle weakness and epilepsy. Record review of the facility's resident tracking log, dated 10/3/24 on 10/9/24, titled COVID+ Residents reflected Resident #10 was COVID-19 tested on [DATE], and positive test results were received on 10/3/24. 11. Record review of Resident #11's quarterly MDS, dated [DATE], reflected an [AGE] year-old male (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675746 If continuation sheet Page 3 of 11 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 10/13/2024 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 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Some who was admitted to the facility on [DATE]. His diagnosis included Dementia, cognitive communication deficit and anxiety disorder. Record review of the facility's resident tracking log, dated 10/4/24 on 10/9/24, titled COVID+ Residents reflected Resident #11 was COVID-19 tested on [DATE], and positive test results were received on 10/4/24. 12. Record review of Resident #12's quarterly MDS, dated [DATE], reflected a [AGE] year-old male who was admitted to the facility on [DATE]. His diagnosis included Dementia, muscle weakness and anxiety disorder. Record review of the facility's resident tracking log, dated 10/4/24 on 10/9/24, titled COVID+ Residents reflected Resident #12 was COVID-19 tested on [DATE], and positive test results were received on 10/4/24. 13. Record review of Resident #13's quarterly MDS, dated [DATE], reflected a [AGE] year-old male who was admitted to the facility on [DATE]. His diagnosis included schizophrenia, bipolar disorder, and muscle weakness. Record review of the facility's resident tracking log, dated 10/7/24 on 10/9/24, titled COVID+ Residents reflected Resident #13 was COVID-19 tested on [DATE], and positive test results were received on 10/7/24. 14. Record review of Resident #14's quarterly MDS, dated [DATE], reflected a [AGE] year-old male who was admitted to the facility on [DATE]. His diagnosis included Dementia, type 2 diabetes mellitus and epilepsy. Record review of the facility's resident tracking log, dated 10/7/24 on 10/9/24, titled COVID+ Residents reflected Resident #14 was COVID-19 tested on [DATE], and positive test results were received on 10/7/24. 15. Record review of Resident #15's quarterly MDS, dated [DATE], reflected a [AGE] year-old male who was admitted to the facility on [DATE]. His diagnosis included Dementia, Metabolic encephalopathy, and muscle wasting. Record review of the facility's resident tracking log, dated 10/7/24 on 10/9/24, titled COVID+ Residents, reflected Resident #15 was COVID-19 tested on [DATE], and positive test results were received on 10/7/24. 16. Record review of Resident #16's quarterly MDS, dated [DATE], reflected a [AGE] year-old male who was admitted to the facility on [DATE]. His diagnosis included Dementia, muscle weakness and anxiety. Record review of the facility's resident tracking log, dated 9/30/24 to 10/11/24, titled COVID- Residents reflected Resident #16 was COVID-19 tested on [DATE], and negative test results were received on 10/11/24. 17. Record review of Resident #17's quarterly MDS, dated [DATE], reflected a [AGE] year-old male who was admitted to the facility on [DATE]. His diagnosis included Dementia, type 2 diabetes mellitus (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675746 If continuation sheet Page 4 of 11 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 10/13/2024 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 and depression. Level of Harm - Immediate jeopardy to resident health or safety Record review of the facility resident tracking log, dated 9/30/24 to 10/11/24, titled COVID- Residents reflected Resident #17 was COVID-19 tested on [DATE], and negative test results were received on 10/11/24. Residents Affected - Some 18. Record review Resident #18's face sheet, dated 9/30/24, reflected a [AGE] year-old male who was admitted to the facility on [DATE]. His diagnoses included Human immunodeficiency virus (HIV) disease, type 2 diabetes mellitus and obesity. Record review of Resident #18's quarterly MDS assessment, dated 9/12/24, reflected he had a BIMS score 12 out of 15, which indicated he had no cognitive impairment. During an observation on 9/27/24 at 1:10 PM, Resident #18 was observed in his wheelchair coming from hallway 6 across the nurses' station and back to hallway 2 where his room was. No mask was being worn by Resident #18 while being out of his room, touching the handrails, coughing, and touching the nurses stating, exposing Residents #19, #20, #21, #22, #23, #24, #25 and #26 to COVID-19 Record review of the facility's resident tracking log, dated 9/27/24 on 10/9/24, titled COVID Residents Testing log, reflected Residents #19, #20, #21, #22, #23, #24, #25 and #26 were all COVID negative. During an interview on 9/27/24 at 1:20 PM, Resident #18 stated he was on isolation because he was COVID positive. He stated he didn't have any symptoms and was feeling good. He stated he left his room because he could not fit onto the toilet in his room, so he went to the restroom in his old room. He stated he went to room [ROOM NUMBER] located on hall 6. He stated he didn't really ask to go to his old room to use the toilet and knew he should stay in his room but when he needed to