Berrien County, Michigan · Nursing home
Royalton Manor, LLC
1 of 5 overall from CMS
288 Peace Blvd, St Joseph, MI 49085
At a glance
- Overall rating 1 of 5 Below the state average of 3.1
- Nurse time per resident, per day 3.29 hours Below the state average of 3.99
- Nursing staff who left in a year 44.6% Above the state average of 44.1%
- Health citations, last 3 inspection cycles 60 3 at the harm level or above
- Fines in 3 years $173,966 2 fines
- Certified beds in use 91.5% of 123 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.
Royalton Manor, LLC is a 123-bed nursing home in St Joseph, Michigan (Berrien County). CMS rates it 1 of 5 stars overall as of Sep 2026. It reports 3.29 nurse staffing hours per resident per day, below the Michigan average of 3.99. CMS lists 2 fines totaling $173,966 in the past three years.
- Certified beds
- 123
- Residents per day (average)
- 112.5
- Certified since
- 2007 (19 yrs)
For profit - Corporation Participates in Medicare and MedicaidPart of Ciena Healthcare/laurel Health Care (81 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 Royalton Manor, LLC
Chosen from this home's public data.
- CMS lists 2 fines totaling $173,966 in the past three years. What changed after the most recent one?Penalties in CMS data
- CMS counts 21 health deficiencies in the latest inspection cycle (the standard inspection on Apr 16, 2025 plus complaint and infection-control inspections); the Michigan average is 9.9. Which have been corrected?Inspection results in CMS data
- Nursing staff turnover is 44.6%, above the Michigan average of 44.1%. 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 1 of 5 Michigan average 3.1
- Health inspections 1 of 5 Michigan average 2.8
- Staffing 3 of 5 Michigan average 3.6
- Quality measures 3 of 5 Michigan average 3.9
The vertical line marks the Michigan 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 3.29 h Michigan average 3.99
- Nurse aides 1.83 h Michigan average 2.33
- Licensed practical nurses 0.69 h Michigan average 0.88
- Registered nurses 0.77 h Michigan average 0.78
- All staff, weekends 2.77 h Michigan average 3.50
How much nurse staffing is enough? All bars share one scale, 0 to 8 hours. The vertical line marks the Michigan average; the national average for all nursing staff is 3.86 hours.
- Nursing staff turnover44.6%
- Michigan average44.1%
- Registered nurse turnover58.3%
- Michigan average39.2%
- Administrators who left0
Quality measures
CMS calculates these from residents' assessments and Medicare claims. They are shown as published, next to the Michigan 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 | Michigan | U.S. |
|---|---|---|---|
| ★ Percentage of long-stay residents whose need for help with daily activities has increased | 28.6% | 10.8% | 13.9% |
| Percentage of long-stay residents who lose too much weight | 5.8% | 5.4% | 5.2% |
| ★ Percentage of long-stay residents with a catheter inserted and left in their bladder | 0.8% | 0.8% | 0.8% |
| ★ Percentage of long-stay residents with a urinary tract infection | 0.6% | 1.5% | 1.6% |
| Percentage of long-stay residents who have depressive symptoms | 3.7% | 4.3% | 12.8% |
| Percentage of long-stay residents who were physically restrained | 0.3% | 0.1% | 0.1% |
| ★ Percentage of long-stay residents experiencing one or more falls with major injury | 3.6% | 3.0% | 3.2% |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 98.9% | 95.3% | 93.6% |
| ★ Percentage of long-stay residents whose ability to walk independently worsened | 37.8% | 12.0% | 14.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 17.4% | 19.4% | 19.5% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 93.3% | 95.0% | 95.5% |
| ★ Percentage of long-stay residents with pressure ulcers | 7.1% | 5.1% | 4.6% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 28.5% | 20.0% | 19.0% |
| ★ Percentage of long-stay residents who received an antipsychotic medication | 7.3% | 14.8% | 15.4% |
| ★ Number of hospitalizations per 1000 long-stay resident days | 2.80 | 1.84 | 1.90 |
| ★ Number of outpatient emergency department visits per 1000 long-stay resident days | 1.33 | 1.64 | 1.78 |
Short-stay residents
| Measure | This home | Michigan | U.S. |
|---|---|---|---|
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 87.9% | 83.3% | 82.0% |
| ★ Percentage of short-stay residents who newly received an antipsychotic medication | 0.0% | 1.1% | 1.6% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 59.0% | 79.5% | 79.8% |
| ★ Percentage of short-stay residents who were rehospitalized after a nursing home admission | 25.3% | 24.0% | 23.8% |
| ★ Percentage of short-stay residents who had an outpatient emergency department visit | 6.9% | 11.7% | 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 60 health deficiencies in the three most recent inspection cycles. Of these, 3 involved actual harm; the rest were graded as no actual harm. 28 were cited in connection with a complaint investigation. The most recent citation at the harm level or above was on Apr 16, 2025: Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
| Standard inspection | Health | Fire safety |
|---|---|---|
| Apr 16, 2025 | 21 | 5 |
| Apr 3, 2024 | 25 | 4 |
| Apr 5, 2023 | 14 | 7 |
Michigan homes averaged 9.9 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 (60)
-
FPotential for more than minimal harm, widespread
Provide and implement an infection prevention and control program.
