Arrowhead Springs Healthcare Center

    1335 N Waterman Ave, San Bernardino, CA, 92404
    3.5 · 21 reviews
    • Assisted living
    • Memory care
    • Skilled nursing
    AnonymousLoved one of resident
    1.0

    Compassionate staff but severe neglect

    I had a split experience. I encountered some extraordinary, compassionate nurses, an involved DON/administrator, and very good therapy/medical care - but I also saw severe neglect: patients left in urine, bedsores, long call-button waits, missed/wrong meds, staff sleeping nights, filthy rooms, stolen/missing belongings and poor management. Because of the safety, staffing and cleanliness issues, I cannot recommend this facility despite a few outstanding staff.

    Pricing

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    Amenities

    Healthcare services

    • Activities of daily living assistance
    • Assistance with bathing
    • Assistance with dressing
    • Assistance with transfers
    • Medication management
    • Mental wellness program

    Healthcare staffing

    • 12-16 hour nursing
    • 24-hour call system
    • 24-hour supervision

    Meals and dining

    • Diabetes diet
    • Meal preparation and service
    • Restaurant-style dining
    • Special dietary restrictions

    Room

    • Air-conditioning
    • Cable
    • Fully furnished
    • Housekeeping and linen services
    • Kitchenettes
    • Private bathrooms
    • Telephone
    • Wifi

    Transportation

    • Community operated transportation
    • Transportation arrangement
    • Transportation arrangement (non-medical)

    Common areas

    • Beauty salon
    • Computer center
    • Dining room
    • Fitness room
    • Gaming room
    • Garden
    • Outdoor space
    • Small library
    • Wellness center

    Community services

    • Concierge services
    • Fitness programs
    • Move-in coordination

    Activities

    • Community-sponsored activities
    • Planned day trips
    • Resident-run activities
    • Scheduled daily activities

    3.48 · 21 reviews

    Overall rating

    1. 5
    2. 4
    3. 3
    4. 2
    5. 1
    • Care

      2.7
    • Staff

      3.2
    • Meals

      2.0
    • Amenities

      1.0
    • Value

      3.5

    Pros

    • Attentive and compassionate nursing staff (reported by multiple reviewers)
    • Caring, friendly, and welcoming caregivers
    • Successful physical therapy outcomes
    • Involved and engaged Director of Nursing and Administrator (per some reviewers)
    • High-quality medical care for some residents
    • Professional, top‑notch service reported by some families
    • Supportive team culture felt by some employees/visitors
    • Leadership praised by several reviewers
    • Positive intake/communication experience for inquiries (per one review)

    Cons

    • Filthy conditions and strong urine odor
    • Understaffing and overworked nurses
    • Neglectful care: patients left in soiled diapers, bed sores reported
    • Long call‑button response times
    • Supply shortages and lack of basic amenities (no filtered drinking water)
    • Nonfunctional air conditioning and hot, dirty break room
    • Poor communication and unhelpful or arguing staff
    • Medication errors, missing medicines, and medication cart issues
    • Theft/missing personal belongings
    • Infection concerns (UTIs) and at least one hospital transfer
    • Staff sleeping on night shift reported
    • Dental care and daily grooming rarely performed
    • Safety issues (breathing machine not set up, unsafe conditions)
    • Retaliation/fear among staff about speaking up and reports of poor management
    • Poor meal quality/taste
    • State complaint filed and calls for facility shutdown from reviewers

    Summary review

    Overall sentiment across the reviews for Arrowhead Springs Healthcare Center is highly polarized. Some reviewers describe outstanding, attentive, and professional care—highlighting caring nursing staff, successful physical therapy outcomes, engaged leadership (Director of Nursing and Administrator), and overall high‑quality medical care. Other reviewers, however, report severe and persistent problems, including filthy conditions, understaffing, neglectful care, safety concerns, and poor management. The prevalence of both strong praise and serious complaints suggests wide variability in experiences that may be tied to shifts, units, time periods, or individual staff members.

    Care quality: Reviews range from “extraordinary staff” and “very happy with my care” to allegations of neglect so severe that patients were left in urine‑ and feces‑filled diapers, developed bed sores, or required hospital transfer for infections such as UTIs. Some families report successful rehabilitation and plan to place loved ones there for physical therapy, while others say daily grooming and dental care are rarely performed. Specific clinical safety issues were mentioned (e.g., breathing machine not set up, wrong medication, medicine missing from carts), indicating lapses in medication management and equipment setup in some cases.

