Harmony Waterloo

201 West Ridgeway Avenue · Waterloo, IA · 50701 · 3192347777

88 certified beds For profit - Limited Liability company Chain: Legacy Healthcare

Why this verdict

  • Carries CMS’s abuse warning icon.
  • Inspectors found immediate jeopardy — danger of serious harm or death — in the most recent cycle (1 citation).
  • Inspection results are getting worse cycle over cycle, not better.

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Red flags

CMS abuse warning

CMS flags this facility with its abuse icon: cited for abuse that caused harm in the past year, or potential harm in the past two years.

1 immediate-jeopardy citation in the most recent inspection cycle

Immediate jeopardy is the most serious finding an inspector can make: a situation likely to cause serious injury, harm, or death.

1 abuse-related citation at the actual-harm level

Inspectors cited failures in the abuse-prevention rules (F600–F610) that resulted in actual harm to a resident.

$95,440 in federal fines in the last 24 months

1 fine — CMS fines are reserved for verified, serious non-compliance.

Score breakdown

Inspection record 30% of score 41
Serious harm & abuse 20% 40
Staffing 20% 64
Federal penalties 15% 60
Trend 10% 36
Context 5% 100

Quality-measure stars are deliberately excluded — they're largely self-reported by facilities. Full method.

CMS ratings & staffing

Overall: 1 of 5 Inspections: 1 of 5 Staffing: 3 of 5 Quality measures: 4 of 5

Total nurse hours / resident-day3.233.48 min · 4.1 strong
RN hours / resident-day0.710.55–0.75
Weekend hours / resident-day2.99≈ weekday level
Nursing turnover / year51%median 45%
Fines (3-yr window)1 · $95,440

Inspection citations (21 in the current record)

  • Potential for harm · D January 14, 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.

    Corrected February 13, 2026 · Quality of Life and Care

  • Potential for harm · E January 14, 2026

    Post nurse staffing information every day.

    Corrected February 13, 2026 · Nursing and Physician Services

  • Potential for harm · D January 14, 2026

    Ensure that residents are free from significant medication errors.

    Corrected February 13, 2026 · Pharmacy Service

  • Potential for harm · E January 14, 2026

    Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.

    Corrected February 13, 2026 · Nutrition and Dietary

  • Potential for harm · E January 14, 2026

    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.

    Corrected February 13, 2026 · Nutrition and Dietary

  • Potential for harm · E January 14, 2026

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

    Corrected February 13, 2026 · Nutrition and Dietary

  • Immediate jeopardy · J October 30, 2025 · found via complaint

    Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

    Corrected November 12, 2025 · Freedom from Abuse, Neglect, and Exploitation

  • Potential for harm · D May 1, 2025 · found via complaint

    Protect each resident from the wrongful use of the resident's belongings or money.

    Corrected May 8, 2025 · Freedom from Abuse, Neglect, and Exploitation

  • Potential for harm · D January 15, 2025

    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.

    Corrected February 7, 2025 · Resident Rights

  • Potential for harm · D January 15, 2025

    Ensure each resident receives an accurate assessment.

    Corrected February 10, 2025 · Resident Assessment and Care Planning

  • Potential for harm · D January 15, 2025

    PASARR screening for Mental disorders or Intellectual Disabilities

    Corrected February 7, 2025 · Resident Assessment and Care Planning

  • Potential for harm · D January 15, 2025

    Ensure services provided by the nursing facility meet professional standards of quality.

    Corrected February 7, 2025 · Resident Assessment and Care Planning

  • Potential for harm · D January 15, 2025 · found via complaint

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

    Corrected February 7, 2025 · Resident Rights

  • Potential for harm · D November 21, 2024 · found via complaint

    Provide appropriate treatment and care according to orders, resident’s preferences and goals.

    Corrected November 22, 2024 · Quality of Life and Care

  • Potential for harm · E August 8, 2024 · found via complaint

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

    Corrected August 22, 2024 · Resident Rights

  • Potential for harm · D August 8, 2024 · found via complaint

    Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

    Corrected August 22, 2024 · Pharmacy Service

  • Potential for harm · D May 22, 2024

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

    Corrected June 12, 2024 · Nutrition and Dietary

  • Potential for harm · D May 22, 2024 · found via complaint

    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.

    Corrected June 12, 2024 · Resident Rights

  • Potential for harm · D May 22, 2024 · found via complaint

    Provide care and assistance to perform activities of daily living for any resident who is unable.

    Corrected June 12, 2024 · Quality of Life and Care

  • Potential for harm · D May 22, 2024 · found via complaint

    Provide safe and appropriate respiratory care for a resident when needed.

    Corrected June 12, 2024 · Quality of Life and Care

  • Potential for harm · E October 18, 2023 · found via complaint

    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.

    Corrected November 9, 2023 · Resident Rights

Federal penalties

DateTypeAmount / length
October 30, 2025Fine$95,440

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Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 165034 · certified since January 19, 1967. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.