Harmony Waterloo

Nursing Home in Iowa

CMS overall rating Info The Overall CMS Rating is scored from 1 to 5 stars and combines results from health inspections, staffing levels, and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
Harmony Waterloo

Nursing Home in Iowa

CMS overall rating Info The Overall CMS Rating is scored from 1 to 5 stars and combines results from health inspections, staffing levels, and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
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Harmony Waterloo accepts Medicare, Medicaid, and private pay.

Overview of Harmony Waterloo

Harmony Waterloo focuses on healing, wellness, and enriching lives through compassionate care. It offers a welcoming atmosphere where expert caregivers deliver personalized treatments. The facility provides services such as short-term rehabilitation, wound care, and orthopedic rehabilitation.
(319) 234-7777

Quality ratings

Measured by Centers for Medicare & Medicaid Services (CMS)

Overall rating Info The Overall CMS Rating combines results from health inspections, staffing levels and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
3/5 ▼ 0.1 Iowa average: 3.1/5
Health Inspection Info Based on the results of the facility's three most recent standard inspections and any complaint investigations. CMS reviews the number, scope, and severity of deficiencies, with more recent findings weighted more heavily.
3/5 ▲ 0.1 Iowa average: 2.9/5
Staffing Info Measures average nursing staff hours per resident per day, including Registered Nurses (RNs) and total nursing staff. Ratings are adjusted based on the level of care residents require and are compared to state and national benchmarks.
4/5 ▲ 0.5 Iowa average: 3.5/5
Quality Measures Info Based on clinical and physical health indicators reported to CMS, such as hospital readmissions, falls, pressure ulcers, and improvements in mobility. These measures reflect how well residents' health needs are being managed.
4/5 ▲ 0.7 Iowa average: 3.3/5

Staffing hours breakdown

Info Daily nursing hours per resident by staff type, reported to CMS. Higher is generally better — compare this facility to state and national averages to see where staffing stands.

Hours per resident per day — compared to Iowa state averages

Total nursing care / resident Info This home is ranked 174th out of 224 homes in Iowa.

Total adjusted nursing hours per resident per day, combining RN, LPN, and aide time. CMS adjusts this for case-mix so facilities can be fairly compared.
3h 51m per day
Rank #174 / 224Nurse hours — state benchmarkedThis home is ranked 174th out of 224 homes in Iowa.Shows adjusted nurse hours per resident per day benchmarked to the Iowa average, with a ranking across 224 Iowa SNFs. More hours mean more direct care. The national average is about 3.5 hrs; below 3.0 is a red flag.
This facility Iowa avg (4h 18m per day)
vs Iowa avg
-11%

3 of 6 metrics below state avg

Standout metric Physical Therapist is +100% above state avg
Staff typeHours / dayvs state avg
Registered Nurse (RN) Info RNs hold the highest nursing license and can assess residents, interpret test results, and direct care plans. More RN hours per day often signals stronger clinical oversight and faster response to health changes. 38m per day ▼ 14% State avg: 44m per day · National avg: 41m per day
LPN / LVN Info Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs) deliver routine hands-on care — medication administration, wound dressing, and monitoring vital signs. They work under RN supervision and make up a large share of daily bedside care. 37m per day ▲ 9% State avg: 34m per day · National avg: 52m per day
Nurse Aide Info Certified Nurse Aides (CNAs) provide the most direct day-to-day assistance: bathing, dressing, feeding, and mobility. Nurse aide hours are typically the largest staffing category and directly affect residents' quality of life. 2h 16m per day ▼ 11% State avg: 2h 32m per day · National avg: 2h 20m per day
Total Nursing (Weekend) Info Combined nursing hours (RN + LPN + Nurse Aide) per resident per day on weekends. Staffing often drops on weekends — this figure reveals whether the facility maintains adequate coverage outside of weekday hours. 3h 25m per day ■ Avg State avg: 3h 21m per day · National avg: 3h 26m per day
Physical Therapist Info Hours per resident per day provided by licensed Physical Therapists (PTs) or PT Assistants. PT services help residents recover mobility after injury or illness and are especially important for post-acute (short-stay) rehabilitation. 4m per day ▲ 100% State avg: 2m per day · National avg: 4m per day
RN (Weekend) Info Registered nurse hours specifically on weekends. Facilities sometimes reduce RN presence on Saturdays and Sundays — a low weekend RN figure compared to weekday hours can indicate reduced clinical oversight when most administrative staff are absent. 21m per day ▼ 30% State avg: 30m per day · National avg: 28m per day

Capacity and availability

This home usually has availability

Occupancy lower than 85% suggests more openings may be available.

