Every person who worked here at any point in the quarter, employees and contractors. It is not how many are on site at once: that is the "on an average day" figure.
114
87 employees · 27 contractors · 36 on an average day Royal of Westerly Nursing Center
Nursing Home, Hospice Care, Memory Care, Palliative Care, Respite Care & Skilled Nursing · Westerly, RI
ALM Inspection Grade
B+
ALM's inspection grade is 89 / 100, a B+ — 7 points above the Rhode Island average for CMS-certified facilities (82/100) · A proprietary Assisted Living Magazine grade.A 0–100 score of a facility's regulatory inspection record, shown as a letter and compared with other facilities of the same kind in the same state. It is not a government rating.
ALM's inspection grade is 89 / 100, a B+ — 7 points above the Rhode Island average for CMS-certified facilities (82/100) · A proprietary Assisted Living Magazine grade.A 0–100 score of a facility's regulatory inspection record, shown as a letter and compared with other facilities of the same kind in the same state. It is not a government rating.
CMS overall rating
4/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
4/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
Royal of Westerly Nursing Center
Nursing Home, Hospice Care, Memory Care, Palliative Care, Respite Care & Skilled Nursing · Westerly, RI
ALM Inspection Grade
B+
ALM's inspection grade is 89 / 100, a B+ — 7 points above the Rhode Island average for CMS-certified facilities (82/100) · A proprietary Assisted Living Magazine grade.A 0–100 score of a facility's regulatory inspection record, shown as a letter and compared with other facilities of the same kind in the same state. It is not a government rating.
ALM's inspection grade is 89 / 100, a B+ — 7 points above the Rhode Island average for CMS-certified facilities (82/100) · A proprietary Assisted Living Magazine grade.A 0–100 score of a facility's regulatory inspection record, shown as a letter and compared with other facilities of the same kind in the same state. It is not a government rating.
CMS overall rating
4/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
4/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
Royal of Westerly Nursing Center accepts Medicare, Medicaid, and private pay.
Overview of Royal of Westerly Nursing Center
Royal of Westerly Nursing Center in Westerly, Rhode Island, delivers comprehensive skilled nursing, long-term nursing home care, memory care, and short-term rehabilitation. Clinical options also encompass hospice, palliative care, and short-term respite stays for caregivers needing temporary relief. Memory care programs use secured environments to support residents with cognitive impairments or wandering risks.
Established in 1970, the 66-bed community is managed by administrator Susan Misto. Staffing logs record an average of 3 hours and 21 minutes of direct nursing time provided per resident each day. Financial options include Medicare for short-term recovery, Medicaid for ongoing stays, and direct private payment.
Interested families looking for memory care or long-term nursing services can connect with the Royal of Westerly Nursing Center to check room availability, review care options, or arrange a personal tour.
Quality ratings
The Overall CMS Rating combines results from health inspections, staffing levels and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
Based on the results of the facility's three most recent standard inspections and any complaint investigations. CMS reviews the number, scope, and severity of deficiencies, with more recent findings weighted more heavily.
Measures average nursing staff hours per resident per day, including Registered Nurses (RNs) and total nursing staff. Ratings are adjusted based on the level of care residents require and are compared to state and national benchmarks.
Based on clinical and physical health indicators reported to CMS, such as hospital readmissions, falls, pressure ulcers, and improvements in mobility. These measures reflect how well residents' health needs are being managed.
Staffing
Data period: Q2 2026 (April 1 – June 30, 2026).
Nursing care per resident per day and state rankings: CMS Provider Information.
Headcount, shifts and contractors: CMS Payroll-Based Journal (PBJ).
Resident count: CMS Long-Term Care Facility Characteristics (data as of Sep 2026).
Total nursing care per resident / day
This nursing home is ranked 41st out of 53 nursing homes we track in Rhode Island for nurse hours. Total adjusted nursing hours per resident per day, combining RN, LPN, and aide time. CMS adjusts this for case-mix so facilities can be fairly compared.
3h 21m
This nursing home is ranked 41st out of 53 nursing homes we track in Rhode Island for nurse hours. Total adjusted nursing hours per resident per day, combining RN, LPN, and aide time. CMS adjusts this for case-mix so facilities can be fairly compared.
3h 21mStandout metric: LPN / LVN is +31% above Rhode Island average
3 of 6 metrics below Rhode Island average
Daily care time per resident, by role
Registered nurse (RN)
RNs hold the highest nursing license and can assess residents, interpret test results, and direct care plans. More RN hours per day often signals stronger clinical oversight and faster response to health changes. 19 total: 11 of the facility's own employees and 8 agency contractors.
19 staff · 7.1-hour shifts
50m
↑ 8% · RI 46mThis facility: 50m per resident per day, 8% above the Rhode Island average of 46m (among Rhode Island facilities reporting a recent figure).
RNs hold the highest nursing license and can assess residents, interpret test results, and direct care plans. More RN hours per day often signals stronger clinical oversight and faster response to health changes. 19 total: 11 of the facility's own employees and 8 agency contractors.
19 staff · 7.1-hour shiftsUS average: 41m.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse. US 41m
LPN / LVN
Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs) deliver routine hands-on care — medication administration, wound dressing, and monitoring vital signs. They work under RN supervision and make up a large share of daily bedside care. 13 total: 11 of the facility's own employees and 2 agency contractors.
13 staff · 8.2-hour shifts
38m
↑ 31% · RI 29mThis facility: 38m per resident per day, 31% above the Rhode Island average of 29m (among Rhode Island facilities reporting a recent figure).
Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs) deliver routine hands-on care — medication administration, wound dressing, and monitoring vital signs. They work under RN supervision and make up a large share of daily bedside care. 13 total: 11 of the facility's own employees and 2 agency contractors.
13 staff · 8.2-hour shiftsUS average: 52m.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse. US 52m
Certified nursing assistant
Certified Nurse Aides (CNAs) provide the most direct day-to-day assistance: bathing, dressing, feeding, and mobility. Nurse aide hours are typically the largest staffing category and directly affect residents' quality of life. All 34 are the facility's own employees; no agency contractors work in this role.
34 staff · 7.3-hour shifts
1h 53m
↓ 23% · RI 2h 28mThis facility: 1h 53m per resident per day, 23% below the Rhode Island average of 2h 28m (among Rhode Island facilities reporting a recent figure).
Certified Nurse Aides (CNAs) provide the most direct day-to-day assistance: bathing, dressing, feeding, and mobility. Nurse aide hours are typically the largest staffing category and directly affect residents' quality of life. All 34 are the facility's own employees; no agency contractors work in this role.
34 staff · 7.3-hour shiftsUS average: 2h 20m.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse. US 2h 20m
Physical therapist
Hours per resident per day provided by licensed Physical Therapists (PTs) or PT Assistants. PT services help residents recover mobility after injury or illness and are especially important for post-acute (short-stay) rehabilitation.
3m
↑ 12% · RI 3mThis facility: 3m per resident per day, 12% above the Rhode Island average of 3m (among Rhode Island facilities reporting a recent figure).
Hours per resident per day provided by licensed Physical Therapists (PTs) or PT Assistants. PT services help residents recover mobility after injury or illness and are especially important for post-acute (short-stay) rehabilitation.
US average: 4m.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse. US 4m
Total nursing, weekends
Combined nursing hours (RN + LPN + Nurse Aide) per resident per day on weekends. Staffing often drops on weekends — this figure reveals whether the facility maintains adequate coverage outside of weekday hours.
RN + LPN + aide · Sat–Sun
2h 51m
↓ 13% · RI 3h 18mThis facility: 2h 51m per resident per day, 13% below the Rhode Island average of 3h 18m (among Rhode Island facilities reporting a recent figure).
Combined nursing hours (RN + LPN + Nurse Aide) per resident per day on weekends. Staffing often drops on weekends — this figure reveals whether the facility maintains adequate coverage outside of weekday hours.
