Health inspection·June 25, 2025

F 0880 Provide and implement an infection prevention and control program. 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 TB (tuberculosis - a serious lung infection) test was completed according to the facility's policy and procedure, for two of three residents (Residents 2 and 3). Residents Affected - Few This failure had the potential for TB to be undetected and could result to the transmission of the disease to the vulnerable residents. Findings: On May 13, 2025, at 9:35 a.m., an unannounced visit was conducted to investigate a complaint on infection control. On May 13, 2025, at 11:57 a.m., during an interview with Licensed Vocational Nurse (LVN) 1, LVN 1 stated a TB test was to be completed within 24 hours of admission and to be documented in the electronic Medication Administration Record (eMAR). On May 13, 2025, at 12:45 p.m., during an interview with LVN 2, LVN 2 stated a TB test was to be completed within 24 hours of admission. Resident 2's record was concurrently reviewed with LVN 2. LVN 2 stated Resident 2 was admitted to the facility on [DATE]. LVN 2 stated there was no documentation a TB test was completed for Resident 2 within 24 hours upon admission on [DATE]. On May 13, 2025, at 1:10 p.m., during an interview with LVN 3, LVN 3 stated a TB test was to be completed within 24 hours of admission and to be read for results within 72 hours. Resident 3's record was concurrently reviewed with LVN 3. LVN 3 stated Resident 3 was admitted to the facility on [DATE]. LVN 2 stated there was no documentation a 1st step of TB test was conducted for Resident 3. On May 13, 2025, at 3:10 p.m., during an interview with the Infection Preventionist (IP), the IP stated newly admitted residents should receive TB testing within 24 hours upon admission, and for the results to be read within 72 hours. The IP stated a second step TB test was to follow after 10 days from the first step TB test. Residents 2 and 3's records were concurrently reviewed with the IP. The IP stated there was no documentation the first step TB test was administered to Resident 2. The IP stated Resident 3's first step TB test was administered on April 25, 2025, however, there was no documentation the TB test was read after 72 hours. The IP stated Resident 3's second step TB test was not documented as completed. The IP further stated the documentation should be consistent across the immunization record tab and the eMAR. A review of the facility's policy and procedure titled, Tubercle Bacillus (TB), dated October 2013, (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 4 Event ID: 555339 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 555339 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/25/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Desert Springs Post Acute 74-350 Country Club Drive Palm Desert, CA 92260 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)