Lower occupancy than the Iowa average: 75.4%
Occupancy rate 70.7% Rank #154 / 231Occupancy rate — state benchmarkedThis home is ranked 154th out of 231 homes in Iowa.Shows this facility's occupancy rate versus the Iowa average, with its statewide rank out of 231. Higher occupancy signals strong local demand and financial stability.
Avg. Length of Stay 117 days
Occupancy rate
70.7% Rank #154 / 231Occupancy rate — state benchmarkedThis home is ranked 154th out of 231 homes in Iowa.Shows this facility's occupancy rate versus the Iowa average, with its statewide rank out of 231. Higher occupancy signals strong local demand and financial stability.
Avg. Length of Stay
117 days

Who this home usually serves

TYPE OF STAY

Mix of rehab and long-term care

This home supports both short-term rehab and long-term care, with residents staying for a wide range of durations.

Breakdown by payment type

Medicare

18% of new residents, usually for short-term rehab.

Typical stay 1 - 2 months

Private pay

52% of new residents, often for short stays.

Typical stay 1 - 2 months

Medicaid

30% of new residents, often for long-term daily care.

Typical stay 9 - 10 months

Finances and operations

Voluntary non-profit community
Home revenue
$8.4M
Surplus of revenue
$220.9K
Voluntary non-profit community
Home revenue
$8.4M Rank #88 / 226Revenue — state benchmarkedThis home is ranked 88th out of 226 homes in Iowa.Shows this facility's annual revenue compared to the Iowa SNF average. Higher revenue generally means more resources for staffing and capital — read alongside Payroll %.
Surplus of revenue
$220.9K
Payroll costs Info The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations. Rank #133 / 226Payroll — state benchmarkedThis home is ranked 133rd out of 226 homes in Iowa.Shows total annual staff payroll benchmarked to the Iowa average. Higher payroll investment relative to peers often signals better staffing and less reliance on cheaper contract labor.
$2.6M
31.5% of revenue Rank #209 / 226Payroll % — state benchmarkedThis home is ranked 209th out of 226 homes in Iowa.Shows payroll as a percentage of revenue versus the Iowa average. Well-run SNFs often land around 55–65%. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings.
Other operating costs Info All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
$5.5M
Total costs $8.1M

About this community

Therapy & Rehabilitation

3 services
Rehabilitation Services
Respite Care
Short-Term Rehab

Amenities & Lifestyle

Specific ProgramsShort-Term Rehabilitation, Wound Care, Orthopedic Rehabilitation, Stroke & Other Neurological Conditions

Contact Harmony Waterloo

Health Inspection History

Inspections
Total health inspections 9

Iowa average 4.9


Last Health inspection on Oct 2025

Total health citations
23 Rank #153 / 224Health citations — state benchmarkedThis home is ranked 153rd out of 224 homes in Iowa.Shows this facility's total health deficiency citations benchmarked to the Iowa state average, with a ranking across all 224 IA SNFs. Lower citation counts earn a better rank.

Iowa average 21.7

Citations per inspection
2.56 Rank #59 / 224Citations per inspection — state benchmarkedThis home is ranked 59th out of 224 homes in Iowa.Shows average deficiency citations per CMS inspection for this facility versus the Iowa mean across 224 SNFs with citation data. Lower is better.

Iowa average 4.11


Health citations are formal notices following inspections when they fail to comply with safety and care standards.

11 of 23 citations resulted from standard inspections; 7 of 23 resulted from complaint investigations; and 5 of 23 came from combined inspections (standard and complaint).

