Nursing home report card · Middletown, RI
Royal Middletown Nursing Center
193 Forest Avenue, Middletown, RI 02842
Call this home: (401) 847-2777
View this home on Medicare.gov ↗
Quick summary
Below-average Medicare rating
Overall rating is 2 of 5 stars. Its health-inspection rating is 2 of 5. Read the dated inspection findings and separate staffing and care ratings below.
Our summary of public Medicare records. It does not establish that this home harmed a particular resident. About this summary.
How recent is this information?
- Medicare file prepared
- Aug 1, 2026
- Our record last updated
- Sep 17, 2026
- Last routine health inspection
- Apr 30, 2026
These dates mean different things. A new file can include older inspections and staffing figures. Read about the dates.
Medicare ratings
One star is the lowest rating. Five stars is the highest. Ratings are a starting point—read the inspection findings too.
Combines inspection, staffing, and care measures.
Below-average Medicare rating
Based on problems found during health inspections.
Below-average Medicare rating
Based on staffing levels and related measures.
Below-average Medicare rating
Based on reported health and care results.
Below-average Medicare rating
What do the ratings and warnings mean?
- Medicare ratings
- One star is the lowest rating. Five stars is the highest. These are government ratings, not family reviews.
- Inspection problems
- Inspectors found that a home did not meet a care or safety rule. The official term is “deficiency.”
- Abuse warning
- Medicare has flagged the home because of abuse-related inspection findings. Read the findings and dates.
- Nursing staff time
- Average staff hours for each resident per day. This does not mean each resident gets that much one-to-one care.
At a glance
These numbers come from the records we have. Inspection problems are rules the home did not meet. The dates covered can differ.
Care, safety, and resident-rights issues on recent inspections
Building, alarms, exits, and related safety citations
Total fine amounts in the imported penalty records
Medicare home ID: 415040
Inspection findings to read first
Start with these past findings. We show the most serious first, then the most recent. They do not describe the home’s condition today.
Caused actual harm · isolated case
Nov 25, 2025 · Inspection rule F0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Caused actual harm · pattern case
Nov 25, 2025 · Inspection rule F0880
Provide and implement an infection prevention and control program.
Could have caused harm · isolated case
Apr 30, 2026 · Inspection rule F0880
Provide and implement an infection prevention and control program.
Nursing staff time
These are average staff hours for each resident per day. They are not one-to-one bedside care. The file does not give the reporting period for each figure.
about 55 minutes per resident per day
about 3 hr 12 min per resident per day
about 40 minutes per resident per day
Latest inspection summary
A summary of the most recent routine inspections. You can open the dated findings below.
Inspectors last checked the home’s day-to-day care on April 30, 2026 and wrote up 16 health problems. The same visit also found 0 fire-safety problems. Looking across recent visits: 16 on visit 1, then 6 on visit 2, then 4 on visit 3.
Top issue areas on the latest visit
- Quality of life & care: 4
- Infection control: 3
- Abuse / neglect / exploitation: 3
- Administration: 2
- Pharmacy: 2
- Resident rights: 1
| Visit | Health check date | Health problems | Fire-safety date | Fire problems |
|---|---|---|---|---|
| #1 | 2026-04-30 | 16 | 2026-04-30 | 0 |
| #2 | 2025-04-02 | 6 | 2025-04-02 | 3 |
| #3 | 2024-04-11 | 4 | 2024-04-11 | 4 |
How this home compares
Compared with state and national averages. The numbers may cover different periods.
- Overall CMS rating: 2 stars — worse than the state average (2.9 stars)
- Health inspection rating: 2 stars — worse than the state average (2.8 stars)
- Staffing rating: 2 stars — worse than the state average (3.2 stars)
- Registered nurse time per resident: 0.92 hours/day
- Total nurse time per resident: 3.21 hours/day
- The latest health inspection listed 16 problems. State and national averages can cover different inspection periods and are not a like-for-like comparison with this inspection.
See the dates used for these averages
Medicare file dates: this home Aug 1, 2026; Rhode Island averages Aug 1, 2026; U.S. averages Oct 1, 2026.
