Forest Farm Assisted Living
State licensed191 Forest Avenue, Middletown, RI 02842
Assisted Living
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Medicare-certifiedSkilled Nursing
Royal Middletown Nursing Center
Middletown, Rhode IslandMedicare inspection record
About Royal Middletown Nursing Center
Royal Middletown Nursing Center provides skilled nursing and rehabilitation services designed to support recovery and healing. Our team in Middletown, Rhode Island delivers personalized care that helps patients regain independence and return home stronger.
Community at a glance
Capacity
50 residents
Location
Middletown, RI
Status
Listed in a public registry
Care & services offered
Skilled Nursing
Contact & location
193 Forest Avenue, Middletown, Rhode Island 02842
Medicare inspection record
From CMS Care Compare, the federal record every Medicare-certified nursing home is held to. Data as of September 1, 2026. Check it on Medicare.gov
At its most recent standard inspection, on April 30, 2026, state inspectors cited 16 health deficiencies (the Rhode Island average is 9.3).
Nurses and nurse aides spend 3 hours 12 minutes with each resident a day, below the Rhode Island average of 3 hours 43 minutes.
Medicare fined Royal Middletown Nursing Center once in the last three years, $19,884 in total.
Staffing
| Measure | This home |
|---|---|
| Nurse and aide time per resident, per day | 3 hours 12 minutesBelow the Rhode Island average |
| Registered nurse time per resident, per day | 55 minutesAbove the Rhode Island average |
| Nursing staff who left in the past year | 63%Above the Rhode Island average |
Inspections
26 health citations in the last three years. Each one is a federal standard inspectors found the home was not meeting.
April 30, 2026 · Complaint investigation · 2 citations
Not hire anyone with a finding of abuse, neglect, exploitation, or theft.
Risk of harm, no one hurt, widespread (level F)Freedom from Abuse, Neglect, and ExploitationFrom a complaintCorrected May 15, 2026Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Risk of harm, no one hurt, a few residents (level D)Freedom from Abuse, Neglect, and ExploitationFrom a complaintCorrected May 15, 2026
April 30, 2026 · Standard inspection · 7 citations
Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.
Risk of harm, no one hurt, a pattern (level E)Resident RightsCorrected May 15, 2026Respond appropriately to all alleged violations.
Risk of harm, no one hurt, a few residents (level D)Freedom from Abuse, Neglect, and ExploitationCorrected May 15, 2026Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
Risk of harm, no one hurt, a few residents (level D)AdministrationCorrected May 15, 2026Provide and implement an infection prevention and control program.
Risk of harm, no one hurt, a few residents (level D)Infection ControlCorrected May 15, 2026Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Risk of harm, no one hurt, a few residents (level D)Quality of Life and CareCorrected May 15, 2026Provide safe, appropriate pain management for a resident who requires such services.
Risk of harm, no one hurt, a few residents (level D)Quality of Life and CareCorrected May 15, 2026Ensure that residents are free from significant medication errors.
Risk of harm, no one hurt, a few residents (level D)Pharmacy ServiceCorrected May 15, 2026
February 19, 2026 · Complaint investigation · 2 citations+
Ensure that residents are free from significant medication errors.
Risk of harm, no one hurt, a few residents (level D)Pharmacy ServiceFrom a complaintCorrected Mar 11, 2026Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
Risk of harm, no one hurt, a few residents (level D)AdministrationFrom a complaintCorrected Mar 11, 2026
January 7, 2026 · Complaint investigation · 2 citations+
Ensure services provided by the nursing facility meet professional standards of quality.
Risk of harm, no one hurt, a few residents (level D)Resident Assessment and Care PlanningFrom a complaintCorrected Jan 16, 2026Provide and implement an infection prevention and control program.
Risk of harm, no one hurt, a few residents (level D)Infection ControlFrom a complaintCorrected Jan 16, 2026
December 8, 2025 · Complaint investigation · 1 citation+
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Risk of harm, no one hurt, a pattern (level E)Quality of Life and CareFrom a complaintCorrected Dec 13, 2025
November 25, 2025 · Complaint investigation · 2 citations+
Provide and implement an infection prevention and control program.
