What does the article mean when it says that the
"facility had not been kept up"? Why would this increase
the mortality rate?

The Facility had not been properly maintained. If this is a Hospital or a similar caregiver Facility, to have water leaks, is to invite vermin and insects, which spread disease; if the Heating and Air/Con ducts are filthy and the filters not cleaned, it creates an environment ripe for molds and bacteria to be spread; maybe the heating/air conditioner don’t even work! All the more for concern. It is in simple terms, a place nowhere near an Ideal to house or treat people who are weakened and prone to infection or respiratory problems from filthy air and a lack of proper maintenance.

Explanation: