This is a repeat deficiency from the complaint survey on [DATE]. The facility failed to ensure that there were sufficient nursing staff that have the appropriate competencies and skills set to assure the following: 1) Nursing staff were documenting, admitting and assessing residents to and on the units in a timely manner; 2) On [DATE] there were two residents (R #245 and 247) that had each passed away at the facility within minutes of each other, each requiring cardiopulmonary resuscitation back-to-back. R #247 had been in the facility for a couple of days, and had passed away unexpectedly. R #245 had been admitted to the facility that afternoon at 3:00, and by 8:30 pm was being resuscitated and thus passing away. …
F725 citations in New Mexico
Sufficient nursing staff · Nursing and Physician Services Deficiencies
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
Against expectation — 2025
New Mexico cites F725 less often than its own record predicts
0.83 times the national share — cited less often here than elsewhere.
Of every deficiency written in New Mexico in 2025, this is the portion that was F725.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What New Mexico surveyors wrote
F725 findings written in New Mexico, one from each severity band recorded here, most serious first.
Severity is as the surveyor wrote it. Some findings had already been corrected before the survey.
Based on record reviews, observation, and interviews, the facility failed to ensure the facility had sufficient staff to meet the needs of 5 (R #8, R #10, R #11, R #25, and R #26) of 6 (R #8, R #10, R #11, R #24, R #25, and R #26) residents reviewed for staffing when staff failed to: 1. To transfer R #8. 2. Change R #10's brief. 3. To assist R #11 to the toilet as needed. 4. Assist R #24 with oral care and showers. 5. Change R #25's brief after 30 minutes or longer. This deficient practice caused R #25 psychological distress, feeling embarrassed and crying when discussing how she was left soiled when she has to wait to be changed. The findings are: A. Record review of R #25's Admission Record, (Face Sheet) no date revealed the following: 1. admitted [DATE]. 2. …
Based on observation, record review, and interview, the facility failed to maintain sufficient nursing staffing to ensure the highest practicable physical, mental, and psychosocial well-being of each resident. This failure has the potential to affect all 54 residents (residents were identified by the resident census list provided by the DON on 07/09/26). This deficient practice could likely result in residents not receiving the care and service needed while in the facility. The findings are: A. Record review of the Call Light-Use of Policy revised date January 2026 revealed the following:1. Ensures that all residents have consistent access to a working call light. 2. …
The short window
Recent years
| Year | Share of New Mexico citations | vs expected |
|---|---|---|
| 2023 | 1.35% | 1.68× |
| 2024 | 0.93% | 1.16× |
| 2025 | 0.64% | 0.83× |
Shares of citations, not counts: earlier years hold fewer inspections.
What else New Mexico surveyors cite →
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