RN + LPN + aide · Sat–SunUS average: 3h 26m.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse. US 3h 26m
RN, weekends
Registered nurse hours specifically on weekends. Facilities sometimes reduce RN presence on Saturdays and Sundays — a low weekend RN figure compared to weekday hours can indicate reduced clinical oversight when most administrative staff are absent.
Sat–Sun
26m
↓ 22% · RI 34mThis facility: 26m per resident per day, 22% below the Rhode Island average of 34m (among Rhode Island facilities reporting a recent figure).
Registered nurse hours specifically on weekends. Facilities sometimes reduce RN presence on Saturdays and Sundays — a low weekend RN figure compared to weekday hours can indicate reduced clinical oversight when most administrative staff are absent.
Sat–SunUS average: 28m.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse. US 28m
Headcount
Every person who worked here at any point in the quarter, employees and contractors. It is not how many are on site at once: that is the "on an average day" figure.
114
87 employees · 27 contractors · 36 on an average day
114 total staff / 59 residents. Residents: CMS Long-Term Care Facility Characteristics (data as of Sep 2026); staff: CMS Payroll-Based Journal (Q2 2026).Residents and staff come from two different CMS releases, so the two counts can be a few months apart.
1.93 : 1
↑ 4% · RI 1.86This facility: 1.93 staff per resident, 4% above the Rhode Island average of 1.86 (among Rhode Island facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
114 staff ÷ 59 residents
See full Rhode Island ranking →
Average hours one staff member works on a day they are on shift, across every role.
7.1 h
↓ 7% · RI 7.6 hThis facility: 7.1 h, 7% below the Rhode Island average of 7.6 h (among Rhode Island facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
23,267 staff hours this quarter
See full Rhode Island ranking →91.3% of staff hours were worked by the facility's own employees
Rhode Island average: 92.9% · Contractors this quarter: Registered Nurse (8), Physical Therapy Assistant (5), Respiratory Therapy Technician (4), Physical Therapy Aide (4), Licensed Practical Nurse (2), Speech Language Pathologist (2), Qualified Social Worker (2)
Why it matters: employees work here week after week and get to know each resident's routines and needs. Agency contractors often rotate between facilities, so a higher employee share usually means more consistent care.
By The Numbers
Community insights.
Bed count
A smaller, more intimate setting that may offer a quieter environment and closer staff-resident interactions.
66
Rank #52 / 65Bed count — State benchmarked This nursing home is ranked 52nd out of 65 nursing homes we track in Rhode Island for bed count. Shows this facility's certified or reported bed count compared to other Rhode Island facilities. Larger communities may offer more amenities, programs, and on-site services for residents and families. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Rhode Island that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
A smaller, more intimate setting that may offer a quieter environment and closer staff-resident interactions.
66
Rank #52 / 65Bed count — State benchmarked This nursing home is ranked 52nd out of 65 nursing homes we track in Rhode Island for bed count. Shows this facility's certified or reported bed count compared to other Rhode Island facilities. Larger communities may offer more amenities, programs, and on-site services for residents and families. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Rhode Island that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.Smaller home · May offer a more intimate, personalized care environment.
Years of operating
A community with a solid operating history and experience delivering ongoing care. This is the number of years in operation under current management.
Rank #23 / 46Years in operation — State benchmarked This nursing home is ranked 23rd out of 46 nursing homes we track in Rhode Island for years in operation. Shows how long this facility has been in operation compared to other Rhode Island facilities. Longer operating histories may benefit residents, families, and staff. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Rhode Island that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
A community with a solid operating history and experience delivering ongoing care. This is the number of years in operation under current management.
Rank #23 / 46Years in operation — State benchmarked This nursing home is ranked 23rd out of 46 nursing homes we track in Rhode Island for years in operation. Shows how long this facility has been in operation compared to other Rhode Island facilities. Longer operating histories may benefit residents, families, and staff. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Rhode Island that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
10
years
Walk Score
Car-dependent. Most errands require a car, with limited nearby walkable options.
Rank #52 / 64Walk Score — State benchmarked This nursing home is ranked 52nd out of 64 nursing homes we track in Rhode Island for walk score. Shows how walkable this facility's neighborhood is compared to the average walk score across Rhode Island facilities. Higher scores benefit residents, families, and staff. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Rhode Island that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
Car-dependent. Most errands require a car, with limited nearby walkable options.
Rank #52 / 64Walk Score — State benchmarked This nursing home is ranked 52nd out of 64 nursing homes we track in Rhode Island for walk score. Shows how walkable this facility's neighborhood is compared to the average walk score across Rhode Island facilities. Higher scores benefit residents, families, and staff. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Rhode Island that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
19
/ 100
Occupancy rate
Occupancy between 85% and 95% suggests balanced demand.
Rank #18 / 53Occupancy rate — State benchmarked This nursing home is ranked 18th out of 53 nursing homes we track in Rhode Island for occupancy. Shows this facility's occupancy rate versus the Rhode Island average, with its Statewide rank out of 53. Higher occupancy signals strong local demand and financial stability. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Rhode Island that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
Occupancy between 85% and 95% suggests balanced demand.
Rank #18 / 53Occupancy rate — State benchmarked This nursing home is ranked 18th out of 53 nursing homes we track in Rhode Island for occupancy. Shows this facility's occupancy rate versus the Rhode Island average, with its Statewide rank out of 53. Higher occupancy signals strong local demand and financial stability. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Rhode Island that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
91.1%
This home usually has limited availability
Based on 60.1 residents and 66 beds. Source: CMS Provider Information, average daily residents (data as of Oct 2026)
Higher than the Rhode Island average: 85.6%
Avg. Length of Stay
Average number of days residents stay at this facility, based on CMS cost report data. Shorter stays often reflect post-acute or rehab care; longer stays reflect long-term care.
Average number of days residents stay at this facility, based on CMS cost report data. Shorter stays often reflect post-acute or rehab care; longer stays reflect long-term care.
144
days
About This Community
Facility TypeNursing Facility
StatusActive
IssuanceJuly 1, 2016
License NumberLTC00801
CMS Certification Number415004
Royal Innovation: Alzheimer's Care Program — Royal Health GroupA branded memory-care program developed by this community's operator - a structured approach to dementia care, rather than an independent external certification.
Certified Dementia Practitioner (CDP) trained staff — National Council of Certified Dementia PractitionersStaff hold the Certified Dementia Practitioner credential from the NCCDP, which requires formal Alzheimer's/dementia training and hands-on experience - a signal of dedicated dementia-care training beyond state minimums.
Owner NameAdministrator Susan Misto
Resident Council
Short-Term Rehab
Short-Term Rehabilitation
Stroke Recovery and Community Reintegration
Physical Therapy
Occupational Therapy
Speech Therapy
Subacute Care
Sub-Acute Care for Complex Medical Conditions
IV Antibiotics and Re-Hydration
Wound Care ManagementClinical care for preventing, assessing, and treating wounds, including pressure injuries and surgical wounds. It can support healing and reduce complications.
Cardiac Care Management
Cardiac Care
Palliative CareCare focused on relieving pain, symptoms, and stress while supporting quality of life. It can be provided alongside treatment for a serious illness.
Hospice and Palliative Care
Respite CareRespite care provides families and unpaid caregivers with short-term relief from caregiving duties. Care can range from a few hours to a few weeks.
Discharge Planning and Coordination
Monthly Family Support Group
Fast-Track Admissions Program for Returning Residents
Fax(401) 596-4925
Pets not allowed
Single-Story Layout
Rehabilitation Area with Working Kitchens
Activities
Music Therapy
Art TherapyA therapeutic activity that uses drawing, painting, or other art to support emotional expression, coping, and engagement. It can be led by a trained therapist or activity professional.
