Inspection·December 7, 2023

F 0557 was damp and smelled musky. Level of Harm - Minimal harm or potential for actual harm During an interview on 12/07/2023 at 10:04 a.m., Resident #6's Family Member said she was aware Resident #6's personal belongings were in her old room because Resident #6's Family Member said she thought the room change was temporary. Resident #6's Family Member said she would prefer Resident #6 had her personal pictures in the room with her so she could see the pictures of all Resident #6's family and not forget them. Residents Affected - Some During an interview on 12/06/2023 at 12:38 p.m., Resident #6 said she had moved from her old room a few weeks prior into room the current room she lived in. Resident #6 said the ceiling had leaked on the floor and staff helped her move to her new room. Resident #6 said that a man had told Resident #6 that her pictures were in her old room and Resident #6 would move back soon to room [ROOM NUMBER]. Resident #6 told this investigator she wanted her belongings in the room with her. During an interview on 12/06/2023 at 2:55 p.m., RN C said Resident #6 resided in room [ROOM NUMBER] at the time when the ceiling began to leak and was moved across the hall to room [ROOM NUMBER]. RN C said the ceiling began to leak the first week in October 2023. RN C said the items currently observed in room [ROOM NUMBER], with the collapsed ceiling, belonged to Resident #6. RN C said she was not sure why Resident #6's pictures and personal belongings were in room [ROOM NUMBER] with the water damage and collapsed ceiling. During an interview on 12/06/2023 at 3:30 p.m., the Maintenance Supervisor said Resident #6's personal possessions were currently in room [ROOM NUMBER] even though Resident was moved out in October 2023. The Maintenance Supervisor said at the time Resident #6 was moved to the current room she lived in because room [ROOM NUMBER] had a water leak from the ceiling, the move was supposed to be temporary. During an interview on 12/07/2023 at 1:20 p.m., Resident #8 said he was moved to the current room he lived in from room [ROOM NUMBER] after the ceiling began leaking on 10/25/2023. Resident #8 said the Administrator said the room change would be temporary, but he had been in the current room he lived in for over month. Resident #8 said at the time he moved, all his belongings were left in room [ROOM NUMBER], which upset him. Resident #8 said the staff brought some of his property to room [ROOM NUMBER] a few days after he moved but until the week prior, Resident #8 said his belongings were still located in room [ROOM NUMBER]. Resident #8 said the Administrator told him that the roof over room [ROOM NUMBER] had been patched but the facility staff had to wait to see if the ceiling would leak so Resident #8 had to wait to move back into room [ROOM NUMBER]. Resident #8 said that could take months because no one knew when the area would have rain. During an interview on 12/07/2023 at 11:42 a.m., the Administrator said the roof was patched over and the ceiling was repaired in room [ROOM NUMBER], which was the room Resident #8 was moved out of and relocated from. The Administrator said Resident #8 was not able to return to the room until the facility was sure the ceiling would not leak. The Administrator said she was aware that Resident #8 was not happy when Resident #8 had to change rooms, but she said the move was supposed to be temporary. The Administrator said the facility should have moved Resident #8's personal possessions with him to the current room he lived in when Resident #8 was relocated. The Administrator said Resident #6's personal items should have been moved when she was relocated and were moved to her room the evening prior, on 12/06/2023. Record review of the facility's policy, Resident Rights, dated 02/23/2016, revealed the resident (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676034 If continuation sheet Page 2 of 8 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 676034 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/07/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brady West Rehab & Nursing 2201 Menard Hwy Brady, TX 76825 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 0557 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some FORM CMS-2567 (02/99) Previous Versions Obsolete had the right to be treated with respect and dignity including: the right to retain and use personal possessions. Record review of the facility's admission form signed by the resident and/or responsible person at admission into the facility, Statement of Resident Rights, not dated, revealed the resident had the right to keep or use personal property, secure from theft or loss. Event ID: Facility ID: 676034 If continuation sheet Page 3 of 8 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 676034 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/07/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brady West Rehab & Nursing 2201 Menard Hwy Brady, TX 76825 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 0559 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Honor the resident's right to share a room with spouse or roommate of choice and receive written notice before a change is made. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interviews and record reviews, the facility failed to ensure 2 of 3 (Resident #6 and Resident #8) residents reviewed for rights, received written notice prior to room change. The facility failed to ensure Resident #6, and Resident #8 received written notice, or the responsible person was contacted prior to room change. The facility failure could place the residents at risk of decreased quality of life due to a change in living environment. Findings include: Record review of Resident #6's Face Sheet, dated 12/06/2023, revealed a [AGE] year-old female who was admitted to the nursing facility on 12/24/2020. Resident #6's diagnoses included Unspecified Dementia (mild memory disturbance due to known physiological condition), Unspecified Severity, without Behavioral Disturbance, and Type II Diabetes (condition that happens because of a problem in the way the body regulates and uses sugar as a fuel). Record review of Resident #6's Annual MDS, dated [DATE], revealed a BIMS score of 12, which indicated moderate impairment. Record review of Resident #8's Face Sheet, dated 12/07/2023, revealed a [AGE] year-old male who was admitted to the nursing facility on 08/31/2022. Resident #8's diagnoses included Parkinson's Disease without Dyskinesia (a progressive, age-specific neuro-degenerative disorder characterized by slowness of movements and tremors), without mention of fluctuations (changes in the ability to move) and Anxiety Disorder (type of mental health condition when you respond to certain things or situations with fear or dread). Record review of Resident #8's Quarterly MDS assessment, dated 11/17/2023, revealed a BIMS score of 15, which meant intake cognitive response. During an interview on 12/07/2023 at 10:04 a.m., Resident #6's family said she was not notified when Resident #6 was moved to a different room on 10/11/2023 after the ceiling began to leak. Resident #6's family said she arrived at the facility and went into Resident #6's old room and Resident #6 was not in her room. Resident #6's family said she asked the housekeeper who was in the hall and was told that Resident #6 was moved because the ceiling had leaked. Resident #6's family said she thought the facility was going to repair the ceiling and move Resident #6 back into room [ROOM NUMBER], but she had been relocated for couple of months. During an interview on 12/07/2023 at 11:42 a.m., the Administrator said the room that Resident #6 resided in, room [ROOM NUMBER], started to have ceiling issues on 10/11/2023 and it started out as a drip. The Administrator said the ceiling caved in after Resident #6 was moved to a different room. The Administrator said the nurse on duty at the time Resident #6 and Resident #8 were moved to different rooms would have been responsible to contact Resident #6's family member and talk to Resident #8 about his options. The Administrator said her expectation was for the facility to contact the family in all situations of room changes. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676034 If continuation sheet Page 4 of 8 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 676034 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/07/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brady West Rehab & Nursing 2201 Menard Hwy Brady, TX 76825 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 0559 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some During an interview on 12/07/2023 at 1:20 p.m., Resident #8 said he was moved to the current room he lived in from room [ROOM NUMBER] after the ceiling began leaking on 10/25/2023. Resident #8 said the Administrator said the room change would be temporary, but he had been in the current room he lived in for over a month. Resident #8 said he was not told he was moving or had any say in which room he moved into. Resident #8 said the staff came in room and told him to get up because they were moving him to a different room. Resident #8 said the Administrator told him that the roof over room [ROOM NUMBER] had been patched but the facility staff had to wait to see if the ceiling would leak. Resident #8 said that could take months because no one knew when the area would have rain. Resident #8 said he decided to stay in room [ROOM NUMBER] but was not happy about how the situation was handled. Record review of the facility's policy, Resident Rights, dated 02/23/2016, revealed the resident had the right to be treated with respect and dignity including: the right to receive written notice, including the reason for the change, before the resident's room in the facility was changed. Record review of the facility's admission form signed by the resident and/or responsible person at admission into the facility, Statement of Resident Rights, not dated, revealed the resident had the right not to be relocated within the facility, except in accordance with nursing facility regulations. Record review of Resident #6's progress notes revealed no documentation of change in room on 10/11/2023. Record review of Resident #8's progress notes revealed no documentation of change in room on 10/25/2023. