Cycle 1
Health 2025-04-08 · Fire 2025-04-08
5 health deficiencies
Top issue: Quality of Life and Care (2 deficiencies)
1 fire-safety deficiencies
Top issue: Emergency Preparedness (1 deficiency)
N Falmouth, MA
Royal Megansett Nursing & Rehabilitation
4-star overall rating with 4-star inspections with 5 recent health deficiencies with 1 fire-safety deficiencies in the latest cycle
209 County Road Box 408, N Falmouth, MA
(508) 563-5913
Overall
4 / 5
CMS overall stars
Health inspections
4 / 5
Survey and complaint cycles
Staffing
2 / 5
RN + nurse staffing
Quality measures
4 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
90
Certified beds
Average residents
65
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
Royal Health Group
Operator or chain grouping
Approved since
1995-08-01
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Chain footprint
12 facilities
Chain averages 3 overall / 3 health / 2 staffing / 3 quality stars
Changed ownership
No
Within the last 12 months
Family council
Yes
Resident and family council reported
Sprinklers
Yes
Automatic sprinklers in all required areas
Staffing
Hours and turnover
RN hours / resident day
0.64
Registered nurse staffing · state 0.65 · national 0.68
LPN hours / resident day
1.08
Licensed practical nurse staffing · state 0.96 · national 0.87
Aide hours / resident day
2.18
Nurse aide staffing · state 2.26 · national 2.35
Total nurse hours
3.90
All reported nurse hours · state 3.86 · national 3.89
Licensed hours
1.72
RN + LPN hours · state 1.60 · national 1.54
Weekend hours
3.35
Weekend nurse staffing · state 3.45 · national 3.43
Weekend RN hours
0.44
Weekend registered nurse coverage · state 0.46 · national 0.47
Physical therapist
0.05
Reported PT staffing · state 0.08 · national 0.07
Adjusted RN hours
0.58
CMS adjusted RN staffing hours
Adjusted total hours
3.49
CMS adjusted total nurse staffing hours
Case-mix index
1.53
Higher values indicate more complex resident acuity
RN turnover
59%
Annual RN turnover · state 45% · national 45%
Total nurse turnover
49%
Annual nurse turnover · state 40% · national 46%
SNF VBP
Value-based purchasing
Program rank
9,225
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
24.38
Composite VBP score used to determine payment impact.
Payment multiplier
0.9834
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
0
Baseline 20.24% · Performance 22.54% · Measure score 0 · Achievement 0 · Improvement 0
Healthcare-associated infections
0.36
Baseline 7.97% · Performance 7.72% · Measure score 0.36 · Achievement 0 · Improvement 0.36
Total nurse turnover
7.56
Baseline 39.71% · Performance 32.79% · Measure score 7.56 · Achievement 7.56 · Improvement 4.16
Adjusted total nurse staffing
1.83
Baseline 3.63 hours · Performance 3.60 hours · Measure score 1.83 · Achievement 1.83 · Improvement 0
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 10.91% |
10.72%
0.2 pts worse
|
No Different than the National Rate · Eligible stays 249 · Observed rate 10.04% · Lower 95% interval 8.31% |
| Discharge to community | 66.62% |
50.57%
16.1 pts better
|
Better than the National Rate · Eligible stays 247 · Observed rate 63.16% · Lower 95% interval 59.28% |
| Medicare spending per beneficiary | 0.97 |
1.02
0.1 pts better
|
|
| Drug regimen review with follow-up | 96.23% |
95.27%
1 pts better
|
Numerator 153 · Denominator 159 |
| Falls with major injury | 0% |
0.77%
0.8 pts better
|
Numerator 0 · Denominator 159 |
| Discharge self-care score | 52.58% |
53.69%
1.1 pts worse
|
Numerator 51 · Denominator 97 |
| Discharge mobility score | 54.64% |
50.94%
3.7 pts better
|
Numerator 53 · Denominator 97 |
| Pressure ulcers or injuries, new or worsened | 1.89% |
2.29%
0.4 pts better
|
Numerator 3 · Denominator 159 · Adjusted rate 1.99% |
| Healthcare-associated infections requiring hospitalization | 7.72% |
7.12%
0.6 pts worse
|
No Different than the National Rate · Eligible stays 163 · Observed rate 7.36% · Lower 95% interval 5.39% |
| Staff COVID-19 vaccination coverage | 6.06% |
8.2%
2.1 pts worse
|
Numerator 4 · Denominator 66 |
| Staff flu vaccination coverage | 66.67% |
42%
24.7 pts better
|
Numerator 62 · Denominator 93 |
| Discharge function score | 53.61% |
56.45%
2.8 pts worse
|
Numerator 52 · Denominator 97 |
| Transfer of health information to provider | 100% |
95.95%
4 pts better
|
Numerator 41 · Denominator 41 |
| Transfer of health information to patient | 98.97% |
