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Complaint Investigation

Haven Of Champaign

Inspection Date: December 31, 2025
Total Violations 1
Facility ID 146017
Location CHAMPAIGN, IL
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Inspection Findings

F-Tag F0727

Nursing and Physician Services Deficiencies
Harm Level: Potential for More Than Minimal Harm

F 0727 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many

Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on

a full time basis. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on

interview and record review, the facility failed to ensure Registered Nurse coverage for at least eight consecutive hours a day, seven days a week. This failure has the potential to affect all 50 residents residing

in the facility.Findings include:The Facility assessment dated [DATE REDACTED] with a review date of 10/9/2025 documents the following: Staffing: The facility will be staffed according to resident needs and required staffing guidelines and considerations of continuity of care.The facility's Daily Assignment Sheets dated December 16, 2025 through December 31, 2025 documents no Registered Nurse coverage on 12/25/25.On 12/31/25 at 10:24am, V2 (Director of Nursing) confirmed the facility did not have Registered Nurse coverage for 8 consecutive hours on 12/25/25. V2 stated the registered nurse who was scheduled had called off and V2 did not come in that day to cover the shift.The facility Room Roster dated 12/30/25 documents 50 residents reside in the facility.

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 REPRESENTATIVE'S SIGNATURE

TITLE

(X6) DATE

FORM CMS-2567 (02/99) Previous Versions Obsolete

Facility ID:

If continuation sheet

Event ID:

📋 Inspection Summary

Haven of Champaign in CHAMPAIGN, IL inspection on recent inspection.

Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.

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

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 CHAMPAIGN, IL, (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 Haven of Champaign or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.
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