Music and Movement for Memory and Cognition
Russian “Sunrise” Immersion Program
Room Types
Private Room
CMS Health Inspection History
ALM Inspection Grade
89 / 100
Calculated from CMS inspection data for this community's nursing-home beds
How it compares
7 points above the Rhode Island average for CMS-certified facilities (82/100)
Category breakdown
Citations
Typical
62 severity-weighted points (18 deficiencies) · 31% lower than the typical CMS-certified RI facility (median: 90)
Enforcement
Strong
$8,647 in fines · 1 enforcement action
Persistence
Concern
31 days to fix issues · slower than the typical CMS-certified RI facility (median: 27)
Total health inspections
4
↓ 51% · RI 8.2This facility: 4, 51% below the RI average of 8.2 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Total health citations
18
Rank #12 / 55Health citations — State benchmarked This nursing home is ranked 12th out of 55 nursing homes we track in Rhode Island for health citations. Shows this facility's total health deficiency citations benchmarked to the Rhode Island State average, with a ranking across all 55 RI facilities. Lower citation counts earn a better rank. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Rhode Island that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.↓ 35% · RI 27.9This facility: 18, 35% below the RI average of 27.9 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Citations per inspection
4.5
Rank #42 / 55Citations per inspection — State benchmarked This nursing home is ranked 42nd out of 55 nursing homes we track in Rhode Island for citations per inspection. Shows average deficiency citations per CMS inspection for this facility versus the Rhode Island mean across 55 facilities with citation data. Lower is better. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Rhode Island that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.↑ 27% · RI 3.54This facility: 4.5, 27% above the RI average of 3.54 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Citation severity
100% corrected
18 of 18 citations corrected
Critical
J–L
0
↓ 100% · RI 1.5This facility: 0, 100% below the RI average of 1.5 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Immediate jeopardy
Serious
G–I
1
↓ 38% · RI 1.6This facility: 1, 38% below the RI average of 1.6 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Actual harm
Moderate
D–F
16
↓ 34% · RI 24.1This facility: 16, 34% below the RI average of 24.1 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
No harm, more than minimal risk
Minor
A–C
1
↑ 43% · RI 0.7This facility: 1, 43% above the RI average of 0.7 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
No harm, minimal riskLatest inspection: Feb 19, 2026 · 9 citations, all corrected
Most cited category: Pharmacy Services, 6 of 18 citations · 6 categories in total
Citations history
Most recent first
Feb 19, 2026
9 citations
Resident Rights moderate citation
Corrected
Corrected
Care Planning moderate citation
Corrected
Corrected
Quality of Care moderate citation
Corrected
Corrected
Nursing Services moderate citation
Corrected
Corrected
Pharmacy moderate citation
Corrected
Corrected
Pharmacy moderate citation
Corrected
Corrected
Infection Control moderate citation
Corrected
Corrected
Quality of Care moderate citation
Corrected
Corrected
Care Planning moderate citation
Corrected
Corrected
Feb 04, 2025
2 citations
Quality of Care serious citation
Corrected
Corrected
Quality of Care moderate citation
Corrected
Corrected
Dec 05, 2024
3 citations
Quality of Care moderate citation
Corrected
Corrected
Pharmacy moderate citation
Corrected
Corrected
Infection Control moderate citation
Corrected
Corrected
Jan 12, 2024
4 citations
Pharmacy moderate citation
Corrected
Corrected
Pharmacy moderate citation
Corrected
Corrected
Pharmacy moderate citation
Corrected
Corrected
Resident Rights minor citation
Corrected
Corrected
Top deficiency categories
Share of 18 citations
Pharmacy Services
6 deficiencies (33%)
Quality of Life & Care
5 deficiencies (28%)
Infection Control
2 deficiencies (11%)
Resident Rights
2 deficiencies (11%)
Resident Assessment & Care Planning
2 deficiencies (11%)
Nursing & Physician Services
1 deficiency (6%)
How citations are counted
Health citations are formal notices following inspections when they fail to comply with safety and care standards.
16 of 18 citations resulted from standard inspections; and 2 of 18 resulted from complaint investigations.
Includes all CMS health inspection records for this property, which could include management/ownership changes.
Source
Data sourced from CMS Health Deficiencies reports. Citation severity codes range from A (least serious) to L (most serious). Immediate Jeopardy (J-L) citations indicate situations where the facility's noncompliance has placed residents at risk of death or serious harm.
Show Inspection Reports
Enforcement
Penalties and fines
Penalties and fines
Federal penalties imposed by CMS for regulatory violations, including civil money penalties (fines) and denials of payment for new Medicare/Medicaid admissions.
Source: CMS Penalties Database · Data as of Oct 2026
1 penalty in the past 3 years
Latest: Feb 4, 2025 · $8,647 civil money penalty
Feb 4, 2025 · $8,647 civil money penalty
Total fines
$8,647
↓ 89% · RI $82KThis facility: $8,647, 89% below the Rhode Island average of $82,189. Average among the 52 Rhode Island facilities with a penalty on record.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.US avg $66KUS average: $66,281, among the 6,725 US facilities with a penalty on record.Rank #19 / 56Federal fines — State benchmarked This nursing home is ranked 19th out of 56 nursing homes we track in Rhode Island for federal fines. Shows this facility's cumulative CMS federal fine dollars versus the Rhode Island average among facilities with fines, and where it ranks among 56 facilities in the pool. Lower total dollars mean a better rank. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Rhode Island that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
Number of fines
1
↓ 66% · RI 2.9This facility: 1, 66% below the Rhode Island average of 2.9. Average among the 52 Rhode Island facilities with a penalty on record.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.US avg 1.88US average: 1.88, among the 6,725 US facilities with a penalty on record.
Payment denials
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
0
RI avg 0.4Rhode Island average: 0.4. Average among the 52 Rhode Island facilities with a penalty on record.US avg 0.35US average: 0.35, among the 6,725 US facilities with a penalty on record.
Penalty history · past 3 years
Feb 4, 2025
Civil money penalty
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
$8,647
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
$8,647Fine amount comparison
This facility
$8,647
Rhode Island average
$82,189
US average
$66,281
Totals count every penalty on record; the history lists the past 3 years. Rhode Island and US averages are among facilities with a penalty on record.
A civil money penalty is a fine for noncompliance, per day or per instance. A payment denial stops Medicare/Medicaid payments for new residents until issues are fixed.
Health Outcomes
Quality of care over time
How residents at this home fare on health outcomes and preventive care, compared with the Rhode Island average.
CMS star rating for the care of long-stay residents, who live at the home for 100 days or more. It is built from the long-stay quality measures below. 5 stars is the best.
3
/ 5
Average
↓ 7% · RI 3.2This facility: 3.0, 7% below the RI average of 3.2 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
CMS star rating for the care of short-stay residents, mostly people recovering after a hospital stay for under 100 days. It is built from the short-stay quality measures below. 5 stars is the best.
4
/ 5
Above average
↑ 66% · RI 2.4This facility: 4.0, 66% above the RI average of 2.4 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Average of five long-stay measures: pressure ulcers, falls with major injury, unplanned weight loss, worsening ability to walk, and needing more help with daily activities. Each is the % of residents affected, so lower is better.
7.7
Score · lower is better
↓ 20% · RI 9.6This facility: 7.7, 20% below the RI average of 9.6 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Average of three long-stay measures: needing more help with daily activities, worsening ability to walk, and loss of bowel or bladder control. Each is the % of residents affected, so lower is better.
