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Complaint Investigation

Casa Real

March 27, 2025 · Santa Fe, NM · 1650 Galisteo Street
Citations 1
Beds 118
Provider ID 325038
Healthcare Facility
Casa Real
Santa Fe, NM  ·  View full profile →
Inspection Summary

Casa Real in Santa Fe, NM — inspection on March 27, 2025.

Found 1 citation. Severity: Standard violations.

Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.

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Inspection Findings

FF0686
TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** 41988 Few and services to prevent the development and worsening of pressure wounds (also called a pressure injury or affected

F-F0686 for pertinent findings related to this citation.

B. On 03/25/25 at 10:59 am during an interview with R #3's POA, he stated he was not notified of R #3 having a new pressure ulcer located on his coccyx (discovered on 07/03/24) by the facility. R #3's POA confirmed he was made aware of the new pressure ulcer by the hospital on 08/05/24.

C. On 03/26/25 at 5:08 pm during an interview with the Skin Health Lead (SHL), she stated she could not remember if she contacted R #3's POA after discovering R #3's new coccyx pressure ulcer.

The SHL also she did not remember contacting a provider for R #3's coccyx pressure ulcer.

The SHL confirmed a provider and R #3's POA should have been notified of R #3's new coccyx pressure ulcer.

D. On 03/26/25 at 5:39 pm during an interview with the Unit Manager (UM) #1, she stated if a resident develops a new wound or pressure ulcer, a provider and the resident's POA should be notified immediately.

E. On 03/27/25 at 2:05 pm during an interview with the Nurse Practitioner (NP) #1, she stated she was not notified of R #3's coccyx pressure and she did not know that R #3 had a pressure ulcer on his coccyx.

The NP #1 confirmed she would expect to be notified immediately of a new pressure ulcer that developed on one of her residents.

F. On 03/27/25 at 2:38 pm during an interview with the Director of Nursing (DON), she stated a provider should have been notified of R #3's coccyx pressure ulcer as soon as the pressure ulcer was identified, and one was not.

The DON also confirmed R #3's POA should have been notified as well.

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 TITLE (X6) DATE REPRESENTATIVE'S SIGNATURE

325038

Form Approved OMB

STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A.

Building 325038 B.

Wing 03/27/2025

NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE

Casa Real 1650 Galisteo Street Santa Fe, NM 87505

Frequently Asked Questions

What is an F-tag violation?
F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
Were these violations corrected?
Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
How often do nursing home inspections happen?
CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
What should families do about these violations?
Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in Santa Fe, NM, (5) Report new concerns to state authorities.
Where can I see the full inspection report?
Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from Casa Real or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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