Division of Health Improvement
The Department of Health’s Division of Health Improvement (DHI) is the regulatory entity providing compliance oversight for the following areas.
- Licensed health facilities such as: non-long term care, long-term care, assisted living home care and hospice, free standing birth centers, community mental health centers and other facilities.
- Home and community-based Medicaid waiver providers for the Developmental Disabilities Waiver, Medically Fragile Waiver and the Mi Via Waiver.
- Conducts investigations of Abuse, Neglect & Exploitation for licensed health facilities and home and community-based Medicaid waiver programs.
- Operates the Caregivers Criminal History Screening Program (CCHSP) which provides criminal background checks on potential caregivers.
- Operates the Employee Abuse Registry (EAR) also known as, the Consolidated Online Employee Abuse Registry (COR) which provides background checks for all caregivers, ensuring they have not been disqualified by a substantiated case of ANE. Individuals placed on the EAR are not eligible for hire as caregivers.
- Operates the Certified Nurse Aide Registry (NAR) and Training program.
- Certifies all clinical laboratories operating in New Mexico meet health and safety requirements.
DHI enforcement activities include:
- Surveys — Conducting health & safety surveys for both health facilities and community based waiver programs.
- Visit the Health Facility Survey Reports page to search the licensed healthcare facility survey reports.
- Visit the Developmental Disabilities Waiver Survey Unit, Medically Fragile Waiver Survey Unit and Mi Via Self-Directed Waiver Survey Unit pages to view completed surveys and past performance of providers.
- Investigations — Conducting investigations of alleged Abuse, Neglect & Exploitation, suspicious or unknown injures, death or environmental hazards in waiver programs and health facilities.
- Compliance — Ensuring caregivers have required Background Checks and screenings, and ensuring compliance with other statutes, rules and regulations.
Health facilities and community based waiver programs found out of compliance may be subject to civil monetary penalties or other sanctions as authorized by Centers for Medicare and Medicaid Services or state law.
The Division of Health Improvement consists of 162 staff members located in 4 field offices across New Mexico with a central office in Santa Fe. Our staff have a variety of professional and educational backgrounds and experiences. Many are licensed as psychologists, nurses, physicians, life safety code engineers, architects, social workers and other related fields, who hold bachelor's, master's, and doctoral degrees. We are organized into the following three areas.
- Health Facility Licensing – Consists of District Operations which conducts surveys, and Program Operations which administers the facility licenses and services such as the Nurse Aide Registry.
- Community Based Waiver Programs – Consists of Incident Management and Quality Management.
- Director’s Office – Consists of Administrative Services, Human Resources and the Office of Policy, Planning & Performance Improvement.
Please see the Human Resources section of our website for a list of Job Opportunities at Division of Health Improvement and obtain our latest organizational chart.
Customer Satisfaction Surveys
Has your nursing home or community program recently been surveyed by the Division of Health Improvement? If so, we would like to know how we performed.
- Nursing Home Customer Satisfaction Survey (See Also: Nursing Home Customer Satisfaction Survey Results)
- Community-Based Waiver Provider Customer Satisfaction Survey
- Incident Management Bureau — Please send IMB customer feedback directly to Edward Stallard.
Please visit the Regulations page for a complete listing of the rules and regulations which govern the majority of what we do.
- Incident Management Bureau Annual Report SFY16
- Incident Management Bureau Annual Report SFY15
- Community Program ANE Reporting Guide (Abuso, Negligencia y Explotación Información Guía)
- Community Program ANE Reporting Form
- Immediate Action Safety Plan
- Abuse, Neglect & Exploitation Reporting Poster for Community Programs
- NMAC 7.1.14 — ANE and death reporting, training, and related requirements for community providers.
Community Provider Survey Report of Findings
- Living Supports, Community Supports and Employment Services Report of Findings
- Case Management Services Report of Findings
- Medically Fragile Waiver Survey Unit Report of Findings
- Mi Via Self-Directed Waiver Survey Unit Report of Findings
ANE Training for Community Providers
- Abuse, Neglect & Exploitation Required Training Director's Release
- Abuse, Neglect & Exploitation Provider Training
Licensed Health Facilities
- Health Facility Consumer Complaint Form — Fax number and mailing address are in the form.
- Health Facility Reporting System
- Incident Management System Guide for All Licensed Health Care Facilities
- Health Facility Consumer Complaint Form
- Health Facility Complaint Investigation Five Day Follow-up Report Form
- Abuse, Neglect & Exploitation Reporting Poster for Health Facilities
- Abuse, Neglect & Exploitation Reporting Tribal Phone Numbers
- NMAC 7.1.13 — Incident Reporting, Intake, Processing & Training Requirements for Facilities