Elkton Nursing and Rehab: Care Plan Failures Found - MD
That resident, identified in inspection records as Resident 58, told a state surveyor on September 29, 2025 that the social worker "is unable to answer any of my questions about my medical care and business concerns." They said they were "always told just to fill out a grievance form." The resident had kept the paperwork: a meeting invitation received two days before the September 25 meeting, a care plan report, and the blank form. That was it.
The inspection, completed October 9, 2025, found the facility failed to ensure residents could meaningfully participate in the development, review, and revision of their own care plans. The deficiency covered every resident investigated, two out of two.
The second resident, Resident 14, told inspectors that care plan meetings happened frequently but were attended only by the social worker, Staff 36, the facility's Director of Social Services. The meetings were "not very helpful," the resident said. They could not discuss their concerns about depression. They did not feel supported.
When the surveyor confronted Staff 36 directly on October 3, the social worker confirmed what both residents had described. Care plan meetings were routinely held at the bedside. The interdisciplinary team, the nurses, physicians, therapists, and other specialists whose collective input is the entire point of a care plan, did not attend. Staff 36 said the team was invited and the meetings were posted, but acknowledged: "IDT does not usually attend at the bedside with Social Services and the resident."
The sign-in sheets made the pattern concrete. For Resident 58's September 25 meeting, only Staff 36's assistant and the resident had signed in. For Resident 14, inspectors reviewed sign-in sheets from four consecutive care plan meetings held across nearly five months, from April through August of 2025. Three of the four were attended solely by the resident and the social services assistant. A recreational therapy director showed up once. A physical therapy director came once. Nobody else, across any of those meetings, ever did.
Inspectors also found two discharge planning notes in Resident 58's file, dated September 1 and September 8, 2025, that were identical word for word. Both described the resident as "alert and easily agitated," with "frustration and anger about their stay at this facility."
On October 9, the final day of the inspection, Staff 36 confirmed there was no additional documentation to support that full care plan meetings had ever taken place for either resident.
Then Staff 36 offered an explanation for why Resident 14 might be upset. The resident was "likely mad," the social worker said, because staff had confiscated the resident's marijuana at the request of the Director of Nursing. The surveyor asked for documentation of the confiscation. Staff 36 said there was none.
The facility is rated by CMS for its care. The inspection was triggered by a complaint.
Resident 14 still cannot discuss their depression in a care plan meeting that includes anyone qualified to address it. Resident 58 still has the blank grievance form.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Elkton Nursing and Rehabilitation Center from 2025-10-09 including all violations, facility responses, and corrective action plans.
Download the official CMS inspection PDF from Medicare.gov
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.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: September 23, 2026 · Our methodology
ELKTON NURSING AND REHABILITATION CENTER in ELKTON, MD was cited for violations during a health inspection on October 9, 2025.
The deficiency covered every resident investigated, two out of two.
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.