Nursing home
Royal Middletown Nursing Center
193 Forest Avenue, Middletown, RI 02842 · Map
For profit - Partnership · Part of Royal Health Group (12 facilities) · 50 certified beds
Royal Middletown Nursing Center is a Medicare-certified nursing home in Middletown, Rhode Island. CMS rates it 3 out of 5 stars overall (2/5 for staffing, 3/5 for health inspections). Nurse staffing is 3.00 hours per resident per day, below the Rhode Island average of 3.72. Its most recent inspection on Apr 2, 2025 cited 9 deficiencies.
CMS quality ratings
Ratings from the Centers for Medicare & Medicaid Services (CMS), updated monthly. 5 stars is the highest quality.
How Royal Middletown Nursing Center compares
This facility vs. the Rhode Island and national averages, from CMS data. For staffing, higher is generally better; for turnover and deficiencies, lower is better.
| Metric | This facility | Rhode Island avg | National avg | Compared with the state |
|---|---|---|---|---|
| Total nurse staffing (hrs/resident/day) | 3.00 | 3.72 | 3.89 | below avg |
| RN staffing (hrs/resident/day) | 0.95 | 0.77 | 0.68 | above avg |
| Aide staffing (hrs/resident/day) | 2.00 | 2.46 | 2.34 | below avg |
| Nursing staff turnover | 79.6% | 40.4% | 46.4% | above avg |
| Deficiencies cited, last inspection | 9.0 | 8.7 | 9.5 | above avg |
Staffing
Hours per resident per day as reported to CMS. Higher numbers indicate more direct care time.
Staff turnover
Lower turnover typically indicates better working conditions and continuity of care. National average for nursing staff is 46.4%.
Recent health inspection
CMS inspects nursing facilities regularly. Deficiencies are categorized by severity.
What inspectors found at Royal Middletown Nursing Center
Specific deficiencies cited in recent CMS health inspections, most recent first. Severity follows the CMS scope/severity scale. Source: CMS Care Compare.
- Potential for harm
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.
Administration Deficiencies · Feb 19, 2026 · Full report (PDF) - Potential for harm
Ensure that residents are free from significant medication errors.
Pharmacy Service Deficiencies · Feb 19, 2026 · Full report (PDF) - Potential for harm
Provide and implement an infection prevention and control program.
Infection Control Deficiencies · Jan 7, 2026 · Full report (PDF) - Potential for harm
Ensure services provided by the nursing facility meet professional standards of quality.
Resident Assessment and Care Planning Deficiencies · Jan 7, 2026 · Full report (PDF) - Potential for harm
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care Deficiencies · Dec 8, 2025 · Full report (PDF)
Show all 12 deficiencies
- Actual harm
Provide and implement an infection prevention and control program.
Infection Control Deficiencies · Nov 25, 2025 · Full report (PDF) - Actual harm
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care Deficiencies · Nov 25, 2025 · Full report (PDF) - Potential for harm
Respond appropriately to all alleged violations.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · Apr 2, 2025 · Full report (PDF) - Potential for harm
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Resident Assessment and Care Planning Deficiencies · Apr 2, 2025 · Full report (PDF) - Potential for harm
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.
Nursing and Physician Services Deficiencies · Apr 2, 2025 · Full report (PDF) - Potential for harm
Ensure services provided by the nursing facility meet professional standards of quality.
Resident Assessment and Care Planning Deficiencies · Apr 2, 2025 · Full report (PDF) - Potential for harm
Provide safe and appropriate respiratory care for a resident when needed.
Quality of Life and Care Deficiencies · Nov 7, 2024 · Full report (PDF)
Read the full inspection reports on Medicare.gov Each inspection there has a “Read the full report” link with the inspectors’ written findings.
About this facility
- Address
- 193 Forest Avenue
Middletown, RI 02842 - CMS certification #
- 415040
- Ownership
- For profit - Partnership
- Certified beds
- 50
- Avg residents/day
- 43.8
- Provider type
- Medicare and Medicaid
- First certified
- 1974-03-31
- Chain
- Royal Health Group (12 facilities)
- Setting
- Urban
Part of Royal Health Group
Royal Health Group operates 12 nursing facilities across the United States. View all Royal Health Group facilities →
Not SLA enrolled. This facility hasn’t enrolled in resident survey verification. Learn about enrollment →
Location and nearby
Explore the area around Royal Middletown Nursing Center using Google Maps.
