River Bend Nursing Center

    2215 Oakmont Way, West Sacramento, CA, 95691
    3.9 · 95 reviews
    • Assisted living
    • Memory care
    • Skilled nursing
    AnonymousLoved one of resident
    3.0

    Caring staff but inconsistent care

    I appreciate the warm, professional, family-like staff - nurses, CNAs, RTs and rehab have helped my mom (here since 2013) and the facility is generally clean and comfortable. That said, staffing is inconsistent and often short, communication with doctors/therapy can be poor, and I've seen lapses: delayed call responses, hygiene/food problems, missing belongings and occasional unsafe or unsanitary conditions. Management and many individual caregivers are responsive and compassionate, but accountability is uneven and some staff are unprofessional. Overall, caring and effective people do great work here, but families must stay vigilant and advocate for their loved ones.

    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

    3.94 · 95 reviews

    Overall rating

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

      3.6
    • Staff

      3.8
    • Meals

      1.2
    • Amenities

      2.8
    • Value

      1.3

    Pros

    • Warm, friendly and compassionate staff
    • Many nurses and CNAs described as attentive and hardworking
    • Strong, effective physical therapy and rehabilitation services (for many residents)
    • Good speech therapy and respiratory care in some cases
    • Helpful and engaged social workers (reported by several families)
    • Regular checks on residents and prompt updates when contacted
    • Responsive communication from some nurses and receptionists
    • Clean rooms and well-maintained areas reported by multiple reviewers
    • Facility-wide cleanliness praised by many families
    • Activities calendar and on-site activities (singing, crafts, group events)
    • Activities brought to residents' rooms when needed
    • Medication management and timely medication delivery in many reports
    • Coordinated discharge planning and insurance coordination
    • Daily doctor visits and attentive physicians reported by some reviewers
    • Staff introduce themselves and create a family-like environment
    • Care conferences and periodic care planning meetings held
    • Maintenance responsiveness and fixed issues when reported
    • Successful recovery stories and positive rehabilitation outcomes
    • Long-term residents reporting consistent care over years
    • Reception and administrative staff praised for responsiveness (in some cases)
    • Facility described as a great place to work by some employees
    • Specific employees repeatedly named for excellent care
    • Residents kept clean and personal grooming attended to in positive reports
    • Quiet, calm environment and no usual nursing-home smell reported by some
    • Compassionate end-of-life and post-surgical care reported by families

    Cons

    • Allegations of abuse and neglect by staff (multiple reports)
    • Reports of unconsented medical procedures and falsified documents
    • Serious incidents: delayed CPR, patient deaths, state investigation
    • Frequent understaffing and staff shortages (including overnight gaps)
    • Inconsistent staffing and heavy staff turnover
    • Undertrained or inexperienced staff on some shifts
    • Nurses and CNAs dismissing or not responding to complaints and call lights
    • Residents left in urine/feces for long periods
    • Poor personal care: not helping with brushing teeth, dentures left unattended
    • Refusal or lack of physical/occupational therapy unless paid
    • Physical therapy/clinical plans not developed or followed for some patients
    • Poor infection control: scabies outbreak, COVID infections reported
    • Unsanitary conditions in some areas (diaper waste odor, contaminated areas)
    • Bathing reported poorly (even using a hose in one account)
    • Meals frequently criticized as poor, insufficient protein, patient hunger/malnutrition
    • Patient grooming neglected (uncut nails, chapped lips) in some reports
    • Belongings lost or not returned; suspected theft
    • Administration unresponsive or evasive; alleged lying about doctor visits
    • Coercive or disruptive discharge practices and delayed discharge paperwork
    • High, unexpected billing for doctor visits and services reported
    • Overcrowded rooms and lack of privacy
    • Inadequate PPE and outdated equipment cited
    • Restricted TV access or other comforts due to roommate issues
    • Skin irritation from soap and other care products reported
    • Glasses and personal items removed or misplaced after moves
    • Poor pain and diabetes management reported in multiple cases
    • Phone responsiveness poor; calls hung up or unanswered
    • Night and weekend care gaps; staff breaks poorly coordinated
    • Disrespectful, unprofessional leadership behavior (e.g., DON yelling)
    • Chaotic floors and lack of teamwork during some shifts
    • Allegations of fake or deceptive positive reviews
    • Inconsistent social work support; families told to constantly advocate
    • Delayed or absent doctor contact and minimal physician visits for some
    • Inadequate rehabilitation availability in-house unless paid privately
    • Residents disturbed by others with behavioral/mental health issues
    • Environment described as money-driven with minimal standards by some reviewers
    • Variable quality across units/shifts leading to highly mixed experiences

    Summary review

    The reviews for River Bend Nursing Center present a deeply mixed and polarized picture with strong praise from many families and severe, sometimes alarming complaints from others. Several recurring positive themes include warm, compassionate staff who create a family-like atmosphere; highly regarded nursing, CNA, respiratory and rehabilitation teams in many cases; effective physical and speech therapy leading to documented recovery successes; responsive communication from specific nurses and administrative personnel; and reports of a generally clean, well-maintained facility and individual rooms. Multiple reviewers recount attentive check-ins, timely medication delivery, coordinated discharge planning, helpful social work involvement, and staff who go beyond expectations for residents’ comfort and rehabilitation. Long-term residents and families who have witnessed recovery after strokes or surgeries often highlight specific staff members and departments (PT, RT, nursing leadership) for outstanding care and recommend the facility.