18.4
Score · lower is better
↓ 3% · RI 18.9This facility: 18.4, 3% below the RI average of 18.9 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.13 long-stay measures: 5 better, 5 worse, 3 near RI average
8 short-stay measures: 3 better, 2 near RI average, 3 compared with US only
Long-stay residents
People who live at the home · 13 measures
Daily care & independence
Needed more help with daily activities
Percent of long-stay residents whose need for help with daily activities has increased
14.3%
↓ 27% · RI 19.5This facility: 14.3, 27% below the RI average of 19.5 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents whose need for help with daily activities has increased
14.3%
↓ 27% · RI 19.5This facility: 14.3, 27% below the RI average of 19.5 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Walking ability worsened
Percent of long-stay residents whose ability to move independently worsened
15.2%
↓ 4% · RI 15.8This facility: 15.2, 4% below the RI average of 15.8 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents whose ability to move independently worsened
15.2%
↓ 4% · RI 15.8This facility: 15.2, 4% below the RI average of 15.8 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Bowel or bladder incontinence (low-risk residents)
Percent of low risk long-stay residents who lose control of their bowels or bladder
25.7%
↑ 20% · RI 21.4This facility: 25.7, 20% above the RI average of 21.4 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of low risk long-stay residents who lose control of their bowels or bladder
25.7%
↑ 20% · RI 21.4This facility: 25.7, 20% above the RI average of 21.4 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Safety & clinical stability
Urinary tract infection
Percent of long-stay residents with a urinary tract infection
3.2%
↑ 25% · RI 2.6This facility: 3.2, 25% above the RI average of 2.6 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents with a urinary tract infection
3.2%
↑ 25% · RI 2.6This facility: 3.2, 25% above the RI average of 2.6 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Falls with major injury
Percent of long-stay residents experiencing one or more falls with major injury
3.2%
↓ 12% · RI 3.6This facility: 3.2, 12% below the RI average of 3.6 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents experiencing one or more falls with major injury
3.2%
↓ 12% · RI 3.6This facility: 3.2, 12% below the RI average of 3.6 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Pressure ulcers (high-risk residents)
Percent of long-stay high risk residents with pressure ulcers
0.4%
↓ 91% · RI 4.0This facility: 0.4, 91% below the RI average of 4.0 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay high risk residents with pressure ulcers
0.4%
↓ 91% · RI 4.0This facility: 0.4, 91% below the RI average of 4.0 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Physical & mental health
Lost too much weight
Percent of long-stay residents who lose too much weight
5.6%
↑ 10% · RI 5.1This facility: 5.6, 10% above the RI average of 5.1 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents who lose too much weight
5.6%
↑ 10% · RI 5.1This facility: 5.6, 10% above the RI average of 5.1 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Depressive symptoms
Percent of long-stay residents who have depressive symptoms
29.4%
↑ 58% · RI 18.6This facility: 29.4, 58% above the RI average of 18.6 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents who have depressive symptoms
29.4%
↑ 58% · RI 18.6This facility: 29.4, 58% above the RI average of 18.6 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Antipsychotic use
Percent of long-stay residents who received an antipsychotic medication
22.0%
↓ 2% · RI 22.5This facility: 22.0, 2% below the RI average of 22.5 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents who received an antipsychotic medication
22.0%
↓ 2% · RI 22.5This facility: 22.0, 2% below the RI average of 22.5 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Preventive care
Pneumococcal vaccine
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
99.5%
↑ 6% · RI 94.0This facility: 99.5, 6% above the RI average of 94.0 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
99.5%
↑ 6% · RI 94.0This facility: 99.5, 6% above the RI average of 94.0 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Flu vaccine
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
98.1%
↑ 3% · RI 95.5This facility: 98.1, 3% above the RI average of 95.5 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
98.1%
↑ 3% · RI 95.5This facility: 98.1, 3% above the RI average of 95.5 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Hospital & emergency visits
Hospitalizations per 1,000 days
Number of hospitalizations per 1,000 long-stay resident days.
1.54
↑ 5% · RI 1.46This facility: 1.54, 5% above the RI average of 1.46 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Number of hospitalizations per 1,000 long-stay resident days.
1.54
↑ 5% · RI 1.46This facility: 1.54, 5% above the RI average of 1.46 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
ER visits per 1,000 days
Number of outpatient emergency department visits per 1,000 long-stay resident days.
1.62
↓ 6% · RI 1.72This facility: 1.62, 6% below the RI average of 1.72 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Number of outpatient emergency department visits per 1,000 long-stay resident days.
1.62
↓ 6% · RI 1.72This facility: 1.62, 6% below the RI average of 1.72 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Short-stay residents
Rehab and recovery after a hospital stay · 8 measures
Daily care & independence
Able to care for self at discharge
Percentage of residents at or above expected ability to care for themselves at discharge.
68.8%
↑ 28% · US 53.7This facility: 68.8, 28% above the US average of 53.7 (among US facilities reporting a recent figure).
Percentage of residents at or above expected ability to care for themselves at discharge.
68.8%
↑ 28% · US 53.7This facility: 68.8, 28% above the US average of 53.7 (among US facilities reporting a recent figure).
Returned home or to the community
Rate of successful return to home or community from a skilled nursing facility.
71.0%
↑ 40% · US 50.6This facility: 71.0, 40% above the US average of 50.6 (among US facilities reporting a recent figure).
Rate of successful return to home or community from a skilled nursing facility.
71.0%
↑ 40% · US 50.6This facility: 71.0, 40% above the US average of 50.6 (among US facilities reporting a recent figure).Safety & clinical stability
Falls with major injury
Percentage of SNF residents who experience falls with major injury during their stay.
0.0%
↓ 100% · US 0.8This facility: 0.0, 100% below the US average of 0.8 (among US facilities reporting a recent figure).
Percentage of SNF residents who experience falls with major injury during their stay.
0.0%
↓ 100% · US 0.8This facility: 0.0, 100% below the US average of 0.8 (among US facilities reporting a recent figure).Physical & mental health
New antipsychotic medication
Percent of short-stay residents who newly received an antipsychotic medication
1.6%
↓ 20% · RI 2.0This facility: 1.6, 20% below the RI average of 2.0 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of short-stay residents who newly received an antipsychotic medication
1.6%
↓ 20% · RI 2.0This facility: 1.6, 20% below the RI average of 2.0 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Preventive care
Pneumococcal vaccine
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
91.8%
↑ 14% · RI 80.3This facility: 91.8, 14% above the RI average of 80.3 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
91.8%
↑ 14% · RI 80.3This facility: 91.8, 14% above the RI average of 80.3 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Flu vaccine
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
94.1%
↑ 21% · RI 77.7This facility: 94.1, 21% above the RI average of 77.7 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
94.1%
↑ 21% · RI 77.7This facility: 94.1, 21% above the RI average of 77.7 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Hospital & emergency visits
Re-hospitalized after admission
Percentage of short-stay residents who were re-hospitalized after their nursing home admission.
25.3%
↑ 1% · RI 25.1This facility: 25.3, 1% above the RI average of 25.1 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percentage of short-stay residents who were re-hospitalized after their nursing home admission.
25.3%
↑ 1% · RI 25.1This facility: 25.3, 1% above the RI average of 25.1 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
ER visits
Percentage of short-stay residents who had an outpatient emergency department visit.
16.1%
↑ 2% · RI 15.8This facility: 16.1, 2% above the RI average of 15.8 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percentage of short-stay residents who had an outpatient emergency department visit.
16.1%
↑ 2% · RI 15.8This facility: 16.1, 2% above the RI average of 15.8 (among RI facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Arrows show whether a figure is above or below the average. Green is better for residents, red is worse, and yellow means within 5% of the average. Grey compares with the US average only, because CMS publishes no state figure. The line on each bar marks the average.
Quality measures are calculated by CMS from Minimum Data Set (MDS) resident assessments and Medicare claims.
Money and staffing.
Royal of Westerly Nursing Center’s finances from its CMS cost report for the fiscal year ending December 2024, compared with 52 Rhode Island nursing homes that filed a recent report. Includes all financial data for this property, which could include management/ownership changes.
FY Dec 2024
Is it financially stable?
