Royal Middletown Nursing Center
193 Forest Avenue · Middletown, RI · 02842 · 4018472777
50 certified beds For profit - Partnership Chain: Royal Health Group
Why this verdict
- 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
Cited under the freedom-from-abuse rule
Cited 1 time under F600 (freedom from abuse/neglect) below the actual-harm level — worth asking about on a tour.
2 actual-harm citations in the most recent cycle
Inspectors found deficiencies that caused real harm to residents, beyond potential-harm paperwork findings.
71% of nursing staff left within a year
High turnover disrupts continuity of care; the national median is 45%.
Score breakdown
Quality-measure stars are deliberately excluded — they're largely self-reported by facilities. Full method.
CMS ratings & staffing
Overall: 2 of 5 Inspections: 2 of 5 Staffing: 2 of 5 Quality measures: 2 of 5
| Total nurse hours / resident-day | 3.37 | 3.48 min · 4.1 strong |
|---|---|---|
| RN hours / resident-day | 1.14 | 0.55–0.75 |
| Weekend hours / resident-day | 3.14 | ≈ weekday level |
| Nursing turnover / year | 71% | median 45% |
| Fines (3-yr window) | 1 · $30,590 |
Inspection citations (26 in the current record)
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Potential for harm · D April 30, 2026 · found via complaint
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected May 15, 2026 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · F April 30, 2026 · found via complaint
Not hire anyone with a finding of abuse, neglect, exploitation, or theft.
Corrected May 15, 2026 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · E April 30, 2026
Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.
Corrected May 15, 2026 · Resident Rights
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Potential for harm · D April 30, 2026
Respond appropriately to all alleged violations.
Corrected May 15, 2026 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D April 30, 2026
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected May 15, 2026 · Quality of Life and Care
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Potential for harm · D April 30, 2026
Provide safe, appropriate pain management for a resident who requires such services.
Corrected May 15, 2026 · Quality of Life and Care
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Potential for harm · D April 30, 2026
Ensure that residents are free from significant medication errors.
Corrected May 15, 2026 · Pharmacy Service
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Potential for harm · D April 30, 2026
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.
Corrected May 15, 2026 · Administration
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Potential for harm · D April 30, 2026
Provide and implement an infection prevention and control program.
Corrected May 15, 2026 · Infection Control
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Potential for harm · D February 19, 2026 · found via complaint
Ensure that residents are free from significant medication errors.
Corrected March 11, 2026 · Pharmacy Service
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Potential for harm · D February 19, 2026 · found via complaint
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.
Corrected March 11, 2026 · Administration
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Potential for harm · D January 7, 2026 · found via complaint
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected January 16, 2026 · Resident Assessment and Care Planning
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Potential for harm · D January 7, 2026 · found via complaint
Provide and implement an infection prevention and control program.
Corrected January 16, 2026 · Infection Control
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Potential for harm · E December 8, 2025 · found via complaint
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected December 13, 2025 · Quality of Life and Care
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Actual harm · G November 25, 2025 · found via complaint
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected December 13, 2025 · Quality of Life and Care
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Actual harm · H November 25, 2025 · found via complaint
Provide and implement an infection prevention and control program.
Corrected December 13, 2025 · Infection Control
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Potential for harm · D April 2, 2025 · found via complaint
Respond appropriately to all alleged violations.
Corrected May 1, 2025 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D April 2, 2025
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected May 1, 2025 · Resident Assessment and Care Planning
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Potential for harm · D April 2, 2025
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 1, 2025 · Nursing and Physician Services
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Potential for harm · D April 2, 2025
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Corrected May 1, 2025 · Resident Assessment and Care Planning
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Potential for harm · E November 7, 2024 · found via complaint
Provide safe and appropriate respiratory care for a resident when needed.
Corrected November 25, 2024 · Quality of Life and Care
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Potential for harm · D October 8, 2024 · found via complaint
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected October 21, 2024 · Resident Assessment and Care Planning
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Potential for harm · E April 11, 2024 · found via complaint
Ensure each resident’s drug regimen must be free from unnecessary drugs.
Corrected April 30, 2024 · Pharmacy Service
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Potential for harm · F April 11, 2024 · found via complaint
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected April 30, 2024 · Nutrition and Dietary
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Potential for harm · F April 11, 2024 · found via complaint
Provide and implement an infection prevention and control program.
Corrected April 30, 2024 · Infection Control
Showing the 25 most recent. The Safety Report includes every citation with full findings.
Federal penalties
| Date | Type | Amount / length |
|---|---|---|
| November 25, 2025 | Fine | $30,590 |
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 415040 · certified since March 31, 1974. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.