All states › Rhode Island › Middletown › Royal Middletown Nursing Center
193 Forest Avenue Middletown, RI 02842 · Newport County
All 3 nursing homes in Middletown, RI (3 take Medicaid)
CMS certification number 415040 · See this home on Medicare Care Compare
Is Royal Middletown Nursing Center a good nursing home? Reviews, ratings and inspection record
There are no official resident reviews of nursing homes: Medicare's Care Compare publishes inspections, staffing and quality data instead. Here is what that record shows for Royal Middletown Nursing Center as of October 2026.
CMS rates it 2 out of 5 stars overall, below the Rhode Island average of 2.9.
Online reviews from families and residents are on Google Maps and other sites; they reflect individual experiences and aren't checked by CMS. The full inspection reports, including what inspectors observed, are on Medicare Care Compare.
Staffing
Nursing staff spend about 3.18 hours per resident per day at Royal Middletown Nursing Center, below the Rhode Island median of 3.61 (US median: 3.72). About 0.90 of those hours are from registered nurses. On weekends it falls to 2.85 hours, 10% below its all-week average. 56.8% of nursing staff left within a year (Rhode Island median 40.3%). High turnover can mean residents see unfamiliar caregivers; ask how long the nurses on the unit have worked there.
About this nursing home
Paying for care at Royal Middletown Nursing Center: Medicare and Medicaid
Royal Middletown Nursing Center is certified for both Medicare and Medicaid. Medicare Part A can cover a short skilled-nursing or rehab stay here after a qualifying hospital stay of at least three inpatient days (observation days don't count), for up to 100 days per benefit period. Medicaid can pay for long-term care for residents who meet Rhode Island's income and asset rules. Being certified doesn't guarantee a Medicaid bed is open, so ask whether the home accepts residents whose Medicaid application is still pending.
In 2026 Medicare covers days 1–20 in full after the Part A deductible ($1,736 per benefit period); for days 21–100 you pay $217 a day; after day 100 you pay all costs. Medicare doesn't pay for long-term custodial care. Medicare's coverage rules.
Health inspections
The most recent standard inspection was on April 30, 2026 and found 7 deficiencies, plus 9 from complaint inspections in the same period. In total, inspectors issued 26 citations in the last three years.
Each citation has a scope and severity letter from A to L. A–C: potential for minimal harm. D–F: potential for more than minimal harm. G–I: actual harm. J–L: immediate jeopardy to resident health or safety.
What the inspections found
Over the last three years, inspectors issued 26 citations at Royal Middletown Nursing Center across 10 inspection dates, 16 of them from complaint investigations. 2 were at the actual-harm level (G–I), most recently on November 25, 2025. The most common areas cited were quality of life and care (5) and freedom from abuse, neglect, and exploitation (4). The most serious was cited under the CMS rule to "provide and implement an infection prevention and control program" (tag F0880, level H, November 25, 2025). 4 citations were under CMS's abuse, neglect and exploitation rules.
April 30, 2026 · 9 citations · includes complaint inspection
FNot hire anyone with a finding of abuse, neglect, exploitation, or theft.
EHonor the resident's right to be treated with respect and dignity and to retain and use personal possessions.
DProtect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
DRespond appropriately to all alleged violations.
DProvide appropriate treatment and care according to orders, resident’s preferences and goals.
DProvide safe, appropriate pain management for a resident who requires such services.
DEnsure that residents are free from significant medication errors.
DArrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
DProvide and implement an infection prevention and control program.
February 19, 2026 · 2 citations · includes complaint inspection
DEnsure that residents are free from significant medication errors.
DArrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
January 7, 2026 · 2 citations · includes complaint inspection
DEnsure services provided by the nursing facility meet professional standards of quality.
DProvide and implement an infection prevention and control program.
December 8, 2025 · 1 citation · includes complaint inspection
EProvide appropriate treatment and care according to orders, resident’s preferences and goals.