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676034 If continuation sheet Page 5 of 8 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 676034 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/07/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brady West Rehab & Nursing 2201 Menard Hwy Brady, TX 76825 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 0921 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interviews, and record reviews, the facility failed to provide a safe, functional, sanitary, and comfortable environment for residents, staff, and the public on 2 of 4 halls (hall 1 and hall 4) and the 1 of 1 dining room reviewed for environmental conditions. 1. The facility failed to repair room [ROOM NUMBER] on Hall 1 that had severe water damage to the ceiling. 2. The facility failed to repair room [ROOM NUMBER] on Hall 4 that had severe water damage where the ceiling had fallen and caved in. 3. The facility failed to maintain the ice machine in the dining room to prevent water damage to the floor and mineral deposits to form on the outside of the machine. These failures could place residents at risk of being in an unsafe environment, a decrease in quality of life and self-worth. Findings include: During an observation on 12/06/2023 beginning at 12:02 p.m., observed an industrial size ice machine in the dining room area standing on discolored tile, that was stained, and water damaged. The area was colored a light grey and lighter than other tile and had chalky residue on the floor. Observed a white, hard chalky deposit on the bottom left leg of the machine and bottom trim in the front and on the left bottom side. Observed a white, chalky deposit on the rim of the ice machine to the left of the hinge on the door used to open the machine to remove ice. Observed behind the machine, and observed the tile was white with chalky residue and water damaged. During an interview on 12/06/2023 at 12:12 p.m., CNA B said she had been employed at the facility for five years. CNA B said room [ROOM NUMBER], located on Hall 4 had issues with the ceiling leaking approximately one to two months prior when it rained. CNA B said the resident who lived in room [ROOM NUMBER] was moved to a different room. CNA B said room [ROOM NUMBER] on Hall 1 and room [ROOM NUMBER] on Hall 2 had leaked and the residents who resided in both rooms were moved to different rooms. During an observation on 12/06/2023 at 12:31 p.m., observed room [ROOM NUMBER] located on Hall 4 of the facility. Observed the door was closed and when opened, the room had an odor that was musty and the air felt wet, humid, and damp. Observation revealed the ceiling had collapsed and a hole that opened into the ceiling in the middle of the room that was approximately 2 feet by 2 feet square. The ceiling was a solid drywall stipple (bumpy) ceiling that was painted with a mixture of drywall. Observed pieces of ceiling drywall and pink insulation that hung down from the hole approximately 10 inches in length in several places. Saw a 55-gallon trash can placed on the floor under the hole in the ceiling. Observed several chunks of drywall and water-damaged ceiling placed in a pile next to the trash can in the floor. Observed several damp towels were on the floor by the trash can. During an interview on 12/06/2023 at 12:38 p.m., Resident #6 said she had moved from her old room a few weeks prior into room [ROOM NUMBER]. Resident #6 said the ceiling had leaked on the floor. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676034 If continuation sheet Page 6 of 8 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 676034 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/07/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brady West Rehab & Nursing 2201 Menard Hwy Brady, TX 76825 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 0921 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some During an observation on 12/06/2023 at 12:59 p.m., observed room [ROOM NUMBER] located on Hall 1 of the facility. Observed the door was closed and when opened, the room had an odor that was musty and the air felt wet, humid, and damp. Entered room [ROOM NUMBER] and observed water damage on the ceiling approximately in the middle of the ceiling in an area that was approximately 5 feet by 5 feet. Observed the ceiling sagged in the middle and was discolored. Observed the water damaged area consisted of water-stained circles that were tan in color and darker brown around the edges of the circles and overlapped each other. Observed a large oblong area approximately 10 inches in length, 5 inches in width, that was dark green in color and black around the edge on the window side of the large water damaged area of the ceiling. Viewed a large 55-gallon trash can under the damaged ceiling and wet towels on the floor. During an interview on 12/06/2023 at 2:33 p.m., Resident #7 said she moved out of her room approximately a year prior because the ceiling had leaked. During an interview on 12/06/2023 at 2:55 