Other concerns in the records
These points may be worth asking about. They do not establish what happened to a particular resident. See our Terms of Use.
- Overall star rating is 2 or lower
- Health inspection rating is 2 stars or lower
- Recent citations include infection-control problems
- Inspectors have listed an unusually high number of problems
- Several recent fire-safety problems are on record
- CMS has fined this home in the recent reporting period
How serious were the problems?
Inspectors rate each problem by how much harm it caused or could cause. We group the CMS letter codes into plain language.
- Caused actual harm2 citations
- Could have caused harm31 citations
Why inspectors showed up
Routine checks happen on a schedule. Complaint visits happen when someone reports a concern.
- Complaints
- 0
- Routine
- 26
- Fire safety
- 7
- Other
- 0
Who owns it
Names CMS lists as owners or managers · reported as For profit - Partnership.
- 5% OR GREATER DIRECT OWNERSHIP INTEREST · Individual · 50% · since 01/14/2016
- OPERATIONAL/MANAGERIAL CONTROL · Individual · NOT APPLICABLE · since 08/19/2016
Other homes in this group: All Royal Health Group nursing homes
Inspection history
Open a date to read what inspectors found. The harm labels explain how serious the problem was at the time.
April 30, 20269 findings
- Freedom from Abuse, Neglect, and Exploitation problemsCould have caused harm · isolated case
Inspection type and official rule codes
Routine health inspection · CMS tag F0610 · code D
Respond appropriately to all alleged violations.
- Freedom from Abuse, Neglect, and Exploitation problemsCould have caused harm · widespread case
Inspection type and official rule codes
Routine health inspection · CMS tag F0606 · code F
Not hire anyone with a finding of abuse, neglect, exploitation, or theft.
- Resident Rights problemsCould have caused harm · pattern case
Inspection type and official rule codes
Routine health inspection · CMS tag F0557 · code E
Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.
- Freedom from Abuse, Neglect, and Exploitation problemsCould have caused harm · isolated case
Inspection type and official rule codes
Routine health inspection · CMS tag F0600 · code D
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
- Quality of Life and Care problemsCould have caused harm · isolated case
Inspection type and official rule codes
Routine health inspection · CMS tag F0684 · code D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- Quality of Life and Care problemsCould have caused harm · isolated case
Inspection type and official rule codes
Routine health inspection · CMS tag F0697 · code D
Provide safe, appropriate pain management for a resident who requires such services.
- Pharmacy Service problemsCould have caused harm · isolated case
Inspection type and official rule codes
Routine health inspection · CMS tag F0760 · code D
Ensure that residents are free from significant medication errors.
- Administration problemsCould have caused harm · isolated case
Inspection type and official rule codes
Routine health inspection · CMS tag F0849 · code D
Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
- Infection Control problemsCould have caused harm · isolated case
Inspection type and official rule codes
Routine health inspection · CMS tag F0880 · code D
Provide and implement an infection prevention and control program.
February 19, 20262 findings
- Administration problemsCould have caused harm · isolated case
Inspection type and official rule codes
Routine health inspection · CMS tag F0849 · code D
Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
- Pharmacy Service problemsCould have caused harm · isolated case
Inspection type and official rule codes
Routine health inspection · CMS tag F0760 · code D
Ensure that residents are free from significant medication errors.
January 7, 20262 findings
- Resident Assessment and Care Planning problemsCould have caused harm · isolated case
Inspection type and official rule codes
Routine health inspection · CMS tag F0658 · code D
Ensure services provided by the nursing facility meet professional standards of quality.
- Infection Control problemsCould have caused harm · isolated case
Inspection type and official rule codes
Routine health inspection · CMS tag F0880 · code D
Provide and implement an infection prevention and control program.
December 8, 20251 finding
- Quality of Life and Care problemsCould have caused harm · pattern case
Inspection type and official rule codes
Routine health inspection · CMS tag F0684 · code E
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
November 25, 20252 findings
- Infection Control problemsCaused actual harm · pattern case
Inspection type and official rule codes
Routine health inspection · CMS tag F0880 · code H
Provide and implement an infection prevention and control program.