Profitable on care
7.3% operating margin
+2.7 pts vs prior year
Positive margin in 6 of the last 8 reported years. Net income $0.7M after other income.
Does it invest in staff?
Spends less on payroll than most Rhode Island homes
52.9% payroll share of revenue
RI average 64.4%Rank #37 / 52Payroll % of net patient revenue — State benchmarked This nursing home is ranked 37th out of 52 nursing homes we track in Rhode Island for payroll % of net patient revenue. Shows payroll as a percentage of net patient revenue versus the Rhode Island average, among facilities reporting a recent fiscal year. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Rhode Island that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
Payroll rose $0.3M while revenue rose $0.9M. A low share can mean leaner staffing; check hours per resident in the staffing section.
FY 2024 scorecard
Each row shows the FY 2024 figure, the change since the prior report, the trend, and how it compares with Rhode Island homes.
Revenue & profit
Profitable on care
| Metric | FY 2024 | vs prior year | Trend 2017 → 2024Trend | RI median | Compared with RI homesRank in RI | In short |
|---|---|---|---|---|---|---|
| Net patient revenue What the home earns from resident care, after discounts and bad debt. | $8.6M | +$0.9M | Trend 20172024 | RI median $12.4M | Rank in RI Rank #40 / 52Net patient revenue — State benchmarked This nursing home is ranked 40th out of 52 nursing homes we track in Rhode Island for net patient revenue. Shows this facility's net patient revenue compared to the Rhode Island average, among facilities reporting a recent fiscal year. Higher revenue generally means more resources for staffing and capital — read alongside Payroll %. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Rhode Island that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric. Higher than 24% of homes | Below RI median Higher net patient revenue than 24% of RI homes that filed a recent report. Revenue mostly follows how big a home is. |
| Operating expenses Everything it costs to run the home: staff, supplies, rent, admin. | $8.0M | +$0.6M | Trend 20172024 | RI median $13.6M | Rank in RI Rank #43 / 52Operating expenses — State benchmarked This nursing home is ranked 43rd out of 52 nursing homes we track in Rhode Island for operating expenses. Shows everything it cost to run the home — staff, supplies, rent, admin — compared with other Rhode Island homes reporting a recent fiscal year. Expenses in dollars mostly follow how big a home is, so this compares size, not efficiency; read it next to operating margin. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Rhode Island that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric. Higher than 18% of homes | Within revenue Operating expenses are lower than net patient revenue, so resident care covers its costs. |
| Net patient income Revenue minus operating expenses. Negative means care loses money. | $0.6M | +$0.3M | Trend 20172024 | RI median −$0.4M | Rank in RI Rank #8 / 52Net patient income — State benchmarked This nursing home is ranked 8th out of 52 nursing homes we track in Rhode Island for net patient income. Shows net patient revenue minus operating expenses, compared with other Rhode Island homes reporting a recent fiscal year. Homes that lost money on care are in the pool too, so a rank in the bottom half usually means a loss. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Rhode Island that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric. Higher than 86% of homes | Profit, growing Resident care made money this year, more than in the prior report. |
| Operating margin Net patient income as a share of revenue. The clearest health signal. | 7.3% | +2.7 pts | Trend 20172024 | RI median −3.5% | Rank in RI Rank #7 / 52Operating margin — State benchmarked This nursing home is ranked 7th out of 52 nursing homes we track in Rhode Island for operating margin. Shows net patient income as a share of net patient revenue, compared with other Rhode Island homes reporting a recent fiscal year. Unlike the dollar figures it does not follow size, so it is the fairest comparison of financial health between a small home and a large one. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Rhode Island that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric. Higher than 88% of homes | Healthy margin More than 5% of revenue is left after operating expenses. |
| Other income Money not from resident care: investments, grants, services. | $0.1M | — | Trend — | RI median $0.2M | Rank in RI Rank #36 / 52Other income — State benchmarked This nursing home is ranked 36th out of 52 nursing homes we track in Rhode Island for other income. Shows income from outside resident care — investments, grants, rentals, services — compared with other Rhode Island homes reporting a recent fiscal year. It is not part of net patient revenue; a high rank here can offset a loss on care. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Rhode Island that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric. Higher than 31% of homes | Adds to profit Income from outside resident care, on top of the profit from care. |
| Net income The bottom line after other income. | $0.7M | +$0.3M | Trend — | RI median −$0.1M | Rank in RI Rank #12 / 52Net income — State benchmarked This nursing home is ranked 12th out of 52 nursing homes we track in Rhode Island for net income. Shows the bottom line after other income, compared with other Rhode Island homes reporting a recent fiscal year. Homes with a net loss are in the pool too, so a rank in the bottom half usually means a loss. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Rhode Island that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric. Higher than 78% of homes | Profit The bottom line is above zero after other income. |
Staffing spend
Spends less of revenue on staff than most Rhode Island homes
| Metric | FY 2024 | vs prior year | Trend 2017 → 2024Trend | RI median | Compared with RI homesRank in RI | In short |
|---|---|---|---|---|---|---|
| Payroll costs Salaries and wage-related benefits, not counting contract labor. | $4.5M | +$0.3M | Trend 20172024 | RI median $7.6M | Rank in RI Rank #45 / 52Payroll costs — State benchmarked This nursing home is ranked 45th out of 52 nursing homes we track in Rhode Island for payroll costs. Shows total staff payroll — salaries plus wage-related benefits — benchmarked to the Rhode Island average, among facilities reporting a recent fiscal year. Higher payroll relative to peers often signals better staffing and less reliance on contract labor. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Rhode Island that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric. Higher than 14% of homes | Below RI median Higher payroll than 14% of RI homes. Payroll in dollars mostly follows how big a home is, so this compares size, not staffing levels. |
| Payroll share of revenue Payroll divided by revenue. Higher usually means more staff per resident. | 52.9% | −2.1 pts | Trend 20172024 | RI median 62.2% | Rank in RI Rank #37 / 52Payroll % of net patient revenue — State benchmarked This nursing home is ranked 37th out of 52 nursing homes we track in Rhode Island for payroll % of net patient revenue. Shows payroll as a percentage of net patient revenue versus the Rhode Island average, among facilities reporting a recent fiscal year. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Rhode Island that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric. Higher than 29% of homes | 11.5 pts under RI average The RI average is 64.4% of revenue. Within 3 points of it reads as near the average. |
Charts, 2017–2024 2 charts · RI benchmark drawn as a dashed line
Revenue, expenses and income
What the home earned from resident care (net patient revenue), what it cost to run (operating expenses) and the difference between the two (net patient income), for each fiscal year it filed a CMS cost report.
USD, millions
Net patient revenue Operating expenses Net patient income
Where revenue goes
Both lines are a share of net patient revenue. Payroll share is what goes to salaries and wage-related benefits; operating margin is what is left after every operating cost (below 0%, resident care lost money). The dashed line is the Rhode Island payroll average.
