Community Extended Care Hospital of Montclair · Community Convalescent Center of Montclair Inc

9096214751 · 9620 Fremont Avenue, Montclair, CA 91763

Overview

Community Extended Care Hospital of Montclair is a nursing home approved by U.S Centers for Medicare & Medicaid Services (CMS). The federal provider number is #056444. The provider type is Medicare and Medicaid. The ownership type is for profit - individual. The address is 9620 Fremont Avenue, Montclair, CA 91763. The overall rating is 4.

Federal Provider Number 056444
Provider Name COMMUNITY EXTENDED CARE HOSPITAL OF MONTCLAIR
Legal Business Name COMMUNITY CONVALESCENT CENTER OF MONTCLAIR INC
Address 9620 Fremont Avenue
Montclair
CA 91763
County San Bernardino
Telephone 9096214751
Ownership Type For profit - Individual
Provider Type Medicare and Medicaid
Date Approved 1974-03-15
Number of Certified Beds 140
Average Number of Residents per Day 117
Provider Resides in Hospital N
Continuing Care Retirement Community N
Abuse Icon N
Cited for abuse or neglect at harm level or above on survey cycle 1 (Scope/severity G or greater) or cited for abuse or neglect at potential harm level (Scope/Severity D or above) on both survey cycles 1 and 2.
Most Recent Health Inspection More Than 2 Years Ago N
Provider Changed Ownership in Last 12 Months N
With a Resident and Family Council Resident
Automatic Sprinkler Systems in All Required Areas Yes
Overall Rating 4
Health Inspection Rating 4
Quality Measure Rating 3
Long Stay Quality Measure Rating 3
Short Stay Quality Measure Rating 3
Staffing Rating 3
Registered Nurses Staffing Rating 2
Reported CNA Staffing Hours per Resident per Day 3.32579
Reported LPN Staffing Hours per Resident per Day 1.99773
Reported RN Staffing Hours per Resident per Day 0.76088
Reported Licensed Staffing Hours per Resident per Day 2.75862
Reported Total Nurse Staffing Hours per Resident per Day 6.08440
Reported Physical Therapist Staffing Hours per Resident Per Day 0.05404
Expected CNA Staffing Hours per Resident per Day 2.22922
Expected LPN Staffing Hours per Resident per Day 0.84766
Expected RN Staffing Hours per Resident per Day 0.73310
Expected Total Nurse Staffing Hours per Resident per Day 3.80997
Adjusted CNA Staffing Hours per Resident per Day 3.07153
Adjusted LPN Staffing Hours per Resident per Day 1.74615
Adjusted RN Staffing Hours per Resident per Day 0.41536
Adjusted Total Nurse Staffing Hours per Resident per Day 5.11013
Rating Cycle 1 Standard Survey Health Date 2019-10-03
Rating Cycle 1 Total Number of Health Deficiencies 11
Rating Cycle 1 Number of Standard Health Deficiencies 5
Rating Cycle 1 Number of Complavarchar Health Deficiencies 3
Rating Cycle 1 Health Deficiency Score 68
Rating Cycle 1 Number of Health Revisits 1
Rating Cycle 1 Health Revisit Score 0
Rating Cycle 1 Total Health Score 68
Rating Cycle 2 Standard Health Survey Date 2018-11-09
Rating Cycle 2 Total Number of Health Deficiencies 5
Rating Cycle 2 Number of Standard Health Deficiencies 3
Rating Cycle 2 Number of Complavarchar Health Deficiencies 2
Rating Cycle 2 Health Deficiency Score 20
Rating Cycle 2 Number of Health Revisits 1
Rating Cycle 2 Health Revisit Score 0
Rating Cycle 2 Total Health Score 20
Rating Cycle 3 Standard Health Survey Date 2017-11-16
Rating Cycle 3 Total Number of Health Deficiencies 7
Rating Cycle 3 Number of Standard Health Deficiencies 6
Rating Cycle 3 Number of Complavarchar Health Deficiencies 1
Rating Cycle 3 Health Deficiency Score 32
Rating Cycle 3 Number of Health Revisits 1
Rating Cycle 3 Health Revisit Score 0
Rating Cycle 3 Total Health Score 32
Total Weighted Health Survey Score 46.000
Number of Facility Reported Incidents 1
Number of Substantiated Complavarchars 5
Number of Citations from Infection Control Inspections 3
Number of Fines 0
Total Amount of Fines in Dollars 0.00
Number of Payment Denials 0
Total Number of Penalties 0
Processing Date 2021-05-01
Notes CMS: Centers for Medicare & Medicaid Services
CNA: Certified Nursing Assistant
LPN: Licensed Practical Nurse
RN: Registered Nurse

Ownership Information
COMMUNITY EXTENDED CARE HOSPITAL OF MONTCLAIR

Role PlayedOwner NameOwner TypeOwnership PercentageAssociation Date
5% OR GREATER DIRECT OWNERSHIP INTERESTMANDELBAUM, BRENDAIndividual100%since 09/01/1998
MANAGING EMPLOYEEGARCIA, JUMARIndividualsince 01/15/2018
OFFICERMANDELBAUM, JANETIndividualsince 01/02/2019

Location Information

Street Address 9620 FREMONT AVENUE
City MONTCLAIR
State CA
Zip Code 91763

Nursing Homes in the same zip code

Nursing Home NameAddressTelephoneDate ApprovedOverall Rating
Montclair Manor Care Center, LLC 5119 Bandera Street, Montclair, CA 9176390962612941973-08-014

Nursing Homes in the same city

Nursing Home NameAddressTelephoneDate ApprovedOverall Rating
Montclair Care Center LLC 111-115 Gates Avenue, Montclair, NJ 0704297374646161996-12-313
Hackensack-Umc Mountainside · Montclair Hospital LLC One Bay Ave, Montclair, NJ 0704297342969491998-01-085
Family of Caring Healthcare At Montclair LLC 42 North Mountain Ave, Montclair, NJ 0704297378394001998-06-154

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Meadowbrook Village Christian Retirement Community 100 Holland Glen, Escondido, CA 9202676074625002017-11-014
South Pasadena Care Center, LLC 904 Mission St, South Pasadena, CA 9103062639903582018-03-134
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Dataset Information

This dataset includes 15 thousand nursing homes approved by U.S Centers for Medicare & Medicaid Services (CMS) to provide Medicare & Medicaid services. CMS created Care Compare, a healthcare compare tool, for consumers to understand information about doctors, hospitals, and skilled nursing facilities. The information on nursing homes include number of certified beds, quality measure scores, staffing and other information used in the Five-Star Rating System.