Home›Rhode Island›Newport County›Royal Middletown Nursing Center
C
Below Standard

Royal Middletown Nursing Center

193 Forest Avenue · Middletown, RI 02842

4018472777 · For profit - Partnership

50 beds43.8 residents173 staff
CMS Five-Star Ratings
Overall
★★★★★
Staffing
★★★★★
Quality
★★★★★
Inspections
★★★★★
Staffing Grades
C
Below Standard
Total Staff
A
Very Good
RN Staff
C
Below Standard
Overall
✗CMS Benchmark(≥ 3.48 HPRD)
✓RN Recommendation(≥ 0.75 HPRD)
✗Research Standard(≥ 4.10 HPRD)
📋

What This Means in Plain English

Royal Middletown Nursing Center receives an overall staffing grade of C (Below Standard). With 3.0022 total nurse hours per resident per day, this facility falls below the CMS staffing benchmark of 3.48 HPRD and has adequate registered nurse (RN) coverage. It is 0.89 HPRD below the national average.

Weekend staffing decreases noticeably — dropping 21.17% compared to weekdays. The facility relies heavily on temporary agency staff (25.7% of hours), suggesting potential workforce instability.

Staffing levels have been declining over recent quarters — worth monitoring.

🔍 Areas of Concern (2)

🚨Does not meet the CMS staffing benchmark of 3.48 HPRD. Current: 3.0022 HPRD — needs 0.48 more hours per resident per day.
⚠️25.7% of nursing hours come from agency/contract workers. High contractor reliance often means less continuity of care — staff who don't know the residents.

✨ Strengths (2)

✅Meets the research-recommended RN staffing level (≥ 0.75 HPRD)
✅No days with zero registered nurse hours this quarter
Total Nurse HPRD
3.0022hrs/resident/day▼ 0.89
CMS benchmark: 3.48
RN HPRD
0.9522hrs/resident/day▲ 0.27
Recommended: 0.75
Weekend Drop-off
21.17%
3.1933 weekday → 2.5172 weekend
⚠ Significant weekend reduction
Agency Staff
25.7%
30.25% of RN hours from contractors
⚠ High contractor reliance
Days with Zero RN
0days this quarter
4+ days = auto 1-star
CNA HPRD
1.7144hrs/resident/day
Direct care aides
LPN HPRD
0.0435hrs/resident/day
Licensed practical nurses
Consistency
0.4942std dev
Lower = more predictable

HPRD Over Time

Total nurse staffing hours per resident per day, by quarter

Total HPRD (shaded area)RN HPRDCMS Benchmark (3.48) — staffing standardResearch Standard (4.10) — recommended level

How Does This Facility Compare?

Compared to county, state, and national averages for total nurse HPRD

vs. Newport County Average-0.50 HPRD
3.51
03.00 HPRD
vs. Rhode Island State Average-0.72 HPRD
3.72
03.00 HPRD
vs. National Average-0.89 HPRD
3.90
03.00 HPRD
■ Colored bar = this facility · | Black line = average · Based on 2025Q3 data

Nearby Facilities

Compare with other nursing homes in the area

FacilityDistanceGradeTotal HPRDRN HPRDCMS Rating
Royal Middletown Nursing Center ★
Middletown · This facility
—
C
3.00220.9522★★☆☆☆
Grand Islander Center
Middletown
1.5 mi
B
3.62930.7099★★☆☆☆
John Clarke Senior Living
Middletown
1.6 mi
B
3.69521.161★★★★★
St Clare Home
Newport
3.4 mi
A
4.38811.1253★★★☆☆
Heatherwood Rehabilitation and Health Care Center
Newport
3.7 mi
C
3.04570.6981★★☆☆☆
Village House Nursing & Rehabilitation Center
Newport
4.3 mi
C
3.27440.8119★★★★★

Inspection History & Penalties

Health inspection results from state surveys — most recent first

8
Inspections
22
Total Deficiencies
$0
Fines Assessed
Dec 8, 2025Health
1 deficiency cited
▼
Nov 25, 2025Health
2 deficiencies cited· Includes actual harm
▼
Apr 2, 2025Health
4 deficiencies cited
▼
Nov 7, 2024Health
1 deficiency cited
▼
Oct 8, 2024Health
1 deficiency cited
▼
Apr 11, 2024Health
3 deficiencies cited
▼
Feb 29, 2024Health
1 deficiency cited
▼
Feb 8, 2023Health
9 deficiencies cited
▼
CMS Severity Scale
A–C: No Harm / PotentialD–F: No Harm but ConcernG–H: Actual HarmI–L: Immediate Jeopardy

Source: CMS Staffing & Quality Data — 2025Q3 · data.cms.gov

Staffing grades are based on CMS-published thresholds and research recommendations. CMS is not affiliated with and does not endorse this website.