Royal Middletown Nursing formerly known as Forest Farm Health Care Center

    193 Forest Ave, Middletown, RI, 02842
    3.9 · 52 reviews
    • Assisted living
    • Memory care
    • Skilled nursing
    AnonymousLoved one of resident
    2.0

    Understaffed care with inconsistent quality

    I had a mixed but mostly negative experience at this senior living facility. It felt severely understaffed (I observed nursing coverage far below reasonable levels), CNAs were often distracted, weekend/temporary staff were inconsistent, and security/admissions felt lax. Rooms and linens were sometimes dirty, medications were delayed or given without clear approval, and I saw issues that raised infection and safety concerns. At the same time some nurses, therapists, and leadership were compassionate, skilled, and responsive - PT/OT and rehab can be excellent, and rooms/food were nice at times. Overall I wouldn't trust this place for my mom without confirming staffing, medication practices, and cleanliness - there's high variability between top-notch care and serious neglect.

    Pricing

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    Amenities

    Healthcare services

    • Activities of daily living assistance
    • Assistance with bathing
    • Assistance with dressing
    • Assistance with transfers
    • Medication management
    • Mental wellness program

    Healthcare staffing

    • 24-hour call system
    • 24-hour supervision

    Meals and dining

    • Diabetes diet
    • Meal preparation and service
    • Restaurant-style dining
    • Special dietary restrictions

    Room

    • Cable
    • Fully furnished
    • Housekeeping and linen services
    • Kitchenettes
    • Telephone
    • Wifi

    Common areas

    • Beauty salon
    • Dining room
    • Garden
    • Outdoor space
    • Small library

    Community services

    • Move-in coordination

    Activities

    • Community-sponsored activities
    • Resident-run activities
    • Scheduled daily activities

    3.87 · 52 reviews

    Overall rating

    1. 5
    2. 4
    3. 3
    4. 2
    5. 1
    • Care

      3.2
    • Staff

      4.0
    • Meals

      3.0
    • Amenities

      4.0
    • Value

      3.0

    Pros

    • Compassionate and caring caregivers, CNAs, and hospice nurses
    • Several nurses and two specific nurses noted as very good
    • Named staff praised for dedication (Bianca Pina, Lisa Perkins, Michael)
    • Responsive and supportive administration/leadership in many reports
    • Clean, attractive facility and large private rooms reported by some
    • Good rehab/therapy (PT & OT) and knowledgeable therapy staff when provided
    • Engaging activities: music, TV, games, exercise and group sessions
    • Good meals and dining experience reported in multiple reviews
    • Affordable cost and availability of state-funded assistance
    • Around-the-clock medication administration reported by some families
    • Management support, resources, and a collaborative team noted

    Cons

    • Rude, disrespectful, or non-compassionate aides and staff
    • Instances of neglect: left on bedpan, no showers for extended periods, bed not changed
    • Medication errors and delays (including delayed seizure medication)
    • Infections reported (suspected MRSA, frequent UTIs) and wounds not treated
    • Poor cleanliness and hygiene: filthy bedding, dirty pillows with discharge, fruit fly infestation
    • Severe understaffing and overworked staff (report of 1 nurse per 45 patients)
    • Inconsistent care—weekend and temporary staff frequently cited as poor
    • Food and meal management problems (ran out of entrees, poor substitutions)
    • Lack of physician oversight and reports of no doctor visits; one report of facility placed on Do Not Admit
    • Safety, security, and oversight concerns (zero admission security, potential unsafe conditions)
    • Inconsistent availability of therapy and rehab despite having a rehab wing
    • Aging building issues (roof leakage) and unused resources (unused bus)
    • Mixed management/oversight—some praise but instances of poor responsiveness until complaint
    • Alleged severe outcomes reported (patient became sick, isolated claims of death or serious harm)

    Summary review

    Overall sentiment in the reviews is highly polarized: a significant number of reviewers report compassionate, dedicated staff, good therapy and activities, and a pleasant, affordable facility; at the same time a substantial number of reviews describe serious care, cleanliness, medication, and safety problems. This split creates an inconsistent picture in which residents and families may have either a very positive or a very negative experience depending on timing, staffing, and which personnel are on duty.

    Care quality is the most frequently debated area. Positive accounts emphasize attentive CNAs, hospice nurses, and several standout nurses who provided thorough, compassionate care, timely medication administration, and effective therapy that supported recovery. Conversely, numerous reviews describe neglectful practices — residents left on bedpans for extended periods (reported up to 15 minutes), no showers for two weeks, beds not changed, delayed or missed medications (including delayed seizure medication), wounds left untreated, and reports of infections including suspected MRSA and recurring UTIs. A few reviewers said a formal complaint was required before improvements were made. One review included a claim that a physician placed the facility on a Do Not Admit list, suggesting at least one strong external professional concern.

