Community Extended Care Hospital Of Montclair
Community Extended Care Hospital Of Montclair in Montclair, CA — inspection on January 2, 2026.
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.
Inspection Findings
medication order to the wrong resident.During a follow up interview on December 30, 2025, at 3:30
unnecessary for her, unfortunately. RN 1 further stated she should have double checked the
entering the order, but she did not.
During an interview on December 31, 2025, at 1:00 PM, the Administrator acknowledged the medication reconciliation practice error, stating Resident 1 did not receive his prescribed medication to manage his medical condition, and it was instead entered under Resident 2, who received six doses unnecessarily.
The Administrator stated the facility expects the admission nurse to review hospital records and verify medication indications at admission and DON will review the admission chart the next business day after admission for accuracy and completeness.
The Administrator also acknowledged that the facility does not have a written P&P governing the admission process, including medication orders upon admission. A review of Resident 1's MAR for the period of December 16, 2025, through December 31, 2025, indicated that Valproic Acid 250 mg, 1 capsule by mouth three times daily, was not initiated for Resident 1 until December 21, 2025, because the medication order had been entered under another resident (Resident 2).
The MAR confirmed Resident 1 did not receive a total of twelve doses of his Valproic Acid required to manage his clinical condition.
During an interview on January 2, 2026, at 2:00PM, with the Pharmacist, the Pharmacist stated that after a resident is admitted to the facility, the pharmacy typically reviews new admission medication orders within 4 to 8 hours or on the same day.
The pharmacist stated that this review includes verification of medication strength, frequency, potential drug interactions, and clinical indication.
The pharmacist further stated that it is not the pharmacy's usual process to review the hospital medication list, and that review of hospital discharge records is typically the responsibility of the facility.
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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.