go, he needed to go; so, he went. He stated there was no other resident in his old room. 19. Record review Resident #19's face sheet, dated 9/30/24, reflected a [AGE] year-old male who was admitted to the facility on [DATE]. His diagnoses included Alzheimer's disease, Parkinson's disease, and depressive disorder. Record review of Resident #19's quarterly MDS assessment, dated 8/14/24, reflected he had a BIMS score 99, which indicated he could not complete the interview. During an observation on 9/27/24 at 12:20 PM, revealed CNA-F was serving food to Resident #19 with no goggles or face shield on. During an interview on 9/27/24 at 12:25 PM, the DON stated that she was the infection preventionist and that Resident #19 was not COVID positive, but he was on isolation because his roommate was previously COVID positive, so he was considered exposed (warm). She stated that's why all the signage was on the door. She stated Resident #18 was positive for COVID and was on quarantine to protect the other residents in the building from being exposed to COVID. 20. Record review of Resident #20's face sheet, dated 9/30/24, reflected a [AGE] year-old female who was admitted to the facility on [DATE]. Her diagnoses included Alzheimer's disease, cognitive communication deficient and bipolar disorder. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675746 If continuation sheet Page 5 of 11 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 10/13/2024 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 Level of Harm - Immediate jeopardy to resident health or safety Record review of Resident #20's quarterly MDS assessment, dated 9/10/24, reflected she had a BIMS score 9 out of 15, which indicated moderate cognitive impairment. 21. Record review of Resident #21's face sheet, dated 9/30/24, reflected a [AGE] year-old female who was admitted to the facility on [DATE]. Her diagnoses included Alzheimer's disease, cognitive communication deficient and bipolar disorder. Residents Affected - Some Record review of Resident #21's quarterly MDS assessment, dated 8/19/24, reflected she had a BIMS score 11 out of 15, which indicated moderate cognitive impairment. 22. Record review Resident #22's face sheet, dated 9/30/24, reflected a [AGE] year-old male who was admitted to the facility on [DATE]. His diagnoses included chronic pain due to trauma, quadriplegia, and lack of coordination. Record review of Resident #22's quarterly MDS assessment, dated 8/14/24, reflected he had a BIMS score 13 out of 15, which indicated no cognitive impairment. 23. Record review Resident #23's face sheet, dated 9/30/24, reflected a [AGE] year-old female who was admitted to the facility on [DATE]. Her diagnoses included heart failure, type 2 diabetes mellitus, and acute kidney failure. Record review of Resident #23's quarterly MDS assessment, dated 8/24/24, reflected she had a BIMS score 9 out of 15, which indicated moderate cognitive impairment. 24. Record review Resident #24's face sheet, dated 9/30/24, reflected a [AGE] year-old female who was admitted to the facility on [DATE]. Her Diagnoses included Alzheimer's disease, cognitive communication deficient and dysphagia. Record review of Resident #24's quarterly MDS assessment, dated 7/23/24, reflected she had a BIMS score, 5 out of 15 which indicated severe cognitive impairment. Record review of the facility resident tracking log, dated 9/24/24 on 10/9/24, titled COVID+ Residents, reflected Resident #24 was COVID-19 tested on [DATE], and positive test results were received on 9/24/24. Indicating the first resident to test positive in the facility. 25. Record review Resident #25's face sheet, dated 9/30/24, reflected a [AGE] year-old male who was admitted to the facility on [DATE]. His diagnoses included dementia, schizoaffective disorder, and anxiety disorder. Record review of Resident #25's quarterly MDS assessment, dated 6/22/24, reflected he had a BIMS score 7 out of 15, which indicated severe cognitive impairment. 26. Record review Resident #26's face sheet, dated 9/30/24, reflected an [AGE] year-old male who was admitted to the facility on [DATE]. His diagnoses included dementia, anxiety disorder and type 2 diabetes mellitus. Record review of Resident #26's quarterly MDS assessment, dated 6/19/24, reflected he had a BIMS score 9 out of 15, 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 6 of 11 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 10/13/2024 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 Level of Harm - Immediate jeopardy to resident health or safety Record review of the facility's COVID testing log, on 10/9/24, indicated on 9/30/24 the facility conducted COVID-19 testing on 17 residents who were on the facility's male memory care unit. Upon receiving the results, the facility moved Resident #1 identified as positive to the hot zone for isolation. During observation on 10/10/24 at 10:45 AM to 12:15PM, CNA A and CNA B working on the memory unit wore the same PPE while working with all 16 residents regardless of Covid status. Residents Affected - Some During an observation on 10/10/24 at 11:20 AM, CNA A wore a gown and mask, no face shield, goggles, or gloves were worn. CNA A wiped Resident #3's (COVID Positive) nose with a tissue and did not use hand