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Nursing HomeMedicaid Investigative

Creekside Center for Rehabilitation and Nursing

Below-average Medicare ratings — review the inspection history and ask the administrator about recent corrections before visiting.

1183 Luther Drive, Hagerstown, MD 2174080 bedsLicensed & Active
1/5
Medicare
Inspection
Quality
Staffing
Google rating
2.8/5

based on 45 Google reviews

5
4
3
2
1

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10/ 10
critical Risk

Quality Concerns Identified

Medicare inspection and quality data reveal areas that families should carefully evaluate before choosing this facility.

  • Special Focus Facility (under heightened CMS scrutiny)
  • Abuse citation on record
  • Low overall rating (1/5 stars)
  • Low staffing rating (2/5 stars)
  • Above-median deficiencies (43 vs median 16.0)
  • High staff turnover (74%)
  • High RN turnover (70%)

Bottom 25% in MD · Below recommended RN staffing · Very high staff turnover · Worst in MORDECHAI WEISZ chain · $101,178 in fines · Special Focus Facility (CMS) · Abuse citation

Source: Medicare data

What this means for your family

While the facility has a capable therapy team, the recurring reports of severe neglect, medication errors, and lack of responsiveness are critical red flags. We strongly advise families to look elsewhere or, if you must choose this facility, ensure you have a family member present daily to monitor care and medication administration.

Google Reviews

Google Reviews

45 reviews on Google
Creekside Center for Rehabilitation and Nursing receives highly polarized feedback, with some families praising the therapy team and facility cleanliness while others report severe neglect and staffing shortages. Multiple reviewers have documented alarming incidents involving medication errors, poor hygiene, and delayed responses to urgent medical needs. Families considering this facility should be aware of a significant pattern of complaints regarding the quality of nursing care and responsiveness.

Quality Themes

Tap a score for details
Food5.0Staff3.0Clean4.0Activities6.0Meds1.0MemoryN/AComms2.0Value2.0

Strengths

  • Effective physical and occupational therapy
  • Clean, well-maintained facility environment
  • Attentive and professional individual staff members

Concerns

  • Severe understaffing and slow response times (mentioned by 8 reviewers)
  • Neglect and poor quality of nursing care (mentioned by 9 reviewers)
  • Rude or unprofessional staff behavior (mentioned by 7 reviewers)
  • Medication management and administration errors (mentioned by 3 reviewers)
  • Unsanitary facility conditions (mentioned by 4 reviewers)

Rating Trends

Tap a year to see what changed

234'17(2)'19(1)'21(2)'23(6)'25(7)'26(3)

Distribution · 47 analyzed

5
18
4
2
3
0
2
2
1
25

How They Respond to Reviews

20%response rate

This facility rarely responds to reviews.

Questions for Your Tour

  • 1Given the recent feedback regarding response times, what specific protocols are in place to ensure residents receive timely assistance when they use their call lights?
  • 2I noticed the facility has had a high volume of state-reported deficiencies recently; what concrete steps is leadership taking to improve oversight and quality of care?
  • 3How does the nursing team manage medication administration to ensure accuracy and prevent the errors that have been a point of concern for some families?
  • 4While the physical therapy department is highly regarded, what measures are being taken to ensure that the nursing staff provides the same level of consistent, professional care throughout the day and night?
  • 5Could you walk me through your process for addressing family concerns or complaints, and how do you ensure that communication remains transparent and responsive?
  • 6What does a typical daily activity schedule look like for residents, and how do you encourage social engagement in a way that keeps the environment vibrant and clean?

Personalized based on this facility's data


Key Review Excerpts

My mom needed help and would be waiting for hours until nurse arrived. Our family ended being the ones to take care of her since the staff wouldn't come help.

Family member of rehab patient · 2024☆☆☆☆

Due to the excellent care and planning by the Physical and Occupational therapy staff within a week I took my first steps.

Rehab patient · 2020★★★★★

My mother was left laying in her own vomit for about an hour. We had to drive there to get her help. When she became ill we were never notified she had been sent to the hospital.

Family member · 2023☆☆☆☆
Source: 45 Google reviews

Staffing

Staffing Hours

per resident/day · Medicare 2026
RN Hours
0.68hrs
91%
Registered nurses for medical care
Total Nursing
3.27hrs
80%
All nurses + aides combined
Staff Turnover
69%
Lower is better (< 30% = good)
RN Turnover
71%
Lower is better (< 30% = good)

Both RN and total nursing hours are below national benchmarks. This can mean less clinical attention per resident, so ask about their staffing plan.