Complaint investigation · Infection Control · Deficient, Provider has plan of correction (Aug 17, 2026)
-
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.
Complaint investigation · Quality of Life and Care · Deficient, Provider has plan of correction (Aug 17, 2026)
-
DPotential for more than minimal harm, isolated
Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.
Complaint investigation · Resident Rights · Deficient, Provider has plan of correction (Aug 17, 2026)
-
DPotential for more than minimal harm, isolated
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
Complaint investigation · Quality of Life and Care · Deficient, Provider has plan of correction (Aug 17, 2026)
-
FPotential for more than minimal harm, widespread
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
Complaint investigation · Nutrition and Dietary · Deficient, Provider has date of correction (Apr 14, 2026)
Show 25 more
-
FPotential for more than minimal harm, widespread
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Complaint investigation · Nutrition and Dietary · Deficient, Provider has date of correction (Apr 14, 2026)
-
DPotential for more than minimal harm, isolated
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Complaint investigation · Resident Rights · Deficient, Provider has date of correction (Apr 14, 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.
Complaint investigation · Quality of Life and Care · Deficient, Provider has date of correction (Apr 14, 2026)
-
DPotential for more than minimal harm, isolated
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Complaint investigation · Nutrition and Dietary · Deficient, Provider has date of correction (Apr 14, 2026)
-
DPotential for more than minimal harm, isolated
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Complaint investigation · Nursing and Physician Services · Past Non-Compliance (May 28, 2025)
-
GActual harm, isolated
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
Freedom from Abuse, Neglect, and Exploitation · Deficient, Provider has date of correction (May 13, 2025)
-
FPotential for more than minimal harm, widespread
Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
Nutrition and Dietary · Deficient, Provider has date of correction (May 13, 2025)
-
FPotential for more than minimal harm, widespread
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 (May 13, 2025)
-
EPotential for more than minimal harm, pattern
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Resident Rights · Deficient, Provider has date of correction (May 13, 2025)
-
EPotential for more than minimal harm, pattern
Ensure services provided by the nursing facility meet professional standards of quality.
Resident Assessment and Care Planning · Deficient, Provider has date of correction (May 13, 2025)
-
EPotential for more than minimal harm, pattern
Ensure 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 · Deficient, Provider has date of correction (May 13, 2025)
-
EPotential for more than minimal harm, pattern
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Pharmacy Service · Deficient, Provider has date of correction (May 13, 2025)
-
EPotential for more than minimal harm, pattern
Provide and implement an infection prevention and control program.
Infection Control · Deficient, Provider has date of correction (May 13, 2025)
-
DPotential for more than minimal harm, isolated
Provide enough food/fluids to maintain a resident's health.
Quality of Life and Care · Deficient, Provider has date of correction (May 13, 2025)
-
DPotential for more than minimal harm, isolated
Provide for the safe, appropriate administration of IV fluids for a resident when needed.
Quality of Life and Care · Deficient, Provider has date of correction (Jun 12, 2025)
-
DPotential for more than minimal harm, isolated
Develop and implement policies and procedures for flu and pneumonia vaccinations.
