Map showing the location of Grand Islander Center in Middletown, Rhode Island
333 Green End Avenue, Middletown, RI, 02842

Overall Score

CMS Five-Star Quality Rating
2/5Below averageCMS Five-Star overall rating
  1. Much below average
  2. Below average
  3. Average
  4. Above average
  5. Much above average

Where it ranks

  • Rhode IslandAbove only 17% of peers72 rated homes · average 3.1★
  • Newport CountyLowest tier among peers6 rated homes · average 3.2★
  • United StatesAbove only 20% of peers14,574 rated homes · average 3.0★

How the rating is built

  • Health inspectionsStarting point2★−0.9 vs RI avg
  • StaffingCan add or remove a star3★−0.4 vs RI avg
  • Quality measuresCan add or remove a star2★−1.4 vs RI avg

CMS starts from the health inspection stars, then adds or subtracts a star for staffing and for quality measures. Stars are assigned relative to other facilities in the same state.

Ratings & measures

Tap a row to see what it means
Health inspection ratingCMS stars from the last three on-site inspection cycles2★Above only 18% of peersRI avg2.9★U.S. avg2.8★
What is health inspection rating?

Stars assigned from the last three standard surveys and every complaint investigation in that window, weighted toward the most recent and the most serious findings. CMS assigns these stars relative to other facilities in the same state.

Why it matters

It carries the most weight in the overall rating and is the only domain based on what trained inspectors saw on site rather than what the facility reported.

Staffing ratingCMS stars from payroll-reported hours and turnover3★Above only 25% of peersRI avg3.4★U.S. avg2.9★
What is staffing rating?

Nurse and aide hours per resident day from payroll records CMS collects every quarter, adjusted for how much care residents need, plus staff turnover and weekend coverage.

Why it matters

More hours and lower turnover are the strongest predictors of fewer falls, pressure sores, and avoidable hospital stays.

Quality measures ratingCMS stars from clinical outcomes and resident assessments2★Above only 6% of peersRI avg3.4★U.S. avg3.6★
What is quality measures rating?

Clinical outcomes from resident assessments and Medicare claims: falls with injury, pressure ulcers, hospitalizations, antipsychotic use, and more, for both short-stay and long-stay residents.

Why it matters

It shows whether care is working, but part of it comes from the facility’s own assessments, so read it alongside the inspection results.

Total nurse hoursPer resident per day, all nursing staff3.63hrsAbove 51% of peersRI avg3.72Benchmark4.10
What is total nurse hours?

All licensed nurse and aide hours worked, divided by the number of residents, on an average day. Reported from payroll, not self-reported.

Why it matters

Federal research links 4.1 hours a day to fewer avoidable harms. Below about 3 hours, residents wait longer for help with basics like toileting and repositioning.

RN hoursPer resident per day, registered nurses only0.71hrsAbove 51% of peersRI avg0.77Benchmark0.75
What is rn hours?

Registered nurse hours only. RNs assess residents, manage medications, and catch changes in condition; LPNs and aides deliver most hands-on care.

Why it matters

RN coverage is the staffing measure most tied to fewer hospital transfers and infections, and it is where thinly staffed facilities cut first.

Nursing staff turnoverShare of nursing staff who left within a year · lower is better44%Above only 35% of peersRI avg40%RN turnover28%
What is nursing staff turnover?

The share of nursing staff who left within the past year, from the same payroll data.

Why it matters

High turnover means residents are cared for by people who do not know them, and it is one of the strongest predictors of inspection problems.

Fines in the last three yearsCivil money penalties imposed by CMS · lower is better$0Above 76% of peersRI avg$67,464Fines · denials0 · 0
What is fines in the last three years?

Civil money penalties CMS imposed after serious or uncorrected deficiencies, and denials of Medicare payment for new admissions.

Why it matters

Penalties follow the worst inspection findings. A recent fine is the clearest sign that inspectors found real harm.

Inspection history

Last three inspection cycles
40citations
11inspection dates
2actual harm (G–I)
0immediate jeopardy (J–L)
Dec 5, 2025most recent

Citations by monthApr 2023 – Dec 2025

  • No actual harm (D–F)
  • Actual harm (G–I)
  • Immediate jeopardy (J–L)
  • $Fine or payment denial

Click a month or a year to filter the findings below. Arrow keys move between months; Esc clears.

