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Skilled nursing facility · CMS certified · CCN 415040

Royal Middletown Nursing Center

193 Forest Avenue, Middletown, RI 02842 · Newport County · one of 72 skilled nursing facilities in Rhode Island
Its Medicare cost report, line by line ↓
50
certified beds
2 / 5
overall CMS rating
For-profit
ownership type
89.0%
occupancy, Oct 2026: 44 residents a day · Rhode Island 87.6%
1.37
case mix, 0.97x the national average
3.21
nurse hours per resident day · Rhode Island 3.71
What if · this building’s own numbers
Medicare cost report, FY2025, and the state rate file

Every slider starts where this building’s FY2025 Medicare cost report left it. Drag occupancy, the Medicaid rate or the costs, and see what the change does to revenue, cost and operating income.

00.0%
00%
$000
$000
$000
0.00
From this change, a year
+$000,000
profit from patient care, before rent, loan interest and depreciation
Where that leaves the building, a year
Patient revenue
$00,000,000
Cost to run it
$00,000,000
Profit from patient care (EBITDAR)
$0,000,000 to $0,000,000

Run this building's own numbers

Free account. Drag its occupancy, Medicaid rate and costs, and see what each change is worth a year.

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How Royal Middletown Nursing Center compares

Better than most of Newport County on 1 of 8 lines.

Occupancy, Oct 202689.0%Behind mostHigher than 1 of the 5 other buildings in Newport County

Residents on an average day as a share of certified beds, from CMS's monthly census. The middle of the set: 90.0%. Source: CMS monthly provider files, Oct 2026.

Nurse hours per resident day3.21Behind mostLower than all 5 other buildings in Newport County

Nurse and aide hours for each resident, each day, from CMS payroll records. The middle of the set: 3.37. Source: CMS monthly provider files, Oct 2026.

Overall CMS rating2 / 5Behind mostHigher than 1 of the 5 other buildings in Newport County, level with 1

CMS's overall star rating, set from inspections, staffing and quality measures. The middle of the set: 3 / 5. Source: CMS Provider Information, Oct 2026 file.

Health inspection rating2 / 5Behind mostHigher than 1 of the 5 other buildings in Newport County, level with 1

CMS's star rating for the building's recent health inspections. The middle of the set: 3 / 5. Source: CMS Provider Information, Oct 2026 file.

Staffing rating2 / 5Behind mostLower than all 5 other buildings in Newport County

CMS's star rating for nurse staffing levels and turnover. The middle of the set: 4 / 5. Source: CMS Provider Information, Oct 2026 file.

Quality measures rating3 / 5Mid-packHigher than 2 of the 5 other buildings in Newport County, level with 2

CMS's star rating for resident-care quality measures. The middle of the set: 3 / 5. Source: CMS Provider Information, Oct 2026 file.

RN hours per resident day0.90Better than mostHigher than 3 of the 5 other buildings in Newport County

Registered nurse hours for each resident, each day. The middle of the set: 0.77. Source: CMS Provider Information, Oct 2026 file.

Deficiencies cited18Behind mostFewer than 1 of the 5 other buildings in Newport County

Health deficiencies cited at the building's most recent standard survey. Fewer is better. The middle of the set: 9. Source: CMS Provider Information, Oct 2026 file.

Better than most of Rhode Island on 1 of 8 lines.

Occupancy, Oct 202689.0%Behind mostHigher than 27 of the 67 other buildings in Rhode Island, level with 1

Residents on an average day as a share of certified beds, from CMS's monthly census. The middle of the set: 90.0%. Source: CMS monthly provider files, Oct 2026.

Nurse hours per resident day3.21Behind mostHigher than 9 of the 68 other buildings in Rhode Island, level with 1

Nurse and aide hours for each resident, each day, from CMS payroll records. The middle of the set: 3.58. Source: CMS monthly provider files, Oct 2026.

Overall CMS rating2 / 5Behind mostHigher than 15 of the 70 other buildings in Rhode Island, level with 14

CMS's overall star rating, set from inspections, staffing and quality measures. The middle of the set: 3 / 5. Source: CMS Provider Information, Oct 2026 file.

Health inspection rating2 / 5Behind mostHigher than 14 of the 70 other buildings in Rhode Island, level with 17

CMS's star rating for the building's recent health inspections. The middle of the set: 3 / 5. Source: CMS Provider Information, Oct 2026 file.

Staffing rating2 / 5Behind mostHigher than 6 of the 70 other buildings in Rhode Island, level with 10

CMS's star rating for nurse staffing levels and turnover. The middle of the set: 3 / 5. Source: CMS Provider Information, Oct 2026 file.

