Barnstable County, Massachusetts · Nursing home
Royal Nursing Center, LLC
3 of 5 overall from CMS
359 Jones Rd, Falmouth, MA 02540
At a glance
- Overall rating 3 of 5 Same as the state average of 3.0
- Nurse time per resident, per day 3.13 hours Below the state average of 3.86
- Nursing staff who left in a year 41.5% Above the state average of 38.2%
- Health citations, last 3 inspection cycles 21 1 at the harm level or above
- Fines in 3 years $8,278 1 fine
- Certified beds in use 87.0% of 121 beds, on an average day
Arrows only show whether a figure is above or below the state average. They are not a judgment of the home.
Royal Nursing Center, LLC is a 121-bed nursing home in Falmouth, Massachusetts (Barnstable County). CMS rates it 3 of 5 stars overall as of Sep 2026. It reports 3.13 nurse staffing hours per resident per day, below the Massachusetts average of 3.86. CMS lists 1 fine totaling $8,278 in the past three years.
- Certified beds
- 121
- Residents per day (average)
- 105.3
- Certified since
- 1990 (36 yrs)
For profit - Limited Liability company Participates in Medicare and MedicaidPart of Royal Health Group (12 homes)
Bed use is this site's calculation: average residents per day divided by certified beds. It is an average, so it does not show today's openings.
Terms used on this page
- CMS
- The Centers for Medicare & Medicaid Services, the federal agency that publishes the ratings, staffing figures, inspection results and penalties shown here.
- Certified beds
- The number of federally certified beds CMS lists for the home.
- Deficiency or citation
- A federal requirement that inspectors found the home did not meet. Each one gets a letter from A to L for how serious it was and how many residents were affected. What the letters mean
- Actual harm
- Letters G, H and I: actual harm to a resident that is not immediate jeopardy.
- Immediate jeopardy
- Letters J, K and L: the problem caused, or was likely to cause, serious injury, harm, impairment or death to a resident.
- Inspection cycle
- A standard inspection plus the complaint and infection-control citations CMS assigns to it. This page shows the three most recent cycles.
- Special Focus Facility (SFF)
- A home CMS has placed under closer oversight because of its inspection record. More about the program
Questions to ask Royal Nursing Center, LLC
Chosen from this home's public data.
- CMS lists 1 fine totaling $8,278 in the past three years. What changed after the most recent one?Penalties in CMS data
- CMS counts 7 health deficiencies in the latest inspection cycle (the standard inspection on Dec 18, 2025 plus complaint and infection-control inspections); the Massachusetts average is 6.8. Which have been corrected?Inspection results in CMS data
- Nursing staff turnover is 41.5%, above the Massachusetts average of 38.2%. How often would the same aides care for my relative?Turnover in CMS data
More in what to ask on a nursing home tour.
CMS star ratings
- Overall 3 of 5 Massachusetts average 3.0
- Health inspections 3 of 5 Massachusetts average 3.0
- Staffing 3 of 5 Massachusetts average 3.1
- Quality measures 4 of 5 Massachusetts average 3.3
The vertical line marks the Massachusetts average. Ratings run from 1 to 5. How to read CMS star ratings
Nurse staffing
Hours of care per resident per day, as the home reported to CMS.
What these roles do
Nurse aides give most hands-on daily care, such as help with bathing, dressing and meals. Licensed practical nurses give medications and routine nursing care. Registered nurses assess residents and direct their care.
- All nursing staff 3.13 h Massachusetts average 3.86
- Nurse aides 1.69 h Massachusetts average 2.25
- Licensed practical nurses 0.77 h Massachusetts average 0.95
- Registered nurses 0.66 h Massachusetts average 0.65
- All staff, weekends 2.83 h Massachusetts average 3.48
How much nurse staffing is enough? All bars share one scale, 0 to 9 hours. The vertical line marks the Massachusetts average; the national average for all nursing staff is 3.86 hours.
- Nursing staff turnover41.5%
- Massachusetts average38.2%
- Registered nurse turnover44.4%
- Massachusetts average42.6%
- Administrators who left0
Quality measures
CMS calculates these from residents' assessments and Medicare claims. They are shown as published, next to the Massachusetts and national averages. marks the measures CMS uses in its quality star rating; for those, the rating gives more points for a lower rate.
