Nursing HomeInspections

Grand Islander Center

Nursing home in Middletown, RI

Medicare & Medicaid certified2★ overall (CMS)

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Public-record details

Address
333 Green End Avenue, Middletown, RI 02842
Phone
(401) 849-7100
Listed under
For-profit
Medicare CCN
415034
Overall star rating
2 of 5 ★★☆☆☆
Health inspection rating
2 of 5
Staffing rating
3 of 5
Quality measures rating
2 of 5
Certified beds
146
Average residents per day
108
Ownership
For-profit, corporation
Legal business name
333 Green End Avenue Operations LLC
Chain
Genesis Healthcare (183 facilities)
Certified for
Medicare and Medicaid
First approved by Medicare/Medicaid
Jan 1, 1975
Changed ownership in last 12 months
No
Continuing care retirement community
No
Located inside a hospital
No
Resident or family council
Resident and family councils
Sprinklers in all required areas
Yes

CMS certification number 415034. Source: CMS Nursing Home Provider Information, Health Deficiencies and Penalties (record). Data as of 2026-11-07.

Inspection record

Most recent standard health inspection: May 14, 2025. CMS lists 43 health citations for this facility across its last three standard inspection cycles and complaint inspections (Apr 27, 2023 to Aug 18, 2026): 16 from complaint inspections, 3 at the “actual harm” level or higher, including 1 at “immediate jeopardy”.

InspectionCitationSeverity
Aug 18, 2026Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Freedom from Abuse, Neglect, and Exploitation · complaint inspection		D
Potential for more than minimal harm, isolated
Aug 18, 2026Administer the facility in a manner that enables it to use its resources effectively and efficiently.
Administration · complaint inspection		D
Potential for more than minimal harm, isolated
Aug 18, 2026Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with…
Quality of Life and Care · complaint inspection		J
Immediate jeopardy, isolated
Dec 5, 2025Ensure services provided by the nursing facility meet professional standards of quality.
Resident Assessment and Care Planning · complaint inspection		D
Potential for more than minimal harm, isolated
Dec 5, 2025Provide medically-related social services to help each resident achieve the highest possible quality of life.
Quality of Life and Care · complaint inspection		D
Potential for more than minimal harm, isolated
Nov 25, 2025Ensure services provided by the nursing facility meet professional standards of quality.
Resident Assessment and Care Planning · complaint inspection		D
Potential for more than minimal harm, isolated
Nov 25, 2025Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care · complaint inspection		G
Actual harm, isolated
Oct 24, 2025Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care · complaint inspection		G
Actual harm, isolated
Aug 20, 2025Develop 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 Planning · complaint inspection		D
Potential for more than minimal harm, isolated
Aug 20, 2025Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Nursing and Physician Services · complaint inspection		D
Potential for more than minimal harm, isolated
May 14, 2025Provide activities to meet all resident's needs.
Quality of Life and Care		D
Potential for more than minimal harm, isolated
May 14, 2025Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Quality of Life and Care		D
Potential for more than minimal harm, isolated

Showing the 12 most recent of 43. Full inspection reports are on Medicare Care Compare.

Severity letters follow CMS's scope-and-severity grid: A–C potential for minimal harm, D–F potential for more than minimal harm, G–I actual harm, J–L immediate jeopardy. Most citations are corrected; a citation is what inspectors found on that date. Source: CMS Health Deficiencies file, processed Oct 1, 2026.

Fines and payment denials

CMS records 4 fines totalling $93,296 in the last three years.

Aug 18, 2026Fine: $27,378
Aug 18, 2026Fine: $44,370
Nov 25, 2025Fine: $12,438
Oct 24, 2025Fine: $9,110

Source: CMS Penalties file, processed Oct 1, 2026. Amounts are as CMS reports them and may reflect later reductions or appeals.

Staffing

Total nurse staffing per resident per day
3.32 hours
Registered nurse (RN) time per resident per day
0.73 hours
Nurse aide time per resident per day
1.98 hours
Total nurse staffing on weekends
3.08 hours
Nursing staff turnover (yearly)
48%
RN turnover (yearly)
50%
Administrators who left in the past year
1

From payroll-based staffing data the facility submits to CMS. Hours are per resident per day.

A citation is what inspectors found on one date; most are corrected within weeks. Look for patterns — the same problem cited in several inspections — and for anything at the G–L level (actual harm or immediate jeopardy). The full inspection narrative (Form CMS-2567) is linked from Medicare Care Compare, and your state long-term care ombudsman can tell you about complaints.

Other nursing homes in Middletown

John Clarke Senior Living600 Valley Road · Middletown, RI 02842 · (401) 846-0743 · Nonprofit5 health citations in 3 inspection cycles · last standard inspection Apr 10, 2026 · $9,350 in CMS fines (3 yrs)Medicare & Medicaid certified3★ overall (CMS)
Royal Middletown Nursing Center193 Forest Avenue · Middletown, RI 02842 · (401) 847-2777 · For-profit26 health citations in 3 inspection cycles · last standard inspection Apr 30, 2026 · $19,884 in CMS fines (3 yrs)Medicare & Medicaid certified2★ overall (CMS)

All 3 in Middletown →

Public record, not an endorsement. This listing was compiled from public records as of 2026-11-07 and may be incomplete or out of date. Nursing Home Inspections does not vet, employ, recommend or guarantee nursing homes; a badge reflects only what the public record showed on that date. Confirm current details with the official record before you decide. The information on Nursing Home Inspections is not medical advice and does not replace a doctor, nurse, discharge planner or other qualified professional. Do not use it to make decisions about diagnosis or treatment. If you have a medical emergency, call 911. Full disclaimer · Report an error