Quality Measures

Quality Measures

Resident outcomes compared with national, state, and local averages · 17 measures

Medicare Rating
3/ 5
Better Than Avg

5

measures

Worse Than Avg

10

measures

Mixed Results

2

measures

Long-Stay Residents
😔

Residents with depression symptoms

↓ Lower is better
This Facility44.4%
Worse than Avg
Here
44.4%
US
12.1%
MD
22.2%
Washington
7.0%

Highly dependent on how each facility screens and codes depressive symptoms, so it varies widely between facilities.

🚶

Residents whose walking got worse

↓ Lower is better
This Facility28.4%
Worse than Avg
Here
28.4%
US
15.3%
MD
24.5%
Washington
15.4%
💊

Residents on anti-anxiety or sleep medication

↓ Lower is better
This Facility29.2%
Worse than Avg
Here
29.2%
US
19.5%
MD
16.6%
Washington
19.2%
🛏️

Residents needing more daily help over time

↓ Lower is better
This Facility11.9%
Better than Avg
Here
11.9%
US
14.4%
MD
21.5%
Washington
14.4%
🚿

Residents whose bladder or bowel control got worse

↓ Lower is better
This Facility27.9%
Worse than Avg
Here
27.9%
US
19.4%
MD
25.1%
Washington
20.0%
💊

Residents on antipsychotic medication

↓ Lower is better
This Facility20.6%
Worse than Avg
Here
20.6%
US
15.5%
MD
14.1%
Washington
16.5%
Short-Stay Residents (Rehab / Post-Acute)
💉

Short-stay residents vaccinated for pneumonia

↑ Higher is better
This Facility63.7%
Worse than Avg
Here
63.7%
US
81.8%
MD
78.7%
Washington
83.4%
💉

Short-stay residents vaccinated for the flu

↑ Higher is better
This Facility62.0%
Worse than Avg
Here
62.0%
US
79.8%
MD
80.6%
Washington
80.1%
💊

Short-stay residents newly given antipsychotics

↓ Lower is better
This Facility1.4%
Mixed vs Avgs
Here
1.4%
US
1.6%
MD
1.3%
Washington
1.1%
Source: Medicare quality measures

US average from Medicare published data

Inspection History

Medicare Inspection History

3-year lookback · Medicare 2026

23deficiencies
2penalties
Above state avg (18.9)
29 complaint-triggered
$101,178 in fines

Families have filed multiple complaints, triggering 26 deficiencies concerning accident prevention, medication management, and abuse prevention response. The facility shows recurring problems with accident hazards across multiple years and complaint investigations into abuse reporting failures as recently as October 2025. While most issues are marked as corrected, the persistent pattern of serious safety concerns and family complaints about inadequate care supervision raises significant quality concerns.

Feb 6, 2026Routine
27
0812Potential for harm · WidespreadCorrected

Nutrition and Dietary Deficiencies

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

0026Potential for harm · WidespreadCorrected

Emergency Preparedness Deficiencies

Establish roles under a Waiver declared by secretary.

0345Potential for harm · WidespreadCorrected

Smoke Deficiencies

Have approved installation, maintenance and testing program for fire alarm systems.

0353Potential for harm · WidespreadCorrected

Smoke Deficiencies

Inspect, test, and maintain automatic sprinkler systems.

0761Potential for harm · WidespreadCorrected

Miscellaneous Deficiencies

To conduct inspection, testing and maintenance of fire doors by qualified individuals.

0918Potential for harm · WidespreadCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Have generator or other power source capable of supplying service within 10 seconds.

0578Potential for harm · PatternCorrected

Resident Rights Deficiencies

Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.

0100Potential for harm · PatternCorrected

Construction Deficiencies

Meet other general requirements.

0211Potential for harm · PatternCorrected

Egress Deficiencies

Keep aisles, corridors, and exits free of obstruction in case of emergency.

0223Potential for harm · PatternCorrected

Egress Deficiencies

Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.

0362Potential for harm · PatternCorrected

Smoke Deficiencies

Ensure that corridors are separated from use areas by walls constructed to limit the passage of smoke.

0363Potential for harm · PatternCorrected

Smoke Deficiencies

Install corridor and hallway doors that block smoke.