Long-stay residents
| Measure | This home | Massachusetts | U.S. |
|---|---|---|---|
| ★ Percentage of long-stay residents whose need for help with daily activities has increased | 12.0% | 16.4% | 13.9% |
| Percentage of long-stay residents who lose too much weight | 3.5% | 5.1% | 5.2% |
| ★ Percentage of long-stay residents with a catheter inserted and left in their bladder | 0.0% | 0.8% | 0.8% |
| ★ Percentage of long-stay residents with a urinary tract infection | 3.1% | 1.8% | 1.6% |
| Percentage of long-stay residents who have depressive symptoms | 26.3% | 15.5% | 12.8% |
| Percentage of long-stay residents who were physically restrained | 0.0% | 0.1% | 0.1% |
| ★ Percentage of long-stay residents experiencing one or more falls with major injury | 3.3% | 3.4% | 3.2% |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 92.4% | 92.6% | 93.6% |
| ★ Percentage of long-stay residents whose ability to walk independently worsened | 14.8% | 15.4% | 14.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 6.5% | 19.5% | 19.5% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 100.0% | 94.8% | 95.5% |
| ★ Percentage of long-stay residents with pressure ulcers | 4.1% | 4.2% | 4.6% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 22.8% | 21.2% | 19.0% |
| ★ Percentage of long-stay residents who received an antipsychotic medication | 19.5% | 21.4% | 15.4% |
| ★ Number of hospitalizations per 1000 long-stay resident days | 1.66 | 1.88 | 1.90 |
| ★ Number of outpatient emergency department visits per 1000 long-stay resident days | 0.56 | 1.50 | 1.78 |
Short-stay residents
| Measure | This home | Massachusetts | U.S. |
|---|---|---|---|
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 77.1% | 78.3% | 82.0% |
| ★ Percentage of short-stay residents who newly received an antipsychotic medication | 0.5% | 1.4% | 1.6% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 92.6% | 77.7% | 79.8% |
| ★ Percentage of short-stay residents who were rehospitalized after a nursing home admission | 30.7% | 25.7% | 23.8% |
| ★ Percentage of short-stay residents who had an outpatient emergency department visit | 11.4% | 11.9% | 12.0% |
Measure periods: April 2025 to March 2026 for most measures; July 2024 to June 2025 for the flu vaccine measures; January to December 2025 for the hospital and emergency department measures, which CMS risk-adjusts. See the measures on Medicare.gov
Inspection history
Inspectors cited 21 health deficiencies in the three most recent inspection cycles. Of these, 1 involved actual harm; the rest were graded as no actual harm. 4 were cited in connection with a complaint investigation. The most recent citation at the harm level or above was on Apr 8, 2025: Ensure that residents are free from significant medication errors.
| Standard inspection | Health | Fire safety |
|---|---|---|
| Dec 18, 2025 | 7 | 12 |
| Sep 17, 2024 | 4 | 5 |
| Jun 8, 2023 | 10 | 3 |
Massachusetts homes averaged 6.8 health deficiencies in the latest cycle; the national average is 9.2. Each cycle's health count covers the standard inspection on that date plus the complaint and infection-control citations CMS assigns to that cycle.
Health citations, three most recent inspection cycles (21)
-
EPotential for more than minimal harm, pattern
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Nutrition and Dietary · Deficient, Provider has date of correction (Jan 21, 2026)
-
DPotential for more than minimal harm, isolated
Ensure services provided by the nursing facility meet professional standards of quality.
Resident Assessment and Care Planning · Deficient, Provider has date of correction (Jan 21, 2026)
-
DPotential for more than minimal harm, isolated
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care · Deficient, Provider has date of correction (Jan 21, 2026)
-
DPotential for more than minimal harm, isolated
Provide and implement an infection prevention and control program.
Infection Control · Deficient, Provider has date of correction (Jan 21, 2026)
-
DPotential for more than minimal harm, isolated
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Complaint investigation · Resident Assessment and Care Planning · Deficient, Provider has date of correction (Oct 9, 2025)
Show 16 more
-
DPotential for more than minimal harm, isolated
Provide safe, appropriate pain management for a resident who requires such services.
Complaint investigation · Quality of Life and Care · Deficient, Provider has date of correction (Sep 17, 2025)
-
DPotential for more than minimal harm, isolated
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Complaint investigation · Resident Assessment and Care Planning · Deficient, Provider has date of correction (Sep 19, 2025)
-
GActual harm, isolated
Ensure that residents are free from significant medication errors.
Complaint investigation · Pharmacy Service · Past Non-Compliance (Apr 1, 2025)
-
DPotential for more than minimal harm, isolated
Honor 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 Rights · Deficient, Provider has date of correction (Oct 11, 2024)
-
DPotential for more than minimal harm, isolated
Develop 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 · Deficient, Provider has date of correction (Oct 11, 2024)
-
DPotential for more than minimal harm, isolated
Provide and implement an infection prevention and control program.
Infection Control · Deficient, Provider has date of correction (Oct 11, 2024)
-
EPotential for more than minimal harm, pattern
Provide activities to meet all resident's needs.
Quality of Life and Care · Deficient, Provider has date of correction (Jun 20, 2023)
-
EPotential for more than minimal harm, pattern
Ensure the activities program is directed by a qualified professional.
Quality of Life and Care · Deficient, Provider has date of correction (Jun 20, 2023)
-
EPotential for more than minimal harm, pattern
Provide 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 Care · Deficient, Provider has date of correction (Jun 20, 2023)
-
EPotential for more than minimal harm, pattern
Ensure that the resident and his/her doctor meet face-to-face at all required visits.