Quality measures rating3 / 5Mid-packHigher than 19 of the 68 other buildings in Rhode Island, level with 22

CMS's star rating for resident-care quality measures. The middle of the set: 3 / 5. Source: CMS Provider Information, Oct 2026 file.

RN hours per resident day0.90Better than mostHigher than 48 of the 67 other buildings in Rhode Island, level with 1

Registered nurse hours for each resident, each day. The middle of the set: 0.72. Source: CMS Provider Information, Oct 2026 file.

Deficiencies cited18Behind mostFewer than 5 of the 71 other buildings in Rhode Island

Health deficiencies cited at the building's most recent standard survey. Fewer is better. The middle of the set: 8. Source: CMS Provider Information, Oct 2026 file.

From its cost report and Medicaid rate, against Rhode Island
Net margin00.0%

Opens with a free account

Medicaid share of days00.0%

Opens with a free account

Medicaid rate$000

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Tap a line for what it measures and the middle of the set. Each count leaves this building out. Source: CMS monthly provider files, Oct 2026; CMS Provider Information, Oct 2026 file.

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Street view of Royal Middletown Nursing Center
Google Street View · opens in Maps
Street View
193 Forest Avenue, Middletown, RI
Map around Royal Middletown Nursing Center
Map · Newport County
Newport County, Rhode Island
6 skilled nursing facilities; average overall rating 2.7, Rhode Island 2.9.
See how Newport County compares ›
Cost report, against Rhode Island
Each line is what this building filed with Medicare for its latest full year, beside the middle building in Rhode Island. The rank counts from the top: 1st is the highest figure among Rhode Island's filing buildings on that line, out of the buildings that filed it. The arrow beside a figure compares it with the building's own full year before: green is better, red is worse, grey is neither. Shares and margins move in points. A line standing on fewer than 20 filings is not ranked. Operating expense is the cost report's own operating line. Net income also counts income and expense outside patient care, such as investment income, rentals and donations, which is why it is not patient revenue minus that line.
Medicare cost reports, as filed

What this building filed with Medicare for FY2025 (the year ending 2025-12-31), against the middle Rhode Island building.

Line
This building
Rank in state
Rhode Island median
Reports
OccupancyPatient days as a share of available bed days, both off Worksheet S-3 Part I.
00.0%0.0 ptsFY0000: 00.0%
00th of 000
86.2%
69
Medicare share of daysTraditional Medicare days as a share of all patient days, off Worksheet S-3 Part I.
00.0%0.0 ptsFY0000: 00.0%
00th of 000
4.6%
69
Medicaid share of daysMedicaid days as a share of all patient days, off Worksheet S-3 Part I.
00.0%0.0 ptsFY0000: 00.0%
00th of 000
67.6%
69
Patient revenue per patient dayNet patient revenue off Worksheet G-3, divided by patient days off Worksheet S-3 Part I. Blended across every payer.
$0000.0 ptsFY0000: 00.0%
00th of 000
$383
69
Operating expense per patient dayTotal operating expense off Worksheet G-3, divided by patient days. Net income also counts income and expense outside patient care, such as investment income, rentals and donations, which is why it is not patient revenue minus this line.
$0000.0 ptsFY0000: 00.0%
00th of 000
$390
69
Net income per patient dayNet income off Worksheet G-3, divided by patient days.
$0000.0 ptsFY0000: 00.0%
00th of 000
$8
69
Net marginNet income off Worksheet G-3 over net patient revenue off the same worksheet.
00.0%0.0 ptsFY0000: 00.0%
00th of 000
2.2%
69

See this building's own numbers

Free account. What it filed, and where it ranks.

Quality and staffing
CMS Care Compare · Oct 2026
Overall rating2 / 5 · state 2.9
Health inspection2 / 5 · state 2.9
Staffing2 / 5 · state 3.3
RN hours per resident per day0.9 · state 0.77
Overall rating, last 8 quarters
053Q3’243Q4’244Q1’254Q2’254Q3’254Q4’253Q1’262Q2’26latest
down 1 star over the 8 quarters shown

CMS sets the overall star rating from health inspections, staffing and quality measures. The occupancy percentage is not the star rating. Occupancy compares average residents with certified beds. Certified beds can include beds the home chooses not to fill; this figure does not tell us why beds are unused.