Infection Control · Deficient, Provider has date of correction (May 13, 2025)
-
DPotential for more than minimal harm, isolated
Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.
Infection Control · Deficient, Provider has date of correction (May 13, 2025)
-
DPotential for more than minimal harm, isolated
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Complaint investigation · Resident Rights · Deficient, Provider has date of correction (Mar 18, 2025)
-
DPotential for more than minimal harm, isolated
Ensure services provided by the nursing facility meet professional standards of quality.
Complaint investigation · Resident Assessment and Care Planning · Deficient, Provider has date of correction (Mar 18, 2025)
-
DPotential for more than minimal harm, isolated
Provide appropriate colostomy, urostomy, or ileostomy care/services for a resident who requires such services.
Complaint investigation · Quality of Life and Care · Deficient, Provider has date of correction (Mar 18, 2025)
-
GActual harm, isolated
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Complaint investigation · Quality of Life and Care · Deficient, Provider has date of correction (Oct 29, 2024)
-
DPotential for more than minimal harm, isolated
Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged.
Complaint investigation · Resident Rights · Deficient, Provider has date of correction (Sep 4, 2024)
-
DPotential for more than minimal harm, isolated
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Complaint investigation · Resident Rights · Deficient, Provider has date of correction (Sep 4, 2024)
-
DPotential for more than minimal harm, isolated
Ensure services provided by the nursing facility meet professional standards of quality.
Complaint investigation · Resident Assessment and Care Planning · Deficient, Provider has date of correction (Sep 4, 2024)
-
DPotential for more than minimal harm, isolated
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Complaint investigation · Quality of Life and Care · Deficient, Provider has date of correction (Sep 4, 2024)
Showing the 30 most recent of 60.
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 16, 2025 | Fine | $121,186 |
| Apr 16, 2025 | Payment Denial | 29 days |
| Oct 3, 2024 | Fine | $52,780 |
Michigan homes averaged 0.7 fines and $29,376 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 Michigan
- Size129 of 422 by certified beds
- Michigan average residents per day85.9
- ChainCiena Healthcare/laurel Health Care
- Chain average overall rating2.8 of 5
- Resident or family councilResident
- Homes in Berrien County7
Common questions
What is the CMS star rating for Royalton Manor, LLC?
Royalton Manor, LLC has an overall rating of 1 of 5 stars from CMS as of Sep 2026. Its health inspection rating is 1, staffing is 3 and quality measures is 3.
How many beds does Royalton Manor, LLC have?
Royalton Manor, LLC has 123 certified beds. It averages 112.5 residents per day, about 91.5% of its certified beds.
How much nursing care do residents get at Royalton Manor, LLC?
The home reports 3.29 hours of nurse staffing per resident per day, including 0.77 hours from registered nurses. The Michigan average is 3.99 hours and 0.78 hours from registered nurses.
Has Royalton Manor, LLC been fined?
Yes. CMS lists 2 fines totaling $173,966 in the past three years. It also lists 1 payment denial.
Does Royalton Manor, 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
- 4 of 5 Coventry House Inn 32beds 89.7%in use 4.37nurse hours a day
- 2 of 5 Corewell Health Rehabilitation & Nursing Center - 111beds 87.8%in use 4.15nurse hours a day
- 1 of 5 West Woods of Bridgman 92beds 84.8%in use 3.96nurse hours a day
Sorted by straight-line distance. This is not a ranking or a recommendation. Compare all homes in Berrien County
Who to call in Michigan
These offices serve residents of every nursing home in Michigan.
- Long-term care ombudsman Michigan Long Term Care Ombudsman Program (MLTCOP) 1-866-485-9393 (Toll-free line to reach a local ombudsman. Program office: 517-827-8040; email MLTCOP@meji.org.) An advocate for residents and their families.
- File a complaint about a nursing home Complaint Intake Unit (Complaint Hotline) 800-882-6006 (Toll-free Complaint Hotline. Complaints can also be filed with the online form (https://apps.lara.state.mi.us/BscComplaintIntakeForm) or by mail: LARA, Bureau of Survey and Certification-Complaint Intake Section, PO Box 30838, Lansing, MI 48909.) The state agency that inspects nursing homes.
Michigan 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 235623. 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.