Dec 5, 20252 citationsCycle 1worst D · no actual harm
  1. F745Provide medically-related social services to help each resident achieve the highest possible quality of life.Quality of Life and CareD · isolatedCorrected Jan 6, 2026
  2. F658Ensure services provided by the nursing facility meet professional standards of quality.Resident Assessment and Care PlanningD · isolatedCorrected Jan 6, 2026
Nov 25, 20252 citationsCycle 1worst G · actual harm
  1. F658Ensure services provided by the nursing facility meet professional standards of quality.Resident Assessment and Care PlanningD · isolatedCorrected Jan 6, 2026
  2. F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareG · isolatedCorrected Nov 20, 2025
Oct 24, 20251 citationCycle 1worst G · actual harm
  1. F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareG · isolatedCorrected Nov 20, 2025
Aug 20, 20252 citationsCycle 1worst D · no actual harm
  1. F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.Resident Assessment and Care PlanningD · isolatedCorrected Sep 19, 2025
  2. F726Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.Nursing and Physician ServicesD · isolatedCorrected Sep 19, 2025
May 14, 202513 citationsCycle 1worst E · no actual harm
  1. F881Implement a program that monitors antibiotic use.Infection ControlD · isolatedCorrected Jun 30, 2025
  2. F760Ensure that residents are free from significant medication errors.Pharmacy ServiceD · isolatedCorrected Jun 30, 2025
  3. F761Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.Pharmacy ServiceE · patternCorrected Jun 30, 2025
  4. F814Dispose of garbage and refuse properly.Nutrition and DietaryD · isolatedCorrected Jun 30, 2025
  5. F880Provide and implement an infection prevention and control program.Infection ControlE · patternCorrected Jun 30, 2025
  6. F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.Resident Assessment and Care PlanningE · patternCorrected Jun 30, 2025
  7. F679Provide activities to meet all resident's needs.Quality of Life and CareD · isolatedCorrected Jun 30, 2025
  8. F686Provide appropriate pressure ulcer care and prevent new ulcers from developing.Quality of Life and CareD · isolatedCorrected Jun 30, 2025
  9. F692Provide enough food/fluids to maintain a resident's health.Quality of Life and CareD · isolatedCorrected Jun 30, 2025
  10. F694Provide for the safe, appropriate administration of IV fluids for a resident when needed.Quality of Life and CareD · isolatedCorrected Jun 30, 2025
  11. F698Provide safe, appropriate dialysis care/services for a resident who requires such services.Quality of Life and CareD · isolatedCorrected Jun 30, 2025
  12. F726Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.Nursing and Physician ServicesE · patternCorrected Jun 30, 2025
  13. F756Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.Pharmacy ServiceD · isolatedCorrected Jun 30, 2025
Apr 22, 20252 citationsCycle 1worst D · no actual harm
  1. F580Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.Resident RightsD · isolatedCorrected May 22, 2025
  2. F658Ensure services provided by the nursing facility meet professional standards of quality.Resident Assessment and Care PlanningD · isolatedCorrected May 22, 2025
Nov 22, 20241 citationCycle 2worst D · no actual harm
  1. F692Provide enough food/fluids to maintain a resident's health.Quality of Life and CareD · isolatedCorrected Dec 9, 2024
Aug 27, 20241 citationCycle 2worst D · no actual harm
  1. F578Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.Resident RightsD · isolatedCorrected Sep 26, 2024
Jul 31, 20242 citationsCycle 2worst D · no actual harm
  1. Ensure each resident’s drug regimen must be free from unnecessary drugs.Pharmacy ServiceD · isolatedCorrected Aug 30, 2024
  2. F658Ensure services provided by the nursing facility meet professional standards of quality.Resident Assessment and Care PlanningD · isolatedCorrected Aug 30, 2024
May 31, 20249 citationsCycle 2worst F · no actual harm
  1. F880Provide and implement an infection prevention and control program.Infection ControlE · patternCorrected Jun 30, 2024
  2. F658Ensure services provided by the nursing facility meet professional standards of quality.Resident Assessment and Care PlanningD · isolatedCorrected Jun 30, 2024
  3. F685Assist a resident in gaining access to vision and hearing services.Quality of Life and CareD · isolatedCorrected Jun 30, 2024
  4. F688Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.Quality of Life and CareD · isolatedCorrected Jun 30, 2024
  5. F690Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.Quality of Life and CareD · isolatedCorrected Jun 30, 2024
  6. F698Provide safe, appropriate dialysis care/services for a resident who requires such services.Quality of Life and CareD · isolatedCorrected Jun 30, 2024
  7. F791Provide or obtain dental services for each resident.Quality of Life and CareE · patternCorrected Jun 30, 2024
  8. F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and DietaryF · widespreadCorrected Jun 30, 2024
  9. F825Provide or get specialized rehabilitative services as required for a resident.Quality of Life and CareD · isolatedCorrected Jun 30, 2024
Apr 27, 20235 citationsCycle 3worst F · no actual harm
  1. Ensure each resident’s drug regimen must be free from unnecessary drugs.Pharmacy ServiceD · isolatedCorrected May 18, 2023
  2. F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.Resident Assessment and Care PlanningD · isolatedCorrected May 18, 2023
  3. F658Ensure services provided by the nursing facility meet professional standards of quality.Resident Assessment and Care PlanningD · isolatedCorrected May 18, 2023
  4. F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareE · patternCorrected May 18, 2023
  5. F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and DietaryF · widespreadCorrected May 18, 2023

