Royal Middletown Nursing Center
193 Forest Avenue, Middletown, RI 02842
Middletown, Rhode Island · CMS verdict
CMS rates Royal Middletown Nursing Center at 2 of 5 stars overall - below-average on the federal scale, and below the Rhode Island average of 3.1.
The rating and the PlainElderCare Index below summarize federal inspection, staffing, and outcome data, they measure specific, documented dimensions of this facility, not a holistic verdict on the care your family member would receive. Visit in person, talk with staff and current residents' families, and weigh your family member's specific needs before choosing.
Royal Middletown Nursing Center in Middletown, Rhode Island holds a CMS overall rating of 2 of 5 stars and a PlainElderCare Quality & Compliance Index of 31 of 100 (grade F). The 50-bed facility operates where a semi-private nursing-home room in Rhode Island runs a median of $12,106 per month. Figures are from CMS Nursing Home Compare.
PlainElderCare Quality & Compliance Index
A transparent composite of this facility's CMS Care Compare sub-ratings and its federal inspection record. It complements, and does not replace, the official CMS overall rating of 2 of 5 stars. How this is calculated.
How the 31 is built
Each segment is a dimension's weighted points toward the score, summing to 31.
Weights: health inspections 30%, staffing 25%, quality measures 25%, inspection record 20%; any dimension CMS has not published drops out and its weight redistributes (no silent deflation). Inspection record is benchmarked against all rated US nursing homes. Source: CMS Nursing Home Compare.
Data insights
Quality ratings
Royal Middletown Nursing Center holds a CMS overall quality rating of 2 out of 5 stars, based on the most recent Care Compare release (data as of April 2026). CMS breaks this into three sub-ratings: health inspection (2/5), staffing (2/5), and quality measures (2/5).
What each sub-rating measures
The health inspection rating reflects on-site surveyor findings from the last three cycles. The staffing rating compares case-mix-adjusted nurse hours per resident day to national benchmarks, and quality measures aggregate 15 clinical indicators including pressure ulcers, falls with injury, and long-stay antipsychotic use.
Size and setting
Located in Middletown, Rhode Island, this facility operates 50 certified beds with an average daily census of roughly 44 residents - an occupancy rate of about 88%. The facility is classified under for profit - partnership ownership, a designation that can influence staffing patterns, reinvestment decisions, and admissions policy. Occupancy of about 88% puts this facility in normal territory for a stabilized operation, neither unusually full nor unusually empty.
Inspection record
On the regulatory side, federal and state surveyors have documented multiple deficiencies at this facility (22 total). CMS has levied no enforcement penalties over the equivalent window. This is a high deficiency count relative to most facilities; requesting the full survey report directly is the only way to see whether these are concentrated in one area or spread across the facility's operations.
Where these figures come from
The figures above come directly from the U.S. Centers for Medicare \& Medicaid Services Nursing Home Compare dataset for federal quality ratings, combined with the CareScout 2025 Cost of Care Survey of more than 15,000 elder-care providers nationwide and U.S. Census American Community Survey income data. Cost figures are monthly medians, refreshed annually with each new CareScout release; quality ratings are refreshed quarterly from the CMS Provider Information File. Read these state and county medians as benchmarks, then verify current rates with individual providers and consult care managers before making placement decisions. See our methodology for source vintage.
How Royal Middletown Nursing Center compares to Rhode Island
CMS five-star sub-ratings (0–5) for this facility against the Rhode Island facility-weighted average. Source: CMS Care Compare.
Bar = this facility's rating · vertical marker = Rhode Island state average. Higher is better on all four CMS measures.
Where Royal Middletown Nursing Center ranks in Rhode Island
Among the 72 CMS-rated nursing homes in Rhode Island, Royal Middletown Nursing Center’s 2-star overall rating is higher than 17% of them. The bars show how all Rhode Island homes spread across the CMS 1-to-5 scale; this facility’s band is highlighted.
17 Rhode Island homes share this 2-star rating. Source: CMS Nursing Home Compare.
Facility details
| Attribute | Value |
|---|---|
| Beds | 50 |
| Residents | 44 |
| Ownership | For profit - Partnership |
| County | Newport |
| Penalties | 0 |
| Deficiencies | 22 |
Source: CMS Care Compare Nursing Homes (data as of April 2026)
What do families ask most?
What is the quality rating for Royal Middletown Nursing Center? ▾
Royal Middletown Nursing Center has an overall CMS quality rating of 2 out of 5 stars, with a health inspection rating of 2/5, staffing rating of 2/5, and quality measures rating of 2/5.
How much does a nursing home cost per month in Rhode Island? ▾
CareScout's 2025 survey puts Rhode Island's median semi-private nursing home rate at $12,106 per month ($145,270 per year), with private rooms averaging $13,383 per month.
What services does Royal Middletown Nursing Center offer? ▾
Royal Middletown Nursing Center operates as a skilled nursing facility (50 beds with approximately 44 current residents) under for profit - partnership ownership. CMS inspections have recorded 22 deficiencies and 0 penalties there.
Does Royal Middletown Nursing Center have any deficiencies or penalties? ▾
Royal Middletown Nursing Center has multiple deficiencies (22 total) and 0 penalties recorded by CMS. A count this high is above what most facilities post; ask the facility directly for its plan of correction on the largest findings.
What are the alternatives to a nursing home in Rhode Island? ▾
In Rhode Island, alternatives include assisted living ($7,781/mo), home health aides ($7,627/mo), and adult day care ($1,408/mo).
Elder Care Guides
Explore PlainElderCare
Related Resources
Compare cost and CMS quality across the state on the Rhode Island elder-care overview, or see how facilities rank nationwide in our highest-rated states ranking.
Weigh nursing care against assisted living, home health, and adult day care, with national median costs, on our care types comparison, and learn how to fund it in our paying for elder care guide.
Source: CMS Nursing Home Compare. Provider ID: 415040.
Read our methodology - how this data is sourced, computed, and verified.