Nursing and Physician Services · Deficient, Provider has date of correction (Jun 20, 2023)
-
EPotential for more than minimal harm, pattern
Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times.
Nutrition and Dietary · Deficient, Provider has date of correction (Jun 20, 2023)
-
EPotential for more than minimal harm, pattern
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary · Deficient, Provider has date of correction (Jun 20, 2023)
-
DPotential for more than minimal harm, isolated
PASARR screening for Mental disorders or Intellectual Disabilities
Resident Assessment and Care Planning · Deficient, Provider has date of correction (Jul 7, 2023)
-
DPotential for more than minimal harm, isolated
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Resident Assessment and Care Planning · Deficient, Provider has date of correction (Jun 20, 2023)
-
DPotential for more than minimal harm, isolated
Develop 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 · Deficient, Provider has date of correction (Jun 20, 2023)
-
BPotential for minimal harm, pattern
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Resident Rights · Deficient, Provider has date of correction (Jun 20, 2023)
What severity letters A to L mean
Each sentence above is the requirement that was not met, in CMS's wording. For the inspection results as Medicare publishes them, open this home's page on Medicare.gov and look under "Health inspections".
Penalties, past three years
| Date | Type | Amount |
|---|---|---|
| Apr 8, 2025 | Fine | $8,278 |
Massachusetts homes averaged 0.8 fines and $34,265 in fine amounts; the national averages are 0.9 and $30,972.
Cost
Not in the public data. CMS does not publish what a nursing home charges.
Ask the home for its daily private-pay rate and whether a bed is open for your coverage. See what Medicare covers and how Medicaid pays for a nursing home.
Compared within Massachusetts
- Size184 of 341 by certified beds
- Massachusetts average residents per day98.5
- ChainRoyal Health Group
- Chain average overall rating3.2 of 5
- Resident or family councilResident
- Homes in Barnstable County15
Common questions
What is the CMS star rating for Royal Nursing Center, LLC?
Royal Nursing Center, LLC has an overall rating of 3 of 5 stars from CMS as of Sep 2026. Its health inspection rating is 3, staffing is 3 and quality measures is 4.
How many beds does Royal Nursing Center, LLC have?
Royal Nursing Center, LLC has 121 certified beds. It averages 105.3 residents per day, about 87.0% of its certified beds.
How much nursing care do residents get at Royal Nursing Center, LLC?
The home reports 3.13 hours of nurse staffing per resident per day, including 0.66 hours from registered nurses. The Massachusetts average is 3.86 hours and 0.65 hours from registered nurses.
Has Royal Nursing Center, LLC been fined?
Yes. CMS lists 1 fine totaling $8,278 in the past three years.
Does Royal Nursing Center, LLC accept Medicare or Medicaid?
CMS lists its participation as "Medicare and Medicaid". Ask the home whether a bed is open for your coverage.
Guides for families looking at this home
- Understanding the recordWhat to ask on a nursing home tourQuestions that turn a home's public record into a useful conversation when you tour, plus what to look for yourself.
- Understanding the recordInspection severity letters A to LHow inspectors grade each deficiency by harm and by how many residents were affected.
- Understanding the recordHow to read CMS star ratingsWhat the overall, health inspection, staffing and quality measure ratings cover, and what they leave out.
Nearest nursing homes
- 1 of 5 Jml Care Center Inc 132beds 67.7%in use 2.92nurse hours a day
- 4 of 5 Royal Megansett Nursing & Rehabilitation 90beds 72.9%in use 3.92nurse hours a day
- 2 of 5 Royal of Cotuit 120beds 61.0%in use 3.32nurse hours a day
Sorted by straight-line distance. This is not a ranking or a recommendation. Compare all homes in Barnstable County
Who to call in Massachusetts
These offices serve residents of every nursing home in Massachusetts.
- Long-term care ombudsman Massachusetts Long-Term Care Ombudsman Program 617-222-7495 (Long-Term Care Ombudsman line listed on the state's nursing and rest home ombudsman page. Local ombudsman programs are listed by city/town on the same page. MassOptions: 800-243-4636.) An advocate for residents and their families.
- File a complaint about a nursing home Complaint Intake Unit, Division of Health Care Facility Licensure and Certification 800-462-5540 (24-hour Consumer Complaint Line. Main Intake Number 617-753-8150 (during business hours). Fax 617-753-8165. Mail: Complaint Intake Unit, 67 Forest Street, Marlborough, MA 01752. No online form; email is not accepted for complaint materials.) The state agency that inspects nursing homes.
Massachusetts staffing, bed-hold and Medicaid rules · Residents' rights in every state
Source: CMS Provider Data Catalog, nursing home datasets processed Sep 1, 2026. CMS Certification Number 225459. See this home's official record on Medicare.gov
See something shown incorrectly? Tell us. This site shows each record as CMS publishes it and cannot change the underlying record.