Breakdown of citation severity (last 3 years)
Critical Health citations More info
1
67% worse than Iowa average

Iowa average: 0.6


Serious Health citations More info 0
100% better than Iowa average

Iowa average: 0.9

1 critical citation More info Iowa average: 0.6

0 serious citations More info Iowa average: 0.9

22 moderate citations More info Iowa average: 19.7

0 minor citations More info Iowa average: 0.5
Citations history (last 3 years)
Abuse/Neglect critical citation Info Issues related to protecting resident's from harm, including abuse, neglect, or mistreatment. Oct 30, 2025
Corrected

Abuse/Neglect moderate citation Info Issues related to protecting resident's from harm, including abuse, neglect, or mistreatment. May 01, 2025
Corrected

Care Planning moderate citation Info Issues related to creating and updating personalized care plans for residents based on their needs and conditions. Jan 15, 2025
Corrected

Care Planning moderate citation Info Issues related to creating and updating personalized care plans for residents based on their needs and conditions. Jan 15, 2025
Corrected

Financial Assistance for
Nursing Home in Iowa

Harmony Waterloo is located in Waterloo, Iowa.
Here are the financial assistance programs available to residents in Iowa.

Get Financial aid guidance

Elderly Waiver

Iowa Medicaid Elderly Waiver

Age 65+
General Iowa resident, Medicaid-eligible, nursing home-level care need.
Income Limits (2025) ~$2,829/month 300% FBR, individual
Asset Limits $2,000 (individual), $3,000 (couple).
IA

Rural focus; waitlists possible.

Benefits
In-home care (5-7 hours/day) Meals ($6/meal) Respite (240 hours/year) Adult day care ($60/day)

Iowa Family Caregiver Support

IA NFCSP

Age Caregiver of someone 60+
General Iowa resident.
Income Limits No strict limit; prioritizes low-income.
Asset Limits Not applicable.
IA

Limited slots; rural emphasis.

Benefits
In-home respite (4-6 hours/day) Adult day care (~$60/day) Short-term facility care (up to 5 days)

Medicare Savings Program (MSP)

Iowa Medicare Savings Program

Age 65+ or disabled
General Iowa resident, Medicare Part A/B.
Income Limits (2025) ~$2,510/month (QMB), ~$3,380/month (SLMB), ~$3,598/month (QI)—individual.
Asset Limits $9,430 (individual), $14,130 (couple).
IA

Three tiers; no waitlist.

Benefits
Covers Part B premiums ($174.70/month) Deductibles ($240/year) Copays (~20%)

Program of All-Inclusive Care for the Elderly (PACE)

Iowa PACE

Age 55+
General Iowa resident, nursing home-level care need, safe with PACE support.
Income Limits (2025) ~$2,829/month 300% FBR, Medicaid-eligible
Asset Limits $2,000 (individual), $3,000 (couple).
IA

Limited to western Iowa (e.g., Council Bluffs); expanding slowly.

Benefits
Personal care (5-7 hours/day) Medical care Meals Transportation Therapy Respite

Senior Community Service Employment Program (SCSEP)

Iowa SCSEP

Age 55+
General unemployed, low-income, Iowa resident.
Income Limits (2025) ~$1,983/month 125% FPL
Asset Limits Not specified; income-focused.
IA

Priority for veterans, rural residents.

Benefits
Paid training (~20 hours/week at ~$7.25/hour) Job placement

VA Aid and Attendance (A&A) and Housebound Benefits

Iowa VA Aid and Attendance/Housebound

Age 65+ or disabled veteran/spouse
General Iowa resident, wartime service, need for ADL help (A&A) or homebound.
Income Limits (2025) Net income < ~$1,984/month (veteran with dependent, A&A); pension offsets income.
Asset Limits ~$155,356 net worth limit
IA

High veteran demand in rural areas.

Benefits
Cash (~$1,433-$2,642/month veteran, ~$951-$1,318 spouse) for care costs (e.g., in-home, assisted living)

Able Up Iowa

Able Up Iowa

Age 65+ or disabled
General Iowa resident, ability to repay loan, need for assistive tech or mods.
Income Limits (2025) No strict limit; must demonstrate repayment capacity.
Asset Limits Not specified; credit-based.
IA

Loans up to $25,000; statewide via Easterseals partnership.

Benefits
Loans for wheelchairs Ramps Walk-in tubs (~$500-$10,000 avg.) Reducing reliance on paid care

Places of interest near Harmony Waterloo

Address 0.0 miles from city center Info Estimated distance in miles from Waterloo's city center to Harmony Waterloo's address, calculated via Google Maps.

Calculate Travel Distance to Harmony Waterloo

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Address

Staffing Data (Q2 2025)

This data corresponds to Q2 2025 and is based on CMS Payroll-Based Journal.

