Grand Islander Center
Grand Islander Center
4.3 (112 reviews)
Skilled Nursing Facility • 146 Licensed Beds
333 Green End Avenue, Middletown, RI
CMS Medicare Ratings
Overall
Inspection
Staffing
Quality
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Grand Islander Center

Skilled Nursing Facility • 146 Licensed Beds
333 Green End Avenue,
Middletown, RI
CMS Medicare Ratings
Overall
Inspection
Staffing
Quality
View details →
About

Grand Islander Center – Medicare Certified Since 1975

Grand Islander Center is a Medicare and Medicaid certified skilled nursing facility located in Middletown, Rhode Island. This is a for profit - corporation facility that has been serving the community for 51 years. A Medicare-certified skilled nursing facility provides 24-hour nursing care, rehabilitation services, and assistance with activities of daily living for patients who need skilled nursing or rehabilitation services on a daily basis.

This facility has 146 certified beds with a current occupancy rate of 76% (averaging 111 residents per day), which is moderate. Skilled nursing facilities provide 24-hour nursing care for patients who need rehabilitation services after a hospital stay or ongoing care for chronic conditions. Services include skilled nursing, physical therapy, occupational therapy, speech therapy, and assistance with daily activities.

Staffing Levels: Based on CMS payroll data, this facility provides approximately 3.55 hours of total nursing care per resident per day (2.17 hours from CNAs, 0.66 hours from LPNs, 0.72 hours from RNs). Physical therapy staffing is 0.07 hours per resident per day.

Medicare Quality Ratings: According to CMS, Grand Islander Center has an overall quality rating of 2 out of 5 stars, which is below average compared to other nursing homes nationwide. Individual category ratings are: health inspection: 2 stars, staffing: 3 stars, quality measures: 3 stars.

Medicare Coverage: Medicare covers skilled nursing facility care for up to 100 days following a qualifying hospital stay of at least 3 days. Days 1-20 are fully covered by Medicare, days 21-100 require a daily coinsurance payment. Many residents also use Medicaid, private insurance, or pay privately for long-term stays.

Questions to Ask: When visiting a nursing home, ask about: staff-to-resident ratios and RN coverage around the clock, how they handle medical emergencies, activities and therapy programs, how they communicate with families, their approach to falls prevention, and policies for managing resident complaints.

Visit Medicare Care Compare to view detailed ratings, inspection reports, staffing data, and compare this facility with others in the area.

Quality ratings and facility data are updated periodically by CMS. We recommend verifying current information at Medicare Care Compare.

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Local Comparison Snapshot

How Grand Islander Center compares to 105 facilities in Providence-Warwick, RI-MA

Click a measure name to jump to details • Hover over for definitions

Measure
This Facility
Area Avg
Comparison
Overall Rating
Medicare 5-star rating
2
2.8
Quality Measures
Clinical outcomes & safety
3
3.1
Health Inspections
State survey results
2
2.8
Staffing
Nurse-to-resident ratio
3
3.1
Staffing Hours (per resident/day)
RN Hours
Registered nurses
0.72 hrs
0.73 hrs
LPN/LVN Hours
Licensed practical nurses
0.66 hrs
0.60 hrs
CNA Hours
Certified nursing assistants
2.17 hrs
2.41 hrs
Total Nursing Hours
CNA + LPN + RN combined
3.54 hrs
3.75 hrs
Agency/Contractor Usage
Lower agency use often indicates more stable, consistent care
RN Agency Use
% of RN hours from contractors
10 %
8.3 %
LPN/LVN Agency Use
% of LPN hours from contractors
55.2 %
10.2 %
CNA Agency Use
% of CNA hours from contractors
27.5 %
5.2 %
Staff Stability & Occupancy
Staff Turnover
Annual nursing staff turnover
46 %
40 %
Occupancy Rate
Percentage of beds filled
76 %
83 %
Financial Estimate
Based on CMS Cost Report data (for reference only)
Est. Daily Rate
Average cost per day
$471
$445
Estimate Only: This figure is calculated from cost reports and is for informational purposes only. Actual rates vary significantly. See details or contact the facility.
Better than Area
Near Average
Below Area Average

Data from CMS Medicare Compare and Payroll-Based Journal. Area averages based on 105 facilities in Providence-Warwick, RI-MA.
Ratings and staffing data typically reflect the most recent quarterly reporting period available.