96.28%
2.7 pts better
|
Numerator 96 · Denominator 97 |
| Resident COVID-19 vaccinations up to date | 40.51% |
25.2%
15.3 pts better
|
Numerator 32 · Denominator 79 |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 2.0 |
1.9
0.1 pts worse
|
1.9
0.1 pts worse
|
Long Stay · 20240701-20250630 · Adjusted 2.0 · Observed 1.5 · Expected 1.5 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 1.5 |
1.5
About the same
|
1.8
0.3 pts better
|
Long Stay · 20240701-20250630 · Adjusted 1.5 · Observed 1.3 · Expected 1.4 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 100.0% |
92.2%
7.8 pts better
|
93.4%
6.6 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 100.0% · Q3 100.0% · Q4 100.0% · 4Q avg 100.0% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 96.1% |
94.8%
1.3 pts better
|
95.5%
0.6 pts better
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 96.1% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 5.1% |
3.5%
1.6 pts worse
|
3.3%
1.8 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 6.1% · Q2 4.2% · Q3 2.0% · Q4 7.8% · 4Q avg 5.1% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 10.8% |
12.0%
1.2 pts better
|
11.4%
0.6 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 8.5% · Q2 7.1% · Q3 14.6% · Q4 13.0% · 4Q avg 10.8% |
| Percentage of long-stay residents who lose too much weight | 9.8% |
5.2%
4.6 pts worse
|
5.4%
4.4 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 9.1% · Q2 10.3% · Q3 11.8% · Q4 8.3% · 4Q avg 9.8% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 16.4% |
19.2%
2.8 pts better
|
19.6%
3.2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 25.7% · Q2 22.6% · Q3 11.1% · Q4 7.9% · 4Q avg 16.4% |
| Percentage of long-stay residents who received an antipsychotic medication | 20.0% |
22.5%
2.5 pts better
|
16.7%
3.3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 14.3% · Q2 16.0% · Q3 21.4% · Q4 27.6% · 4Q avg 20.0% · Used in QM five-star |
| Percentage of long-stay residents who were physically restrained | 0.0% |
0.1%
0.1 pts better
|
0.1%
0.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% |
| Percentage of long-stay residents whose ability to walk independently worsened | 20.1% |
17.7%
2.4 pts worse
|
16.3%
3.8 pts worse
|
Long Stay · 2024Q4-2025Q3 · 4Q avg 20.1% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 17.0% |
17.6%
0.6 pts better
|
14.9%
2.1 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 29.4% · Q2 10.0% · Q3 17.6% · Q4 10.8% · 4Q avg 17.0% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 0.6% |
1.0%
0.4 pts better
|
1.0%
0.4 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 2.4% · Q3 0.0% · Q4 0.0% · 4Q avg 0.6% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 2.6% |
2.0%
0.6 pts worse
|
1.7%
0.9 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 2.2% · Q3 2.1% · Q4 6.1% · 4Q avg 2.6% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 29.1% |
21.7%
7.4 pts worse
|
19.8%
9.3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 18.5% · Q2 36.7% · Q3 32.4% · Q4 29.3% · 4Q avg 29.1% |
| Percentage of long-stay residents with pressure ulcers | 1.2% |
4.6%
3.4 pts better
|
5.1%
3.9 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 1.3% · Q2 0.0% · Q3 1.2% · Q4 2.0% · 4Q avg 1.2% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 87.5% |
77.1%
10.4 pts better
|
81.7%
5.8 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 88.1% · Q2 86.3% · Q3 87.5% · Q4 88.0% · 4Q avg 87.5% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 12.4% |
11.8%
0.6 pts worse
|
12.0%
0.4 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 12.4% · Observed 12.3% · Expected 11.0% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 0.6% |
1.3%
0.7 pts better
|
1.6%
1 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 1.2% · Q4 1.3% · 4Q avg 0.6% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 87.5% |
77.7%
9.8 pts better
|
79.7%
7.8 pts better
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 87.5% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 24.7% |
25.8%
1.1 pts better
|
23.9%
0.8 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 24.7% · Observed 24.6% · Expected 23.8% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2024-05-24 · Fire 2024-05-24
6 health deficiencies
Top issue: Pharmacy Service (2 deficiencies)
0 fire-safety deficiencies
No concentrated fire-safety issue counts in this cycle.