sanitizer or change PPE. CNA A then tried to stop Resident #4 (COVID negative) from trying to get items out of the community refrigerator located in the dining room. Resident #4 touched multiple juice cups and other cups. At 11:30 AM items from the refrigerator were then served to residents in the dining room for lunch. During an observation on 10/10/24 at 10:55 AM, Resident #5 (COVID positive) was sitting in his room and was on the B side of the room. Resident #4 was (COVID negative) in the same room on the A side of the room. Neither resident was wearing a face mask. During an observation on 10/10/24 at 11:20 AM, Resident #4 (COVID negative) was sitting at the lunch table with Resident #5 (COVID positive) to eat lunch. The residents shared the table together for approximately 10 minutes before staff moved Resident #4 to be at a table with another table. Both residents were within arm's reach of each other. During an interview on 10/11/24 at 2:15 PM, the DON stated the facility had the means to keep the Covid positive residents separated from exposed residents. She stated the facility chose not to separate the residents on the locked memory care unit. She stated the exposed residents on the locked memory care unity would eventually become COVID positive regardless. During an interview on 10/10/24 at 1:55 PM, CNA A stated the unit was much a hot unit (unit housing COVID positive residents). She stated all the residents hang out the same and we treat them all the same. She stated that all the residents were exposed. During a follow-up interview on 10/10/2024 at 2:15 PM, the DON stated there were 16 total residents on the hot COVID unit. She stated there were 12 COVID positive residents (#1, #3, #5, #7, #8, #9, #10, #11, #12, #13, #14, #15) and 4 COVID negative residents (#4, #6, #16, and #17). She stated the COVID-19 infection prevention policy was the policy they used for much everything COVID related. She stated there was no quarantine or isolation separate policy this was the policy they used regarding both isolation and quarantine. She stated they were following all CDC guidelines they could, but regarding the male locked unit it was more difficult to keep the residents quarantined. During an interview on 10/10/24 at 2:55 PM, CNA B stated she wore all her PPE the entire time she was on the unit, which included mask, face shield/goggles, gown, and gloves. She stated all the residents were exposed, so they were all getting treated the same. She stated she had not removed her PPE since getting to work. She stated Resident #2 normally used his walker. She stated she noticed after being diagnosed with COVID, Resident #2 seemed a little unstable on his walker and to prevent Resident #2 from falling she would put him in a wheelchair. During an interview on 10/10/24 at 8:20 PM, CNA B stated everyone on the unit was much COVID (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675746 If continuation sheet Page 7 of 11 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 10/13/2024 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 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Some positive. He stated he was not sure why the facility did not move the positive residents over to the other locked unit when Resident #1 first tested positive. He stated the facility had a locked unit and the staffing, to him, was enough to cover a second locked unit. He stated each night he got to the facility, it's a hot zone. He stated he went to work and treated every resident the same. He stated some of the residents did have symptoms and he only knew of one that went to the hospital. During an interview on 10/10/24 at 8:30 PM, CNA D stated she had been working the unit the past few nights, maybe a week. She stated the unit was treated like a hot zone. She stated she never saw PPE boxes outside of each room, PPE was only located at the entrance of the unit not really for each individual resident. She stated she kept the same PPE on while on the unit the entire time and treated every resident the same because they were either hot or exposed. She stated she was not sure why the facility did not move the covid positive residents. She stated there was a locked unit with no one on it and the facility was using agency staff to help cover shifts, so the facility could have covered the shifts if they needed to. During an interview on 10/10/24 at 9:00 PM, RN E stated she was not sure why the facility did not move the first positive resident. She stated she was told by the DON it was how the corporate company worked and it was in the facility policy to work the unit that way. She stated she was not sure why Resident #4 and Resident #5, one negative and one positive were roomed together. She stated she guessed the facility could have moved Resident #5 to another room, but she was not sure how that would have affected him. She stated all the residents got COVID. She stated she believed the facility had another locked unit and had the staff to move the residents. During an interview on 9/28/24 at 10:15 AM, LVN B stated it was her first day back in a week. She stated she needed to get an updated COVID list for Side A of the building. She stated she knew a few of the residents were good to be removed from isolation and