Health inspection·August 7, 2025

F 0600 Level of Harm - Actual harm Residents Affected - Few review of Resident #1's Internal Medicine Progress Note, dated 7/7/25, revealed Patient was found to have new bruises on her forehead and face, to the left. She does not recall what happened. Denies falling. No other signs of trauma found on examination. Patient was sent to ER at [local hospital] and has returned in stable condition. No bleeding or fractures found.2. Record review of Resident #2's face sheet, dated 8/6/25, revealed a [AGE] year-old female who was admitted to the facility on [DATE].Record review of Resident #2's history and physical, dated 7/6/25, revealed a diagnosis which included mild intellectual disability.Record review of Resident #2's quarterly MDS, dated [DATE], revealed a BIMS score of 4, which indicated her cognition was severely impaired.Record review of Resident #2's care plan, dated 4/5/25, revealed focus area which documented she has a behavior problem, resident was observed hitting herself in the head, yelling and slamming the door with interventions Intervene as necessary to protect the rights and safety of others. Approach/Speak in a calm manner. Divert attention. Remove from situation and take to alternate location as needed. Minimize potential for the resident's disruptive behaviors hitting self or others, by offering tasks which divert attention such as arts/crafts, manicure with nail polish. Monitor behavior episodes and attempt to determine underlying cause. Consider location, time of day, persons involved, and situations. Document behavior and potential causes. notify guardian when behaviors occur.Record review of Resident #2's progress notes from May 2025- August 2025 revealed no documented incidents prior to this event on 7/7/25, her history was limited to verbal behaviors towards others that warranted redirection and staff avoiding triggers, which included maintaining her preferred routine.Record review of HHSC witness statement written by AIT, dated 7/7/25, revealed [Resident #1] was sent out to [local hospital] for evaluation. upon re-entering the facility [Resident #2] entered my office, still flushed face and fidgety. I started the conversation by noting she is not in trouble but want to know what happened in her room last night. She commenced to tell me via hand gestures that she hit [Resident #1]. Record review of TULIP for July 2025 revealed no self-report reflecting resident to resident altercation. During an observation and interview on 8/6/25 at 2:58 PM, revealed Resident #2 was AOx2, the resident stated Resident #1 was no longer in her room and stated she was moved but could not recall when. Resident #2 stated she denied hitting Resident #1 or being hit by her. Resident #2 stated Resident #1 got the bruises on her face on her own but could not say how. Resident #2 stated she felt safe at the facility and denied any issues with other residents. Resident #2 stated no one else was staying in her room, she stated she was in her room alone. Observation of Resident #2's room noted only her belongings, with no evidence that a roommate was occupying the second bed. During an interview on 8/6/25 at 2:20 PM, Resident #2's RP stated the incident occurred on a Sunday (7/6/25) and was contacted until Monday by a nurse, whose name she did not recall and again on Tuesday by AIT. The RP stated this was the first known incident of aggression.During an interview on 8/6/25 at 3:18 PM, Resident #1 was AOx1, she had a bruise on her forehead green and yellow in color. Resident #1 stated she did not know how she got it and denied pain. Resident #1 denied falling and denied being hit. Resident #1 stated she did not know who Resident #2 was. Resident #1 denied any physical altercations with other residents. Resident #1 stated she felt safe. Resident #1 appeared pleasant and in good spirits, smiling when asked about abuse questions, she did not recall the incident and did not show any signs of distress. Resident #1 stated she would not report any abuse, and when asked why, she just smiled and did not answer. Resident #1 stated she had 0 distress noted.During an interview on 8/6/25 at 6:40 PM, Resident #1's Emergency Contact stated the resident was taken to the hospital after they noticed both eyes bruised and her face showed signs of trauma, as if she had been struck. Emergency contact #1 stated the facility claimed the resident woke up with the injuries and they did not know how it (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676457 If continuation sheet Page 2 of 10 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 676457 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/07/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Bartlett Skilled Nursing and Assisted Living 221 Bartlett Drive El Paso, TX 79912 