% of net patient revenue
Payroll share Operating margin RI payroll average
Year-by-year data, 2017–2024 every reported year · latest first, scroll sideways
| Metric | 2017 | 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | 2024 |
|---|---|---|---|---|---|---|---|---|
| Net patient revenue | $6.6M | $7.0M | $7.1M | $5.9M | $6.0M | $6.7M | $7.7M | $8.6M |
| Operating expenses | $6.1M | $6.2M | $6.1M | $6.4M | $6.0M | $6.8M | $7.3M | $8.0M |
| Net patient income | $0.6M | $0.8M | $1.0M | −$0.4M | $0.0M | −$0.1M | $0.3M | $0.6M |
| Operating margin | 9.0% | 11.2% | 14.0% | −7.2% | 0.0% | −1.6% | 4.5% | 7.3% |
| Net income | $0.7M | $0.8M | $1.0M | $0.2M | $1.2M | $0.6M | $0.4M | $0.7M |
| Payroll costs | $3.2M | $3.3M | $3.1M | $3.2M | $3.1M | $3.9M | $4.2M | $4.5M |
| Payroll share of revenue | 48.2% | 47.9% | 42.9% | 53.8% | 51.7% | 57.4% | 55.0% | 52.9% |
| Beds | 66 | 66 | 66 | 66 | 66 | 66 | 66 | 66 |
| Gross revenue | $7.8M | $8.3M | $8.3M | $6.3M | $6.7M | $7.6M | $8.6M | $9.6M |
| Salaries | $2.8M | $2.8M | $2.7M | $2.7M | $2.7M | $3.4M | $3.7M | $3.9M |
| Wage-related costs | $0.4M | $0.5M | $0.4M | $0.4M | $0.4M | $0.5M | $0.5M | $0.7M |
| Contract labor | $0.6M | $0.6M | $0.5M | $0.4M | $0.6M | $0.4M | $0.4M | $0.5M |
| Other operating costs | $2.8M | $2.9M | $3.1M | $3.2M | $2.9M | $3.0M | $3.1M | $3.4M |
| Net patient revenue per day | $296 | $315 | $324 | $321 | $311 | $317 | $348 | $374 |
| Cost per day | $270 | $279 | $278 | $345 | $311 | $322 | $332 | $346 |
| Average length of stay | 195.2 days | 146.8 days | 146.4 days | 134.6 days | 136.3 days | 101.2 days | 120.0 days | 143.6 days |
Showing 2024–2022 · scroll sideways for 5 earlier years
Who this home usually serves
Residents split by who pays for their care: Medicare, Medicaid, or private pay and other sources.
Over a year: CMS SNF Cost Report, FY2024
Snapshot: CMS Long-Term Care Facility Characteristics (quarterly), Sep 2026
Arriving
140 admissions · FY2024
Residents admitted during the year.
Medicare
62 · 44%
Medicaid
2 · 1%
Private pay & other
76 · 54%
Resident snapshot
59 residents · Sep 2026
Residents counted on the date of the latest CMS report, which updates quarterly.
Medicare
8 · 14%
Medicaid
17 · 29%
Private pay & other
34 · 58%
Leaving
160 discharges · FY2024
Residents discharged during the year.
Medicare
71 · 44%
Medicaid
12 · 8%
Private pay & other
77 · 48%
Mix of rehab and long-term care
This home supports both short-term rehab and long-term care, with residents staying for a wide range of durations.
Places of interest near Royal of Westerly Nursing Center
2.3 miles from city center
Estimated distance in miles from Westerly's city center to Royal of Westerly Nursing Center's address, calculated via Google Maps.
Calculate Travel Distance to Royal of Westerly Nursing Center
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Info below is compiled from CMS reports & the RI Dept. of Health (RIDOH), senior community websites & trusted data sources such as Walk Score & BBB.
Communities are listed from highest-ranked to lowest-ranked based on our methodology.
The facility name. Click to view the full profile page on Assisted Living Magazine, including photos, services, and contact info.
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CMS (Centers for Medicare & Medicaid Services, the federal agency that regulates nursing homes) Overall 5-star rating — a composite of Health Inspection, Staffing, and Quality Measures scores. 5 stars = top 10% nationally. 1 star = bottom 10%. The single most important number to start with when comparing facilities.
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Care Types in This Table
AL (Assisted Living):
Housing with help for daily activities like bathing, dressing, and medication, without 24-hour skilled nursing.
NH (Nursing Home):
24/7 skilled nursing care for residents with complex, ongoing medical needs.
SNF (Skilled Nursing Facility):
Round-the-clock nursing care, often for recovery after surgery, injury, or illness.
MC (Memory Care):
Secured, specialized care for people living with Alzheimer's or dementia.
RC (Respite Care):
Short-term temporary care that gives family caregivers a break.
IL (Independent Living):
Community living with dining, activities, and transportation for active seniors who need little personal care.
HOS (Hospice Care):
Comfort-focused care for those with a terminal illness, prioritizing quality of life over treatment.
ADC (Adult Day Care):
Daytime supervision, health monitoring, and social activities for seniors who live at home.
PC (Palliative Care):
Comfort-focused care for serious illness at any stage, including alongside curative treatment.
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Neighborhood or city area where the facility is located. Proximity to family, hospitals, and green space matters for both quality of life and ease of visitation. Consider drive time and transit access when evaluating location.
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Licensed bed capacity. Larger facilities (300+ beds) often have more specialized programs but can feel institutional. Smaller homes (under 150 beds) tend to deliver more personalized care. Compare with Avg Res/Day to understand how full the facility typically runs.
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A 0–100 score of a facility's regulatory inspection record, shown as a letter and compared with other facilities of the same kind in the same state. This is a proprietary Assisted Living Magazine grade. It is not a government rating. A dash means we have no inspection data for that facility.
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Percentage of licensed beds filled on an average day. Color indicates financial health: green (90%+) = operationally strong, typically profitable. Amber (80–89%) = stable but leaving revenue on the table. Orange (70–79%) = financial strain likely, may struggle with fixed costs. Red (<70%) = significant distress, closure or ownership change risk increases sharply.
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This facility's occupancy rate compared to the statewide average for similar facilities. A positive number means above-average demand. Facilities running 5%+ above the state average are typically the most sought-after in their market — a strong proxy for reputation.
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CMS-adjusted total nurse hours per resident per day (RN + LPN + CNA combined). The national average is approximately 3.5 hrs. Higher is better — more direct care time per resident. Below 3.0 is a red flag. CMS weights RN hours more heavily because RNs handle complex clinical decisions that CNAs cannot.
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CMS Health Inspection star rating (1–5 stars), based on the 3 most recent annual state surveys plus any complaint investigations. This is the hardest rating to manipulate — it reflects real surveyor findings on-site. 5 stars = fewest deficiencies found. 1 star = most. It carries the heaviest weight in the Overall CMS rating.
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CMS Staffing star rating (1–5 stars), based on daily nurse staffing hours submitted to CMS via verified payroll data. Compares RN, LPN, and CNA coverage relative to resident acuity level. 5 stars = well above expected staffing. Weekend staffing is evaluated separately, as that's where many facilities quietly reduce coverage.
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CMS Quality Measures star rating (1–5 stars), based on 15 clinical outcome metrics including fall rates, pressure ulcers, antipsychotic drug use, and hospital readmissions. Captures actual resident health outcomes, not just compliance. High QM combined with low Health Inspection scores can indicate a facility with strong care but weak documentation practices.
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Registered Nurse hours per resident/day compared to the statewide average. RNs are the highest-skilled nursing staff — they assess residents, manage medications, and respond to emergencies. A value of +50% means RN coverage is 50% above the state norm. Negative values are a concern for residents with complex or acute medical needs.
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Total nursing staff hours (RN + LPN + CNA combined) per resident/day vs. the statewide average. A broader measure than RN vs State — it captures the entire care team. A facility can have high total staffing but low RN hours, meaning more aides and fewer nurses. Read both columns together for the full picture.
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Total dollar amount of federal monetary fines (civil money penalties) issued by CMS in the past 3 years. Fines are only levied for serious violations — typically actual harm to residents, repeated uncorrected deficiencies, or systemic non-compliance. Even a single fine is noteworthy. Multiple fines strongly suggest a pattern, not isolated incidents.
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Total health deficiency citations from the most recent standard inspection cycle. Minor citations (scope A–C) are common and often administrative in nature. Higher counts aren't always disqualifying, but should be read alongside Severe Citations to understand actual harm levels. Under 10 is strong for a large facility; 30+ warrants a closer look.
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Average deficiency citations per CMS inspection (survey) in the reporting window — total citations divided by the number of inspections. Lower is better; compare alongside total Citations and Severe Citations for context.
