F606 · Severity F
Not hire anyone with a finding of abuse, neglect, exploitation, or theft.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · Complaint citation · Deficient, Provider has date of correction 2026-05-15For-profit
Royal Middletown Nursing Center
193 Forest Avenue, Middletown, RI 02842
(401) 847-2777 · Royal Health Group
At a glance
CMS data snapshot: 2026-08-01 · Sources and limitations
| Ownership | For profit - Partnership | Certified beds | 50 |
|---|---|---|---|
| Estimated occupancy | 89.0% | Latest inspection | 2026-04-30 |
County and Rhode Island comparison
Navy: facility · Teal: county · Gray: Rhode Island
Overall rating
Facility: 2 of 5
Health-inspection score
Facility: 119.3 points
Total nurse staffing
Facility: 3.21 hours/day
RN staffing
Facility: 0.92 hours/day
Staff turnover
Facility: 62.5%
Latest health deficiencies
Facility: 16 deficiencies
View data table
| Metric | Facility | County | Rhode Island |
|---|---|---|---|
| Overall rating | 2 of 5 | 2 of 5 | 3 of 5 |
| Health-inspection score | 119.3 points | 115.8 points | 75.9 points |
| Total nurse staffing | 3.21 hours/day | 3.36 hours/day | 3.58 hours/day |
| RN staffing | 0.92 hours/day | 0.86 hours/day | 0.72 hours/day |
| Staff turnover | 62.5% | 39.1% | 39.3% |
| Latest health deficiencies | 16 deficiencies | 11 deficiencies | 7 deficiencies |
Comparisons describe CMS data; they are not recommendations.
Inspection history
2026-04-30
16 deficiencies
Highest severity: F
Immediate-jeopardy citations: 0
F557 · Severity E
Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.
Resident Rights Deficiencies · Standard survey citation · Deficient, Provider has date of correction 2026-05-15F600 · Severity D
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · Complaint citation · Deficient, Provider has date of correction 2026-05-15F610 · Severity D
Respond appropriately to all alleged violations.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · Standard survey citation · Deficient, Provider has date of correction 2026-05-15F684 · Severity D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care Deficiencies · Standard survey citation · Deficient, Provider has date of correction 2026-05-15F697 · Severity D
Provide safe, appropriate pain management for a resident who requires such services.
Quality of Life and Care Deficiencies · Standard survey citation · Deficient, Provider has date of correction 2026-05-15F760 · Severity D
Ensure that residents are free from significant medication errors.
Pharmacy Service Deficiencies · Standard survey citation · Deficient, Provider has date of correction 2026-05-15F849 · Severity 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.
Administration Deficiencies · Standard survey citation · Deficient, Provider has date of correction 2026-05-15F880 · Severity D
Provide and implement an infection prevention and control program.
Infection Control Deficiencies · Standard survey citation · Deficient, Provider has date of correction 2026-05-152025-04-02
6 deficiencies
Highest severity: D
Immediate-jeopardy citations: 0
F610 · Severity D
Respond appropriately to all alleged violations.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · Complaint citation · Deficient, Provider has date of correction 2025-05-01F658 · Severity D
Ensure services provided by the nursing facility meet professional standards of quality.
Resident Assessment and Care Planning Deficiencies · Standard survey citation · Deficient, Provider has date of correction 2025-05-01F726 · Severity 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.
Nursing and Physician Services Deficiencies · Standard survey citation · Deficient, Provider has date of correction 2025-05-01F842 · Severity D
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 · Standard survey citation · Deficient, Provider has date of correction 2025-05-012024-04-11
4 deficiencies
Highest severity: F
Immediate-jeopardy citations: 0
F812 · Severity F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies · Complaint citation, Standard survey citation · Deficient, Provider has date of correction 2024-04-30F880 · Severity F
Provide and implement an infection prevention and control program.
Infection Control Deficiencies · Complaint citation, Standard survey citation · Deficient, Provider has date of correction 2024-04-30F757 · Severity E
Ensure each resident’s drug regimen must be free from unnecessary drugs.
Pharmacy Service Deficiencies · Complaint citation, Standard survey citation · Deficient, Provider has date of correction 2024-04-30Staffing composition
2.07 hours/dayNurse aide
0.22 hours/dayLPN
0.92 hours/dayRN
- Total staffing
- 3.21 hours/day
- County median
- 3.36 hours/day
- Rhode Island median
- 3.58 hours/day
- Weekend total
- 2.94 hours/day
- Staff turnover
- 62.5%
- RN turnover
- 69.2%
Reported averages, not a real-time staffing schedule.
Resident outcomes
Lower is generally better
Hospitalizations
Not reported: cms footnoteunavailableRhode Island: 1.5 per 1,000 days · County: 1.6 per 1,000 days20250101-20251231
Emergency-department visits
Not reported: cms footnoteunavailableRhode Island: 1.6 per 1,000 days · County: 2.1 per 1,000 days20250101-20251231
Falls with major injury
5.0%worseRhode Island: 3.3% · County: 4.6%2025Q2-2026Q1
Pressure ulcers
4.0%betterRhode Island: 4.2% · County: 4.1%2025Q2-2026Q1
Urinary tract infections
2.2%worseRhode Island: 2.0% · County: 2.2%2025Q2-2026Q1
Antipsychotic medication use
25.6%worseRhode Island: 22.3% · County: 22.7%2025Q2-2026Q1
These group measures do not predict an individual resident’s experience.
Questions to ask
Use these prompts during a tour or phone call
What is driving staff turnover, and what is being done to retain nurses and aides?
Suggested because of: staff turnoverWhat fall-prevention program is used, and how are families notified after a fall?
Suggested because of: falls major injuryHow are antipsychotic medications reviewed, reduced when appropriate, and discussed with families?
Suggested because of: antipsychotic useWhat operational changes followed the facility's most recent penalty?
Suggested because of: penaltiesHow will the care plan be developed, reviewed, and shared with our family?
Suggested because of: general care planning
Facility Details
- County
- Newport County
- Certified beds
- 50
- Average daily residents
- 44.5
- Ownership
- For profit - Partnership
- Provider type
- Medicare and Medicaid
- In hospital
- No
- Date certified
- 1974-03-31
- CCN
- 415040
Staffing Data
| Reported measure | Value |
|---|---|
| Nurse aide hours | 2.06724 |
| Lpn hours | 0.22473 |
| Rn hours | 0.91619 |
| Reported total hours | 3.20817 |
| Weekend total hours | 2.9444 |
| Weekend rn hours | 0.66103 |
| Adjusted total hours | 3.21348 |
| Total turnover percent | 62.5 |
| Rn turnover percent | 69.2 |
| Administrators left | 0 |
Hours are per resident per day; turnover values are percentages. Missing values are not zero.
Penalties & Enforcement
$30,590.00Total fines
1Number of fines
0Payment denials
| Date | Type | Amount |
|---|---|---|
| 2025-11-25 | Fine | $30,590.00 |
Totals reflect the supplied CMS records, not a lifetime total.
Citations
16Health citations
7Fire safety citations
Health counts describe the latest rating cycle. Fire counts cover supplied fire-safety records.
Serious Deficiencies
RI counts scope/severity G–L as serious deficiencies. Immediate jeopardy is J–L; these are not interchangeable.
2
Provide and implement an infection prevention and control program.
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Ownership & Operators
| Name | Role | Share |
|---|---|---|
| MAMARY, JAMES | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 50% |
| MAMARY, JAMES | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
Helpful resources
Educational information, not medical or legal advice. Data & methodology