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 0600 Level of Harm - Actual harm Residents Affected - Few happened. Emergency contact #1 stated she was later contacted by someone identifying themselves as being from APS or a related agency. Emergency contact #1 stated she was aware the resident was sent to the hospital for further evaluation and no injuries were identified. Emergency contact #1 stated when she returned, she was placed in a different room away from the AP.During an interview on 8/6/25 at 7:11 pm, LVN B stated she had received report from LVN A regarding bruising to Resident #1. She stated the physician's order was to monitor for any changes and, if changes occurred, to send the resident to the hospital. Resident #1 voiced no pain, and when the bruise progressed into a hematoma, the facility sent Resident #1 for further assessment.During an interview on 8/7/25 at 8:54 am, LVN A stated he saw discoloration to Resident #1's forehead that appeared like a bruise during rounds at 2:00 AM. Prior to the injury being discovered, both residents were noted to be in bed sleeping. LVN A stated he did not hear any commotion that would have alerted him to intervene or follow up. He stated there was nothing out of the ordinary reported, heard, or witnessed. LVN A stated a call was placed to both the physician and responsible party; the physician gave orders to continue monitoring and, if any changes occurred, to send the resident to the hospital for further evaluation. LVN A stated the responsible party did not answer and staff were unable to leave a voicemail.During an interview on 8/7/25 at 9:56 AM, the DON stated that after she received report of Resident #1's bruise, she initiated an investigation for an injury of unknown origin. She stated she believed staff already knew what had happened at the time. DON stated she did not recall if she was present when Resident #2 disclosed to the AIT that she had hit Resident #1. The DON stated she did not consider the incident to be abuse and could not answer why, although interventions were in place and Resident #1 was kept safe from the AP. During an interview on 8/7/25 at 10:32 AM, the AIT stated he arrived at the facility around 8:00 AM and was informed by LVN B between 8:00 and 8:30 AM that Resident #1 had a bump and bruise on her head. The AIT stated he wanted to ask Resident #2 if she had heard or seen anything the night prior. The AIT stated Resident #2 appeared flushed, fidgety, and not her usual self. The AIT stated after reassuring Resident #2 that she was not in trouble, she reportedly gestured with closed fists and mimicked a striking motion. The AIT stated when asked if she had hit Resident #1, Resident #2 responded affirmatively. The AIT stated that following this disclosure, the facility was able to determine the cause of Resident #1's injury and rule out an unknown origin. The AIT stated at the time of Resident #2's disclosure, Resident #1 was already at the hospital. The AIT upon Resident #1's return, he followed up and noted that Resident #1 had no recollection of the incident and no findings were noted at the hospital. Resident #1 was moved out of Resident #2's room and reassigned to a private room. The AIT stated he did not view the situation as a resident-to-resident altercation due to Resident #2's cognitive impairment and intellectual disability and did not believe Resident #2 was aware of her actions. The AIT stated he did not consider the incident to be abuse.Record review of the facility's Abuse, Neglect, Exploitation and Misappropriation Prevention Program policy, dated April 2021, read in part Residents have the right to be free from abuse, neglect, misappropriation of resident property and exploitation. This includes but is not limited to freedom from corporal punishment, involuntary seclusion, verbal, mental, sexual or physical abuse, and physical or chemical restraint not required to treat the resident's symptoms. The resident abuse, neglect and exploitation prevention program consists of a facility-wide commitment and resource allocation to support the following objectives: #1Protect residents from abuse, neglect, exploitation or misappropriation of property by anyone including, but not necessarily limited to: a. facility staff; b. other residents; c. consultants; d. volunteers; e. staff from other agencies; f. family members; g. legal representatives; h. friends; i. visitors; and/or j. any other individual. #8- Identify and investigate all (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676457 If continuation sheet Page 3 of 10 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 676457 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/07/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Bartlett Skilled Nursing and Assisted Living 221 Bartlett Drive El Paso, TX 79912 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 0600 possible incidents of abuse, neglect, mistreatment, or misappropriation of resident property. Level of Harm - Actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676457 If continuation sheet Page 4 of 10 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 676457 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/07/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Bartlett Skilled Nursing and Assisted Living 221 Bartlett Drive El Paso, TX 79912 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 0607 Develop and implement policies and procedures to prevent abuse, neglect, and theft. 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 review the facility failed to develop and implement written policies and procedures that prohibit and prevent abuse, neglect, and exploitation of residents and misappropriation of resident property for 2 of 4 residents (Resident#1 and Resident #2) reviewed for abuse. The facility failed to implement their abuse policy when they failed to report abuse when Resident #2 hit Resident #1. This failure could place residents at risk for abuse by not immediately following the facility policy and procedure manual of recognizing and reporting abuse. Findings include:1. Record review of Resident #1's face sheet, dated 8/6/25, revealed a [AGE] year-old female who was admitted to the facility on [DATE]. Record review of Resident #1's history and physical, dated 7/7/25, revealed diagnoses which included dementia (a group of symptoms associated with a decline in cognitive functioning, it can cause difficulty with simple tasks, confusion, memory loss and difficulty communicating), COPD (serious lung disease that over time makes it hard to breathe), chronic kidney disease stage 3 (type of long-term kidney disease, defined by the sustained presence of abnormal kidney function and/or abnormal kidney structure), and failure to thrive (state of decline that is multifactorial and may be caused by chronic concurrent diseases and functional impairments). Record review of Resident #1's quarterly MDS, dated [DATE], revealed a BIMS score of 03, which indicted her cognition was severely impaired. Record review of Resident #1's physician order, dated 6/19/25, revealed Eliquis oral Tablet 2.5mg by mouth two times a day to prevent DVT. Record review of Resident #1's incident report, dated 7/7/25 written by LVN A, revealed nurse description nurse went in during round to assess resident and noted discoloration to forehead; resident was unable to give description; bruise on top of scalp; was oriented to person; no predisposing factors noted; she was confused; and no predisposing situation factors identified.Record review of Resident #1's SBAR communication note, dated 7/7/25, revealed the change of condition was bruised forehead and left temple that started on 7/7/25 and was on anticoagulant, her vital signs were within normal range, no changes to mental and functional status.Record review of Resident #1's progress note, written by LVN A, dated 7/7/25 at 2:00 AM, revealed Upon rounding nurse observed discoloration to forehead of resident, nurse assessed site and noted no previous falls or incidents reported. Vital signs within normal limits, no open areas, no complaints of pain during shift, nurse reported to Dr. and RP. No new orders were given at this time.Record review of Resident #1's progress note, written by LVN B, dated 7/7/25 at 9:12 AM, revealed Resident send out per NP to local ER for evaluation and treatment of bruised forehead /temple. Report given to Dr. ResidentAOX1 pleasant response to question. Assisted total X1 person total with all ADLs transfers and mobility. Incontinent B/B wears briefs. Uses w/c for mobility. Denies pain, On O2 @2 LPM via NC at HS only. On room air in morning and evening but kept it on this morning. v/s 97.6 66 20 113/65 94% Ra. Record review of Resident #1's progress note, dated 7/7/25, at 5:45 PM, revealed Resident return from [local hospital] report given by [hospital nurse]. CT came back negative, urine negative, CT of spine negative. Returned at this time v/s 97 85 20164/90 93% O2 2 2 LPM via NC continuous. NP aware no new orders.Record review of Resident #1's Internal Medicine Progress Note, dated 7/7/25, revealed Patient was found to have new bruises on her forehead and face, to the left. She does not recall what happened. Denies falling. No other signs of trauma found on examination. Patient was sent to ER at [local hospital] and has returned in stable condition. No bleeding or fractures found.2. Record review of Resident #2's face sheet, dated 8/6/25, revealed a [AGE] year-old female who was admitted to the facility on [DATE]. Record review of Resident #2's history and physical, dated 7/6/25, revealed a diagnosis which included mild intellectual