were allowed to be out of their rooms. She stated all the COVID room doors should be closed. She stated she was not sure why all the doors were not closed. She stated she was not sure how COVID got in the building, but it spread very quickly. She stated the PPE required to go into any hot or warm room was, gloves, gown, N95 and face shield/goggles. During a follow-up interview on 9/27/24 at 1:57 PM, the DON stated the facility required PPE for hot zone or warm zone was mask, gown, and gloves. She stated that was what every employee should put on if they entered a resident's room who was COVID positive or suspected of COVID. She stated, oh yeah, face shield and or goggles should be worn, I forgot about that. She stated she did not know her staff were not wearing goggles. She stated CNA F should have been wearing goggles or a face shield while in Resident #19's room. She stated she did not know Resident #18 was leaving his room to go use the restroom in his old room. She stated she was going to fix his toilet seat immediately, so he did not leave his room anymore because he was exposing other residents. Record review of Covid-19 testing from 09/30/24 through 10/09/24 for the male memory care unit reflected: 09/30/24-1 Covid-19 positive of 17 residents 10/02/24- 1 additional Covid-19 positive residents 10/03/24 -4 additional Covid-19 positive residents (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675746 If continuation sheet Page 8 of 11 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 10/13/2024 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 10/04/24 - 2 additional Covid-19 positive residents Level of Harm - Immediate jeopardy to resident health or safety 10/07/24- 4 additional Covid-19 positive residents Residents Affected - Some Record review of the facility's, undated, COVID-19 Infection Prevention policy reflected, 10/09/24- 1 additional Covid-19 positive resident. 7. Placement and Response to Newly Identified COVID-19 Infected residents. A. Residents with signs or symptoms consistent with COVID-19 who have had close contact of those who test positive should be placed (isolated) in a single-person room, if possible, and the door should be kept closed (if safe to do so). Record review of the facility's, undated, Use Personal Protective Equipment (PPE) When Care for Patients with Confirmed or Suspected COVID-19 reflected: Before caring for patients with confirmed or suspected COVID-19 Healthcare Personnel (HCP) must wear: Face Shield or Goggles, N95 or higher respirator, one pair of clean non-sterile gloves, and isolation gown. Record review of the facility's Infection Control Policy, Before moving a positive resident to a COVID19 unit, consider if the COVID19 unit staff can manage the secure unit resident safely. If not, then the resident must remain on the secure unit for his/her protection as a higher priority. This was determined to be an Immediate Jeopardy (IJ) was identified on 10/11/24. The DON and Administrator were notified. The Administrator was provided with the IJ template on 10/11/24 at 5:44 PM The following Plan of Removal submitted by the facility was accepted on 10/12/24 at 6:20 PM: Please accept this Plan of Removal as a credible allegation of compliance for immediate jeopardy initiated on October 12th, 2024. Plan of Removal: F880: Infection Control The facility must establish and maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment and to help prevent the development and transmission of communicable diseases and infections. Immediate Actions Taken for Those Residents Identified: Action: COVID negative residents will be temporarily moved to another hall (off the secured unit). Residents will continue to be tested per policy. As residents of the secure unit recover, they will be relocated to the negative cohort secure unit. Residents will be moved back into the secured unit if they test positive or there are no longer COVID+ residents on the male secured unit. The negative residents, who have not tested positive within the last 30-days, are separated on their own hall, residents are residing in separate rooms, staff was wearing masks and eye protection. Testing Policy: Testing will occur every three days, until the facility had been COVID free for 14-days. Person(s) Responsible: Administrator, Director of Nursing, and/or Designee Date: 10/12/2024 2. How the Facility Identified Other Possibly Effected Residents: (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675746 If continuation sheet Page 9 of 11 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 10/13/2024 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 Level of Harm - Immediate jeopardy to resident health or safety Action: Residents in the secured unit were tested on [DATE]. Four (4) residents were identified as COVID negative (Residents #4, #6, #16, and #17). Person(s) Responsible: Director of Nursing and Assistant Director of Nursing Date: 10/12/2024 3. Measures Put into Place/System Changes to remove the immediacy, and what date these actions occurred: Residents Affected - Some Action: Administrator and Director of Nursing educated by Clinical Resource Nurse over COVID policy as it related to isolation protocol (COVID positive residents will not cohort with negative residents.) The