Health inspection·June 5, 2025

F 0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. 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 ensure proper monitoring and neurological assessments (used to monitor patients, checking mental status, nerves, reflexes and motor function) were completed, for one of three residents (Resident A). Residents Affected - Few This failure had the potential to cause delay in care and treatment for Resident A following an unwitnessed fall. Findings: On May 5, 2025, at 9:15 a.m., an unannounced visit was made to the facility for the investigation of a complaint regarding quality of care. On May 5, 2025, at 10:30 a.m., a review of Resident A's medical record was conducted. Resident A was admitted to the facility on [DATE], with diagnoses which included cerebral infarction (an ischemic stroke-a condition where blood flow to the brain is interrupted, causing brain damage) and encephalopathy (brain disease which alters brain function or structure). Resident A had a change in condition, dated April 11, 2025, at 10:33 p.m., which indicated, .falls .monitor . A review of Resident A's Progress Notes, dated April 12, 2025, at 3:44 a.m., indicated, .per RN (registered nurse) [name] patient fell during pm shift (2:30 p.m. until 11:00 p.m.) in hallway. Patient assessed and vitals (temperature, blood pressure, pulse, respiration rate, and oxygen saturation) taken. No visible injuries noted. Patient C/O (complain of) discomfort to left hip/outer thigh .patient given Tylenol and xray ordered .patient to start on neuro checks, MD and [family] aware . A review of Resident A's Neurological Assessment, dated April 11, no year indicated, first set of vital signs were timed for 11:10 p.m., followed by April 12, at 12:00 a.m., 12:30 a.m., and 1:30 a.m. Respirations were normal, no assessment of pupils or extremities documented, oriented and name documented twice, the neurological assessment was not complete. The Falls Checklist, was reviewed, no date or signature by the licensed nurse or Certified Nursing Assistant (CNA) were documented, and the CNA Post Fall Assessment, was not completed. A review of Resident A's Progress Notes, dated Aril 18, 2025, at 1:08 p.m., indicated, .Patient had a fall today at 1305 (1:05 p.m.). Pt (patient) was ambulating with walker and attempted to walk with a food tray. Patient stated he slipped .Vital signs and neuro check within normal limits . A review of Resident A's POST FALL - Neurological Check, indicated Resident A's date and time of fall was April 18, 2025, at 1:05 p.m. The document indicated neurological checks should be completed (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 3 Event ID: 056328 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 056328 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/05/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Premier Care Center for Palm Springs 2990 East Ramon Road Palm Springs, CA 92264 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)