Residents were harmed, a pattern (level H)Infection ControlFrom a complaintCorrected Dec 13, 2025Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Residents were harmed, a few residents (level G)Quality of Life and CareFrom a complaintCorrected Dec 13, 2025
April 2, 2025 · Complaint investigation · 1 citation+
Respond appropriately to all alleged violations.
Risk of harm, no one hurt, a few residents (level D)Freedom from Abuse, Neglect, and ExploitationFrom a complaintCorrected May 1, 2025
April 2, 2025 · Standard inspection · 3 citations+
Ensure services provided by the nursing facility meet professional standards of quality.
Risk of harm, no one hurt, a few residents (level D)Resident Assessment and Care PlanningCorrected May 1, 2025Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Risk of harm, no one hurt, a few residents (level D)Nursing and Physician ServicesCorrected May 1, 2025Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Risk of harm, no one hurt, a few residents (level D)Resident Assessment and Care PlanningCorrected May 1, 2025
November 7, 2024 · Complaint investigation · 1 citation+
Provide safe and appropriate respiratory care for a resident when needed.
Risk of harm, no one hurt, a pattern (level E)Quality of Life and CareFrom a complaintCorrected Nov 25, 2024
October 8, 2024 · Complaint investigation · 1 citation+
Ensure services provided by the nursing facility meet professional standards of quality.
Risk of harm, no one hurt, a few residents (level D)Resident Assessment and Care PlanningFrom a complaintCorrected Oct 21, 2024
April 11, 2024 · Standard inspection · 3 citations+
Provide and implement an infection prevention and control program.
Risk of harm, no one hurt, widespread (level F)Infection ControlFrom a complaintCorrected Apr 30, 2024Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Risk of harm, no one hurt, widespread (level F)Nutrition and DietaryFrom a complaintCorrected Apr 30, 2024Ensure each resident’s drug regimen must be free from unnecessary drugs.
Risk of harm, no one hurt, a pattern (level E)Pharmacy ServiceFrom a complaintCorrected Apr 30, 2024
February 29, 2024 · Complaint investigation · 1 citation+
Ensure each resident’s drug regimen must be free from unnecessary drugs.
Risk of harm, no one hurt, a few residents (level D)Pharmacy ServiceFrom a complaintCorrected Mar 22, 2024
Fines and payment denials
1 fine totaling $19,884 in the last three years.
- November 25, 2025Fine: $19,884
About the home, per Medicare
- Ownership
- For profit - Partnership
- Legal business name
- Royal Middletown Nursing Center LLC
- Medicare-certified beds
- 50
- Average residents per day
- 45
- Accepts
- Medicare and Medicaid
- First certified
- March 31, 1974
- Part of a chain
- Royal Health Group, 12 homes
- Inside a hospital
- No
- Continuing care retirement community
- No
- Resident or family council
- Resident
- Sprinklers in all required areas
- Yes
- CMS Certification Number
- 415040
Location
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193 Forest AvenueMiddletown, RI 02842
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Questions about Royal Middletown Nursing Center
How did Royal Middletown Nursing Center do on its last inspection?+
State inspectors visited on April 30, 2026 and cited 16 health deficiencies, 9 of them from complaint investigations. The Rhode Island average is 9.3.
How much nursing care does each resident get at Royal Middletown Nursing Center?+
Nurses and aides spend 3 hours 12 minutes with each resident per day, including 55 minutes from registered nurses. 63% of nursing staff left over the past year.
Has Royal Middletown Nursing Center been fined by Medicare?+
Yes. Medicare fined Royal Middletown Nursing Center once in the last three years, totaling $19,884.
Does Medicare cover skilled nursing?+
Medicare covers up to 100 days of skilled nursing per benefit period after a qualifying 3-day hospital stay — fully for the first 20 days, then with a daily copay. Long-term custodial stays are generally not covered.
How much does a nursing home cost?+
A semi-private room averages about $7,900 per month nationally; private rooms cost more. Medicaid is the largest payer for long-term nursing home care.
What is the CMS star rating?+
Medicare rates nursing homes 1 to 5 stars on its Care Compare site. We don't repeat those stars here. Each nursing home page shows Medicare's underlying record instead: inspections, staffing and fines, with a link to check it on Medicare.gov.