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Medicare Star Ratings

Official CMS ratings based on health inspections, staffing, and quality measures

Data as of March 2026

What do Medicare star ratings measure?
Medicare rates nursing homes on a 1-5 star scale based on three key areas: health inspection results, staffing levels, and quality measures like falls and infections.
How often are ratings updated?
CMS updates nursing home ratings monthly. Ratings can change based on new inspection results, staffing data from payroll records, and clinical quality outcomes.
Overall Rating
2/5
Quality Measures
3/5
Health Inspections
2/5
Staffing
3/5

Star Ratings History

Quarterly performance from 2013-2026

View on Medicare.gov
Overall
Health Inspections
Quality
Staffing
Source: Centers for Medicare & Medicaid Services

How Does This Facility Compare?

Compared to 105 other nursing homes in Providence-Warwick, RI-MA

Why compare to local facilities?
Local comparisons account for regional staffing markets and demographics. A facility performing above local averages often indicates strong management and quality care relative to area standards.
Grand Islander Center
Providence-Warwick, RI-MA Average

Based on CMS Medicare star ratings. Higher ratings indicate better performance.

Staffing Hours per Resident Day

Grand Islander Center
Providence-Warwick, RI-MA Average

Staffing data from CMS Payroll-Based Journal. Higher hours generally indicate more direct care time.

Staff Turnover Rate

Grand Islander Center
Providence-Warwick, RI-MA Average

Lower turnover rates generally indicate a more stable workforce and better continuity of care.

Agency/Contract Staff Usage

Grand Islander Center
Providence-Warwick, RI-MA Average

Lower agency usage often indicates better staff retention. High agency rates (>30%) may suggest staffing challenges.

Agency Staff Trends

Historical agency/contract staff usage by role

What does agency usage indicate?
Agency/contract staff fill temporary staffing gaps. Lower percentages typically indicate a stable, permanent workforce. Facilities with consistently high agency usage (>30%) may face staff retention challenges, though temporary spikes can occur during seasonal illness or transitions.
CNA
LPN
RN

Data from CMS Payroll-Based Journal (PBJ). Agency % = contractor hours / total hours.

Direct Care Staffing

Average minutes of direct nursing care per resident per day

Data as of March 2026

Understanding staffing levels: Higher staffing is associated with better quality outcomes. Research suggests around 4.1 hours of total nursing care per resident per day as a quality benchmark. Compare this facility's staffing to local averages to assess relative care levels.
130
minutes/day
CNAs
Certified Nursing Assistants
39
minutes/day
LPNs
Licensed Practical Nurses
43
minutes/day
RNs
Registered Nurses
4
minutes/day
PTs
Physical Therapists

Staffing Trends

Direct care minutes per resident per day

CNAs
LPNs
RNs
PTs
Source: Centers for Medicare & Medicaid Services

Occupancy Rate History

Average daily residents as a percentage of certified beds

Understanding occupancy: Higher occupancy can indicate strong community reputation and demand. Very low occupancy may affect financial stability, while extremely high occupancy could mean limited bed availability.
Grand Islander Center
Providence-Warwick, RI-MA Average (83%)

Data from CMS Provider Info files. Occupancy = Average Residents per Day / Certified Beds.

Staff Turnover History

Annual percentage of nursing staff who left the facility

Data as of March 2026

Understanding turnover: Lower turnover rates generally indicate a more stable workforce and better continuity of care. High turnover can affect care quality and resident relationships. The national average for nursing homes is around 50-60%.
All Nursing Staff
Registered Nurses (RN)
Area Average

Data from CMS Payroll-Based Journal. Turnover = staff who left during the year / total staff.