    Counterbalancing this praise are numerous and serious negative reports that collectively indicate inconsistent care quality and, in some instances, potential systemic problems. A strong cluster of complaints centers on neglect and abuse: claims include staff-caused harm, unconsented procedures, falsified documentation, delayed emergency response (alleged delayed CPR), multiple deaths and a state investigation. These are among the most severe allegations and are echoed by reports of residents being left in urine or feces, poor personal hygiene assistance (including denture and oral care neglect), and refusal or failure to develop or provide physical/occupational therapy plans for some residents. Multiple families report that therapy services are inconsistent or only provided if families pay privately, contributing to perceptions of money-driven policies.

    Understaffing and staff inconsistency are frequent explanations given for many negative experiences. Reviewers report nights and weekends with inadequate coverage, staff who take breaks at the same time leaving units short-staffed, and a perception of undertrained or inexperienced personnel on certain shifts. Operational consequences described include slow or absent responses to call lights, delayed medication or physician contact, poor infection control (scabies, COVID outbreaks), unsanitary conditions in parts of the building, and general chaos on certain floors. Several reviews call out problematic administrative behavior — from unresponsiveness to families, alleged lies about doctor visits, to coercive discharge practices and missing or delayed paperwork — which exacerbates family distress and undermines trust.

    There is a notable dichotomy in reports about cleanliness, privacy, and the environment: many reviewers praise the facility as clean, quiet, and well-maintained with no persistent odors, while others describe diaper waste, odor, contaminated areas, overcrowded rooms, and inadequate equipment or PPE. Dining quality is another consistent pain point—numerous reviewers complain of poor food, insufficient protein, and residents on puree diets becoming hungry or malnourished. Personal belongings and valuables are another common concern, with multiple reports of lost items, dentures not returned promptly, and even suspected theft; these issues are aggravated by poor phone responsiveness and administrative evasiveness in follow-up.

    Activities and social engagement receive generally positive mentions: an activities calendar, group events (singing, crafts), and bringing activities into residents’ rooms are noted as strengths, though some families feel mental health and meaningful engagement remain insufficient. Staffing praise is often very specific — particular RNs, CNAs, therapists, or the Director of Nursing receive repeated commendations — suggesting pockets of excellence. Conversely, there are also reports of verbally abusive behavior by some staff, uncomfortable situations involving certain CNAs, and an unprofessional leadership presence that affects morale and care on some shifts.

    Overall, the reviews suggest a facility capable of delivering very high-quality, compassionate care in many instances, with strong rehabilitation outcomes and a cadre of dedicated staff. However, there are serious, recurring concerns about inconsistent staffing, potential neglect or abuse, infection control lapses, poor administrative transparency, and variable housekeeping and dining standards. The pattern indicates that resident experience at River Bend can vary dramatically depending on the unit, shift, or individual caregivers involved. Families considering placement should weigh the positive testimonials of skilled, caring teams and successful recoveries against the documented negative incidents and systemic complaints. Prospective residents and families would be wise to ask specific questions about staffing ratios (including nights/weekends), therapy availability and coverage, infection control practices, how grievances and incidents are investigated, and to request tours, staff introductions, and references from current families or residents before making decisions.

    Location

    Map showing location of River Bend Nursing Center

    About River Bend Nursing Center

    River Bend Nursing Center sits in West Sacramento, California, and offers skilled nursing and sub-acute care, which means folks here get help from trained nurses around the clock and can also get extra care if they're recovering from an illness or surgery, and you know, this place feels warm and nurturing because the staff make sure everyone's treated kindly. Residents find a variety of activity programs to keep them busy and engaged through the week, and there are social services to help with personal or family challenges. The facility gives rehabilitation services, which include things like physical or occupational therapy to help people regain strength or movement, and there are certified wound care nurses who know how to take care of more complex wounds, which is something not every place offers. Everyone here gets a customized care plan, because not everyone needs the same kind of care, and the team of professionals are qualified in their fields. All day and all night, skilled nursing and sub-acute care are available, and many families find comfort in knowing the staff is always around.

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