LEGACY HEALTHCARE
Ownership rollup across 95 nursing homes in 4 states: Alabama, Iowa, Illinois, South Dakota. The "follow the money" view of an operator’s whole portfolio — the pattern a single facility page can’t show.
The chain’s homes average 2.9 of 5 stars on the CMS overall rating — roughly in line with the ~2.8 average of the 4 states it operates in. It has been broadly flat, moving -0.09 stars across the same 95 homes rated throughout between 2025-02 and 2026-06. We benchmark against its own states because CMS ranks the health-inspection star within each state, so a national comparison (national average ~3.0) partly measures where a chain operates rather than how it operates.
Where the rating comes from
The CMS overall star blends three different things. Split apart across the whole portfolio, they say different things about an operator: thin staffing is a budget decision made above the building, while a weak inspection score is what surveyors actually found inside it.
| Component | Chain average | Basis | |
|---|---|---|---|
| Health inspection | 2.8 of 5 | 94 rated homes | state surveyors’ findings, ranked within each state |
| Staffing | 2.5 of 5 | 94 rated homes | from payroll (PBJ) hours |
| Quality measures | 3.3 of 5 | 94 rated homes | largely self-reported clinical data |
Averaged across this chain’s rated homes. Health-inspection stars are assigned within each state’s own distribution, so for a chain spanning several states this component mixes distributions and is best read alongside each home’s actual citations.
Portfolio red flags
How many of this chain’s homes carry the most serious CMS markers. One flagged home can be local; a pattern across the portfolio is an operator-level signal worth researching.
1 of this chain’s 95 home is tied to a real-estate investment trust (REIT) in CMS ownership records. Private-equity and REIT operators are the focus of most research into how money is moved out of nursing homes — often through the related-party payments shown below. CMS under-reports these ties, so read this as a floor.
Follow the money — chain finances
Aggregated from each home’s CMS Medicare cost report (HCRIS). Related-party payments are dollars a home sends to landlords or management companies under common ownership — the main channel through which private-equity and REIT owners can pull money out of a home while its own books still show a thin margin.
Only homes with a cost report on file are included, so the related-party total is a floor. Cost reports are self-filed, unaudited, and a year or two behind.
Weighted by each home’s average daily census, across the all 95 homes that report both a usable payer mix and a census. Homes whose cost report fails the same validity check the facility pages apply are left out of this figure entirely rather than counted as zero.
Every home in this chain
Lowest-rated first, so the homes most worth a closer look sit at the top. Each links to its full inspection, staffing, fines, and ownership record.
| Home | CMS rating | Flags |
|---|---|---|
| Birmingham Nursing And Rehabilitation Ctr LLCBirmingham, AL | 1 of 5 | 4 immediate-jeopardy Abuse flag $68,647 fined |
| Emmetsburg Care CenterEmmetsburg, IA | 1 of 5 | 1 immediate-jeopardy $25,695 fined |