Average Daily Rate

Average daily charge for care at this facility

Based on CMS Cost Report data (inpatient revenue ÷ total patient days)

FY 2023 Daily Rate
$471
per resident per day
Compared to 103 facilities in your area
Above local median ($445)
Daily Rate Trend (2018-2023)
Contact Facility for Actual Rates
This figure is an average calculated from cost reports and is for informational purposes only. Actual rates vary significantly based on level of care needed, room type, payer source (Medicare, Medicaid, private pay), and other factors. Please contact the facility directly for current pricing and availability.
How This Is Calculated
This average daily rate is calculated from CMS Cost Reports by dividing total inpatient revenue by total patient days. It represents an average across all payers and care levels. Higher rates may indicate more intensive care, specialized services, or regional cost factors.

Data Source: Financial data from CMS Skilled Nursing Facility Cost Reports. Data typically lags 1-2 years. This information is for educational purposes only and should not be the sole basis for financial or care decisions. CareListings does not guarantee accuracy.

Financial Health

Comprehensive financial indicators from CMS Cost Reports

Data from fiscal year 2023 (most recent available - cost report data lags ~2 years)

For-Profit Facility

Financial Summary

Metric This Facility Local Median Comparison
Operating Margin
Profitability ratio
-4% -6% Above
Net Income
Annual profit or loss
$-55,249 $-182,634.5 Above
Staff Cost per Resident
Daily salary expense per resident
$160/day $169/day Lower
Occupancy Rate
Bed utilization percentage
76% 86% Lower
Est. Daily Rate
Average revenue per patient day
$471/day $445/day Higher
Total Beds
Licensed bed capacity
146 120 Larger

Local comparisons based on 103 skilled nursing facilities in the Providence-Warwick, RI-MA metro area

Revenue & Expenses

Net Patient Revenue
After adjustments & allowances
$15,568,448
Operating Expenses
Total operating costs
$16,166,303
Total Salaries
Staff compensation
$6,811,840
Contract Labor
Agency & temp staff
$3,932,078

Payer Mix

Medicare
12%
Medicaid
60%
Private Pay & Other
28%

Operating Margin Trend (2018-2023)

Understanding Financial Health
Operating Margin: Percentage of revenue remaining after operating costs. Positive = profitable operations.
Staff Investment: Higher spending per resident often correlates with better care quality.
Payer Mix: Shows revenue sources. Higher Medicare % typically means more post-acute/rehab care; higher Medicaid % indicates more long-term care residents.
Nonprofit/Government: May operate with lower margins while still providing quality care due to community mission.

Data Source: All financial data on this page comes from CMS Skilled Nursing Facility Cost Reports submitted by the facility to the Centers for Medicare & Medicaid Services. This information is provided for educational purposes only and should not be the sole basis for any financial or care decisions. Cost report data typically lags 1-2 years. CareListings does not guarantee the accuracy of this data.

Who Stays Here

Breakdown of residents by payment type

Based on fiscal year 2023 cost report data

Total Days
42,522
Medicare
Short-term skilled nursing
12%
Medicaid
Long-term care residents
60%
Private Pay / Other
Self-pay, insurance, VA
28%
Higher Medicare %
Indicates more short-term rehabilitation residents. Medicare typically covers up to 100 days of skilled nursing care after a hospital stay.
Higher Medicaid %
Indicates more long-term care residents. Medicaid covers nursing home care for those who qualify financially.

Average Length of Stay

How long residents typically stay at this facility

Based on fiscal year 2023 cost report data

Overall Average
109.88
days
Medicare Stays
39.52
days
Medicaid Stays
398.53
days
Total Admissions
406
Total Discharges
387
Medicare (Short-Term)
Medicare covers skilled nursing for rehabilitation after a hospital stay. Typical stays are 20-30 days for recovery from surgery, stroke, or illness.
Medicaid (Long-Term)
Medicaid covers long-term nursing home care for those who qualify. Many residents stay months or years, receiving ongoing daily care and support.

