Harmony House Health Care Center

A nursing home in Waterloo, Iowa 50701

2950 West Shaulis Road, Waterloo, Iowa 50701. (319) 234-4495.

A candidate for CMS’s special focus list

Watch and the shortlist are kept with a free account, on every device. Your watch list. CMS’s own record is on Care Compare.

The short answer

Record last released by CMS on Oct 28, 2026.

1of 5 CMS’s overall rating
32 health citations at the latest inspection cycle Iowa average: 6.6
3.92 nurse hours per resident per day Iowa average: 3.86
1 fine in the last three years (needs attention)

The last 24 months 38 citations in 7 months of the last 36. Last cited Jun 2026. Most serious: immediate jeopardy to health or safety (J). Every month

Each figure’s source sits beside it, in its section below.

What these words mean8

Star ratings: CMS rates some kinds of place from 1 to 5 stars, more stars meaning better on CMS’s own measures for that kind: for a nursing home, its health inspections, staffing and quality measures. A rating is CMS’s summary of those measures; it doesn’t promise good care. Source: CMS, Care Compare and the Five-Star Quality Rating System.
Inspection (survey): A visit by state inspectors, often unannounced, who check a place against the rules it must meet. For nursing homes and other places Medicare pays, CMS calls these visits surveys: a standard survey of a nursing home comes at least every 15 months, and a complaint survey whenever a complaint calls for one. Source: CMS; 42 CFR 488.308.
Deficiency, citation, violation: What inspectors write up when a place didn’t meet a rule: the rule, what they saw, and when. CMS calls it a deficiency; states may say citation or violation. It is the inspectors’ finding, not a court’s, and the place is usually asked for a plan to correct it. Source: CMS, statement of deficiencies (Form CMS-2567); each state’s licensing agency.
Scope and severity (A to L): CMS grades each nursing home deficiency with a letter. A to C: no actual harm, with potential for minimal harm. D to F: no actual harm, but potential for more. G to I: actual harm. J to L: immediate jeopardy. Within each band, the letter rises as more residents were affected or could be: one or a few, a pattern, or widespread. Source: CMS, nursing home scope and severity grid (State Operations Manual, chapter 7).
Nurse staffing hours: The hours registered nurses, licensed practical nurses and nurse aides worked, per resident per day, from the payroll records each home sends CMS. Source: CMS, Payroll-Based Journal.
Fines and payment denials: A fine (civil money penalty) is money CMS makes a nursing home pay when it falls short of federal rules. A payment denial means Medicare and Medicaid stop paying for new admissions until the home meets the rules again. Source: CMS; 42 CFR 488.430 and 488.417.
Immediate jeopardy: CMS’s most serious finding: the place’s failure to meet a rule caused, or was likely to cause, serious injury, harm, impairment or death to someone in its care. Source: CMS; 42 CFR 489.3.
Capacity: The most people the licence or certification lets the place care for at once: residents, children, beds or apartments, as the state counts them. It isn’t how many are there now. Source: Each state’s licensing agency.

What did inspectors find?

32 health citations at the latest inspection cycle

The Iowa average is 6.6.

Last standard inspection Aug 6, 2025.

Most serious in three years: immediate jeopardy to health or safety (J), at a standard inspection on Aug 6, 2025

CMS, Provider Information, State and US Averages and Health Deficiencies. Released Oct 28, 2026. Updated monthly.

When those citations happened

38 citations in 7 months of the last 36. Last cited Jun 2026. Most serious: immediate jeopardy to health or safety (J). The last 3 years, to Nov 5, 2026.

38 citations by month over the last 3 years. Each cell is one month.
	Jan	Feb	Mar	Apr	May	Jun	Jul	Aug	Sep	Oct	Nov	Dec
2023												Dec
2024	Jan	Feb	Mar	Apr	May	Jun	Jul	Aug	Sep	Oct	Nov	Dec
2025	Jan	Feb	Mar	Apr	May	Jun	Jul	Aug	Sep	Oct	Nov	Dec
2026	Jan	Feb	Mar	Apr	May	Jun	Jul	Aug	Sep	Oct	Nov

Hover or focus a month to read it.

No visit on record Visited, nothing cited A stronger orange is more serious, on its source’s own levels, read onto four bands: from the least serious it publishes to the most

Hearth Record drew this from the dates and levels in the source’s own records.

