Inspection·September 20, 2023

F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to ensure two residents were treated with dignity and respect, when Certified Nursing Assistant (CNA) 1 made disrespectful comments and gestures towards Resident 1 and 2. This failure resulted in not ensuring residents' rights to be treated with dignity and respect and could potentially result in negative psychosocial outcomes, such as changes in mood and/or behavior. Findings: 1. On July 20, 2023, at 10:40 a.m., during an interview, Resident 3 stated she heard the conversation between CNA 1 and Resident 1 on July 11, 2023, while CNA 1 was providing care to Resident 1. Resident 3 stated CNA 1 said look at that fat, referring to her roommates body. Resident 3 stated CNA 1's comments made her uncomfortable. On July 20, 2023, at 12:12 p.m., an interview with CNA 2 was conducted. CNA 2 stated Resident 1 told him CNA 1 made her feel uncomfortable, by making statements that she was too fat. Resident 1 said to CNA 2 that CNA 1 made her feel uncomfortable and insulted her of being fat. CNA 2 stated no facility staff was allowed to make inappropriate comments to any residents and every resident has the right to be treated with dignity and respect by the staff. On July 20, 2023, at 1 p.m., an interview and observation with Resident 1 was conducted. Resident 1 was observed in bed, in her room. Resident 1 was alert and oriented. Resident 1 stated in the morning of July 11, 2023, CNA 1 provided care for her prior to her going to dialysis (a treatment to remove blood toxins when the kidneys are not able to). Resident 1 stated CNA 1 touched her abdomen, pointing a finger to it, and said look at that fat. Resident 1 stated her roommate (Resident 3) was in the room and overheard the conversation between her and CNA 1. Resident 1 stated CNA 1's comment and gesture was disrespectful and made her feel uncomfortable. Resident 1's record was reviewed. Resident 1 was re-admitted to the facility on [DATE], with diagnoses which included end stage renal (kidney) disease, dependence on renal dialysis, diabetes, morbid (severe) obesity, and anxiety disorder. 2. On July 20, 2023, at 11:12 a.m., an interview and observation was conducted with Resident 2. Resident 2 was in the activities room. Resident 2 was alert and oriented. (continued on next page) Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE FORM CMS-2567 (02/99) Previous Versions Obsolete Facility ID: If continuation sheet Page 1 of 2 Event ID: 056229 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 056229 B. Wing A. Building (X3) DATE SURVEY COMPLETED 09/20/2023 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Palm Springs Healthcare & Rehabilitation Center 277 S Sunrise Way Palm Springs, CA 92262 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)