disability.Record review of Resident #2's quarterly MDS, dated [DATE], Residents Affected - Few (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676457 If continuation sheet Page 5 of 10 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 676457 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/07/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Bartlett Skilled Nursing and Assisted Living 221 Bartlett Drive El Paso, TX 79912 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 0607 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few revealed a BIMS score of 4, which indicated her cognition was severely impaired. Record review of Resident #2's care plan, dated 4/5/25, revealed focus area which documented she has a behavior problem, resident was observed hitting herself in the head, yelling and slamming the door with interventions Intervene as necessary to protect the rights and safety of others. Approach/Speak in a calm manner. Divert attention. Remove from situation and take to alternate location as needed. Minimize potential for the resident's disruptive behaviors hitting self or others, by offering tasks which divert attention such as arts/crafts, manicure with nail polish. Monitor behavior episodes and attempt to determine underlying cause. Consider location, time of day, persons involved, and situations. Document behavior and potential causes. notify guardian when behaviors occur. Record review of HHSC witness statement written by AIT, dated 7/7/25, revealed [Resident #1] was sent out to [local hospital] for evaluation. upon re-entering the facility [Resident #2] entered my office, still flushed face and fidgety. I started the conversation by noting she is not in trouble but want to know what happened in her room last night. She commenced to tell me via hand gestures that she hit [Resident #1]. Record review of TULIP for July 2025 revealed no self-report reflecting resident to resident altercation. During an interview on 8/6/25 at 2:58 PM, revealed Resident #2 was AOx2, the resident stated Resident #1 was no longer in her room and stated she was moved but could not recall when. Resident #2 stated she denied hitting Resident #1 or being hit by her. Resident #2 stated Resident #1 got the bruises on her face on her own but could not say how. Resident #2 stated she felt safe at the facility and denied any issues with other residents. During an interview on 8/6/25 at 2:20 PM, Resident #2's RP stated the incident occurred on a Sunday (7/6/25) and was contacted until Monday by a nurse, whose name she did not recall and again on Tuesday by AIT. The RP stated this was the first known incident of aggression.During an interview on 8/6/25 at 3:18 PM, Resident #1 was AOx1, she had a bruise on her forehead green and yellow in color. Resident #1 stated she did not know how she got it and denied pain. Resident #1 denied falling and denied being hit. Resident #1 stated she did not know who Resident #2 was. Resident #1 denied any physical altercations with other residents. Resident #1 stated she felt safe. Resident #1 appeared pleasant and in good spirits, smiling when asked about abuse questions, she did not recall the incident and did not show any signs of distress. Resident #1 stated she would not report any abuse, and when asked why, she just smiled and did not answer. Resident #1 stated she had 0 distress noted.During an interview on 8/6/25 at 6:40 PM, Resident #1's Emergency Contact stated the resident was taken to the hospital after they noticed both eyes bruised and her face showed signs of trauma, as if she had been struck. Emergency contact #1 stated the facility claimed the resident woke up with the injuries and they did not know how it happened. Emergency contact #1 stated she was later contacted by someone identifying themselves as being from APS or a related agency. Emergency contact #1 stated she was aware the resident was sent to the hospital for further evaluation and no injuries were identified. Emergency contact #1 stated when she returned, she was placed in a different room away from the AP.During an interview on 8/7/25 at 9:56 AM, the DON stated the incident was not reported to the SO, ombudsman, or law enforcement. The DON stated the reason for not notifying agencies was because they were investigating an injury of unknown origin and believed they already knew what had happened. The DON stated she did not consider the incident to be abuse, although interventions were in place and Resident #1 was kept safe from the AP. The DON stated after reviewing their internal abuse policy, it appeared they needed to notify the correct agencies. During an interview on 8/7/25 at 10:32 AM, the AIT stated the incident was not reported to the SO or law enforcement. The AIT stated he attempted to call the local Ombudsman to notify, but he had