facility policy was developed based on the CDC's recommendation & guidance. PPE must be donned correctly before entering the patient area (e.g., isolation rooms or isolation unit if cohorting). PPE should be doffed when leaving an individual patient room or isolation unit if cohorting. PPE must remain in place and be worn correctly for the duration of work in contaminated areas and should not be adjusted during patient care. If cohorting, positive residents' gown and gloves should be changed following patient care. PPE includes NIOSH approved respirator, well-fitting face masks, gowns, gloves, eye protection (goggles or face shields). N95 masks may be worn for the duration of the shift when used solely for source control but should be changed when soiled or compromised. Other PPE should be changed when it becomes soiled. https://www.cdc.gov/infection-control/hcp/core-practices/index.html and https://www.cdc.gov/covid/hcp/infection-control/index.html#cdc_infection_control_background_1_recommended_routine_in (section 1) Person(s) Responsible: Clinical Resource Nurse Date: 10/12/2024 Action: Administrator and Director of Nursing educated by Clinical Resource Nurse over COVID policy as it related to isolation protocol (COVID positive residents will not cohort with negative residents.) The facility policy was developed based on the CDC's recommendation & guidance. PPE must be donned correctly before entering the patient area (e.g., isolation rooms or isolation unit if cohorting). PPE should be doffed when leaving an individual patient room or isolation unit if cohorting. PPE must remain in place and be worn correctly for the duration of work in contaminated areas and should not be adjusted during patient care. If cohorting positive residents' gown and gloves should be changed following patient care. PPE includes NIOSH approved respirator, well-fitting face masks, gowns, gloves, eye protection (goggles or face shields). N95 masks may be worn for the duration of the shift when used solely for source control but should be changed when soiled or compromised. Other PPE should be changed when it becomes soiled. https://www.cdc.gov/infection-control/hcp/core-practices/index.html and https://www.cdc.gov/covid/hcp/infection-control/index.html#cdc_infection_control_background_1_recommended_routine_in (section 1) All staff will be educated prior to working their next shift. Any new or temporary staff (agency) will be educated prior to working their first shift. Person(s) Responsible: Administrator, Director of Nursing, and/or Designee Date: 10/12/2024 4. How the Corrective Actions Will be Monitored, by whom and for how long: Action: Administrator, Director of Nursing, Assistant Director of Nursing, and/or Designee will observe the secured unit x2 daily, until COVID resolves to monitor for correct PPE usage (staff should wear gown, eye protection, and N95 mask when caring for COVID positive residents) and proper hand hygiene. Director of Nursing, Assistant Director of Nursing, and/or Designee will continue to test per (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675746 If continuation sheet Page 10 of 11 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 10/13/2024 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 protocol and will follow isolation guidelines per the facility policy. Person(s) Responsible: Administrator, Director of Nursing, Assistant Director of Nursing, and/or Designee Date: 10/12/2024 Level of Harm - Immediate jeopardy to resident health or safety Action: Ad hoc QAPI performed with Medical Director informing him of the IJ template for F880 and the facility's plan to remove immediacy. Person(s) Responsible: Administrator Date: 10/12/2024 Residents Affected - Some Monitoring of the Plan of Removal included the following: During an observation on 10/13/24 at 4:30 AM walked facility, two sides to the building. Side A where most of the residents were and no locked units. There were 6 total covid positive residents on this side. Most residents were out of bed, walking around or sitting in the dining room. Side B had the male locked units and some residents who were removed from the hot unit that were on that side of the building for their covid outbreak. Both sides, all staff were wearing facemasks. During an interview on 10/13/24 at 4:50 AM DON stated that the facility had been organized by: Side A was no hot or warm unit, individual rooms with individual residents on quarantine. Side B was broken down into two units: Unit 1, locked unit with 4 negative residents currently. One CNA required only to wear mask and face shield. Unit 2, male locked unit with currently 12 positives that always have a CNA and a Nurse on the unit in full PPE. During an interview on 10/13/24 at 4:45 AM, CNA G stated yes she did get in-serviced before she started her shift on 10/12/24. She stated she stays on the unit 1 all the time. She stated there were only 4 negative residents on this unit at this time. She stated the DON's education included all the PPE required to wear while in the facility, were on unit 1, and what to wear on unit 2. She stated a mask must be always worn while in th[TRUNCATED] FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 675746 If continuation sheet Page 11 of 11