Resident care
CMS quality measures · 2025Q3 to 2026Q2 · Oct 2026
measurethis buildingRhode Islandnationrecent quarters
Needed more help with daily activities29.8%worse than state19.5%13.5%2025Q2: 39.3%2025Q3: 38.5%2025Q4: 33.3%2026Q1: 20.7%2026Q2: 27.6%
39.3% → 27.6%
Q2’25 to Q2’26
Catheter inserted and left in0.5%better than state0.8%0.7%2025Q2: 0.0%2025Q3: 0.0%2025Q4: 1.7%2026Q1: 0.0%2026Q2: 0.0%
0.0% → 0.0%
Q2’25 to Q2’26
Urinary tract infection2.1%better than state2.6%1.5%2025Q2: 3.0%2025Q3: 3.0%2025Q4: 2.7%2026Q1: 0.0%2026Q2: 2.9%
3.0% → 2.9%
Q2’25 to Q2’26
Fall with major injury4.9%worse than state3.6%3.2%2025Q2: 2.9%2025Q3: 6.1%2025Q4: 5.3%2026Q1: 5.7%2026Q2: 2.8%
2.9% → 2.8%
Q2’25 to Q2’26
Newly given an antipsychotic (short stay)0.0%better than state2.0%1.5%2025Q2: 2.6%2025Q3: 0.0%2025Q4: 0.0%2026Q1: 0.0%2026Q2: 0.0%
2.6% → 0.0%
Q2’25 to Q2’26
Ability to walk independently worsened32.7%worse than state15.8%12.7%too few quarters to chart
Pressure ulcers3.0%better than state4.0%4.5%2025Q2: 7.1%2025Q3: 4.2%2025Q4: 2.2%2026Q1: 2.6%2026Q2: 3.0%
7.1% → 3.0%
Q2’25 to Q2’26
Given an antipsychotic24.7%worse than state22.5%15.4%2025Q3: 28.6%2026Q1: 25.0%2026Q2: 20.0%
28.6% → 20.0%
Q3’25 to Q2’26

Each figure is the share of residents, so lower is better. The building's figure, the state's and the nation's are CMS's four-quarter averages; the small bars are single quarters, which move more than the average does.

Surveys and enforcement
CMS health inspections
Apr 2026
last standard survey
18
deficiencies cited · Rhode Island avg 9.1
$19,884
fines, last 3 years
Reported
CMS affiliation

CMS groups homes with shared ownership or management. An affiliation does not establish that a chain owns this building.

Medicaid in Rhode Island
state rate files
$244
median daily rate across the Rhode Island buildings in our rate book, Oct 2025 file
Rhode Island rates and what changed ›
Newport County
buildingbedsoverallSt Clare Home504 / 5Village House Nursing & Rehabilitation Center954 / 5John Clarke Senior Living603 / 5Grand Islander Center1462 / 5Royal Middletown Nursing Center502 / 5Adviniacare Newport, LLC1141 / 5
All Rhode Island buildings in Newport County ›
Also in Middletown, RI
2 other certified skilled nursing facilities in Middletown
buildingbedsoverallGrand Islander Center1462 / 5John Clarke Senior Living603 / 5
Rhode Island at a glance
72
buildings
8,190
licensed beds
83%
occupancy
85%
for-profit
Rhode Island market intelligence report ›
The neighborhood
Street map © OpenStreetMap · satellite © Esri · pins: CMS Care Compare · loads as you reach it
Nearby skilled nursing
buildingbedsoveralloccupancyGrand Islander CenterMiddletown · 1.5 mi1462 / 570-85%John Clarke Senior LivingMiddletown · 1.6 mi603 / 5over 85%St Clare HomeNewport · 3.4 mi504 / 5over 85%Adviniacare Newport, LLCNewport · 3.7 mi1141 / 5over 85%Village House Nursing & Rehabilitation CenterNewport · 4.3 mi954 / 5over 85%Bayview Rehabilitation and Healthcare CenterNorth Kingstown · 10.4 mi1202 / 5over 85%
The map and the list carry the same facts, from SNFRadar's system.
About this data
What is the CMS overall rating of Royal Middletown Nursing Center?
Royal Middletown Nursing Center in Middletown, RI carries an overall CMS rating of 2 out of 5 stars in the Oct 2026 CMS file.
How many beds does Royal Middletown Nursing Center have?
Royal Middletown Nursing Center is certified for 50 beds in the Oct 2026 CMS file.
How full is Royal Middletown Nursing Center?
CMS's reported average residents put Royal Middletown Nursing Center's occupancy in the over 85% band in the Oct 2026 CMS file.
Source: CMS Provider Information, Care Compare and Payroll-Based Journal staffing · CMS files dated October 2026.
Published by 3G Healthcare Real Estate, skilled nursing advisors. Authors: Stan Klos III, Founder · Christian Patrick, President.
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Source: CMS Provider Information and Care Compare, Oct 2026 files. Tracked every month in SNFRadar's system.

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