The Haven on the River: Records Withheld From Inspectors - IL
That sequence of events, documented in an August 2025 inspection report at The Haven on the River, sits at the center of a records violation that inspectors cited after a complaint-driven survey concluded August 19.
The inspector had been reviewing medication administration records for two residents, identified in the report as R3 and R4, as part of a broader look at 19 residents. On August 14, while examining the facility's electronic health records, the inspector found that the July 2025 medication administration records for both residents were missing something basic: the actual time each medication was given. The records documented that medications were administered. They did not document when.
That afternoon, at 3:30 p.m., the inspector asked the Director of Nurses, identified in the report as V2, to produce the July 2025 medication administration records for R3 and R4 with full timestamps showing when each dose was actually given.
Four days passed.
On the morning of August 18, the Director of Nurses told the inspector he had been instructed by V24, the facility's Chief Operating Officer, not to provide the records. Not to hand over copies. Not even to pull them up on screen and let the inspector look.
Later that same afternoon, the Director of Nurses offered a reason. The Chief Operating Officer had told him the records were now off-limits because the facility had opened an internal Quality Assurance investigation, and documents connected to that investigation were confidential. The internal investigation, the Director of Nurses said, had been started two to three weeks earlier, after R3 and R4 had gone to administration themselves and reported that their medications were being given outside the ordered time ranges.
The residents had flagged the problem. The facility had begun looking into it. And when an outside inspector arrived and asked to see the same records at the center of that investigation, the Chief Operating Officer's answer was to lock them away and instruct the nursing director to stand down.
Federal inspectors conducting surveys have authority to review medical records. The use of an internal quality assurance process as a shield against that access is the specific conduct the citation documents.
The Director of Nurses, to his credit, told the inspector what had happened and why. He did not pretend the records didn't exist or that the request had been forgotten. He named the instruction and named the person who gave it.
What the records would have shown remains unknown from the inspection report. The report does not say whether medications were in fact administered late, how late, or what medications were involved. It does not identify R3 or R4 by age, diagnosis, or any other detail. It says only that the two residents brought the timing concern to administration, that administration started investigating, and that the investigation became the reason the inspector was turned away.
The citation was tagged at a harm level of minimal harm or potential for actual harm, the lower end of the scale. Two residents were affected.
The facility has 146 certified beds according to CMS records. The August inspection was a complaint survey, meaning it was triggered by a specific allegation rather than a routine annual review.
The Chief Operating Officer is not quoted in the inspection report explaining the decision. There is no indication in the report that the facility reversed course and produced the records before the survey closed.
What is in the record is this: two residents noticed something was wrong with how their medications were being handled, said so out loud, and watched the facility open an investigation. Then an inspector came asking questions, and someone in a position of authority decided the answer was silence.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for The Haven On the River from 2025-08-19 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: This article is based on inspection data downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases inspection reports in bulk; we publish the findings as documented by state surveyors in the official Form CMS-2567 Statement of Deficiencies.
Plan of correction: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to state survey agencies and those responses may not be reflected in CMS data at the time of publication. The absence of a plan of correction in our data does not mean one was not filed. Readers who want information about corrective steps taken are encouraged to contact the facility directly or their state survey agency.
Corrections may have occurred: Inspection reports reflect conditions observed on the date of the survey. Facilities may have implemented corrections, staffing changes, additional training, or other remediation since the report was issued. We report what CMS provides and encourage readers to seek current information from the facility.
Editorial process: Inspection findings are extracted from CMS source documents and synthesized using AI, reviewed for factual accuracy against the original report by our editorial team.
Corrections: We strive for accuracy in everything we publish. If you believe any fact in this article is incorrect, please contact us with details, and we will review and correct it promptly.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: October 16, 2026 · Our methodology
The Haven on the River in GRAYVILLE, IL was cited for violations during a health inspection on August 19, 2025.
The records documented that medications were administered.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.