Services

Comprehensive skilled nursing services, rehabilitation programs, and medical care in MIDDLETOWN

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MIDDLETOWN, RI
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Reviews

4.3 (112 reviews)
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Sachiko Furukawa's profile photo

I wasn't going to go into detail but to my surprise, they looked through their patients, cross-referencing my last name and called my mother to push for details. I do not appreciate this. - No roommate (which was good) but I went to sit in the other chair in the room but it had a red-brown stain on the seat that appeared like a bloodstain. - Could be a patient's condition but every other time I walked down the hall I heard someone screaming, "help me! someone help me!". If this is a special case, a note on the outside of the room may put people at ease. - Some patients/residents (unsure which) were left in a wheelchair in the middle of the hallway unattended. Perhaps just for a few minutes, I am not sure but I felt this was a safety/fire hazard. - Strong odor in hallway. Could be something that cannot be helped, but I have visited many such facilities before and this was a first. - Room run down, old peeling furniture. I fixed the curtains because they were not hung up properly. I get people are busy, but no bonus for facilities. - Staff appeared generally apathetic. I do not blame them as it's a tough job, but no bonus for friendliness. There are many wings/sections of this place and I only saw one. Perhaps the others are better. I visited approximately 12-15 times over the course of 2 weeks. This is just my perception and opinion based on comparison with other similar facilities that I have seen.

Heather Rousseau's profile photo
Heather Rousseau 5 months ago

Horrible facility overall. A few of the staff are kind, caring, but majority could care less about the residents. Constantly missing cellphone chargers, failure by staff to charge hearing aids for clients. Facility very rundown and in disrepair. Yes, I'll be transferring my parent out ASAP.

Carolyn Feddersen's profile photo
Carolyn Feddersen 9 months ago

Grand Islander has been a very wonderful experience for me! Every department has excelled in their performance, from admissions all the way to housekeeping and in between! Thank you admissions director for acknowledging me daily not just at admission! These nurses are amazing! Thank you therapy for all of our sessions that gave me all of these blessings to get the chance to return home! Even maintenance always accommodated my every request! From the moment I was on the Transitional care unit to then being on the longterm care unit for some time I have been very happy with my treatment. I went through some very difficult transitions and everyone was there to help me every step of the way! I wouldn’t hesitate to recommend the Grand Islander for rehab services and long term care! My meals were always excellent and I praise the kitchen for always making accommodations! Recreation encouraged me every single day to participate and I enjoyed every single part that they have played in my journey! I had a very special care team,and they know who they all are! You All meant the world to me and I will never forget you and the difference you’ve made in my life! Today I get to return to my home after a very lengthy stay!! Thank you isn’t enough for this facility!

Maureen Cook's profile photo
Maureen Cook 3 years ago

I have had three family members who have been cared for by the wonderful staff at the Grand Islander. Most recent has been my Mom. When she was first moved there from my home she was not happy and wanted to know when she would be going home. Very hard to hear and harder to tell her that she was in her new home. Sometimes she was agitated and angry with me. Over time due to the care and kindness she has adopted her new home and seems content. I know as her former life further slips away and when she no longer knows who I am it will become so much harder for me. But I know with the knowledgeable staff I feel she is where she will get the care and understanding that she needs. From the moment you step in the front and are greeted by “Mary” you know that you have made the right choice in choosing the Grand Islander for your loved one. Thank you all so much! From Family of: Celia Cook Patricia Murphy Barbara Murphy

Cate Meffert's profile photo
Cate Meffert a month ago

I believe my friend who is there was being well taken care of.I do wonder if the staff is being over worked with the ratio of caregivers to residents.

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