November 25, 2025 · 2 citations, includes actual harm · includes complaint inspection
HProvide and implement an infection prevention and control program.
GProvide appropriate treatment and care according to orders, resident’s preferences and goals.
April 2, 2025 · 4 citations · includes complaint inspection
DRespond appropriately to all alleged violations.
DEnsure services provided by the nursing facility meet professional standards of quality.
DEnsure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
DSafeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
November 7, 2024 · 1 citation · includes complaint inspection
EProvide safe and appropriate respiratory care for a resident when needed.
October 8, 2024 · 1 citation · includes complaint inspection
DEnsure services provided by the nursing facility meet professional standards of quality.
April 11, 2024 · 3 citations · includes complaint inspection
FProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
FProvide and implement an infection prevention and control program.
EEnsure each resident’s drug regimen must be free from unnecessary drugs.
February 29, 2024 · 1 citation · includes complaint inspection
DEnsure each resident’s drug regimen must be free from unnecessary drugs.
Questions to ask on a tour of Royal Middletown Nursing Center
- Inspectors cited the home at the actual-harm level on November 25, 2025 under the rule on infection control. What changed afterwards, and can I see the plan of correction?
- CMS cited the home under its abuse and neglect rules on April 30, 2026. How are staff trained, and how are concerns reported?
- CMS rates staffing 2 out of 5. How many residents does each nurse aide care for on day, evening and night shifts?
- Nursing staff turnover was 56.8% a year. How many of the staff come from agencies?
- Do you have a Medicaid bed open now, and will you admit someone whose Medicaid application is still pending?
- When is the first care-plan meeting, and can family attend?
Questions come from this home's CMS data: its inspections, staffing and ownership record.
Fines and payment denials
1 penalty in the last three years, including $19,884 in fines.
| Date | Type | Amount or length |
|---|---|---|
| Nov 25, 2025 | Fine | $19,884 |
Rating history
| CMS month | Overall | Inspection | Staffing | Quality |
|---|---|---|---|---|
| October 2026 | 2/5 | 2/5 | 2/5 | 3/5 |
| August 2026 | 2/5 | 2/5 | 2/5 | 2/5 |
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Location
Hospitals near Royal Middletown Nursing Center
The Medicare-certified hospitals closest to this nursing home, with their CMS data. Ask the home which hospital it usually sends residents to.
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2.3 mi
Newport Hospital NewportEmergency room ★★★★☆ Medicare overall 4 of 5Median ER visit 2h 52m for patients treated and sent home
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12.7 mi
South County Hospital INC WakefieldEmergency room ★★★★☆ Medicare overall 4 of 5Median ER visit 3h 17m for patients treated and sent home
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13.1 mi
Saint Anne's Hospital, a Caritas Family Hospital Fall RiverEmergency room ★★★☆☆ Medicare overall 3 of 5Median ER visit 3h 14m for patients treated and sent home
Hospital ratings, ER visit times and more at Hospitals In Each State
Source: CMS Care Compare. Distances are approximate.
Nearby nursing homes
More nursing homes near Royal Middletown Nursing Center › All nursing homes in Middletown ›
Compare Royal Middletown Nursing Center with the 3 closest homes side by side ›
Higher-rated nursing homes within 10 miles
- St Clare Home · Newport · 4 stars · 3.4 mi
- Village House Nursing & Rehabilitation Center · Newport · 4 stars · 4.3 mi
- John Clarke Senior Living · Middletown · 3 stars · 1.6 mi
Other Royal Health Group nursing homes in Rhode Island
- Royal of Westerly Nursing Center · Westerly · 4 stars
Affiliation comes from CMS's affiliated-entity data, October 2026. All 12 Royal Health Group nursing homes ›
Source: CMS Provider Data Catalog (provider information, health deficiencies, penalties), October 2026. Inspection citations and penalties cover the last three years. Nursing Homes In Each State is independent and not affiliated with CMS or Medicare. About the data · Report a problem with this listing. Is this your nursing home? Feature it here.