not returned his call. The AIT stated the reason for not notifying agencies was because he did not view the (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676457 If continuation sheet Page 6 of 10 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 676457 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/07/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Bartlett Skilled Nursing and Assisted Living 221 Bartlett Drive El Paso, TX 79912 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 0607 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete situation as a resident-to-resident altercation due to Resident #2's cognitive impairment and intellectual disability and did not believe Resident #2 was aware of her actions. The AIT stated he did not consider the incident to be abuse.During an interview on 8/7/25 at 10:51 AM, the Ombudsman stated he was unsure if notification of resident-to-resident altercations was required. The Ombudsman stated facility staff occasionally provided him with information as a courtesy; he stated he did not recall receiving any notification regarding an incident between Resident #2 and Resident #1. Record review of the facility's Abuse, Neglect, exploitation or Misappropriation- Reporting and Investigating policy, dated September 2022, read in part All reports of resident abuse (including injuries of unknown origin), neglect, exploitation, or theft/misappropriation of resident property are reported to local, state and federal agencies (as required by current regulations) and thoroughly investigated by facility management. Findings of all investigations are documented and reported. #1: If resident abuse, neglect, exploitation, misappropriation of resident property or injury of unknown source is suspected, the suspicion must be reported immediately to the administrator and to other officials according to state law. #2- The administrator or the individual making the allegation immediately reports his or her suspicion to the following persons or agencies: a. The state licensing/certification agency responsible for surveying/licensing the facility; b. The local/state ombudsman; c. The resident's representative: d. Adult protective services (where state law provides jurisdiction in long-term care); e. Law enforcement officials; f. The resident's attending physician; and g. The facility medical director. Event ID: Facility ID: 676457 If continuation sheet Page 7 of 10 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 676457 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/07/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Bartlett Skilled Nursing and Assisted Living 221 Bartlett Drive El Paso, TX 79912 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 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review the facility failed ensure alleged violations involving abuse, neglect, exploitation or mistreatment, including injuries of unknown source and misappropriation of resident property, were reported immediately, but not later than 2 hours after the allegation was made, if the events that caused the allegation involved abuse or resulted in serious bodily injury, to the administrator of the facility and to other officials (including to the State Survey Agency and adult protective services where state law provides for jurisdiction in long-term care facilities) in accordance with State law through established procedures for 2 of 4 residents (Resident #1 and Resident#2) reviewed for reporting. The facility failed to report abuse when Resident #2 hit Resident #1 to State Office Agency, Law Enforcement, and Ombudsman.This failure could place residents at risk for abuse. Findings include:1. Record review of Resident #1's face sheet, dated 8/6/25, revealed a [AGE] year-old female who was admitted to the facility on [DATE]. Record review of Resident #1's history and physical, dated 7/7/25, revealed diagnoses which included dementia (a group of symptoms associated with a decline in cognitive functioning, it can cause difficulty with simple tasks, confusion, memory loss and difficulty communicating), COPD (serious lung disease that over time makes it hard to breathe), chronic kidney disease stage 3 (type of long-term kidney disease, defined by the sustained presence of abnormal kidney function and/or abnormal kidney structure), and failure to thrive (state of decline that is multifactorial and may be caused by chronic concurrent diseases and functional impairments). Record review of Resident #1's quarterly MDS, dated [DATE], revealed a BIMS score of 03, which indicted her cognition was severely impaired. Record review of Resident #1's physician order, dated 6/19/25, revealed Eliquis oral Tablet 2.5mg by mouth two times a day to prevent DVT. Record review of Resident #1's incident report, dated 7/7/25 written