Federal inspection record · CMS data as of October 1, 2026
Harmony House Health Care Center
2950 West Shaulis Road, Waterloo, IA · (319) 234-4495
- Special Focus Facility
- Certified beds
- 65
- Residents per day
- 49
- Ownership
- For-Profit
- Chain
- Legacy Healthcare
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- March 30, 1989
1
How this home got 1 star
The overall rating isn't an average. CMS starts from the inspection rating and nudges it at most two steps. Here is the arithmetic for this home, using CMS's own rules.
-
Health inspections
★★★★★starting point
Everything starts from what state inspectors found on site. This is a ranking against other homes in Iowa.
-
Staffing
★★★★★no change
Only a 5-star staffing rating adds a star, and only a 1-star rating removes one. Ratings of 2 to 4 change nothing.
-
Quality measures
★★★★★no change
Same rule: 5 stars adds one, 1 star takes one away. These measures are mostly reported by the home itself.
-
Overall
★★★★★1 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among Iowa homes
Harmony House Health Care Center carries 238.5 inspection points. That is fewer than 1% of Iowa's 385 rated homes.
Inspectors' citations earn points by how serious and how widespread they were (the grid below). CMS then ranks every home in Iowa: the 10% with the fewest points get 5 stars, the 20% with the most get 1 star, and the middle 70% split evenly into 2, 3 and 4.
- 5★ 0–7 pts
- 4★ 7–21 pts
- 3★ 21–41 pts
- 2★ 41–86.5 pts
- 1★ over 86.5 pts
Bars show every rated home in Iowa by its weighted inspection score. CMS recalibrates the cut points monthly but holds a home's rating until its own score changes, so a home can sit just outside today's band.
3
What inspectors found
38 health citations on record since 2024. Each one gets a letter: the row says how badly residents were affected, the column how many.
Immediate jeopardyResidents at risk of serious injury or death
Actual harmA resident was hurt
Potential for harmNo one was hurt, but could have been
Minimal harmPaperwork-level problems
Read the rows, not the total. Most citations nationwide are a D: one problem, nobody hurt. Rows G–I mean a resident was harmed; J–L mean inspectors found residents in immediate danger of serious injury or death.
Small numbers in each cell are the inspection points CMS assigns per citation. Those points are what the state curve above ranks.
Harm and immediate-jeopardy citations (4)
-
G
Provide enough food/fluids to maintain a resident's health.
-
J
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
-
J
Respond appropriately to all alleged violations.
-
G
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Everything else, by area of care
Quality of Life and Care10E
- E
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.
- E
Provide safe and appropriate respiratory care for a resident when needed.
- D
Provide care and assistance to perform activities of daily living for any resident who is unable.
- D
Provide care and assistance to perform activities of daily living for any resident who is unable.
- D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D
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.
- D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- D
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Resident Rights6E
- D
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
- D
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
- D
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
- D
Reasonably accommodate the needs and preferences of each resident.
- D
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
- E
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Assessment and Care Planning4D
- D
Ensure services provided by the nursing facility meet professional standards of quality.
- D
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Nursing and Physician Services3E
- D
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
- E
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
- E
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Nutrition and Dietary3E
- D
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
- D
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Infection Control3E
- D
Provide and implement an infection prevention and control program.
- D
Provide and implement an infection prevention and control program.
- E
Provide and implement an infection prevention and control program.
Freedom from Abuse, Neglect, and Exploitation2D
- D
Respond appropriately to all alleged violations.
- D
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Pharmacy Service2D
- D
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- D
Ensure that residents are free from significant medication errors.
Administration1E
- E
Employ staff that are licensed, certified, or registered in accordance with state laws.
Inspection history
2025-08-06
32 health deficiencies · 0 fire-safety deficiencies
Top issue: Quality of Life and Care (11 deficiencies)
2024-09-12
5 health deficiencies · 1 fire-safety deficiencies
Top issue: Administration (1 deficiency)
2023-06-22
1 health deficiencies · 0 fire-safety deficiencies
Top issue: Resident Rights (1 deficiency)
4
Nursing time per resident, per day
Each resident here gets about 3 h 55 min of nursing staff time a day, 40 min of it from a registered nurse.
This home
3 h 55 min
Iowa average
3 h 52 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 65% of nursing staff and 33% of registered nurses left in the past year.
Reported hours from payroll data the home submits to CMS, divided by its daily resident count. Not adjusted for how sick residents are.
5
Fines and payment denials
$31,736 in federal fines on record over the past three years.
| Date | Penalty | Amount |
|---|---|---|
| 2026-03-25 | Fine | $31,736 |
6
Resident outcomes
Quality measures compared with state and national averages. Most come from assessments the home itself reports.
| Measure | This home | State | U.S. |
|---|---|---|---|
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine21 pts worse | 73.2% | 94.2% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine4.1 pts worse | 91.7% | 95.8% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury3.9 pts better | 0.0% | 3.9% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms2.2 pts better | 2.0% | 4.2% | 13.5% |
| Percentage of long-stay residents who lose too much weight1.5 pts better | 2.9% | 4.4% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication2.3 pts worse | 23.3% | 21.0% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication11.8 pts worse | 31.6% | 19.8% | 15.4% |
| Percentage of long-stay residents who were physically restrained0.2 pts better | 0.0% | 0.2% | 0.1% |
| Percentage of long-stay residents whose ability to walk independently worsened8.6 pts better | 6.6% | 15.2% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased8.6 pts better | 8.0% | 16.6% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder0.9 pts better | 0.5% | 1.4% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection1.9 pts better | 0.5% | 2.4% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence4.6 pts better | 20.4% | 25.0% | 18.3% |
| Percentage of long-stay residents with pressure ulcers1.8 pts worse | 5.9% | 4.1% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine49.3 pts worse | 34.7% | 84.0% | 82.3% |
| Percentage of short-stay residents who newly received an antipsychotic medication2.1 pts better | 0.0% | 2.1% | 1.5% |
·
Who owns and runs it
41 owners and managers reported to CMS. The last column counts how many nursing homes each one is tied to.