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Citations at CMS scope/severity level G or higher — G–I means actual harm occurred; J–L means residents were placed in immediate jeopardy. (D–F is potential for harm only). Examples include unaddressed falls, medication errors causing injury, neglect, or abuse.
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Average number of residents in the building on any given day, derived from annual census data. Reflects true operating scale — a 400-bed facility running 200 residents/day operates very differently from one at 390. Higher resident counts generally mean more funded staffing hours.
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Better Business Bureau rating (A+ to F). Reflects complaint history, business transparency, and how family disputes were resolved. A+ means no significant unresolved complaints. A blank (—) means the facility isn't BBB-accredited, which is common for healthcare providers and not necessarily a negative signal.
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Walk Score® (0–100). Measures walkability of the surrounding area. 90–100 = Walker's Paradise. 70–89 = Very Walkable. 50–69 = Somewhat Walkable. Below 50 = Car-Dependent. Higher scores benefit family visitors, resident outings, and staff commuting.
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The licensed owner or operator of record filed with CMS — the individual or organization legally accountable for the facility. Searching the operator name across other facilities can reveal chain or multi-site ownership, which matters: chain-operated homes tend to have more variable quality outcomes than independently run facilities.
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What the home actually collects for resident care, after contractual allowances, bad debt and discounts — not gross billings. Taken from the latest complete annual cost report, so it is comparable across homes reporting the same period. Revenue alone doesn't indicate care quality, but it funds staffing and capital reinvestment. Pair with Payroll %. Figures are from each facility's most recent complete fiscal year — hover a value for the exact year; a * marks homes that report an older period than most facilities.
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Staff salaries plus wage-related benefits from the latest complete annual cost report. Contract and agency labour is counted separately, under other operating costs, so a home leaning on agency staff can show a low figure here. Payroll is the cost most directly tied to care quality — compare with Payroll % for full context. Figures are from each facility's most recent complete fiscal year — hover a value for the exact year; a * marks homes that report an older period than most facilities.
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Payroll as a share of NET PATIENT REVENUE (not gross revenue). Both figures come from the same cost-report year. A higher figure means more of each revenue dollar goes to staff pay. Read with the Staffing star rating to judge whether spend translates into coverage — and note that homes whose patient revenue covers only part of their operation can read implausibly high. The Rhode Island average is: 64.4% Figures are from each facility's most recent complete fiscal year — hover a value for the exact year; a * marks homes that report an older period than most facilities.
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CMS Certification Number: the unique federal identifier for this skilled nursing provider.
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|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Briarcliffe Manor | NH AL IL MC RC SNF | Johnston | 122
Facility
122
RI AVG
109
Rank
#26 / 65 | A+ |
87.8%
Facility
87.8%
RI AVG
85.6%
Rank
#28 / 53 | +3% | 5.30
Facility
5.30
RI AVG
3.92
Rank
#5 / 53 | -28% | +35% | $0
Facility
$0
RI AVG
$82.2k
Rank
#1 / 56 | 4
Facility
4
RI AVG
27.9
Rank
#2 / 55 | 2.0
Facility
2.0
RI AVG
3.5
Rank
#2 / 55 | - | 107 | A+ |
38
Facility
38
RI AVG
49
Rank
#37 / 64 | Adm Akshay K. Talwar | $13.9MFiscal year ending 12/2024
Facility
$13.9MFiscal year ending 12/2024
RI AVG
$12.6M
Rank
#21 / 52 | $10.4MFiscal year ending 12/2024
Facility
$10.4MFiscal year ending 12/2024
RI AVG
$7.6M
Rank
#8 / 52 | 74.3%Fiscal year ending 12/2024
Facility
74.3%Fiscal year ending 12/2024
RI AVG
64.4%
Rank
#10 / 52 | 415012 | ||||
| The Dawn Hill Home for Rehab and Healthcare | NH MC SNF | Bristol | 133
Facility
133
RI AVG
109
Rank
#18 / 65 | B+ |
93.5%
Facility
93.5%
RI AVG
85.6%
Rank
#14 / 53 | +9% | 3.42
Facility
3.42
RI AVG
3.92
Rank
#41 / 53 | -4% | -13% | $33.8k
Facility
$33.8k
RI AVG
$82.2k
Rank
#30 / 56 | 32
Facility
32
RI AVG
27.9
Rank
#36 / 55 | 2.5
Facility
2.5
RI AVG
3.5
Rank
#4 / 55 | 2 | 124 | - |
63
Facility
63
RI AVG
49
Rank
#25 / 64 | Administrator Douglas C Klein III | $16.7MFiscal year ending 12/2024
Facility
$16.7MFiscal year ending 12/2024
RI AVG
$12.6M
Rank
#9 / 52 | $8.7MFiscal year ending 12/2024
Facility
$8.7MFiscal year ending 12/2024
RI AVG
$7.6M
Rank
#21 / 52 | 51.8%Fiscal year ending 12/2024
Facility
51.8%Fiscal year ending 12/2024
RI AVG
64.4%
Rank
#41 / 52 | 415050 | ||||
| St Clare – Newport | NH ADC AL MC SNF | Newport | 62
Facility
62
RI AVG
109
Rank
#54 / 65 | A+ | - | - | 4.76
Facility
4.76
RI AVG
3.92
Rank
#8 / 53 | -28% | +21% | $0
Facility
$0
RI AVG
$82.2k
Rank
#1 / 56 | 22
Facility
22
RI AVG
27.9
Rank
#18 / 55 | 3.7
Facility
3.7
RI AVG
3.5
Rank
#29 / 55 | - | 50 | - |
68
Facility
68
RI AVG
49
Rank
#20 / 64 | Laura Dos Santos | $11.4MFiscal year ending 12/2024
Facility
$11.4MFiscal year ending 12/2024
RI AVG
$12.6M
Rank
#29 / 52 | $5.3MFiscal year ending 12/2024
Facility
$5.3MFiscal year ending 12/2024
RI AVG
$7.6M
Rank
#38 / 52 | 47.1%Fiscal year ending 12/2024
Facility
47.1%Fiscal year ending 12/2024
RI AVG
64.4%
Rank
#48 / 52 | 415111 | ||||
| Royal of Westerly Nursing Center | NH HOS MC PC RC SNF | Westerly | 66
Facility
66
RI AVG
109
Rank
#52 / 65 | B+ |
91.1%
Facility
91.1%
RI AVG
85.6%
Rank
#18 / 53 | +6% | 3.35
Facility
3.35
RI AVG
3.92
Rank
#41 / 53 | +19% | -15% | $8.6k
Facility
$8.6k
RI AVG
$82.2k
Rank
#19 / 56 | 18
Facility
18
RI AVG
27.9
Rank
#12 / 55 | 4.5
Facility
4.5
RI AVG
3.5
Rank
#42 / 55 | 1 | 60 | - |
19
Facility
19
RI AVG
49
Rank
#52 / 64 | Administrator Susan Misto | $8.6MFiscal year ending 12/2024
Facility
$8.6MFiscal year ending 12/2024
RI AVG
$12.6M
Rank
#40 / 52 | $4.5MFiscal year ending 12/2024
Facility
$4.5MFiscal year ending 12/2024
RI AVG
$7.6M
Rank
#45 / 52 | 52.9%Fiscal year ending 12/2024
Facility
52.9%Fiscal year ending 12/2024
RI AVG
64.4%
Rank
#37 / 52 | 415004 | ||||
| John Clarke Senior Living | NH IL MC RC SNF | Middletown (Newport East) | 60
Facility
60
RI AVG
109
Rank
#56 / 65 | C- |
89.8%
Facility
89.8%
RI AVG
85.6%
Rank
#23 / 53 | +5% | 3.56
Facility
3.56
RI AVG
3.92
Rank
#28 / 53 | +52% | -9% | $9.4k
Facility
$9.4k
RI AVG
$82.2k
Rank
#20 / 56 | 5
Facility
5
RI AVG
27.9
Rank
#3 / 55 | 1.3
Facility
1.3
RI AVG
3.5
Rank
#1 / 55 | 2 | 54 | - |
34
Facility
34
RI AVG
49
Rank
#40 / 64 | Joan M. Woods | $7.5MFiscal year ending 12/2024
Facility
$7.5MFiscal year ending 12/2024
RI AVG
$12.6M
Rank
#44 / 52 | $5.0MFiscal year ending 12/2024
Facility
$5.0MFiscal year ending 12/2024
RI AVG
$7.6M
Rank
#43 / 52 | 66.7%Fiscal year ending 12/2024
Facility
66.7%Fiscal year ending 12/2024
RI AVG
64.4%
Rank
#22 / 52 | 415076 |
Rank badges are statewide and care-type specific: each nursing home is ranked against every other RI nursing home we track that reports that metric, not just the 5 on this page. See how we rank facilities
Financial assistance
Get financial aid guidance Programs that may help with care and living costs in Rhode Island
Royal of Westerly Nursing Center is in WESTERLY, Rhode Island. These programs may support different care settings or living expenses. A listing does not confirm this community participates; our concierge team can help confirm.
