F 0569
Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.
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 the personal funds of a deceased resident was
provided to the resident's legal representative with the required timeframe, for one of three residents
reviewed (Resident 1). In addition, the facility failed to provide the final financial statement and invoices of
the breakdown of personal funds after multiple requests from Resident 1's legal representative.This
deficient practice had the potential for loss and misuse of Resident 1's personal funds.Findings:On [DATE],
at 10:30 a.m., an unannounced visit was conducted to investigate a complaint. On [DATE], Resident 1's
record was reviewed. Resident 1 was admitted on [DATE], and expired on [DATE], with diagnoses which
included dementia (memory loss). Resident 1's legal representative was her family member (FM)A review
of Resident 1's Minimum Data Set (MDS - a resident assessment tool), dated [DATE], indicated Resident 1
was severely impaired in cognition. On [DATE], at 11 a.m., during an interview with Resident 1 legal
representative (LR), she indicated Resident 1 expired on [DATE]. Resident 1's LR stated she called the
facility and spoke with the previous Business Office Manager (BOM) on [DATE], and was informed Resident
1 had over $2000 on the resident's account. Resident 1's LR stated the following after Resident expired on
[DATE]:-Called the facility on [DATE], to follow up regarding Resident 1's remaining money with no call back
from facility;-Called the facility on [DATE], talked to previous BOM and informed Resident 1's LR that the
supervisor had to release the funds;-Called the facility on [DATE], and was told the funds would be released
and check would follow, but the previous BOM was not able to tell the LR the amount due to be
disbursed;-Spoke with the previous Administrator (ADM) on [DATE], and was told the a check would be
issued to the LR representing closed account of Resident 1, but the ADM was not able to tell the
amount;-LR received a check amounting to $1,024 on [DATE] (two months after Resident 1 expired), but
the facility was not able to provide her an itemized account for the refund;-LR received an invoice from the
facility requesting payment from the LR in the amount of $1,311, with no breakdown of the amount due to
be paid; and-LR received a check in the amount of $5,458.23, on [DATE], without itemized breakdown of
the amount.On [DATE], at 11:30 a.m., an interview and concurrent record review was conducted with the
Director of Nursing (DON). The DON stated the Business Office Manager (BOM) were involved in ensuring
the resident's personal funds were to be accounted for when a resident gets discharged from the facility.
The DON stated resident legal representative follow up calls should be returned within 24 to 48 hours. The
DON further stated if a resident or legal representative request for itemized invoice from the facility, the
request should have been sent immediately upon request.On [DATE], at 11:58 a.m., an interview with the
Social Services Director (SSD) was conducted. The SSD stated Resident 1 had a trust fund money coming
to the facility to cover share of cost or anything else the resident might need. The SSD stated the process
was for the BOM to process the remaining money left by a resident upon discharge or upon death, then the
corporate staff would process it thereafter. The SSD stated if the resident
Residents Affected - Few
(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:
555084
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
555084
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
07/30/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Desert Springs Healthcare & Wellness Centre
82262 Valencia Avenue
Indio, CA 92201
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 0569
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
legal representative requested final financial statements and invoices, it should be sent on request per
policy.On [DATE], at 12:10 p.m., an interview and record review with the Business Office Manager (BOM)
was conducted. the BOM stated she had just started in the facility about two months. The BOM stated she
reviewed Resident 1's record and conferred with the corporate supervisor and indicated the first check
Resident 1's legal representative received on [DATE], was a refund, and the second check was from the
trust account. The BOM stated any refund or money due to the resident who expired should be sent to the
legal representative within 30 days from the death of the resident. The BOM stated any call should be
returned to the resident or legal representative immediately and the request for itemized invoice should
have been sent immediately upon request.A review of the facility's policy and procedure
titled,BO-OP-14A-Refunds-Private, dated [DATE], indicated, .refunds will be processed within 30 days or
within state guidelines.A review of the facility's policy and procedure titled, Resident Funds - Transactions,
dated [DATE], indicated, .Objectives.provide for an individual and confidential accounting of funds received
and disbursed on the resident's behalf.upon notification of a resident's death.business office reviews the
resident's records and determines the resident trust account balance.the business office makes a final
accounting.administering the resident's estate within 30 days of the death of the resident.A review of the
facility's policy and procedure titled, Resident Funds-General, dated [DATE], indicated, .provide for the an
individual and confidential accounting of funds received and disbursed on the resident's behalf.provide the
resident with.statement .upon request. Statements are printed from the Residential Trust software system.
Event ID:
Facility ID:
555084
If continuation sheet
Page 2 of 2