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Complaint Investigation

The Haven On The River

August 19, 2025 · Grayville, IL · 320 South 2nd Street
Citations 2
CMS Rating 1/5
Beds 66
Provider ID 146119
Healthcare Facility
The Haven On The River
Grayville, IL  ·  View full profile →
Source Document
Official CMS Inspection Report (Medicare.gov)
Downloaded from CMS/Medicare.gov. Reflects what state inspectors documented and does not include the facility's plan of correction, which is submitted separately. Facilities may have taken corrective actions since this report was released.
Inspection Summary

The Haven on the River in GRAYVILLE, IL — inspection on August 19, 2025.

Found 2 citations. 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.

Inspection Findings

FF0755
Pharmacy Service Deficiencies
Potential for More Than Minimal Harm

Medications will be administered safely to residents within the facility by licensed nurses at the specified time/timeframe.The facility's Daily Census sheet, dated 8/13/25, documents there are 49 residents residing in the facility.

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

08/19/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

The Haven on the River

320 South 2nd Street Grayville, IL 62844

SUMMARY STATEMENT OF DEFICIENCIES

Based on interview and record review, the facility failed to provide medical records requested to aide in the survey process for 2 of 2 residents (R3 and R4) reviewed for medication administration in a sample of 19.Findings includeOn 8/14/25, this surveyor reviewed the July 2025 Medication Administration Records (MAR's) for R3 and R4 in their Electronic Health Records.

The MAR's for R3 and R4 did not document the actual time the medication was administered.On 8/14/25 at 3:30 PM, this surveyor requested R3 and R4's July 2025 MAR's with documented and timestamped medication administration times from V2, Director of Nurses (DON).On 8/18/25 at 8:00 AM, V2, DON, stated he had been instructed by V24, Chief Operating Officer, not to provide the copies of R3 and R4's MAR's with documentation of the times the medications were administered or allow this surveyor to visualize them in the Electronic Health Record.On 8/18/25 at 3:20 PM, V2, DON, he stated he was instructed by V24 not to turn the time stamped MAR's R3 and R4 over to this surveyor because the facility had started an internal Quality Assurance investigation, and those documents were now considered confidential. V2 stated the internal investigation was started approximately 2-3 weeks ago. V2 stated the internal investigation was started when R3 and R4 had brought it to administration's attention that medications were being administered past the ordered time ranges.

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 GRAYVILLE, 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 The Haven on the River or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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About This Inspection Report

Source: This inspection report was downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases nursing home inspection reports in bulk. The findings reflect what state surveyors documented in the official Form CMS-2567 Statement of Deficiencies on the date of the inspection.

Plan of correction not included: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to their state survey agency and those responses may not appear in CMS public data at the time of release. The absence of a plan of correction in this report does not mean one was not filed. Readers who want information about corrective steps taken by the facility are encouraged to contact the facility or their state survey agency directly.

Corrections may have been made: This report reflects conditions observed on the date of the survey. The facility may have implemented staffing changes, additional training, policy revisions, or other corrective actions since this report was issued. We publish what CMS provides and encourage readers to seek current information from the facility.