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Complaint Investigation

Bria Of Godfrey

October 15, 2025 · Godfrey, IL · 1623 29 West Delmar
Citations 1
CMS Rating 1/5
Beds 68
Provider ID 145656
Healthcare Facility
Bria Of Godfrey
Godfrey, IL  ·  View full profile →
Inspection Summary

BRIA OF GODFREY in GODFREY, IL — inspection on October 15, 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

FF0760
Pharmacy Service Deficiencies
Potential for More Than Minimal Harm

10/14/2025 at 3:10 PM, V14, R2's family, stated he received a phone call from the facility stating R2 had received a double dose of one of her insulin. V14 stated he was informed there was a mix up with which nurse was taking care of which resident and R2 was given more insulin than she should have been given.

V14 stated he was informed R2 was being taken to the local hospital for high blood pressure. V14 states R2 can get anxious and does not always understand what is going on.On 10/15/2025 at 1:15 PM, V9, LPN, stated she was R2's nurse the night that R2 received a double dose of insulin. V9 stated she went to do R2's accu- check and bedtime medications and gave R2 her Lantus. V9 stated the nurse she was working with stated she also gave R2 the dosage of Lantus about an hour after V9 administered the insulin to R2.

V9 stated V10 informed her V10 thought R2 was V10's resident to pass medications to. V9 stated the facility has frequent internet and computer issues and when she gave R2 the insulin, she had the MAR pulled up and could not click off that the medication was administered due to internet issues. V9 stated R2's blood pressure was taken a little while later and R2's blood pressure was elevated. V9 stated R2 was sent to the hospital for evaluation.The Facility's Medication Administration Policy, reviewed 4/2025, documents, All medications are administered safely and appropriately to aid residents to overcome illness, relieve and prevent symptoms and help in diagnosis.

Guideline #6 documents Check medication administration record prior to administering medication for the right medication, dose, route, patient/resident and time.

Facility ID:

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 GODFREY, 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 BRIA OF GODFREY or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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