p.m., RN C said she had been at the facility for 14 months. RN C said the ceiling in the facility leaked every time the area received rain. RN C said the ceiling would leak in several different places throughout the facility. RN C said room [ROOM NUMBER] on Hall 4 had major water damage and the ceiling fell in approximately two months prior. During an interview on 12/06/2023 at 3:30 p.m., the Maintenance Supervisor said he had been employed at the facility since June 2023. The Maintenance Supervisor said the ceiling in room [ROOM NUMBER] caved in from rain and leaking in late August 2023 or early September 2023. The Maintenance Supervisor said contractors had come out prior to the ceiling collapse to work on the dry wall and ceiling because the ceiling had been leaking before the major damage had occurred. The Maintenance Supervisor said the plan for repairs was to have contractors from a larger city come to facility and make the repairs. The Maintenance Supervisor said the issue was the corporation put the building on the back burner because the facility was small. The Maintenance Supervisor said the process for work orders and repairs in the facility was for staff to write the issue in the work order binder located at the nurses' station. The Maintenance Supervisor said he checked the book each day and prioritized the tasks to work on the most immediate needs first. The Maintenance Supervisor said the issues with ceiling leaking was a long-standing issue and he addressed this week by week. During an interview on 12/07/2023 at 9:15 a.m., LVN E said she had been at the facility for 2 ½ years. She said the ceiling in the facility had leaked in many places since she had started working. LVN E said the facility had the roof patched on several occasions but not repaired or replaced. LVN E said the roof contained large air conditioner units located on the roof that were not used that were heavy. LVN E said when the area received rain again, the roof would leak. During an interview on 12/07/2023 at 10:46 a.m., the Administrator said the facility did not have a formal policy for work orders but utilized a binder notebook that was kept at the nurses' station and container work order forms. The Administrator said the staff documented the repair need or issue and the form remained in the binder. The Administrator said the maintenance supervisor reviewed the binder daily and would prioritize the repairs based on urgency. The Administrator said the staff would notify the maintenance supervisor. The Administrator said she checked the binder randomly to ensure the work orders were completed and the maintenance supervisor signed off when the repair was completed. The Administrator said staff are informed of the maintenance binder when hired during orientation or if they report an issue to administration. The Administrator said administration staff will direct other staff to document in the maintenance binder. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676034 If continuation sheet Page 7 of 8 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 676034 B. Wing A. Building (X3) DATE SURVEY COMPLETED 12/07/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Brady West Rehab & Nursing 2201 Menard Hwy Brady, TX 76825 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 0921 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some During an interview on 12/07/2023 at 11:42 a.m., The Administrator said the facility had a flat roof that caused water to travel and several different areas of the areas of the roof would leak when the area received rain. The Administrator said over the summer, shingles were replaced over the lobby and the pitched roof area. The Administrator said prior to the summer, the roof over the therapy hall was repaired. The Administrator said room [ROOM NUMBER] was not repaired because the facility was waiting on the roofers to determine where the water traveled from on the roof. The Administrator said the contractors would treat the areas that were water damaged for mold or mildew. The Administrator said the facility had not sprayed any type of chemicals in room [ROOM NUMBER] or room [ROOM NUMBER]. Record review of the facility's policy, Resident Rights, dated 02/23/2016, revealed the resident had the right to a safe environment including a safe, clean, comfortable, and homelike environment including but not limited to receiving treatment and supports for daily living safely. Record review of the facility's admission form signed by the resident and/or responsible person at admission into the facility, Statement of Resident Rights, not dated, revealed the resident had the right to a safe, decent, and clean conditions. Record review of the Maintenance Binder revealed a three-ringer notebook that held several copies of a form labeled Maintenance Work Request Form. Review revealed the form contained three (3) work request on one (1) page and had space to add the date, the location, description of the work required, who made the request, and who completed the request. FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676034 If continuation sheet Page 8 of 8