Total staff 118
Employees 111
Contractors 7
Staff to resident ratio 1.48:1
26% worse than Iowa average

Iowa average ratio: 2.00:1

Avg staff/day 45
Average shift 6.9 hours
7% worse than Iowa average

Iowa average: 7.4 hours

Total staff hours (quarter) 28,323
Nursing staff breakdown
Registered Nurse

Manages medical care and health needs.

Total count 10
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 7.4 hours

This role is partially covered by contractors.

Licensed Practical Nurse

Assists with medical care and medications.

Total count 13
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 7.1 hours

No contractors work on this role.

Certified Nursing Assistant

Helps with daily care and mobility.

Total count 57
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 6.9 hours

No contractors work on this role.

Contractor staffing

Total hours from contractors

2.2%

620 contractor hours this quarter

Occupational Therapy Aide: 2 Occupational Therapy Assistant: 2 Registered Nurse: 1 Therapeutic Recreation Specialist: 1 Medical Director: 1
Staff by category
Certified Nursing Assistant5705713,48391100%6.9
Licensed Practical Nurse130134,53291100%7.1
Registered Nurse91102,95891100%7.4
Medication Aide/Technician8082,46491100%8.6
Clinical Nurse Specialist2029846470%8
Other Dietary Services Staff2026358290%5
Dental Services Staff1014966268%8
Nurse Practitioner1014946268%8
Therapeutic Recreation Specialist0114706167%7.7
Dietitian1014485662%8
Administrator1014245358%8
Physical Therapy Aide4043626875%4.9
Physical Therapy Assistant3032036369%3.1
Respiratory Therapy Technician4041355156%2.4
Occupational Therapy Aide022971415%5.7
Speech Language Pathologist303551011%5.5
Qualified Social Worker202482325%2.1
Occupational Therapy Assistant022241314%1.9
Medical Director0111533%5
57 Certified Nursing Assistant
% of Days 100%
13 Licensed Practical Nurse
% of Days 100%
10 Registered Nurse
% of Days 100%
8 Medication Aide/Technician
% of Days 100%
2 Clinical Nurse Specialist
% of Days 70%
2 Other Dietary Services Staff
% of Days 90%
1 Dental Services Staff
% of Days 68%
1 Nurse Practitioner
% of Days 68%
1 Therapeutic Recreation Specialist
% of Days 67%
1 Dietitian
% of Days 62%
1 Administrator
% of Days 58%
4 Physical Therapy Aide
% of Days 75%
3 Physical Therapy Assistant
% of Days 69%
4 Respiratory Therapy Technician
% of Days 56%
2 Occupational Therapy Aide
% of Days 15%
3 Speech Language Pathologist
% of Days 11%
2 Qualified Social Worker
% of Days 25%
2 Occupational Therapy Assistant
% of Days 14%
1 Medical Director
% of Days 3%

Facility Characteristics

Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)

Total residents 80
Medicare
7
8.8% of residents
Medicaid
60
75% of residents
Private pay or other
13
16.3% of residents
Programs & Services
Residents Group

Residents meet regularly to discuss policies, care quality, and activities

Active Resident Council

Organized group of residents that meets regularly to discuss facility policies, quality of life, and activities.

Quality of care over time

These measures show how residents usually do over time at this home, based on health outcomes and preventive care.

High-risk clinical events score Info A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline. 9.9
In line with Iowa average

Iowa average: 10.2

Functional decline score Info A composite score based on activities of daily living decline, walking ability decline, and incontinence. 22.7
In line with Iowa average

Iowa average: 21.6

Long-stay resident measures
Above average Iowa avg: 3.3 Info CMS star rating based on long-stay quality measure performance. 5 stars = significantly above average, 1 star = significantly below average.
Need for Help with Daily Activities Increased Info Percent of long-stay residents whose need for help with daily activities has increased 10.6%
44% better than Iowa average

Iowa average: 18.8%

Walking Ability Worsened Info Percent of long-stay residents whose ability to move independently worsened 22.7%
15% worse than Iowa average

Iowa average: 19.7%

Low Risk Residents with Bowel/Bladder Incontinence Info Percent of low risk long-stay residents who lose control of their bowels or bladder 34.7%
32% worse than Iowa average

Iowa average: 26.2%

Falls with Major Injury Info Percent of long-stay residents experiencing one or more falls with major injury 0.4%
90% better than Iowa average