All 38 citations in the last three years

Grouped by inspection, newest first. Each carries , from A, the least serious, to L, the most. 25 came from complaint inspections.

CMS, Health Deficiencies. Released Oct 28, 2026. Updated monthly.

Jun 30, 2026: complaint inspection5 citations

Honor the resident’s right to and the facility must promote and facilitate resident self-determination through support of resident choice.

Rule F0561. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Jul 30, 2026.
Provide care and assistance to perform activities of daily living for any resident who is unable.

Rule F0677. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Jul 30, 2026.
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.

Rule F0688. E: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Jul 30, 2026.
Provide safe and appropriate respiratory care for a resident when needed.

Rule F0695. E: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Jul 30, 2026.
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.

Rule F0725. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Jul 30, 2026.

May 18, 2026: complaint inspection3 citations

Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.

Rule F0804. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: May 27, 2026.
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Rule F0812. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: May 27, 2026.
Provide and implement an infection prevention and control program.

Rule F0880. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: May 27, 2026.

Mar 25, 2026: complaint inspection11 citations

Provide enough food/fluids to maintain a resident’s health.

Rule F0692. G: actual harm. From a complaint. Correction date, as CMS recorded it: Apr 16, 2026.
Honor the resident’s right to a dignified existence, self-determination, communication, and to exercise his or her rights.

Rule F0550. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Apr 16, 2026.
Respond appropriately to all alleged violations.

Rule F0610. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Apr 16, 2026.
Ensure services provided by the nursing facility meet professional standards of quality.

Rule F0658. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Apr 16, 2026.
Provide care and assistance to perform activities of daily living for any resident who is unable.

Rule F0677. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Apr 16, 2026.
Provide appropriate treatment and care according to orders, resident’s preferences and goals.

Rule F0684. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Apr 16, 2026.
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Rule F0689. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Apr 16, 2026.
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.

Rule F0693. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Apr 16, 2026.
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.

Rule F0725. E: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Apr 16, 2026.
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

Rule F0755. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Apr 16, 2026.
Ensure that residents are free from significant medication errors.

Rule F0760. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Apr 16, 2026.

Aug 6, 2025: standard inspection11 citations

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

Rule F0609. J: immediate jeopardy to health or safety. Correction date, as CMS recorded it: Sep 9, 2025.
Respond appropriately to all alleged violations.

Rule F0610. J: immediate jeopardy to health or safety. Correction date, as CMS recorded it: Sep 9, 2025.
Honor the resident’s right to a dignified existence, self-determination, communication, and to exercise his or her rights.

Rule F0550. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 15, 2025.
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

Rule F0600. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 9, 2025.
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.

Rule F0644. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 15, 2025.
Develop and implement a complete care plan that meets all the resident’s needs, with timetables and actions that can be measured.

Rule F0656. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 15, 2025.
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

Rule F0657. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 15, 2025.
Provide appropriate treatment and care according to orders, resident’s preferences and goals.

Rule F0684. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 15, 2025.
Provide appropriate pressure ulcer care and prevent new ulcers from developing.

Rule F0686. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 15, 2025.
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Rule F0689. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 15, 2025.
Provide and implement an infection prevention and control program.

Rule F0880. D: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Sep 15, 2025.

Aug 6, 2025: standard and complaint inspection2 citations

Reasonably accommodate the needs and preferences of each resident.

Rule F0558. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Sep 15, 2025.
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.

Rule F0582. D: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Aug 7, 2025.

Apr 16, 2025: complaint inspection1 citation

Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.

Rule F0725. E: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: May 16, 2025.

Sep 12, 2024: standard inspection2 citations

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Rule F0812. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Oct 12, 2024.
Provide and implement an infection prevention and control program.

Rule F0880. E: no actual harm, potential for more than minimal harm. Correction date, as CMS recorded it: Oct 12, 2024.

Sep 12, 2024: standard and complaint inspection2 citations

Honor the resident’s right to a dignified existence, self-determination, communication, and to exercise his or her rights.

Rule F0550. E: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Oct 12, 2024.
Employ staff that are licensed, certified, or registered in accordance with state laws.

Rule F0839. E: no actual harm, potential for more than minimal harm. From a complaint. Correction date, as CMS recorded it: Oct 12, 2024.