Medicaid Long-Term Services and Supports (LTSS)
Medicaid Long-Term Services and Supports (LTSS)
Eligibility
- General
- People with long-term-care needs who meet Rhode Island Medicaid financial and functional eligibility requirements.
- RI specifics
- Medicaid Long-Term Services and Supports requires both financial and functional eligibility.
What it provides
- Covered long-term health and personal-care support to help eligible people live as safely and independently as possible.
SSI Enhanced Assisted Living Program
SSI Enhanced Assisted Living Program
- Income limit
- 2026 · The Category D assisted-living maximum combined SSI/state payment is $1,326/month individual, consisting of $994 federal SSI plus up to $332 state supplement. This payment standard is not a universal gross-income limit.
Eligibility
- General
- People in a qualifying assisted-living arrangement who are eligible for SSI and the applicable state supplemental payment category.
- RI specifics
- The January 1, 2026 rule sets the assisted-living payment standard; qualifying living arrangement and SSI/SSP eligibility must be assessed.
What it provides
- For eligible Category D assisted-living residents; state supplement may be up to $332/month alongside federal SSI; the actual award depends on countable income and living arrangement.
VA Aid and Attendance (A&A) and Housebound Benefits
VA Aid and Attendance (A&A) and Housebound Benefits
- Who it is for
- Veterans or survivors with VA pension eligibility and an Aid and Attendance or Housebound medical need
- Income limit
- 2026 · Countable income is compared with the applicable maximum annual pension rate (MAPR), which varies by dependents and benefit category. For a veteran with one dependent and Aid and Attendance, MAPR is $34,488/year.
- Asset limit
- VA pension net-worth ceiling is $163,699 from December 1, 2025 through November 30, 2026. Net worth includes countable assets plus income for VA purposes; exclusions and transfer rules apply.
Eligibility
- General
- Aid and Attendance or Housebound is an increased VA pension rate for eligible veterans or surviving spouses who meet pension and additional care/disability requirements; it is not a stand-alone state benefit.
- RI specifics
- Federal VA pension rules apply nationwide.
What it provides
- Monthly pension is based on the applicable MAPR less countable annual income; divided by 12. Maximum annual veteran Aid and Attendance rates are $29,093 without dependents and $34,488 with one dependent; actual payments may be lower.
Lifespan Respite Care Program
Lifespan Respite Care Program
Eligibility
- General
- Unpaid caregivers supporting older adults, children with disabilities or kinship family members; individual partner programs have their own criteria.
What it provides
- Respite; peer support; mentorship; advocacy and resource access through OHA community partners.
At HOME Cost Share
At HOME Cost Share
- Income limit
- Current OHA program page caps annual income at 250% of the federal poverty level, with income-based cost sharing.
- Asset limit
- No asset limit.
Eligibility
- General
- Age 65+, or age 19–64 with Alzheimer’s or related dementia, and a qualifying needs assessment for home/community support.
- RI specifics
- Administered by the Office of Healthy Aging; each participant receives an individualized assessment and care plan.
What it provides
- State shares the cost of authorized in-home help or adult-day services; including personal care; housekeeping or meal preparation.
Medicare Savings Program (MSP)
Medicare Savings Program (MSP)
- Who it is for
- Medicare beneficiaries with limited income who need help with premiums or cost sharing
Eligibility
- General
- Medicare beneficiary; the state determines the applicable Medicare Savings Program. QMB helps with premiums and Medicare cost sharing; SLMB and QI generally help with Part B premiums.
- RI specifics
- QI requires annual application and is funded first-come, first-served with priority for prior recipients. QMB, SLMB and QI confer Part D Extra Help.
What it provides
- QMB pays eligible Part A/Part B premiums and Medicare deductibles and cost sharing; SLMB and QI pay Part B premiums. The exact benefit depends on the approved program.
Low-Income Home Energy Assistance Program (LIHEAP)
Low-Income Home Energy Assistance Program (LIHEAP)
- Who it is for
- Income-eligible households responsible for home heating or energy costs
Eligibility
- General
- Income-eligible households with qualifying home-energy costs; the administering agency applies household-size and program eligibility rules.
What it provides
- Assistance with qualifying household heating costs through LIHEAP.
Senior Farmers’ Market Nutrition Program (SFMNP)
Senior Farmers’ Market Nutrition Program (SFMNP)
Eligibility
- General
- Rhode Island residents age 60+, or disabled residents of housing facilities that provide congregate nutrition services, who meet the household-income guidelines. Limited to one benefit issuance per household per year.
- RI specifics
- 2026 benefit cards are distributed through participating centers and locations; cards are valid through November 30, 2026.
What it provides
- A benefit card loaded with $50 to purchase eligible local produce; herbs and honey from participating farmers markets and farm stands; subject to eligibility and distribution availability.
Rhode Island Pharmaceutical Assistance to the Elderly (RIPAE)
Rhode Island Pharmaceutical Assistance to the Elderly (RIPAE)
- Income limit
- For age 65+ tiers in 2026, the highest listed annual limits are $85,848 single and $97,928 married; subsidy percentages vary by tier.
Eligibility
- General
- Rhode Island residents 65+, or disabled adults 55–64 under the separate tier, with qualifying income and Medicare Part D or Medicare Advantage prescription coverage. Medicaid and Extra Help enrollment exclude eligibility.
What it provides
- Pays a share of approved generic-drug costs during the Medicare prescription plan deductible stage; depending on the income tier.
Know before you visit
Frequently Asked Questions about Royal of Westerly Nursing Center
Quick answers from public records and the community's own listing.01 Who is the owner of Royal of Westerly Nursing Center?
Royal of Westerly Nursing Center is legally operated by Susan Misto, Administrator.
02 Is Royal of Westerly Nursing Center in a walkable area?
Royal of Westerly Nursing Center has a walk score of 19. Car-dependent. Most errands require a car, with limited nearby walkable options.
03 What is the license number of Royal of Westerly Nursing Center?
According to RI state health department records, Royal of Westerly Nursing Center's license number is LTC00801.
04 What is the occupancy rate at Royal of Westerly Nursing Center?
Royal of Westerly Nursing Center's occupancy is 91.1%.
05 How long has Royal of Westerly Nursing Center been in business?
Royal of Westerly Nursing Center has been operating for approximately 10 years, based on available licensing and registration records.
06 Are pets allowed at Royal of Westerly Nursing Center?
No, Royal of Westerly Nursing Center has a no-pet policy.
07 Does Royal of Westerly Nursing Center operate as a for-profit or non-profit?
Royal of Westerly Nursing Center is registered as a for-profit in RI.
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