Health inspection·March 25, 2024

F 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few 1 separated both residents and informed the charge nurse (LVN 2). Admin further stated, he was not notified of the incident between Residents 1 and 2 and neither was the DON (Director of Nursing) on February 3, 2024. The Admin further stated, he should have reported to CDPH when Resident 1's family member brought up the allegation. The Admin stated, any type of abuse or allegation should be reported within two hours. On February 14, 2024, at 12:47 p.m., LVN 1 was interviewed. LVN 1 stated, on February 3, 2024, approximately at 12 p.m., she observed Resident 1 was sitting really close to her, side by side and Resident 2 had his hand between Resident 1's legs. LVN 1 stated, it seemed the position of Resident 2's hand was inappropriate. LVN 1 stated, I don't think she (Resident 1) knew what was going on. LVN 1 stated, she informed her charge nurse (LVN 2). On February 14, 2024, at 2 p.m., LVN 2 was interviewed. LVN 2 stated, the incident happened on February 3, 2024, between 11-12 p.m. LVN 2 stated, she heard a conversation, voice getting louder in the dining room. LVN 2 stated, LVN 1 came out of the dining room upset. LVN 2 stated, LVN 1 told her Resident 2's hand was in between Resident 1's legs. LVN 2 stated, she told LVN 1 to inform the charge nurse of the incident (between Residents 1 and 2). LVN 2 stated, the person who witnessed the incident should report to the state (CDPH). On February 14, 2024, at 4 p.m., an interview was conducted with Social Services Director (SSD), who stated, she found out on February 5, 2024, through the communication board (communication via electronic charting to department heads and nursing staff). The SSD stated, Residents 1 and 2 were holding hands and their hands were in Resident 1's lap. The SSD stated, she did not report (to the authorities), because she wanted to investigate to see if it was reportable. SSD further stated, she did not report the incident to Admin or DON, until February 9, 2024. The SSD stated, she would report abuse right away to abuse coordinator, DON, or file the report herself with authorities CDPH, ombudsman, APS (Adult Protective Services) if needed. On February 14, 2024, at 4:35 p.m., an interview was conducted with the Director of Nursing (DON), who stated, we are all mandated reporters and if she saw or heard something that was reportable, she would report it immediately. On March 1, 2024, at 9:22 a.m., an interview was conducted with Resident 1's Family Member (FM), who stated, on February 3, 2024, LVN 1 informed her, she saw Resident 2's hands in-between Resident 1's legs in the dining room. The FM further stated, I kinda let it go (Residents 1 & 2's hands in Resident 1's lap), because I thought it was reported by the facility to CDPH. The FM stated, until February 9, 2024, when she asked the Admin of what happened with Resident 1's sexual abuse. The FM stated, the Admin said, What abuse? The FM stated, she realized, the sexual abuse allegation was not reported to authorities by the Admin and or facility. The FM stated, she reported the sexual abuse allegation on February 13, 2024 (10 days after she was made aware of the incident). A review of the facility's Policy & Procedure, titled, Abuse Prevention and Mandated Reporting, revised, August 2021, indicated, .Purpose: To ensure that resident's rights are protected by providing a method for the prevention of any type of resident abuse . Policy .Each resident has the right to be free from . reasonably (sic) suspicion of abuse . Reporting .Facility staff members are required to report incidents of known or suspected abuse as follows .Suspected abuse, neglect, exploitation or mistreatment (including injuries of unknown source and misappropriation of resident property) will (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 555247 If continuation sheet Page 2 of 3 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 555247 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/25/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Rancho Mirage Health and Rehabilitation Center 39950 Vista Del Sol Rancho Mirage, CA 92270 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 0609 be reported within two hours .If events that cause the allegation do not involve abuse or not resulted in serious bodily injury, the report must be made within twenty-four hours . Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 555247 If continuation sheet Page 3 of 3