Staffing

From quarterly payroll reports

Hours per resident per day

  • All nursing staffRNs, LPNs and aides combined3.63hrsAbove 51% of peers−0.09 vs RI avg
  • Registered nursesRN hours only0.71hrsAbove 51% of peers−0.06 vs RI avg
  • Licensed practical nursesLPN hours0.72hrs
  • Nurse aidesCNA hours2.20hrs
  • Weekend nursingAll staff on Saturdays and Sundays3.30hrs
  • Rhode Island average
  • Research benchmark (4.10 total, 0.75 RN)

Turnover & capacity

  • Nursing staff turnoverShare who left within a year · lower is better44%Above only 35% of peersRI avg 40%
  • RN turnoverRegistered nurses only28%Not ranked by CMS
  • Administrators who leftIn the past year3Leadership changed
  • Occupancy146 certified beds · ~110 residents a day75%Above only 13% of peersRI avg 85%

Fines & penalties

Roughly the past three years

Enforcement summary

  • $0In fines
  • 0Fines
  • 0Payment denials
  • $67,464RI avg in fines
Above 76% of peersFewer fines than 76% of rated homes in Rhode Island

Actions on record

No fines or payment denialsNothing on record in the current reporting window. Rhode Island facilities average 2.2 penalties.

Ownership

As filed with CMS

Structure

Ownership type
For profit - Corporation
Chain
Genesis Healthcare195 facilities in the chain2.4★ chain average
Certification
Medicare and Medicaid
Location type
Urban
Ownership change
None in the last 12 months

People and entities on file

Direct owners (5%+)
  • Genesis Ri Holdings LLC
Indirect owners (5%+)
  • Fc-Gen Operations Investment LLC
  • Gen Operations I LLC
  • Gen Operations II LLC
  • Genesis Healthcare INC
  • Genesis Healthcare LLC
  • Genesis Holdings LLC
  • Genesis Operations LLC
  • Ghc Holdings LLC
  • +7 more
Operational or managerial control
  • Ronicia Lopes
Corporate directors
  • Steven Fishman
  • Arnold Whitman
Corporate officers
  • Michael Berg
  • Laura Bridgeford
  • Avi Mendelson
  • Arnold Whitman

Person Organization

Sources & notes

Public data, updated quarterly

Data sources

  • CMS Care Compare · Provider InformationStar ratings, staffing hours, turnover, penalties and flags · processed February 2026.
  • CMS Health CitationsEvery deficiency from the last three inspection cycles, with scope, severity and inspection cycle.
  • CMS Penalties and Ownership filesCivil money penalties, payment denials, and the owners and managers on file.

Notes

  • CMS Certification Number 415034 · 333 Green End Avenue, Middletown, RI, 02842.
  • Percentiles compare this facility with every rated nursing home in Rhode Island and Newport County. Turnover and fines are inverted so a high percentile is always good.
  • This is an informational summary of public data, not medical, legal, or placement advice. Facilities cannot pay to change it; a facility that believes a record is wrong can dispute it with CMS.

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