Show ownership list
| Name | Role | Share | Homes |
|---|---|---|---|
| Rajchenbach, Chaim | 5% Or Greater Direct Ownership Interest · Individual | 50% | 55 facilities |
| Beasley, Karla | Operational/Managerial Control · Individual | 0% | 29 facilities |
| Behounek, Linsey | Operational/Managerial Control · Individual | 0% | 29 facilities |
| Borcherding, Jenny | Operational/Managerial Control · Individual | 0% | 29 facilities |
| Burken, Sheri | Operational/Managerial Control · Individual | 0% | 30 facilities |
| Cascade Capital Holdings LLC | Adp Of The SNF · Organization | 0% | 30 facilities |
| Cascade Capital Partners LLC | Adp Of The SNF · Organization | 0% | 30 facilities |
| Ccg Gorgona LLC | Adp Of The SNF · Organization | 0% | 29 facilities |
| Cutler, Darron | Operational/Managerial Control · Individual | 0% | 4 facilities |
| Elwick, Lisa | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Friedenberg, Laura | Operational/Managerial Control · Individual | 0% | 29 facilities |
| Friedman, Brian | Trustee Of The SNF · Individual | 0% | 28 facilities |
| Geiger, Mary | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Gorgona Holdco LLC | Adp Of The SNF · Organization | 0% | 28 facilities |
| Gorgona Propco Holdings LLC | Adp Of The SNF · Organization | 0% | 29 facilities |
| Gorgona Sub Holdco LLC | Adp Of The SNF · Organization | 0% | 29 facilities |
| Hedberg, Jennifer | Operational/Managerial Control · Individual | 0% | 29 facilities |
| Hennager, Christina | Operational/Managerial Control · Individual | 0% | 14 facilities |
| Heying, Larina | Operational/Managerial Control · Individual | 0% | 29 facilities |
| Houston, Mindy | Operational/Managerial Control · Individual | 0% | 30 facilities |
| Jaeger, Krystle | Operational/Managerial Control · Individual | 0% | 29 facilities |
| Knutson, Michele | Operational/Managerial Control · Individual | 0% | 13 facilities |
| Larson, Melissa | Operational/Managerial Control · Individual | 0% | 29 facilities |
| Legacy Healthcare Financial Services LLC | Operational/Managerial Control · Organization | 0% | 78 facilities |
| Mcclure, Dorothy | Operational/Managerial Control · Individual | 0% | 29 facilities |
| Mn8 Rh Holdco LLC | Adp Of The SNF · Organization | 0% | 28 facilities |
| Otterbeck, Patricia | Operational/Managerial Control · Individual | 0% | 29 facilities |
| Rajchenbach, Avrum | Trustee Of The SNF · Individual | 0% | 27 facilities |
| Rajchenbach, Chaim | Operational/Managerial Control · Individual | 0% | 55 facilities |
| Rajchenbach, Rivka | Trustee Of The SNF · Individual | 0% | 28 facilities |
| Scott, Kathleen | Operational/Managerial Control · Individual | 0% | 13 facilities |
| Seu, Joshua | Operational/Managerial Control · Individual | 0% | 13 facilities |
| Shabat, Ahuva | Trustee Of The SNF · Individual | 0% | 29 facilities |
| Shabat, Menachem | Corporate Officer · Individual | 0% | 86 facilities |
| Shabat, Menachem | Operational/Managerial Control · Individual | 0% | 86 facilities |
| Shear, Kiley | Operational/Managerial Control · Individual | 0% | 29 facilities |
| Staudt, Sandra | Operational/Managerial Control · Individual | 0% | 13 facilities |
| Van Veghel, Elizabeth | Operational/Managerial Control · Individual | 0% | 29 facilities |
| Wierschem, Bobbie | Operational/Managerial Control · Individual | 0% | 29 facilities |
| Wood, Rosemary | Operational/Managerial Control · Individual | 0% | 13 facilities |
| Wright, Amy | Operational/Managerial Control · Individual | 0% | 14 facilities |
·
Fire safety
1 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Emergency Preparedness1F
- F
Conduct testing and exercise requirements.
·
Other homes nearby
-
Pinnacle Specialty Care
Cedar Falls, IA · Care Initiatives
★★★★★- Worst citation, 3 yrs
- G
- Nursing / resident / day
- 3 h 40 min
- Fines
- $8,362
-
The Suites at Western Home Communities
Cedar Falls, IA · Western Home Communities
★★★★★- Worst citation, 3 yrs
- E
- Nursing / resident / day
- 4 h 35 min
- Fines
- $0
-
Harmony Waterloo
Waterloo, IA · Legacy Healthcare · Abuse icon
★★★★★- Worst citation, 3 yrs
- J
- Nursing / resident / day
- 3 h 19 min
- Fines
- $95,440