Other public records
Full public records, with dates and sources
Location and nearby care
- Nearest hospital with an emergency room
- Newport Hospital, Newport. 2.3 miles away, straight line. CMS overall hospital rating: 4 of 5 stars.
- Nearest Medicare nursing home
- Grand Islander Center, Middletown. 1.5 miles away, straight line.
- Nearest home health agency office
- Visiting Nurse Home And Hospice, Middleton. 0.5 miles away, straight line. Agencies travel to clients, so ask which ones serve this address.
- Nearest pharmacy
- Matt's Local Pharmacy. 0.9 miles away, straight line. From OpenStreetMap, which does not list every pharmacy, so one may be closer.
- Area
- USDA classes ZIP code 02842 as metropolitan (metropolitan core).
- Dialysis within 15 miles
- Dialysis Center Of Tiverton, Tiverton, 11.6 miles away, straight line (CMS rating 5 of 5 stars)
Wakefield Dialysis Center, Wakefield, 12.7 miles away, straight line (CMS rating 5 of 5 stars)
Fresenius Medical Care Of Warwick, Warwick, 15.0 miles away, straight line (has a shift starting after 5 pm; CMS rating 4 of 5 stars) - Hospice
- 8 Medicare hospices tell CMS they serve ZIP code 02842.
Visiting Nurse Health And Hospice, office in Middletown, 0.5 miles away, straight line (CMS family survey rating 4 of 5 stars)
Athena Rhode Island Hospice LLC, office in Warwick, 14.7 miles away, straight line
Vna Of Care New England, office in Warwick, 15.7 miles away, straight line (CMS family survey rating 4 of 5 stars) - Nearest geriatric medicine practice
- Lifespan Physician Group Inc, Newport. 2.3 miles away, straight line. 2 geriatric medicine doctors listed there.
Distances are straight lines from the community, not driving distance. Hospitals, home health, dialysis, hospice and doctors come from CMS provider data (CMS, hospital list updated Jul 22, 2026). Star ratings are CMS’s own.
Emergency and natural hazard risk
Public hazard maps for this location. Ask the community about its emergency plan, its generator and where residents would go in an evacuation.
- Flood zone
- Outside the high and moderate risk flood areas on FEMA's flood map (Zone X, minimal flood hazard, or not studied). (FEMA flood map)
- FEMA National Risk Index
- Overall: very low. By hazard: hurricane relatively low, inland flooding relatively low, wildfire very low, tornado very low, heat wave very low, earthquake very low. These are FEMA’s ratings for the census tract, compared with tracts nationwide. (FEMA, December 2025)
A flood zone describes the map at this point, not the building's elevation. In an emergency, follow the local emergency management agency.
What we checked
Every public source we searched for this community. “Nothing on record” means we found no record that matched it. A record can be missed when a name or address differs.
| Source | Data as of | What we found |
|---|---|---|
| U.S. Department of Labor wage and hour cases | Oct 15, 2026 | Nothing on record |
| OSHA workplace safety inspections since 2016 | Oct 15, 2026 | Nothing on record |
| Hurricane evacuation zone maps | Not in a mapped zone | |
| FEMA flood map | See above | |
| USDA wildfire risk | Apr 15, 2026 | Not shown: FEMA rates wildfire risk here very low |
| FEMA National Risk Index | See above | |
| CMS hospitals, home health, dialysis, hospice and doctors; OpenStreetMap pharmacies | See above | |
| HUD Multifamily Properties - Assisted | Jul 6, 2026 | Nothing on record |
| State Veterans Homes (NASVH directory) | Sep 20, 2026 | Nothing on record |
| CMS Hospice - General Information | Aug 19, 2026 | Nothing on record |
| CMS Home Health Care Agencies | May 27, 2026 | Nothing on record |
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Frequently asked questions
Is Royal Middletown Nursing Center a good nursing home?
CMS gives Royal Middletown Nursing Center an overall rating of 3 out of 5 stars, including 2/5 for staffing and 3/5 for health inspections. These ratings come from the Centers for Medicare & Medicaid Services and are updated monthly.
How is Royal Middletown Nursing Center staffed?
Royal Middletown Nursing Center reports 3.00 total nurse hours per resident per day, compared with the Rhode Island average of 3.72.
Has Royal Middletown Nursing Center had inspection problems?
Its most recent CMS inspection cited 9 deficiencies.
How many beds does Royal Middletown Nursing Center have?
Royal Middletown Nursing Center is certified for 50 beds.