Harmony Waterloo
Below-average Medicare ratings — review the inspection history and ask the administrator about recent corrections before visiting.
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Quality Concerns Identified
Medicare inspection and quality data reveal areas that families should carefully evaluate before choosing this facility.
- Abuse citation on record
- Low overall rating (2/5 stars)
- Above-median deficiencies (7 vs median 5)
Below average in IA · Below recommended RN staffing · Below chain average · $146,830 in fines · Abuse citation
What this means for your family
This facility has areas of concern that warrant careful consideration. Registered Nurse hours are only 95% of the national benchmark, which can affect medication management and response times. We recommend asking the administrator directly: "How are you addressing recent staffing shortfalls?" These are not reasons to panic, but they are reasons to ask tough questions and visit in person.
Staffing
Staffing Hours
per resident/day · Medicare 2026Both RN and total nursing hours are below national benchmarks. This can mean less clinical attention per resident, so ask about their staffing plan.
Quality Measures
Quality Measures
Resident outcomes compared with national, state, and local averages · 17 measures
6
measures
8
measures
3
measures
Residents whose bladder or bowel control got worse
Residents needing more daily help over time
Residents on antipsychotic medication
Residents whose walking got worse
Residents with depression symptoms
Highly dependent on how each facility screens and codes depressive symptoms, so it varies widely between facilities.
Residents on anti-anxiety or sleep medication
Short-stay residents vaccinated for the flu
Short-stay residents vaccinated for pneumonia
Short-stay residents newly given antipsychotics
US average from Medicare published data
Inspection History
Medicare Inspection History
3-year lookback · Medicare 2026
Harmony Waterloo has significant inspection issues including resident abuse/neglect concerns, with families filing multiple complaints about care quality, medication errors, and safety violations. The facility shows recurring problems with fire safety systems, electrical maintenance, and medication management that persist across multiple surveys. While all deficiencies report correction dates, the pattern of repeated violations in critical safety areas warrants careful scrutiny before placement.
Jan 14, 2026Routine16
Emergency Preparedness Deficiencies
Develop and maintain an Emergency Preparedness Program (EP).
Emergency Preparedness Deficiencies
Conduct testing and exercise requirements.
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Smoke Deficiencies
Install smoke barrier doors that can resist smoke for at least 20 minutes.
Miscellaneous Deficiencies
Have simulated fire drills held at unexpected times.
Miscellaneous Deficiencies
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Gas, Vacuum, and Electrical Systems Deficiencies
Have generator or other power source capable of supplying service within 10 seconds.
Gas, Vacuum, and Electrical Systems Deficiencies
Ensure that testing and maintenance of electrical equipment is performed.
Nursing and Physician Services Deficiencies
Post nurse staffing information every day.
Nutrition and Dietary Deficiencies
Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.
Nutrition and Dietary Deficiencies
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
Nutrition and Dietary Deficiencies
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Gas, Vacuum, and Electrical Systems Deficiencies
Meet requirements for the installation and maintenance of electrical systems.
Quality of Life and Care Deficiencies
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.
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
Oct 30, 2025Complaint1
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
May 1, 2025Complaint1
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from the wrongful use of the resident's belongings or money.
Jan 15, 2025Routine16
Emergency Preparedness Deficiencies
Conduct risk assessment and an All-Hazards approach.
Emergency Preparedness Deficiencies
Address patient/client population and determine types of services needed.
Emergency Preparedness Deficiencies
Conduct testing and exercise requirements.
Egress Deficiencies
Install emergency lighting that can last at least 1 1/2 hours.
Smoke Deficiencies
Provide properly protected cooking facilities.
Smoke Deficiencies
Properly provide smoke detection systems in areas open to corridors.
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Smoke Deficiencies
Install smoke barrier doors that can resist smoke for at least 20 minutes.
Miscellaneous Deficiencies
Have simulated fire drills held at unexpected times.
Gas, Vacuum, and Electrical Systems Deficiencies
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
Gas, Vacuum, and Electrical Systems Deficiencies
Have generator or other power source capable of supplying service within 10 seconds.
Gas, Vacuum, and Electrical Systems Deficiencies
Ensure that testing and maintenance of electrical equipment is performed.
Resident Rights Deficiencies
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
Resident Assessment and Care Planning Deficiencies
PASARR screening for Mental disorders or Intellectual Disabilities
Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
Jan 15, 2025Complaint1
Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Nov 21, 2024Complaint1
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Federal Penalties
Fine
Oct 30, 2025
$95,440
State Inspection History
State Inspections
Source: Iowa Dept. of Inspections, Appeals & Licensing
Jul 2, 2026ComplaintClean
Fed violations: 0, State violations: 0
Jun 11, 2026ComplaintClean
Fed violations: 1, State violations: 0
Apr 22, 2026OtherClean
Fed violations: 0, State violations: 0
Feb 16, 2026InspectionClean
Fed violations: 0, State violations: 0
Jan 14, 2026InspectionClean
Fed violations: 6, State violations: 0
Dec 2, 2025ComplaintClean
Fed violations: 0, State violations: 0
Oct 30, 2025ComplaintClean
Fed violations: 1, State violations: 0
Oct 2, 2025ComplaintClean
Fed violations: 0, State violations: 0
Ownership & Operations
Who Operates This Facility
Harmony Waterloo
for profit
Chain Affiliation
Legacy Healthcare
89 facilities nationwide
Chain avg rating: 3.0/5 · Rank 63 of 89
Ownership & Management
Owners
Doros Generation Trust U/a/d 1/3/12
Owner · Organization
Gpn Family Trust U/a/d 4/28/08
Owner · Organization
Oakway Operations LLC
Owner · Organization
Key personnel
Contact
Get in Touch
Contact this facility directly and verify the details that matter most to your family.
References & Resources
Medicare Care Compare
Official Medicare quality ratings, inspections & staffing data
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Medicare data downloads
Original nursing home datasets
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Safer Alternatives Nearby
Based on current clinical data, we identified 6 nearby facilities within 10 miles that may offer a stronger care environment. We encourage families to compare options carefully.
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