Health inspection·December 1, 2025

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 for 15 of 18 rooms (Rooms 102, 202, 203, 401, 402, 403, 411, 503, 508, 601, 603, 607, 608, 612, and 806) reviewed for physical environment. The facility failed to ensure residents had functioning toilets, sinks, and electrical outlets in Rooms 102, 202, 203, 401, 402, 403, 411, 503, 508, 601, 603, 607, 608, 612, and 806. This failure could place residents at an increased risk of infection or poor sanitation. Findings included:Interview on 10/13/25 at 11:00 AM with Resident #1's Family Member revealed Resident #1 when the resident admitted to the facility on [DATE], the resident was put in a room with a toilet that would not flush. The resident was then moved to a different room, but there was no call light cord in the room, and the air conditioner was not working. Resident #1's Family Member stated the air conditioner plug and the cord had black scorch marks on them. She stated the nurse told them not to plug it in because it was a fire hazard. The resident was then moved to a third room where they noticed the toilet had no seat. They opted to stay in that room because the resident would most likely not use the toilet. She stated their observations were mentioned to staff, and they seemed unfazed. She stated they moved the resident to another facility within 24 hours. Observations on 10/14/25 of the following resident rooms revealed the following: 9:20 AM - room [ROOM NUMBER] (Unoccupied)The toilet would not flush.9:23 AM - room [ROOM NUMBER] (Unoccupied)The toilet did not have a toilet seat, and the plug for the air conditioner unit was loose in the wall. 9:30 AM - room [ROOM NUMBER] (Unoccupied)The hot water did not turn on at the bathroom sink. 9:32 AM - room [ROOM NUMBER] (Unoccupied)The lighting in the bathroom was dim. 9:34 AM - room [ROOM NUMBER] (Unoccupied)The toilet tank leaked water on the floor when flushed. 9:37 AM - room [ROOM NUMBER] (Unoccupied)The cold water did not turn on at the bathroom sink. 9:40 AM - room [ROOM NUMBER] The light in the bathroom was burnt out. The resident stated he has a urinary catheter and does not use the bathroom.9:42 AM - room [ROOM NUMBER] The hot water did not turn on at the bathroom sink. The resident stated he uses hand sanitizer instead of washing his hands. 9:48 AM - room [ROOM NUMBER] (Unoccupied)There was no hot water at the bathroom sink.9:50 AM - room [ROOM NUMBER] There was no outlet cover for the air conditioner plug. The resident did not notice the condition of the cover. 9:52 AM - room [ROOM NUMBER] The electrical outlet cover was broken. The resident did not notice the condition of the cover. 9:55 AM - room [ROOM NUMBER] There was no outlet cover for the air conditioner plug. The resident did not notice the condition of the cover. 10:00 AM - room [ROOM NUMBER] The toilet would not flush, and the flush handle spun around on the tank. The resident stated he only uses the bathroom to brush his teeth.10:03 AM - room [ROOM NUMBER]The toilet would not flush, and there was no water in the toilet tank. The resident was bedridden. 10:05 AM - room [ROOM NUMBER] The outlet cover for the air conditioner was broken. The resident did not notice the condition of the cover. Interview on 10/14/254 at 10:15 AM, the Page 1 of 3 676132 676132 12/01/2025 Avir at Fort Worth 7100 Trail Lake Dr Fort Worth, TX 76133