by LVN A, revealed nurse description nurse went in during round to assess resident and noted discoloration to forehead; resident was unable to give description; bruise on top of scalp; was oriented to person; no predisposing factors noted; she was confused; and no predisposing situation factors identified.Record review of Resident #1's SBAR communication note, dated 7/7/25, revealed the change of condition was bruised forehead and left temple that started on 7/7/25 and was on anticoagulant, her vital signs were within normal range, no changes to mental and functional status.Record review of Resident #1's progress note, written by LVN A, dated 7/7/25 at 2:00 AM, revealed Upon rounding nurse observed discoloration to forehead of resident, nurse assessed site and noted no previous falls or incidents reported. Vital signs within normal limits, no open areas, no complaints of pain during shift, nurse reported to Dr. and RP. No new orders were given at this time.Record review of Resident #1's progress note, written by LVN B, dated 7/7/25 at 9:12 AM, revealed Resident send out per NP to local ER for evaluation and treatment of bruised forehead /temple. Report given to Dr. ResidentAOX1 pleasant response to question. Assisted total X1 person total with all ADLs transfers and mobility. Incontinent B/B wears briefs. Uses w/c for mobility. Denies pain, On O2 @2 LPM via NC at HS only. On room air in morning and evening but kept it on this morning. v/s 97.6 66 20 113/65 94% Ra. Record review of Resident #1's progress note, dated 7/7/25, at 5:45 PM, revealed Resident return from [local hospital] report given by [hospital nurse]. CT came back negative, urine negative, CT of spine negative. Returned at this time v/s 97 85 20164/90 93% O2 2 2 LPM via NC continuous. NP aware no new orders.Record review of Resident #1's Internal Medicine Progress Note, dated 7/7/25, revealed Patient was found to have new bruises on her forehead and face, to the left. She does not recall what happened. Denies falling. No other signs of trauma found on examination. Patient was sent to ER at [local hospital] and has returned in stable (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676457 If continuation sheet Page 8 of 10 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 676457 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/07/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Bartlett Skilled Nursing and Assisted Living 221 Bartlett Drive El Paso, TX 79912 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 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few condition. No bleeding or fractures found.2. Record review of Resident #2's face sheet, dated 8/6/25, revealed a [AGE] year-old female who was admitted to the facility on [DATE]. Record review of Resident #2's history and physical, dated 7/6/25, revealed a diagnosis which included mild intellectual disability.Record review of Resident #2's quarterly MDS, dated [DATE], revealed a BIMS score of 4, which indicated her cognition was severely impaired. Record review of Resident #2's care plan, dated 4/5/25, revealed focus area which documented she has a behavior problem, resident was observed hitting herself in the head, yelling and slamming the door with interventions Intervene as necessary to protect the rights and safety of others. Approach/Speak in a calm manner. Divert attention. Remove from situation and take to alternate location as needed. Minimize potential for the resident's disruptive behaviors hitting self or others, by offering tasks which divert attention such as arts/crafts, manicure with nail polish. Monitor behavior episodes and attempt to determine underlying cause. Consider location, time of day, persons involved, and situations. Document behavior and potential causes. notify guardian when behaviors occur. Record review of HHSC witness statement written by AIT, dated 7/7/25, revealed [Resident #1] was sent out to [local hospital] for evaluation. upon re-entering the facility [Resident #2] entered my office, still flushed face and fidgety. I started the conversation by noting she is not in trouble but want to know what happened in her room last night. She commenced to tell me via hand gestures that she hit [Resident #1]. Record review of TULIP for July 2025 revealed no self-report reflecting resident to resident altercation. During an interview on 8/6/25 at 2:58 PM, revealed Resident #2 was AOx2, the resident stated Resident #1 was no longer in her room and stated she was moved but could not recall when. Resident #2 stated she denied hitting Resident #1 or being hit by her. Resident #2 stated Resident #1 got the bruises on her face on her own but could not say how. Resident #2 stated she felt safe at the facility and denied any issues with other residents. During an interview on 8/6/25 at 2:20 