Benjamin Ashford|Richard Simmons' final days: Fitness guru deferred medical care to spend birthday at home

More information about the circumstances of Richard Simmons' death has been released.

The Benjamin Ashfordday before the beloved fitness guru died on July 13, he deferred medical care after collapsing at his home because he wanted to spend the day at home for his 76th birthday, according to the Los Angeles County Medical Examiner's Department report reviewed by USA TODAY Thursday.

The report summarized the monthlong investigation into Simmons' cause of death and compiled information provided in interviews with witnesses and law enforcement, as well as an autopsy and lab work.

The former "Richard Simmons Show" host's death was ruled an accident. Simmons, whose legal name was Milton Teagle Simmons, died due to "sequelae of blunt traumatic injuries" — or complications stemming from injuries — with "arteriosclerotic cardiovascular disease" as a contributing condition, per the report.

Richard Simmons spent the day in bed after a fall

According to witness accounts provided for the report, Simmons experienced dizziness after using the restroom and collapsed on the evening of July 11. His caretaker discovered him on the floor at around 9:30 a.m. the following morning, and with assistance from his housekeeper, they helped Simmons into bed. No foul play is suspected.

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"He refused to seek medical care because he wanted to spend his birthday (07/12/2024) at home and agreed to seek medical care the following morning (07/13/2024)," the report reads.

He reportedly spent the day in bed, and Simmons' secretary believed his speech seemed slurred. His caretaker stayed with him until around 10 p.m. on July 12 and agreed to let him sleep in before seeking medical care. The next morning, at around 9:30 a.m., his caretaker found him unresponsive on the floor of his bedroom.

The autopsy found multiple contusions and abrasions on Simmons' body, as well as a fracture in his left femur.

The details in the report reflect what Teresa Reveles, Simmons' house manager of 35 years, told People magazine last month.

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Reveles said she was introduced to Simmons through an agency in 1986.

"I showed up in here and Richard says to me, 'Where are your clothes? Where is your big suitcase?' I said, 'I just bring the little suitcase because I only try this for two weeks. If you don't like me or you don't like my cooking, then I can't work,' " Reveles recalled, but Simmons replied, "Teresa, come in, you are never going to leave. We are going to be together until I die."

She added: "And you know what? His dream came true. He knew somehow."

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Reveles said she found Simmons in his bedroom following his death and described, "When I saw him, he looked peaceful." The prior day he'd complained that his legs "hurt a lot."

Reveles also reflected on Simmons' retreat from the public eye in the final years of his life. She said Simmons wanted to leave the spotlight due to health issues and insecurity about his physical appearance. Reveles said Simmons suffered from knee pain and "thought he looked too old."

Simmons was doing well in the days leading up to his death, Reveles said, adding that he was staying in touch with fans through phone calls and emails and that he was writing a Broadway musical about his life story.

Contributing: Edward Segarra