BALTIMORE, MD — Federal health inspectors found 10 deficiencies at Levindale Hebrew Geriatric Center & Hospital following a complaint investigation completed on November 18, 2025, including a citation for failing to honor residents' fundamental right to refuse treatment and participate in decisions about their own care.
The facility has not submitted a plan of correction.
Advance Directive and Treatment Refusal Rights at Issue
Among the deficiencies identified, inspectors cited Levindale Hebrew under federal regulatory tag F0578, which addresses a nursing home's obligation to respect residents' rights regarding treatment decisions. Specifically, the facility failed to properly honor residents' rights to request, refuse, or discontinue treatment, to decline participation in experimental research, and to formulate advance directives.
Advance directives — legal documents such as living wills and durable powers of attorney for healthcare — allow individuals to outline their medical care preferences in the event they become unable to communicate those wishes. Federal regulations under 42 CFR §483.10 require nursing facilities to inform residents of these rights, document their preferences, and ensure clinical staff follow those documented wishes in all care decisions.
The citation was classified at Scope/Severity Level D, meaning the violation was isolated in nature and did not result in documented actual harm. However, inspectors determined there was potential for more than minimal harm to residents — a designation that signals real risk if the deficiency is not addressed.
Why Treatment Consent Protections Matter
The right to refuse or discontinue treatment is one of the most fundamental protections in long-term care. When a facility fails to properly honor these rights, residents may receive unwanted medical interventions, experience procedures they explicitly declined, or find that their end-of-life preferences are not followed during critical moments.
For elderly residents, particularly those with cognitive decline or communication difficulties, the consequences of inadequate advance directive protocols can be significant. Without proper documentation and staff adherence, a resident who has clearly expressed a preference against aggressive resuscitation measures, for example, could receive interventions that contradict their stated wishes.
Proper protocol requires that facilities discuss advance directive options with every resident upon admission, document those decisions in the medical record, ensure all clinical staff are aware of each resident's preferences, and review those preferences periodically or when a resident's condition changes. A breakdown at any point in this chain can lead to care that does not align with what the resident has authorized.
Ten Total Deficiencies and No Correction Plan
The advance directive citation was one of 10 deficiencies identified during the complaint investigation. While the full details of each citation span multiple regulatory categories, the volume of findings from a single investigation indicates inspectors identified concerns across multiple areas of facility operations.
Perhaps most notable is the facility's correction status. As of the inspection record, Levindale Hebrew Geriatric Center & Hospital is listed as "Deficient, Provider has no plan of correction." Federal regulations typically require facilities to submit a plan of correction outlining specific steps they will take to remedy cited deficiencies and prevent recurrence. The absence of such a plan raises questions about the facility's timeline for addressing the identified issues.
Industry Context and Federal Standards
Nursing homes participating in Medicare and Medicaid programs are required to meet federal quality standards enforced through regular inspections and complaint investigations. Complaint investigations, such as the one conducted at Levindale Hebrew, are typically triggered by concerns reported by residents, family members, or staff.
A facility that does not submit a timely plan of correction may face escalating enforcement actions, which can include civil monetary penalties, denial of payment for new admissions, or in severe cases, termination from federal healthcare programs.
Levindale Hebrew Geriatric Center & Hospital is located in Baltimore, Maryland, and provides both geriatric and hospital-level care. Families with loved ones at the facility may wish to review the full inspection findings, which are available through the Centers for Medicare & Medicaid Services Care Compare website, and to discuss advance directive documentation directly with facility administration.
The full inspection report contains additional details on all 10 cited deficiencies. Readers are encouraged to review the complete findings on the [CMS Care Compare](https://www.medicare.gov/care-compare/) database.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Levindale Hebrew Ger Ctr & Hsp from 2025-11-18 including all violations, facility responses, and corrective action plans.