| Harmony House Health Care CenterWaterloo, IA | 1 of 5 | 2 immediate-jeopardy SFF candidate $31,736 fined |
| Harmony MarshalltownMarshalltown, IA | 1 of 5 | 2 immediate-jeopardy $78,878 fined |
| Harmony WaterlooWaterloo, IA | 1 of 5 | 1 immediate-jeopardy Abuse flag $95,440 fined |
| Harmony West Des MoinesWest Des Moines, IA | 1 of 5 | — |
| Northgate Care CenterWaukon, IA | 1 of 5 | 1 immediate-jeopardy SFF candidate $87,160 fined REIT-owned |
| Park View Rehabilitation CenterSac City, IA | 1 of 5 | — |
| Southfield Wellness CommunityWebster City, IA | 1 of 5 | 1 immediate-jeopardy $71,897 fined |
| Avantara Evergreen ParkEvergreen Park, IL | 1 of 5 | $261,963 fined |
| Grove Of Elmhurst, TheElmhurst, IL | 1 of 5 | 2 immediate-jeopardy $143,281 fined |
| Harmony Park RidgePark Ridge, IL | 1 of 5 | Abuse flag $224,934 fined |
| Warren Barr South LoopChicago, IL | 1 of 5 | $152,896 fined |
| Avantara ArrowheadRapid City, SD | 1 of 5 | Abuse flag $153,583 fined |
| Avantara MilbankMilbank, SD | 1 of 5 | $125,981 fined |
| Avantara WatertownWatertown, SD | 1 of 5 | 2 immediate-jeopardy SFF candidate Abuse flag $71,591 fined |
| Highlands Rehabilitation and Wellness CenterBirmingham, AL | 2 of 5 | 5 immediate-jeopardy $24,834 fined |
| Mobile Nursing And Rehabilitation CenterMobile, AL | 2 of 5 | $8,788 fined |
| Pine Haven Rehabilitation And Wellness CenterEight Mile, AL | 2 of 5 | — |
| Colonial Manor of ElmaElma, IA | 2 of 5 | Abuse flag $31,906 fined |
| Hallmark Care CenterMount Vernon, IA | 2 of 5 | — |
| Harmony Cedar RapidsCedar Rapids, IA | 2 of 5 | $10,509 fined |
| Harmony DavenportDavenport, IA | 2 of 5 | — |
| Harmony DubuqueDubuque, IA | 2 of 5 | $19,371 fined |
| Harmony Utica RidgeDavenport, IA | 2 of 5 | 2 immediate-jeopardy $51,292 fined |
| Heritage Care And Rehabilitation CenterMason City, IA | 2 of 5 | — |
| Avantara JolietJoliet, IL | 2 of 5 | $33,535 fined |
| Avantara Lincoln ParkChicago, IL | 2 of 5 | Abuse flag $202,448 fined |
| Avantara Palos HeightsPalos Heights, IL | 2 of 5 | $22,645 fined |
| Bella Terra BloomingdaleBloomingdale, IL | 2 of 5 | Abuse flag $10,358 fined |
| Bella Terra Morton GroveMorton Grove, IL | 2 of 5 | Abuse flag $47,223 fined |
| Carlton At The Lake, TheChicago, IL | 2 of 5 | 1 immediate-jeopardy $253,556 fined |
| Chalet Living & RehabChicago, IL | 2 of 5 | 2 immediate-jeopardy Abuse flag $350,306 fined |
| Harmony PalosPalos Heights, IL | 2 of 5 | $25,874 fined |
| Peterson Park Health Care CtrChicago, IL | 2 of 5 | 1 immediate-jeopardy Abuse flag $13,042 fined |
| Warren Barr Buffalo GroveBuffalo Grove, IL | 2 of 5 | Abuse flag $9,311 fined |
| Avantara GrotonGroton, SD | 2 of 5 | $6,168 fined |
| Avantara HuronHuron, SD | 2 of 5 | 1 immediate-jeopardy $8,338 fined |
| Avantara Mountain ViewRapid City, SD | 2 of 5 | $38,613 fined |
| Avantara PierrePierre, SD | 2 of 5 | Abuse flag $22,048 fined |
| Avantara RedfieldRedfield, SD | 2 of 5 | $23,044 fined |
| Avantara Saint CloudRapid City, SD | 2 of 5 | $39,131 fined |
| Florence Nursing And Rehabilitation Ctr, LLCFlorence, AL | 3 of 5 | — |
| Bloomfield Care CenterBloomfield, IA | 3 of 5 | — |
| Manor House Care CenterSigourney, IA | 3 of 5 | — |
| Nora Springs Care CenterNora Springs, IA | 3 of 5 | — |
| Oakwood Care CenterClear Lake, IA | 3 of 5 | — |
