Nursing HomeMedicaid Investigative

Royal Middletown Nursing Center

Below-average Medicare ratings — review the inspection history and ask the administrator about recent corrections before visiting.

193 Forest Avenue, Newport East · Middletown, RI 02842|50 beds|Licensed & Active

2/5

Medicare

Inspection

Quality

Staffing

Google rating

4.1/5

based on 50 Google reviews

(401) 847-2777 Directions

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4/ 10

moderate Risk

Quality Concerns Identified

Medicare inspection and quality data reveal areas that families should carefully evaluate before choosing this facility.

Low staffing rating (2/5 stars)
Above-median deficiencies (9 vs median 7)
High staff turnover (80%)
High RN turnover (94%)

Below average in RI · Meets national RN staffing standard · Very high staff turnover · No penalties on record

Source: Medicare data

What this means for your family

While the facility receives praise for its rehab and hospice teams, the recurring reports of hygiene issues and poor weekend staffing are significant red flags. We strongly recommend visiting on a weekend to observe the environment firsthand and asking management specifically how they address cleanliness and responsiveness during off-hours.

Google Reviews

50 reviews on Google

“Royal Middletown Nursing Center receives highly polarized feedback, with recent positive reviews often praising leadership and specific staff members, while critical reviews highlight significant lapses in basic care and hygiene. Families report inconsistent experiences, noting that while some staff are compassionate and professional, others are described as inattentive, particularly on weekends. Potential residents should be aware of serious complaints regarding cleanliness, food quality, and responsiveness to basic patient needs.”

Quality Themes

Tap a score for details

Strengths

Professional and compassionate administrative leadership
Effective physical and occupational therapy services
Supportive hospice care team
Some highly dedicated nursing and CNA staff

Concerns

Inattentive or dismissive staff attitude (mentioned by 3 reviewers)
Poor food quality and service (mentioned by 3 reviewers)
Hygiene and cleanliness issues (mentioned by 3 reviewers)
Understaffing or slow response times, especially on weekends (mentioned by 2 reviewers)

Rating Trends

Tap a year to see what changed

Distribution · 52 analyzed

How They Respond to Reviews

0%response rate

Questions for Your Tour

1Given that staffing levels can fluctuate, what specific protocols do you have in place to ensure timely assistance for residents during weekend shifts?
2I noticed some feedback regarding the dining experience; could you walk me through how you gather resident feedback on meal quality and what recent improvements have been made to the menu?
3With cleanliness being a top priority for our family, could you describe your daily housekeeping schedule and how you maintain high standards in resident rooms and common areas?
4How does your nursing team coordinate with the physical and occupational therapy staff to ensure a seamless recovery process for residents?
5We appreciate that leadership is active in responding to family feedback; how do you ensure that communication remains consistent and transparent when a resident has a change in condition?
6Could you explain how your team manages medication administration and what steps you take to ensure accuracy and timely delivery for each resident?

Personalized based on this facility's data

Key Review Excerpts

“PT & OT were essential to my recovery and we worked hard to get me back up and moving. It is hard to be away from home at least they made me feel like I could ask anything and they helped.”

Rehab patient · 2024★★★★☆

“It was absolutely terrible the place was infested with fruit flies could not eat a meal without one of them landing in your meal the care was terrible wasn't given a shower for 2 weeks never had my bed changed had to ask for washcloth during the day.”

Resident · 2024★☆☆☆☆

“Some of the staff was wonderful. The non regular staff on weekends were not good. Trying to get someone to answer the phone on the weekends is terrible.”

Long-term resident's family · 2025★★☆☆☆

Source: 50 Google reviews

Staffing

Staffing Hours

per resident/day · Medicare 2026

RN Hours

1.14hrs

Registered nurses for medical care

Total Nursing

3.37hrs

82%

All nurses + aides combined

Staff Turnover

71%

Lower is better (< 30% = good)

RN Turnover

89%

Lower is better (< 30% = good)

Total nursing hours are below minimum, though RN coverage is adequate. This may mean fewer aides for daily tasks like bathing and mobility.

Quality Measures

Resident outcomes compared with national, state, and local averages · 17 measures

Medicare Rating

2/ 5

Better Than Avg

measures

Worse Than Avg

measures

Mixed Results

measures

Long-Stay Residents

🚶

Residents whose walking got worse

↓ Lower is better

This Facility40.9%

Worse than Avg

Here

40.9%

15.3%

17.5%

Newport

18.9%

🛏️

Residents needing more daily help over time

↓ Lower is better

This Facility39.6%

Worse than Avg

Here

39.6%

14.4%

19.5%

Newport

21.0%

😔

Residents with depression symptoms

↓ Lower is better

This Facility0.0%

Better than Avg

Here

0.0%

12.1%

15.5%

Newport

16.3%

Highly dependent on how each facility screens and codes depressive symptoms, so it varies widely between facilities.

💊

Residents on antipsychotic medication

↓ Lower is better

This Facility26.0%

Worse than Avg

Here

26.0%

15.4%

22.7%

Newport

20.8%

🚿

Residents whose bladder or bowel control got worse

↓ Lower is better

This Facility27.5%

Worse than Avg

Here

27.5%

19.4%

22.4%

Newport

25.9%

💉

Residents vaccinated for the flu

↑ Higher is better

This Facility94.3%

Mixed vs Avgs

Here

94.3%

95.5%

95.3%

Newport

86.8%

Short-Stay Residents (Rehab / Post-Acute)

💉

Short-stay residents vaccinated for pneumonia

↑ Higher is better

This Facility94.8%

Better than Avg

Here

94.8%

81.8%

77.7%

Newport

77.1%

💉

Short-stay residents vaccinated for the flu

↑ Higher is better

This Facility81.9%

Better than Avg

Here

81.9%

79.7%

78.2%

Newport

78.9%

💊

Short-stay residents newly given antipsychotics

↓ Lower is better

This Facility1.8%

Mixed vs Avgs

Here

1.8%

1.6%

2.0%

Newport

3.5%

Source: Medicare quality measures

US average from Medicare published data

Inspection History

Medicare Inspection History

3-year lookback · Medicare 2026

10deficiencies

Above state avg (8.7)

15 complaint-triggered

Royal Middletown has a concerning pattern of recurring deficiencies, with families filing 12 complaints that triggered federal inspections. The facility repeatedly struggles with infection control (cited 4 times across multiple years), care quality standards, and medication management. Most troubling are issues with abuse/neglect reporting procedures and a recent high-severity infection control violation. While all deficiencies show correction dates, the persistent recurrence of similar problems suggests ongoing systemic challenges families should carefully consider.

Feb 19, 2026Complaint2 findings

0760Potential for harm · IsolatedCorrected

Pharmacy Service Deficiencies

Ensure that residents are free from significant medication errors.

0849Potential for harm · IsolatedCorrected

Administration Deficiencies

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.

Jan 7, 2026Complaint2 findings

0658Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Ensure services provided by the nursing facility meet professional standards of quality.

0880Potential for harm · IsolatedCorrected

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

Dec 8, 2025Complaint1 finding

0684Potential for harm · PatternCorrected

Quality of Life and Care Deficiencies

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

Nov 25, 2025Complaint2 findings

0880Actual harm · PatternCorrected

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

0684Actual harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

Apr 2, 2025Routine6 findings

0511Potential for harm · WidespreadCorrected

Services Deficiencies

Have properly installed electrical wiring and gas equipment.

0712Potential for harm · WidespreadCorrected

Miscellaneous Deficiencies

Have simulated fire drills held at unexpected times.

0918Potential for harm · WidespreadCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Have generator or other power source capable of supplying service within 10 seconds.

0658Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Ensure services provided by the nursing facility meet professional standards of quality.

0726Potential for harm · IsolatedCorrected

Nursing and Physician Services Deficiencies

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.

0842Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

Apr 2, 2025Complaint2 findings

0610Potential for harm · IsolatedCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Respond appropriately to all alleged violations.

0610Potential for harm · IsolatedCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Respond appropriately to all alleged violations.

Ownership & Operations

Who Operates This Facility

Owner / Operator

Royal Middletown Nursing Center

Organization Type

for profit

Chain Affiliation

Chain Name

Royal Health Group

Chain Size

12 facilities nationwide

Chain avg rating: 3.3/5 · Rank 7 of 12

Ownership & Management

Owners

Mamary, James

Owner

50%

Mamary, Jonathan

Owner

25%

Key personnel

Mamary, JamesManager

Source: Medicare provider data

Contact

Get in Touch

Contact this facility directly and verify the details that matter most to your family.

(401) 847-2777

193 Forest Avenue

Middletown, RI 02842

Get Directions View on Google Maps

References & Resources

Medicare Care Compare

Official Medicare quality ratings, inspections & staffing data

Google Maps

Photos, directions & neighborhood info

Google Reviews

50 reviews from families & visitors

Medicare data downloads

Original nursing home datasets

EveryPlace is a research directory. Facility information is compiled from public sources — Medicare.gov, state licensing portals, Google Places, and publicly available street-level imagery. Listings do not constitute endorsement, recommendation, or advertisement, and we do not accept payment for placement. Families should verify all details directly with the facility and the original sources linked above before making any care decisions. See our Research Policy for our editorial standards, correction process, and image-removal policy.

Safer Alternatives Nearby

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