F 0921 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Administrator stated at the beginning of October 2025 the facility had converted from paper maintenance request forms to a digital system (TELS). He stated all staff received training on how to use the new system for submitting maintenance requests. He stated the new system allowed himself, the DON, and others at the corporate level to see what issues were being reported to the Maintenance Director.Record review of paper maintenance requests from August and September 2025 reflected none of the environmental issues observed on 10/14/25 had been reported to the Maintenance Director. Record review of the electronic log from TELS for the month of October 2025 reflected none of the environmental issues observed on 10/14/25 had been reported to the Maintenance Director. Interview on 10/14/25 at 10:25 AM, RN A stated maintenance requests were submitted on a paper request form that was then placed in the Maintenance Request binder for maintenance to address. She was not aware of any of the issues found on Halls 500, 600, and 800. She stated the residents needed working toilets and hot water for basic sanitation. Interview on 10/14/25 at 10:40 AM, CNA B stated maintenance requests were submitted on a paper form that was put in the binder for the Maintenance Director to work on. She was not aware of any of the issues on Hall 500. She stated it was important for the residents to have a toilet and hot water to prevent infections and for sanitation. Interview on 10/14/25 at 10:44 AM, RN C stated work orders were placed in the maintenance binder to be fixed. She was not aware of the issues on Halls 100, 200, 300, or 400. She stated the residents needed working toilets, hot water, and safe electrical outlets for safety and infection prevention. Interview on 10/14/25 at 10:48 AM, CNA D stated requests for repairs were placed in the binder for maintenance. She was not aware of the issues on Halls 100 and 300. She stated it was important for residents to have working toilets, hot water, and safe electrical plugs for their safety, comfort, and to prevent infections. Interview on 10/14/25 at 11:00 AM, CNA E stated she did not know how to request for something to be repaired by maintenance. She stated she usually just told the nurse, or the Maintenance Director if she saw him. She stated it was important for the residents to have hot water and flushing toilets for their comfort. Interview on 10/14/25 at 11:13 AM, CNA F stated requests for maintenance were put in their binder at the nurse's station. She was not aware of the issues on Halls 200 and 400. She stated residents needed working toilets and hot water for sanitation and infection reasons. Interview on 10/14/25 at 11:55 AM, Resident #2 stated there were always maintenance issues in the building. He stated when staff were notified about the issues, it took quite a while for things to get fixed. He stated there was never any feedback about whether maintenance knew about the issues, or if there was a wait for parts to be ordered.Interview on 10/14/25 at 12:03 PM, Resident #3 stated there had been no hot water in his bathroom for a while. He stated it made washing his hands uncomfortable. He stated he told the Maintenance Director about the lack of hot water, but he did not know what the status on it was. Interview on 10/14/25 at 12:15 PM, Resident #4 stated his hot water in the bathroom sink ran wide open, and the Maintenance Director had turned it off at the valve under the sink. Resident #4 stated he knew how to turn the valve on when he wanted hot water. Interview on 10/14/25 at 1:00 PM, the Maintenance Director stated he was aware of the sinks that had no water. He stated he had new faucets ordered on 10/06/25, and he was waiting for their delivery. He was not aware of the other issues with the toilets and the electric outlets. He stated staff had been trained on the new TELS system, but the majority still filled out paper forms and put them in the binder. He stated he still checked the binders every morning, and then again before he left for the day. He stated he could not fix things that were not reported to him. He stated he tried to do basic checks weekly on resident rooms but could not always get to them. The Maintenance Director stated it was important for the residents to have safe and functional rooms for their comfort as it was their home. Interview on 10/14/25 at 3:00 676132 Page 2 of 3 676132 12/01/2025 Avir at Fort Worth 7100 Trail Lake Dr Fort Worth, TX 76133

F 0921 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some PM, the DON stated she was not aware of the issues found. She stated staff knew how to use the TELS system. She stated it was supposed to be linked to their electronic record system, but Information Technology was having a hard time making that work. There was a link the staff could click and then sign in to place work orders, but she felt since it was so inconvenient staff were just not reporting anything. She stated it was important to have functioning toilets and hot water for infection control issues as well as basic comfort. Interview on 10/14/25 at 3:12 PM, the Administrator stated staff had been trained on the TELS system before it went live at the beginning of the month, so there was no reason for them not to report anything needing repairs. He stated he would have the DON in-service staff again. The Administrator stated it was important for the residents to have a functional and safe environment for their comfort and for basic sanitation reasons. The Administrator was unable to provide a policy that addressed a safe, comfortable, homelike environment. 676132 Page 3 of 3