    Staffing and staff behavior show clear variability. Many reviews single out individual caregivers, CNAs, and nurses as compassionate, hardworking, and supportive; some name specific employees positively (Bianca Pina, Lisa Perkins, Michael). Multiple reviewers praise management and leadership for being supportive, resident-focused, and for providing staff resources. At the same time, staffing shortages and overwork are recurrent themes — including an alarming report of one nurse covering 45 patients — and weekend or temporary staff are repeatedly called out as lower-quality, snippy, or unavailable by phone. There are also reports of rude or abusive staff behavior (for example, an aide yelling at a resident about shaking), CNAs seen watching TV while on duty, and inconsistent enforcement of standards.

    Facility, cleanliness, and infection control are another set of mixed findings. Several reviewers describe the facility as warm, home-like, attractive, and well-laid-out with great activity rooms and clean spaces. Other reviewers report serious sanitation problems: filthy bedding, dirty pillows with discharge, a fruit fly infestation, and general unclean rooms. Some reviews say cleanliness improved only after a complaint. Aging-building issues such as roof leakage and unused resources (an unused bus) were also mentioned, contributing to a sense that some infrastructure and maintenance needs are unmet.

    Dining, activities, and therapy receive both praise and criticism. Many reviewers commented positively on meals, social activities, music, TV, games, and robust PT/OT programming that aided recovery. Several testimonials emphasize excellent food and active programming. In contrast, other reviewers describe chaotic mealtimes, poor food management (running out of main entrees and substituting peanut butter and jelly), and meals that were incorrect or unappetizing. Rehab and therapy are praised when available, but a number of reviewers stated therapy was inconsistent or absent.

    Safety, oversight, and administration show conflicting reports. Some families report proactive, resident-focused leadership and management that models good care and supports staff. Others highlight poor oversight: alleged lack of physician visits, medication given without approval, poor admission/security processes, and statements that the facility felt like a state institution with limited resources. A few reviewers explicitly advise relying on word-of-mouth rather than public rating sites and warn strongly against placing loved ones at this facility based on their negative experiences.

    Patterns and implications: The recurring pattern is one of inconsistency. Positive experiences tend to emphasize specific compassionate staff, active therapy programs, good leadership, and a pleasing physical environment. Negative experiences concentrate on systemic issues — understaffing, weekend/agency staff variability, lapses in basic hygiene and infection control, medication mistakes or delays, and occasional abusive interactions. Because reviews indicate that care level may change substantially depending on staff on duty and that complaints sometimes spur improvements, prospective residents and families should do in-person visits multiple times (including weekends and evenings), ask specific questions about staffing ratios and weekend coverage, request recent infection-control records, and verify medication and physician oversight procedures. Checking up-to-date inspection reports and seeking recent firsthand word-of-mouth from current families can help reconcile the wide variance in reported experiences.

    Location

    Map showing location of Royal Middletown Nursing formerly known as Forest Farm Health Care Center

    About Royal Middletown Nursing formerly known as Forest Farm Health Care Center

    Royal Middletown Nursing Center stands as a trusted provider of skilled nursing care in a picturesque rural setting, serving the community since 1932. Nestled on Aquidneck Island, midway between Portsmouth and Newport, the center enjoys a prime location within a vibrant beachside neighborhood, adjacent to an elementary school, a church, and numerous family homes. The nine-acre campus provides a tranquil, home-like environment where residents can enjoy both privacy and a sense of connection with the surrounding community. With a resident-centered approach, Royal Middletown Nursing Center ensures every individual receives personalized attention and care tailored to their unique needs.

    The center boasts a 50-bed capacity, featuring a limited selection of private rooms designed for comfort and convenience. Royal Middletown is committed to delivering both short-term rehabilitation and long-term care options, creating plans that are as individualized as the residents themselves. Whether recovering from surgery, managing chronic conditions, or seeking a supportive setting for daily living, the care team ensures specialized services are always available. The center’s commitment to excellence is reflected in its prestigious five-star quality rating, a testament to the high standards maintained in every aspect of care.

    Royal Middletown Nursing Center also serves as the home for Royal at Home, offering in-home health support, and Forest Farm Assisted Living, which rounds out a continuum of care services on campus. This integration allows for easy access to a wide range of specialty services and resources, supporting seniors through every stage of their health journey. Programs such as Activity Enrichment, Cardiac Care, Hospice Services, Nutritional Care, and comprehensive Rehabilitation are provided, with a focus on enhancing the social, emotional, physical, and spiritual well-being of each resident.

    Dedicated nurses, certified nursing assistants, therapists, and support staff at Royal Middletown approach their roles with a philosophy of compassion, professionalism, and respect. The atmosphere is one of warmth and genuine care, helping residents feel at home and valued. The culinary team takes pride in offering nutritious and appealing meals, contributing to residents’ enjoyment and wellness. Through continuous evolution and expansion of its services, Royal Middletown Nursing Center remains steadfast in its commitment to meeting the ever-changing needs of the community it has served for decades.

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