0920Potential for harm · PatternCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Ensure proper usage of power strips and extension cords.

0550Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

0636Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.

0641Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Ensure each resident receives an accurate assessment.

0657Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

0684Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

0686Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide appropriate pressure ulcer care and prevent new ulcers from developing.

0689Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

0697Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide safe, appropriate pain management for a resident who requires such services.

0756Potential for harm · IsolatedCorrected

Pharmacy Service Deficiencies

Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.

0760Potential for harm · IsolatedCorrected

Pharmacy Service Deficiencies

Ensure that residents are free from significant medication errors.

0880Potential for harm · IsolatedCorrected

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

0887Potential for harm · IsolatedCorrected

Infection Control Deficiencies

Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.

0919Potential for harm · IsolatedCorrected

Environmental Deficiencies

Make sure that a working call system is available in each resident's bathroom and bathing area.

0947Potential for harm · IsolatedCorrected

Nursing and Physician Services Deficiencies

Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.

Feb 6, 2026Complaint
3
0580Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.

0609Potential for harm · IsolatedCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

0677Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide care and assistance to perform activities of daily living for any resident who is unable.

Dec 23, 2025Complaint
1
0689Immediate jeopardy · IsolatedResolved (past non-compliance)

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Oct 17, 2025Complaint
3
0689Actual harm · IsolatedResolved (past non-compliance)

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

0609Potential for harm · PatternCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

0610Potential for harm · IsolatedCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Respond appropriately to all alleged violations.

Feb 21, 2025Complaint
4
0880Potential for harm · PatternCorrected

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

0656Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

0684Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

0757Potential for harm · IsolatedCorrected

Pharmacy Service Deficiencies

Ensure each resident’s drug regimen must be free from unnecessary drugs.

Aug 5, 2024Complaint
18
0604Immediate jeopardy · IsolatedCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.

0684Immediate jeopardy · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

0689Actual harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

0660Potential for harm · WidespreadCorrected

Resident Assessment and Care Planning Deficiencies

Plan the resident's discharge to meet the resident's goals and needs.

0838Potential for harm · WidespreadCorrected

Administration Deficiencies

Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies.

0610Potential for harm · PatternCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Respond appropriately to all alleged violations.

0711Potential for harm · PatternCorrected

Nursing and Physician Services Deficiencies

Ensure the resident's doctor reviews the resident's care, writes, signs and dates progress notes and orders, at each required visit.

0677Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide care and assistance to perform activities of daily living for any resident who is unable.

0580Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.

0622Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged.

0656Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

0658Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Ensure services provided by the nursing facility meet professional standards of quality.

0712Potential for harm · IsolatedCorrected

Nursing and Physician Services Deficiencies

Ensure that the resident and his/her doctor meet face-to-face at all required visits.

0744Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.

0686Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide appropriate pressure ulcer care and prevent new ulcers from developing.

0692Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide enough food/fluids to maintain a resident's health.

0695Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide safe and appropriate respiratory care for a resident when needed.

0697Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide safe, appropriate pain management for a resident who requires such services.

Federal Penalties

Fine

Oct 17, 2025

$10,358

Fine

Aug 5, 2024

$101,178

Ownership & Operations

Who Operates This Facility

Owner / Operator

Creekside Center for Rehabilitation and Nursing

Organization Type

for profit

Chain Affiliation

Chain Name

Mordechai Weisz

Chain Size

7 facilities nationwide

Chain avg rating: 2.6/5 · Rank 7 of 7 (Worst)

Ownership & Management

Key personnel

Elebiary, AhmedManaging Control - Governing BodyWeisz, MordechaiManaging Control - Governing BodyLions Healthcare Management LLCManagerElebiary, AhmedManagerTruslow, CynthiaManager
Source: Medicare provider data

Contact

Get in Touch

Contact this facility directly and verify the details that matter most to your family.

References & Resources

EveryPlace is a research directory. Facility information is compiled from public sources — Medicare.gov, state licensing portals, Google Places, and publicly available street-level imagery. Listings do not constitute endorsement, recommendation, or advertisement, and we do not accept payment for placement. Families should verify all details directly with the facility and the original sources linked above before making any care decisions. See our Research Policy for our editorial standards, correction process, and image-removal policy.

Safer Alternatives Nearby

Based on current clinical data, we identified 6 nearby facilities within 10 miles that may offer a stronger care environment. We encourage families to compare options carefully.

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