Iowa average: 3.6%

High Risk Residents with Pressure Ulcers Info Percent of long-stay high risk residents with pressure ulcers 5.5%
26% worse than Iowa average

Iowa average: 4.4%

Urinary Tract Infection Info Percent of long-stay residents with a urinary tract infection 5.2%
109% worse than Iowa average

Iowa average: 2.5%

Lost Too Much Weight Info Percent of long-stay residents who lose too much weight 10.2%
103% worse than Iowa average

Iowa average: 5.0%

Depressive Symptoms Info Percent of long-stay residents who have depressive symptoms 6.7%
72% worse than Iowa average

Iowa average: 3.9%

Antipsychotic Use Info Percent of long-stay residents who received an antipsychotic medication 24.6%
29% worse than Iowa average

Iowa average: 19.0%

Pneumococcal Vaccine Info Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine 91.5%
In line with Iowa average

Iowa average: 94.4%

Influenza Vaccine Info Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine 92.2%
In line with Iowa average

Iowa average: 95.3%

Short-stay resident measures
Significantly above average Iowa avg: 2.6 Info CMS star rating based on short-stay quality measure performance. 5 stars = much above average, 1 star = much below average.
Pneumococcal Vaccine Info Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine 77.8%
9% worse than Iowa average

Iowa average: 85.1%

Antipsychotic medication increase Info Percent of short-stay residents who newly received an antipsychotic medication 4.2%
128% worse than Iowa average

Iowa average: 1.8%

Influenza Vaccine Info Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine 28.2%
62% worse than Iowa average

Iowa average: 73.3%

Re-hospitalized after SNF stay Info Percentage of short-stay residents who were re-hospitalized after their nursing home admission. 14.3%
33% better than Iowa average

Iowa average: 21.3%

Emergency department visits Info Percentage of short-stay residents who had an outpatient emergency department visit. 6.1%
53% better than Iowa average

Iowa average: 13.1%

Falls with major injury Info Percentage of SNF residents who experience falls with major injury during their stay. 0.0%
100% better than Iowa average

Iowa average: 0.8%

Ability to care for self at discharge Info Percentage of residents at or above expected ability to care for themselves at discharge. 70.0%
30% better than Iowa average

Iowa average: 53.7%

Successful return to home or community Info Rate of successful return to home or community from a skilled nursing facility. 54.5%
8% better than Iowa average

Iowa average: 50.6%

Penalties and fines

Federal penalties imposed by CMS for regulatory violations, including civil money penalties (fines) and denials of payment for new Medicare/Medicaid admissions.

Source: CMS Penalties Database (Data as of Jan 2026)

Total fines amount $11K
78% lower than Iowa average

Iowa average: $48K

Number of fines 1
41% fewer fines than Iowa average

Iowa average: 1.7

Payment Denials Info Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed. 0
100% fewer payment denials than Iowa average

Iowa average: 0.5

Fines amount comparison
Fines amount comparison
This facility $11K
Iowa average $48K
Penalty History

Penalties are imposed by CMS for violations of federal nursing home regulations.

No penalties in the past 3 years

No civil money penalties or payment denials were reported in the last 3 years.

Compare Nursing Homes around Iowa The information below is reported by the Iowa Department of Inspections, Appeals, and Licensing.

5 facilities compared · CMS & IA Dept. of Health data · Updated Apr 2026

Filter by care type
Akron Care Center, INC
NH

Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).

AL

Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.

Akron45 98.1% +30%4.71 +15%+10%042.0042-City Of Akron$4.7M$2.1M45.1%165595
Accura HealthCare of Carlisle
NH

Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).

AL

Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.

Carlisle80 80.5% +7%5.85 -40%+36%0175.7239-American Healthcare Associates Inc$4.1M$2.5M59.6%165311
Harmony Waterloo
NH

Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).

AL

Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.

Waterloo97 70.7% -6%3.84 -27%-11%1232.6173-Knapp, Justin$8.4M$2.6M31.5%165034
Accura Healthcare of Spirit Lake
NH

Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).

AL

Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.

Spirit Lake85 66.6% -12%4.29 -8%0%1217.0165--$7.1M$3.0M42.3%165528
Accura Healthcare of Lake City, LLC
NH

Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).

AL

Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.

Lake City46 70.4% -7%5.17 -33%+20%4393.9440-Accura Healthcare Of The Heartland Llc$2.1M$1.0M46.7%165082

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