Jan 24, 2024: complaint inspection1 citation

Honor the resident’s right to a dignified existence, self-determination, communication, and to exercise his or her rights.

Rule F0550. G: actual harm. From a complaint. Correction date, as CMS recorded it: Jan 30, 2024.

Is it certified, and in good standing?

Certified for Medicare and Medicaid since Mar 30, 1989.
A candidate for CMS’s special focus list, which CMS keeps for homes with a history of serious problems.
No abuse icon from CMS.
No change of ownership in the last 12 months.
CMS lists its ownership as for profit, limited liability company.
65 certified beds.

CMS, Provider Information. Released Oct 28, 2026. Updated monthly.

Has it been fined or penalized?

1 fine in the last three years, $31,736 in all.
No Medicare payment denials in the last three years.
25 citations in the last three years came from complaint inspections.

CMS, Penalties and Health Deficiencies. Released Oct 28, 2026. Updated monthly.

Fines and payment denials, newest first
Date	Kind	Amount
Mar 25, 2026	Fine	$31,736

Who does the caring?

3.92 nurse hours per resident per day

The Iowa average is 3.86.

CMS publishes staffing about four months after the fact.

CMS, Provider Information and State and US Averages. Released Oct 28, 2026. Updated monthly.

Staffing measures
Measure	This home	Iowa average
Nurse hours per resident per day	3.92	3.86
Of which registered nurses	0.67	0.74
At weekends	3.60	3.38
Nursing staff turnover	64.8%	44.1%
Registered nurse turnover	33.3%	42.1%
Administrators who left	Not given	Not given

Who owns it?

Iowa Portfolio OPCO Holdings LLC owns 100% directly since Aug 15, 2024.
Legacy Healthcare Financial Services LLC runs it.
33 owners or officers are people: Chaim Rajchenbach (owns 5% or more directly, 50%); Amy Wright (runs it (operational or managerial control)); Sandra Staudt (runs it (operational or managerial control)); Mindy Houston (runs it (operational or managerial control)); Larina Heying (runs it (operational or managerial control)); Jenny Borcherding (runs it (operational or managerial control)); Joshua Seu (runs it (operational or managerial control)); Brian Friedman (trustee); Jennifer Hedberg (runs it (operational or managerial control)); Laura Friedenberg (runs it (operational or managerial control)); Menachem Shabat (corporate officer); Menachem Shabat (runs it (operational or managerial control)); Patricia Otterbeck (runs it (operational or managerial control)); Rivka Rajchenbach (trustee); Melissa Larson (runs it (operational or managerial control)); Chaim Rajchenbach (runs it (operational or managerial control)); Elizabeth Van Veghel (runs it (operational or managerial control)); Karla Beasley (runs it (operational or managerial control)); Mary Geiger (runs it (operational or managerial control)); Bobbie Wierschem (runs it (operational or managerial control)); Kiley Shear (runs it (operational or managerial control)); Dorothy Mcclure (runs it (operational or managerial control)); Lisa Elwick (runs it (operational or managerial control)); Avrum Rajchenbach (trustee); Rosemary Wood (runs it (operational or managerial control)); Linsey Behounek (runs it (operational or managerial control)); Kathleen Scott (runs it (operational or managerial control)); Darron Paul Cutler (runs it (operational or managerial control)); Sheri Burken (runs it (operational or managerial control)); Christina Hennager (runs it (operational or managerial control)); Ahuva Shabat (trustee); Michele Knutson (runs it (operational or managerial control)); Krystle Jaeger (runs it (operational or managerial control)).
Part of Legacy Healthcare (96 homes in CMS’s data).
No private-equity firm among the owners CMS lists.
No real-estate investment trust among the owners CMS lists.

CMS, All Owners. Checked Nov 5, 2026. Updated monthly.

CMS, Provider Information. Released Oct 28, 2026. Updated monthly.