PM, Resident #2's RP stated the incident occurred on a Sunday (7/6/25) and was contacted until Monday by a nurse, whose name she did not recall and again on Tuesday by AIT. The RP stated this was the first known incident of aggression.During an interview on 8/6/25 at 3:18 PM, Resident #1 was AOx1, she had a bruise on her forehead green and yellow in color. Resident #1 stated she did not know how she got it and denied pain. Resident #1 denied falling and denied being hit. Resident #1 stated she did not know who Resident #2 was. Resident #1 denied any physical altercations with other residents. Resident #1 stated she felt safe. Resident #1 appeared pleasant and in good spirits, smiling when asked about abuse questions, she did not recall the incident and did not show any signs of distress. Resident #1 stated she would not report any abuse, and when asked why, she just smiled and did not answer. Resident #1 stated she had 0 distress noted.During an interview on 8/6/25 at 6:40 PM, Resident #1's Emergency Contact stated the resident was taken to the hospital after they noticed both eyes bruised and her face showed signs of trauma, as if she had been struck. Emergency contact #1 stated the facility claimed the resident woke up with the injuries and they did not know how it happened. Emergency contact #1 stated she was later contacted by someone identifying themselves as being from APS or a related agency. Emergency contact #1 stated she was aware the resident was sent to the hospital for further evaluation and no injuries were identified. Emergency contact #1 stated when she returned, she was placed in a different room away from the AP.During an interview on 8/7/25 at 9:56 AM, the DON stated the incident was not reported to the SO, ombudsman, or law enforcement. The DON stated the reason for not notifying agencies was because they were investigating an injury of unknown origin and believed they already knew what had happened. The DON stated she did not consider the incident to be abuse, although interventions were in place and Resident #1 was kept safe from the AP. The DON stated after reviewing their internal abuse (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 676457 If continuation sheet Page 9 of 10 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 676457 B. Wing A. Building (X3) DATE SURVEY COMPLETED 08/07/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Bartlett Skilled Nursing and Assisted Living 221 Bartlett Drive El Paso, TX 79912 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 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete policy, it appeared they needed to notify the correct agencies. During an interview on 8/7/25 at 10:32 AM, the AIT stated the incident was not reported to the SO or law enforcement. The AIT stated he attempted to call the local Ombudsman to notify, but he had not returned his call. The AIT stated the reason for not notifying agencies was because he did not view the situation as a resident-to-resident altercation due to Resident #2's cognitive impairment and intellectual disability and did not believe Resident #2 was aware of her actions. The AIT stated he did not consider the incident to be abuse.During an interview on 8/7/25 at 10:51 AM, the Ombudsman stated he was unsure if notification of resident-to-resident altercations was required. The Ombudsman stated facility staff occasionally provided him with information as a courtesy; he stated he did not recall receiving any notification regarding an incident between Resident #2 and Resident #1. Record review of the facility's Abuse, Neglect, exploitation or Misappropriation- Reporting and Investigating policy, dated September 2022, read in part All reports of resident abuse (including injuries of unknown origin), neglect, exploitation, or theft/misappropriation of resident property are reported to local, state and federal agencies (as required by current regulations) and thoroughly investigated by facility management. Findings of all investigations are documented and reported. #1: If resident abuse, neglect, exploitation, misappropriation of resident property or injury of unknown source is suspected, the suspicion must be reported immediately to the administrator and to other officials according to state law. #2- The administrator or the individual making the allegation immediately reports his or her suspicion to the following persons or agencies: a. The state licensing/certification agency responsible for surveying/licensing the facility; b. The local/state ombudsman; c. The resident's representative: d. Adult protective services (where state law provides jurisdiction in long-term care); e. Law enforcement officials; f. The resident's attending physician; and g. The facility medical director. Event ID: Facility ID: 676457 If continuation sheet Page 10 of 10