**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observations, staff interviews, record review, and review of the facility policy titled, Safe and Homelike Environment, the facility failed to maintain a clean and homelike environment in five of 52 resident rooms and one of 30 resident bathrooms as evidenced by dirty packaged terminal air conditioner (PTAC) filters in resident rooms (110, 121, 203, 207, and 209) and one malfunctioning light switch in the bathroom in room [ROOM NUMBER]. Findings include: Review the facility policy titled Safe and Homelike Environment revealed in accordance with resident rights the facility will provide a safe, clean, comfortable and homelike environment, allowing the resident to use his or her personal belonging to the extent possible. This includes ensuring that the resident can receive care and services safely and that the physical layout of the facility maximizes resident independence and does not pose a safety risk. 1. Observation on 2/20/2024 at 11:03 am revealed PTAC units with dusty filters and a black substance across the upper rim of the filters. Observation on 2/21/2024 at 11:25 am revealed PTAC units with dusty filters and a black substance across the upper rim of the filters. 2. Observation on 2/20/2024 at 9:50 am revealed in room [ROOM NUMBER] that the light switch in the bathroom was not working. There was a piece of tape holding up the light switch to keep the light from turning off. Observation on 2/22/2024 at 9:15 am revealed in room [ROOM NUMBER] that the light switch in the bathroom was not working. There was a piece of tape holding up the light switch to keep the light from turning off. Observation on 2/22/2024 between 9:40 am and 9:53 am revealed dirty PTAC filters in rooms 110, 121, 203, 207, and 209. Observation/interview on 2/22/2024 at 10:35 am with the Maintenance Assistant (MA), he confirmed the damaged light switch in room [ROOM NUMBER]. He stated the PTAC units in rooms 110, 121, 203, 207, and 209 were last cleaned on 2/16/2024. After removing the filters, the MA acknowledged the PTAC filters and internal structures needed to be cleaned.

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and review of the facility policy titled, Resident's Rights Under Federal Law, the facility failed to provide maintenance services necessary to maintain a safe, orderly, and comfortable interior by failing to repair drywall, air conditioner frames, and an area behind a resident's bed on one (Wing 2) of two wings. Findings include: Review of a policy titled, Resident's Rights Under Federal Law revealed, that the facility will present a 'Homelike Atmosphere. Each resident has the right to a safe, clean, comfortable, and homelike environment, and to use his or her personal belongings to the extent possible. Each resident has the right to housekeeping and maintenance services necessary to maintain a sanitary, orderly, and comfortable interior; clean bed and bath linens that are in good condition; private closet space in their room; adequate and comfortable lighting levels in all areas; comfortable and safe temperature levels; and comfortable sound levels. Observation of rooms [ROOM NUMBERS] on Wing 2 on 4/5/22 at 9:44 a.m. revealed that the air conditioners had no frames. Observation of room [ROOM NUMBER] on Wing 2 on 4/5/22 at 9:45 a.m. revealed that there was a board behind the window bed lying on the floor. Further observation revealed there was cracked drywall around an electrical outlet under the window next to the air conditioner. Observation of room [ROOM NUMBER] on Wing 2 on 4/5/22 at 9:56 a.m. revealed that the caulking around the sink had come loose and the sink/vanity was unstable and there was no frame around the air conditioner. Observation of room [ROOM NUMBER] on Wing 2 on 4/5/22 at 9:59 a.m. revealed the framing around the air conditioner was loose and staff could see through cracks to the outside of the building. Observation of room [ROOM NUMBER] on Wing 2 on 4/5/22 at 10:01 a.m. revealed there were no personal effects. Further observation revealed at the bottom right-hand side of the bathroom was an area that had a foam filler around the baseboard. An interview on 4/6/22 at 8:50 a.m. with Licensed Practical Nurse CC revealed that when maintenance issues arise staff can input requests through the maintenance software online system. On 4/7/22 10:13 a.m. a tour of Wing 2 with Maintenance Director, Administrator, and Director of Nursing (DON) were shown above mentioned areas of concern. The administrator stated that the owners have plans to relocate residents to another facility. The other facility is being renovated and remodeled to accommodate long term care residents. The building that is being remodeled is a vacant assisted living facility. The administrator further revealed that there was not a definite date on when the opening and transfer of the residents would occur. Interviews with Maintenance Director, Administrator and DON confirmed the missing air conditioning frames, the unstable sink/vanity, loose board lying in the floor and the foam filler in the baseboard area were in need of repair. On 4/7/22 at 11:17 a.m. interview with the administrator revealed that there was no staff in maintenance for about a month, but they had a corporate environmental staff that was at the facility daily until the current maintenance director was hired.