- Quality of Life and Care problemsCaused actual harm · isolated case
Inspection type and official rule codes
Routine health inspection · CMS tag F0684 · code G
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
April 2, 20257 findings
- Freedom from Abuse, Neglect, and Exploitation problemsCould have caused harm · isolated case
Inspection type and official rule codes
Routine health inspection · CMS tag F0610 · code D
Respond appropriately to all alleged violations.
- Resident Assessment and Care Planning problemsCould have caused harm · isolated case
Inspection type and official rule codes
Routine health inspection · CMS tag F0658 · code D
Ensure services provided by the nursing facility meet professional standards of quality.
- Nursing and Physician Services problemsCould have caused harm · isolated case
Inspection type and official rule codes
Routine health inspection · CMS tag F0726 · code D
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.
- Resident Assessment and Care Planning problemsCould have caused harm · isolated case
Inspection type and official rule codes
Routine health inspection · CMS tag F0842 · code D
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- Services problemsCould have caused harm · widespread case
Inspection type and official rule codes
Fire-safety inspection · CMS tag K0511 · code F
Have properly installed electrical wiring and gas equipment.
- Miscellaneous problemsCould have caused harm · widespread case
Inspection type and official rule codes
Fire-safety inspection · CMS tag K0712 · code F
Have simulated fire drills held at unexpected times.
- Gas, Vacuum, and Electrical Systems problemsCould have caused harm · widespread case
Inspection type and official rule codes
Fire-safety inspection · CMS tag K0918 · code F
Have generator or other power source capable of supplying service within 10 seconds.
November 7, 20241 finding
- Quality of Life and Care problemsCould have caused harm · pattern case
Inspection type and official rule codes
Routine health inspection · CMS tag F0695 · code E
Provide safe and appropriate respiratory care for a resident when needed.
October 8, 20241 finding
- Resident Assessment and Care Planning problemsCould have caused harm · isolated case
Inspection type and official rule codes
Routine health inspection · CMS tag F0658 · code D
Ensure services provided by the nursing facility meet professional standards of quality.
April 11, 20247 findings
- Smoke problemsCould have caused harm · widespread case
Inspection type and official rule codes
Fire-safety inspection · CMS tag K0345 · code F
Have approved installation, maintenance and testing program for fire alarm systems.
- Smoke problemsCould have caused harm · pattern case
Inspection type and official rule codes
Fire-safety inspection · CMS tag K0351 · code E
Install an approved automatic sprinkler system.
- Gas, Vacuum, and Electrical Systems problemsCould have caused harm · isolated case
Inspection type and official rule codes
Fire-safety inspection · CMS tag K0923 · code D
Have proper medical gas storage and administration areas.
- Egress problemsCould have caused harm · widespread case
Inspection type and official rule codes
Fire-safety inspection · CMS tag K0291 · code F
Install emergency lighting that can last at least 1 1/2 hours.
- Nutrition and Dietary problemsCould have caused harm · widespread case
Inspection type and official rule codes
Routine health inspection · CMS tag F0812 · code F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- Pharmacy Service problemsCould have caused harm · pattern case
Inspection type and official rule codes
Routine health inspection · CMS tag F0757 · code E
Ensure each resident’s drug regimen must be free from unnecessary drugs.
- Infection Control problemsCould have caused harm · widespread case
Inspection type and official rule codes
Routine health inspection · CMS tag F0880 · code F
Provide and implement an infection prevention and control program.
February 29, 20241 finding
- Pharmacy Service problemsCould have caused harm · isolated case
Inspection type and official rule codes
Routine health inspection · CMS tag F0757 · code D
Ensure each resident’s drug regimen must be free from unnecessary drugs.
Fines & penalties
These fines appear in Medicare’s records. A listed amount does not tell us whether it has been paid.
- Fine · Nov 25, 2025$30,590
Other homes in this chain
Royal Health Group · other locations in Rhode Island
Related topics
Questions about Royal Middletown Nursing Center
What is Royal Middletown Nursing Center's Medicare star rating?
Has Royal Middletown Nursing Center been fined?
Does Royal Middletown Nursing Center have a Medicare abuse warning?
How does Royal Middletown Nursing Center compare with other nursing homes in Rhode Island?
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