    Staffing and staff behavior: Staffing levels and staff performance are recurring themes. Multiple reports describe nurses as overworked and the facility as understaffed; other reports highlight passionate, attentive nurses who provide compassionate care. Concerning claims include staff sleeping on night shift, long waits for call‑button responses, arguments among staff, and instances where nurses feel unable to speak up for fear of being fired. At least one reviewer filed a state complaint. These mixed reports point to inconsistent staffing practices and variability in staff conduct and morale.

    Facilities, supplies, and cleanliness: Several reviewers report serious problems with the physical environment—filthy rooms, strong urine odor, dirty wet beds, and a dirty, hot break room. Infrastructure issues include nonfunctional air conditioning and lack of filtered drinking water. Supply shortages are mentioned explicitly. Conversely, other reviewers describe the facility as wonderful and top notch. The cleanliness, odour control, and maintenance appear to be inconsistent across reports and are a major area of concern for those who had negative experiences.

    Safety, security, and belongings: Theft and missing personal belongings were reported (including a $40 item and a stolen wallet), with at least one reviewer stating there was no callback about missing items. Medication errors, missing medicines from carts, and safety lapses such as breathing equipment not being set up have been cited. One reviewer reported an infection that led to hospital transfer. These issues raise red flags about the facility’s security procedures, property handling, and clinical safety protocols.

    Communication, management, and culture: Communication problems were described by multiple reviewers — long response times, poor follow‑up on concerns, and staff who are unhelpful or argumentative. Yet some reviews praise leadership for being extremely involved in patient care and culture, and others say they felt like part of the team. This split suggests management practices and culture may vary by department or over time; some families view leadership as proactive, while others perceive poor management and even retaliation against staff who speak up.

    Dining and other services: Food quality received at least one negative comment (meals poor/bad tasting), while small positive gestures (e.g., donuts given as thanks) were noted by some. There is little detailed information about activities programming, but physical therapy was singled out positively in several accounts.

    Patterns and recommendations: The most frequently mentioned positive theme is the dedication and compassion of many individual nurses and therapists, and successful rehabilitation for some residents. The most frequent and serious negative themes are environmental cleanliness, understaffing/overworked staff, neglect of basic hygiene and grooming, medication and equipment errors, theft of personal items, and inconsistent management. Because of the starkly opposite accounts, prospective residents and families should treat these reviews as indicators of variability rather than as definitive proof of uniformly good or bad care.

    If considering this facility, it would be prudent to: (1) tour the unit(s) where the resident would stay at different times (day/night) to assess staffing and cleanliness; (2) ask administration about staffing ratios, turnover, and staff training; (3) request recent state inspection reports and any corrective action plans; (4) inquire about infection control protocols, call‑bell response times, medication management procedures, and property/security measures; and (5) seek references from current families receiving similar services (skilled nursing vs. rehab). The reviews show there are talented, caring staff and positive clinical outcomes for some residents, but also serious and potentially dangerous lapses reported by others — warranting careful, individualized investigation before placing a loved one.

    Location

    Map showing location of Arrowhead Springs Healthcare Center

    About Arrowhead Springs Healthcare Center

    Arrowhead Springs Healthcare Center stands as a non-profit skilled nursing facility with a strong reputation in the community, having earned various accreditations and a 4-star overall rating on Medicare.gov, which says a lot about its level of care and safety. The facility has gone through recent renovations, adding new amenities and making the place more comfortable for residents, and it pays close attention to outdoor spaces with landscaped grounds and activity areas so people can enjoy fresh air and socialize at their own pace. People here receive a wide range of care, including comprehensive medical support, wound care, skilled nursing services, short-term rehabilitation, and long-term care, all carried out by a dedicated staff that works in a favorable patient-to-staff ratio, so residents get more personal attention when they need it. Arrowhead Springs Healthcare Center offers expertise in physical, occupational, and speech therapy, with in-house therapy options that use modern, hands-on therapeutic approaches tailored to help folks regain strength and mobility, making recovery a main focus for those coming from hospital stays.

    When it comes to daily living, the center assists with things like bathing, dressing, meals, and getting around, and also helps with more specialized care such as sub-acute rehab and wound care, which some residents need for their condition. The place offers studio and companion apartments, and inside you'll find walk-in showers, Wi-Fi, and spaces to relax or join activities like art programs, cards and games, fitness classes, movie nights, social events, and worship services, so there's always a way to stay engaged without feeling rushed. Residents can join in a wide variety of excursions and activities that are listed on a monthly calendar, and these programs are personalized to suit each person's interests and needs, making life feel a bit fuller. Transportation is available for appointments and outings, and community engagement is encouraged, so folks don't feel too isolated. Staff members work with residents and families through a personalized care planning process, focusing on what helps each person get stronger and more comfortable as the days go by, and overall, the supportive environment here helps many people feel safe and cared for as they recover or settle into longer-term stays.

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