Organisations CMS lists
Organisation	Role	Share	Since
Iowa Portfolio OPCO Holdings LLC	Owns 5% or more directly	100%	Aug 15, 2024
Gpn Family Trust U/A/D 4/28/08	Owns 5% or more through other companies	68%	Aug 15, 2024
Oakway Operations LLC	Owns 5% or more through other companies	22.5%	Aug 15, 2024
Doros Generation Trust U/A/D 1/3/12	Owns 5% or more through other companies	5%	Aug 15, 2024
Gorgona Sub Holdco LLC	Additional disclosable party (controls, leases property to, or provides services to the home)		Aug 15, 2024
Mn8 Rh Holdco LLC	Additional disclosable party (controls, leases property to, or provides services to the home)		Aug 15, 2024
Legacy Healthcare Financial Services LLC	Runs it (operational or managerial control)		Aug 15, 2024
Cascade Capital Partners LLC	Additional disclosable party (controls, leases property to, or provides services to the home)		Aug 15, 2024
Ccg Gorgona LLC	Additional disclosable party (controls, leases property to, or provides services to the home)		Aug 15, 2024
Gorgona Propco Holdings LLC	Additional disclosable party (controls, leases property to, or provides services to the home)		Aug 15, 2024
Cascade Capital Holdings LLC	Additional disclosable party (controls, leases property to, or provides services to the home)		Aug 15, 2024
Gorgona Holdco LLC	Additional disclosable party (controls, leases property to, or provides services to the home)		Aug 15, 2024

How do residents fare?

CMS rates its quality measures 4 of 5 (Iowa average 3.4).

CMS, Provider Information and State and US Averages. Released Oct 28, 2026. Updated monthly.

CMS’s star ratings, from 1 to 5
Measure	Rating
Overall rating	1 of 5
Health inspections	1 of 5
Staffing	2 of 5
Quality measures	4 of 5

How does it compare nearby?

Among the 12 nearest homes, within 12.7 miles, this one had the 1st most health citations at the latest inspection cycle (32; the middle value was 9.5).

CMS, Provider Information. Released Oct 28, 2026. Updated monthly.

The 12 nearest, by straight-line distance
Place	Miles away	Citations, latest cycle
Harmony House Health Care Center This nursing home		32
Pinnacle Specialty Care	3.4	15
The Suites at Western Home Communities	3.5	1
Harmony Waterloo	3.5	8
Friendship Village Retirement	3.6	3
Ravenwood Specialty Care	3.9	15
Newaldaya Lifescapes	5.1	6
Martin Health Center, Inc.	6.1	2
Cedar Falls Health Care Center	6.6	17
Northcrest Specialty Care	7.0	11
Pillar of Cedar Valley	9.2	11
Parkview Manor Care Center	12.7	6

What the record doesn’t say

Complaints that didn’t lead to a citation aren’t published.
Inspections reach CMS’s data about six weeks after they happen, and staffing about four months after.
CMS publishes the inspectors’ full written findings in a separate monthly file, which isn’t loaded yet.
Fines and Medicare payment denials are the only enforcement CMS publishes; state licence actions aren’t included.

Sources

Centers for Medicare & Medicaid Services, Provider Information (4pq5-n9py).

Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
Centers for Medicare & Medicaid Services, Health Deficiencies (r5ix-sfxw).

Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
Centers for Medicare & Medicaid Services, Penalties (g6vv-u9sr).

Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
Centers for Medicare & Medicaid Services, All Owners (afe44b85-cc6d-40d7-b5df-00ae8910d1d2).

Checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
Centers for Medicare & Medicaid Services, State and US Averages (xcdc-v8bm).

Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).

If you believe something here is wrong, a correction starts with the agency whose record this copies: CMS. CMS’s own record is on Care Compare. If Hearth Record copied something wrongly, it will fix it and log the correction publicly, with its date: how corrections work.

This copy of the record was made on Nov 5, 2026.

From the home

The public record above comes first. Anything the home adds will appear here, below it, and say who wrote it.

Replies

None. Replies aren’t open yet. When they open, the home will be able to answer any finding for free, and the reply will show beside that finding, unedited and dated.

Paid listing

None. Paid listings aren’t open yet. When they open, anything paid for will say “Paid by the home”, and paying will never change a finding, a rating or the order of results.

Harmony House Health Care Center

The short answer

What did inspectors find?

When those citations happened

All 38 citations in the last three years

Is it certified, and in good standing?

Has it been fined or penalized?

Who does the caring?

Who owns it?

How do residents fare?

How does it compare nearby?

What the record doesn’t say

Sources

From the home

Replies

Paid listing

How to read a record

Every fact names its source.

A number never stands alone.

What needs attention is marked.

The public record comes first.