Overall impression: The reviews for One Heartland at San Antonio Wellness and Rehabilitation are highly polarized. A substantial portion of reviewers describe excellent care, strong therapy teams, compassionate individual caregivers, and well-run aspects of the facility — especially within rehabilitation services. At the same time, a significant number of reviews recount serious lapses in basic nursing care, cleanliness, communication, and safety. The dominant pattern is one of variability: some families experienced near-exemplary, person-centered care and rapid rehab progress, while others report neglect, safety incidents, and administrative breakdowns. This creates an environment where outcomes depend heavily on timing, specific staff on duty, and unit assignment.
Care quality and staffing: The most consistent negative theme is understaffing and its downstream consequences. Many reviewers report that call bells go unanswered for long periods, hygiene needs (bathing, toileting, diaper changes) are delayed or missed, and meals are not administered with necessary assistance. Night shift care is repeatedly singled out as weaker than day shift, and families often report having to supervise or assist with basic care due to staff shortages. Medication delays, missed antibiotics, and delayed pain management are frequently cited. On the positive side, dozens of reviews praise individual nurses, CNAs, and coordinators for being compassionate, attentive, and skilled — some staff members are repeatedly named and celebrated. The net picture is inconsistent staffing competence and coverage: when the right staff and leadership are present, care is good; when understaffing or management lapses occur, patient safety and dignity suffer.
Safety, clinical concerns, and severe incidents: Several reviewers describe serious safety incidents including falls, delayed response to emergent conditions (low oxygen saturation, delayed antibiotics), and injuries that families believe were mishandled. There are multiple reports of unanswered 911/ambulance calls, delayed emergency response, and inadequate monitoring or supervision of high-fall-risk residents. In more extreme accounts reviewers reported outcomes as severe as hospitalization or death after perceived neglect. These reports, coupled with mentions of high nurse-to-patient ratios, inconsistent wound/dressing changes, and bandages left unchanged, create a clear pattern of safety risk when staffing and communication fail.
Therapy and rehabilitation: One of the facility’s consistent strengths in reviews is its rehabilitation services. Numerous reviewers praise physical, occupational, and speech therapists by name and describe measurable functional gains and successful returns home. Speech and wound therapists also receive commendations. However, there are also complaints about lack of in-house therapy resources in some cases or therapy schedules that were unclear, inconsistent, or outsourced — creating variability in experience. Overall, rehab appears to be a strong focus and a frequent source of positive outcomes when staffed and coordinated properly.
Cleanliness, maintenance, and facilities: Reviews are mixed regarding facility cleanliness and upkeep. Many family members say rooms and common areas are clean, modern, and comfortable, with private rooms, large TVs, and accessible bathrooms. Conversely, a substantial minority report dirty rooms, dead bugs, spider webs, missing bedside furniture, stained ceilings, peeling paint, overgrown grounds, and other maintenance issues. These maintenance and housekeeping inconsistencies often correlate with reports of understaffing and budget constraints. Several reviews also note that dining rooms and some living areas appear dated and in need of upgrades despite newer or remodeled wings.
Dining and dietary management: Food quality is another split area. Many reviewers commend the food and meal service (with some giving five-star ratings for dining), while others complain about cold, burnt, or high-sodium meals and improper diets for diabetic or renal patients. Reports of meals served in takeout containers, snack machines that require payment, and inadequate assistance during mealtimes are concerning for residents who need help eating.
Communication, administration, and responsiveness: Communication from frontline staff to families and between the facility and outside physicians is frequently criticized. Reported issues include unanswered calls/texts, voicemail failures, unreturned physician or PT calls, miscommunication from social workers, and an unresponsive administration. At the same time, several reviews highlight engaged leadership, named administrators, and responsive nursing coordinators who advocate effectively for residents. This inconsistency suggests variability in management responsiveness and possible turnover or changes in ownership/leadership that affect continuity. A few reviewers raised serious contractual and billing concerns (high daily rates, problematic waivers, and lack of clear cancellation terms), as well as allegations of theft and broken camera systems.
Activities, social environment, and visitation: When activities are provided, reviewers describe meaningful programming (bingo, music, outings, church services) that contributes to a home-like environment. Several reviews note a warm, family-like atmosphere and staff who treat residents as part of a community. Conversely, other families complain of limited activities, restricted visitation, and poor social engagement leading to boredom and decline in morale. The presence and quality of activities appear to vary by unit and leadership.
Patterns of leadership and culture: Multiple reviewers single out certain leaders and staff (by name) for praise, describing compassionate, present leadership that materially improves resident experience. Conversely, other reviewers describe disorganized or dismissive administrators and an uncaring culture that tolerates low staffing and poor practices. Several reviews reference a change in ownership or management and describe improvement under new leadership, while others say management failed to address repeated complaints. This suggests that culture and quality can shift over time and between departments.
Notable legal/ethical concerns: A subset of reviews mention troubling issues such as potential retaliation toward family members who complain, confusing consent/authorization or privacy handling, and concerns about questionable contract language or waivers tied to funeral benefits. There are also allegations of theft of personal items and camera failures. These concerns point to the need for transparent documentation, stronger grievance resolution, and oversight of resident rights.
Bottom line and recommendations: The aggregate of reviews indicates a facility with real strengths — particularly in therapy and many dedicated individual caregivers — but also persistent operational weaknesses around staffing, communication, safety, infection control, maintenance, and dietary management. Prospective residents and families should weigh these mixed reports carefully: verify current staffing levels and ratios for the specific unit of interest, ask for names of key clinicians and recent outcomes, request to see maintenance and housekeeping logs, confirm dietary accommodations for special needs, and get clear written terms on contracts and cancellation policies. Families should also inquire about night shift staffing, emergency response protocols, and how complaints are escalated and resolved. If considering a short-term rehab stay, the facility’s therapy program has many positive testimonials; for long-term placement, review the facility’s recent inspection records, staff turnover data, and references to gauge consistency of care over time.