| Oelwein Health Care CenterOelwein, IA | 3 of 5 | — |
| Rehabilitation Center of AllisonAllison, IA | 3 of 5 | — |
| Rehabilitation Centers of Independence West CampusIndependence, IA | 3 of 5 | 1 immediate-jeopardy $22,740 fined |
| Rolling Green Village Care CenterNevada, IA | 3 of 5 | $9,347 fined |
| Clark ManorChicago, IL | 3 of 5 | — |
| Glenview TerraceGlenview, IL | 3 of 5 | 1 immediate-jeopardy $67,830 fined |
| Grove Of Lagrange Park, TheLa Grange Park, IL | 3 of 5 | — |
| Warren Barr Lincoln ParkChicago, IL | 3 of 5 | 1 immediate-jeopardy $117,488 fined |
| Warren Barr North ShoreHighland Park, IL | 3 of 5 | $47,317 fined |
| Warren Barr Orland ParkOrland Park, IL | 3 of 5 | $60,348 fined |
| Whitehall Of DeerfieldDeerfield, IL | 3 of 5 | — |
| Avantara NorthRapid City, SD | 3 of 5 | $24,108 fined |
| Grandview Healthcare CenterOelwein, IA | 4 of 5 | — |
| Lake Mills Care CenterLake Mills, IA | 4 of 5 | — |
| Maple Manor VillageAplington, IA | 4 of 5 | — |
| Rehabilitation Center of HamptonHampton, IA | 4 of 5 | — |
| Rehabilitation Center of LisbonLisbon, IA | 4 of 5 | — |
| Willow Dale Wellness VillageBattle Creek, IA | 4 of 5 | — |
| Astoria Place Living & RehabChicago, IL | 4 of 5 | $4,784 fined |
| Avantara AuroraAurora, IL | 4 of 5 | — |
| Avantara Chicago RidgeChicago Ridge, IL | 4 of 5 | $137,658 fined |
| Avantara LibertyvilleLibertyville, IL | 4 of 5 | $26,130 fined |
| Avantara Long GroveLong Grove, IL | 4 of 5 | — |
| Avantara Park RidgePark Ridge, IL | 4 of 5 | $24,515 fined |
| Bella Terra ElmhurstElmhurst, IL | 4 of 5 | — |
| Bella Terra LombardLombard, IL | 4 of 5 | — |
| Bella Terra SchaumburgSchaumburg, IL | 4 of 5 | $96,025 fined |
| Grove Of Fox Valley,theAurora, IL | 4 of 5 | $17,010 fined |
| Grove Of Northbrook,theNorthbrook, IL | 4 of 5 | 1 immediate-jeopardy $83,860 fined |
| Grove Of Skokie, TheSkokie, IL | 4 of 5 | — |
| Lakefront Nursing & Rehab CtrChicago, IL | 4 of 5 | $13,729 fined |
| Warren Barr Gold CoastChicago, IL | 4 of 5 | $24,962 fined |
| Warren Barr LiebermanSkokie, IL | 4 of 5 | — |
| Warren Barr Oak LawnOak Lawn, IL | 4 of 5 | — |
| Avantara Clark CityClark, SD | 4 of 5 | $11,057 fined |
| Concord Care CenterGarner, IA | 5 of 5 | — |
| Guttenberg Care CenterGuttenberg, IA | 5 of 5 | — |
| Rehabilitation Center of BelmondBelmond, IA | 5 of 5 | — |
| Valley Vue Care CenterArmstrong, IA | 5 of 5 | — |
| Westview Care CenterBritt, IA | 5 of 5 | — |
| Westview of Indianola Care CenterIndianola, IA | 5 of 5 | — |
| Avantara Lake ZurichLake Zurich, IL | 5 of 5 | $15,124 fined |
| Bella Terra LagrangeLa Grange, IL | 5 of 5 | — |
| Bella Terra StreamwoodStreamwood, IL | 5 of 5 | — |
| Bella Terra WheelingWheeling, IL | 5 of 5 | $28,054 fined |
| Harmony Healthcare & Rehab CtrChicago, IL | 5 of 5 | $5,244 fined |
| Avantara Lake NordenLake Norden, SD | 5 of 5 | — |
| Avantara NortonSioux Falls, SD | Not rated | 1 immediate-jeopardy Special Focus Abuse flag $312,233 fined |
Source: CMS Provider Data Catalog (nursing-home ratings, deficiencies, penalties, and ownership) and the CMS Medicare cost report (HCRIS) for finances. Chain membership is as reported to CMS. CMS extracts retrieved 11 October 2026; CMS refreshes them monthly, so counts here are as of that date. Verify with the facility and your state regulator.