Harmony Marshalltown
910 East Olive · Marshalltown, IA · 50158 · 6417524581
72 certified beds For profit - Corporation Chain: Legacy Healthcare
Why this verdict
- Inspectors found immediate jeopardy — danger of serious harm or death — in the most recent cycle (2 citations).
- Inspection record is far worse than the national median (deficiency count and severity).
- Inspection results are getting worse cycle over cycle, not better.
The complete Safety Report — $19
Everything on this page plus the full citation-by-citation history with inspector findings, the complete penalty record, staffing vs benchmarks, side-by-side nearby comparisons, and the printable tour checklist. One PDF, emailed in minutes, yours to keep and share with family.
Red flags
2 immediate-jeopardy citations 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.
$78,878 in federal fines in the last 24 months
1 fine — CMS fines are reserved for verified, serious non-compliance.
If someone you love was harmed at a facility with findings like these, you have options — read this.
Score breakdown
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: 3 of 5
| Total nurse hours / resident-day | 4.11 | 3.48 min · 4.1 strong |
|---|---|---|
| RN hours / resident-day | 0.49 | 0.55–0.75 |
| Weekend hours / resident-day | 3.64 | ≈ weekday level |
| Nursing turnover / year | 56% | median 45% |
| Fines (3-yr window) | 1 · $78,878 |
Inspection citations (45 in the current record)
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Potential for harm · D January 14, 2026
Provide care and assistance to perform activities of daily living for any resident who is unable.
Corrected February 13, 2026 · Quality of Life and Care
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Potential for harm · D January 14, 2026
Post nurse staffing information every day.
Corrected February 13, 2026 · Nursing and Physician Services
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Potential for harm · F January 14, 2026
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected February 13, 2026 · Nutrition and Dietary
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Potential for harm · D January 14, 2026
Provide and implement an infection prevention and control program.
Corrected February 13, 2026 · Infection Control
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Immediate jeopardy · J August 5, 2025 · found via complaint
Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge.
Corrected September 5, 2025 · Resident Rights
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Immediate jeopardy · J August 5, 2025 · found via complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected September 5, 2025 · Quality of Life and Care
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Actual harm · G August 5, 2025 · found via complaint
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Corrected September 5, 2025 · Quality of Life and Care
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Potential for harm · D August 5, 2025 · found via complaint
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Corrected September 5, 2025 · Resident Rights
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Potential for harm · D August 5, 2025 · found via complaint
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Corrected September 5, 2025 · Resident Rights
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Potential for harm · E August 5, 2025 · found via complaint
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Corrected September 5, 2025 · Nursing and Physician Services
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Potential for harm · D August 5, 2025 · found via complaint
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Corrected September 5, 2025 · Resident Assessment and Care Planning
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Potential for harm · E August 5, 2025 · found via complaint
Have policies on smoking.
Corrected September 5, 2025 · Environmental
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Potential for harm · D April 10, 2025 · found via complaint
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected May 9, 2025 · Quality of Life and Care
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Potential for harm · D April 10, 2025 · found via complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected May 9, 2025 · Quality of Life and Care
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Potential for harm · D April 10, 2025 · found via complaint
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Corrected May 9, 2025 · Nursing and Physician Services
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Potential for harm · D April 10, 2025 · found via complaint
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Corrected May 9, 2025 · Resident Assessment and Care Planning
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Potential for harm · D December 12, 2024 · found via complaint
Provide safe and appropriate respiratory care for a resident when needed.
Corrected January 9, 2025 · Quality of Life and Care
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Potential for harm · D December 12, 2024
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Corrected January 9, 2025 · Resident Assessment and Care Planning
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Potential for harm · D December 12, 2024
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected January 9, 2025 · Resident Assessment and Care Planning
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Potential for harm · D December 12, 2024
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Corrected January 9, 2025 · Quality of Life and Care
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Potential for harm · D December 12, 2024
Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
Corrected January 9, 2025 · Nursing and Physician Services
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Potential for harm · E December 12, 2024
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected January 9, 2025 · Nutrition and Dietary
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Potential for harm · D December 12, 2024
Provide and implement an infection prevention and control program.
Corrected January 9, 2025 · Infection Control
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Potential for harm · D December 12, 2024
Develop and implement policies and procedures for flu and pneumonia vaccinations.
Corrected January 9, 2025 · Infection Control
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Potential for harm · D December 12, 2024
Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.
Corrected January 9, 2025 · Infection Control
Showing the 25 most recent. The Safety Report includes every citation with full findings.
Federal penalties
| Date | Type | Amount / length |
|---|---|---|
| August 5, 2025 | Fine | $78,878 |
Family & resident reviews — a separate signal, never mixed into the score
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Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 165385 · certified since February 1, 1998. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.