Cycle 3
Health 2023-01-27 · Fire 2023-01-27
12 health deficiencies
Top issue: Pharmacy Service (3 deficiencies)
0 fire-safety deficiencies
No concentrated fire-safety issue counts in this cycle.
Fire safety
Fire-safety citations
F · Potential for more than minimal harm
2025-04-08
E20 · Emergency Preparedness Deficiencies
Fire Safety
Establish policies and procedures including evacuation.
Corrected 2025-05-16
Inspection history
Recent health citations
E · Potential for more than minimal harm
2025-04-08
F686 · Quality of Life and Care Deficiencies
Health
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Corrected 2025-04-15
D · Potential for more than minimal harm
2025-04-08
F558 · Resident Rights Deficiencies
Health
Reasonably accommodate the needs and preferences of each resident.
Corrected 2025-04-22
D · Potential for more than minimal harm
2025-04-08
F658 · Resident Assessment and Care Planning Deficiencies
Health
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected 2025-04-15
D · Potential for more than minimal harm
2025-04-08
F689 · Quality of Life and Care Deficiencies
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2025-04-09
B · Minimal harm
2025-04-08
F712 · Nursing and Physician Services Deficiencies
Health
Ensure that the resident and his/her doctor meet face-to-face at all required visits.
Corrected 2025-04-18
E · Potential for more than minimal harm
2024-05-24
F755 · Pharmacy Service Deficiencies
Health
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected 2024-06-07
E · Potential for more than minimal harm
2024-05-24
F812 · Nutrition and Dietary Deficiencies
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2024-06-07
D · Potential for more than minimal harm
2024-05-24
F557 · Resident Rights Deficiencies
Health
Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.
Corrected 2024-06-12
D · Potential for more than minimal harm
2024-05-24
F658 · Resident Assessment and Care Planning Deficiencies
Health
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected 2024-06-07
D · Potential for more than minimal harm
2024-05-24
F761 · Pharmacy Service Deficiencies
Health
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Corrected 2024-06-07
B · Minimal harm
2024-05-24
F640 · Resident Assessment and Care Planning Deficiencies
Health
Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
Corrected 2024-06-10
E · Potential for more than minimal harm
2023-01-27
F756 · Pharmacy Service Deficiencies
Health
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Corrected 2023-02-14
E · Potential for more than minimal harm
2023-01-27
F757 · Pharmacy Service Deficiencies
Health
Ensure each resident’s drug regimen must be free from unnecessary drugs.
Corrected 2023-02-14
E · Potential for more than minimal harm
2023-01-27
F758 · Pharmacy Service Deficiencies
Health
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Corrected 2023-02-03
E · Potential for more than minimal harm
2023-01-27
F812 · Nutrition and Dietary Deficiencies
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2023-01-30
E · Potential for more than minimal harm
2023-01-27
F847 · Administration Deficiencies
Health
Inform resident or representatives choice to enter into binding arbitration agreement and right to refuse.
Corrected 2023-02-15
E · Potential for more than minimal harm
2023-01-27
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2023-02-03
E · Potential for more than minimal harm
2023-01-27
F881 · Infection Control Deficiencies
Health
Implement a program that monitors antibiotic use.
Corrected 2023-02-14
D · Potential for more than minimal harm
2023-01-27
F604 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
Corrected 2023-01-30
D · Potential for more than minimal harm
2023-01-27
F656 · Resident Assessment and Care Planning Deficiencies
Health
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected 2023-02-01
D · Potential for more than minimal harm
2023-01-27
F677 · Quality of Life and Care Deficiencies
Health
Provide care and assistance to perform activities of daily living for any resident who is unable.
Corrected 2023-01-30
D · Potential for more than minimal harm
2023-01-27
F685 · Quality of Life and Care Deficiencies
Health
Assist a resident in gaining access to vision and hearing services.
Corrected 2023-02-01
D · Potential for more than minimal harm
2023-01-27
F849 · Administration Deficiencies
Health
Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
Corrected 2023-02-03
Penalties and ownership
What sits behind the stars
Ownership
Mamary, James
5% Or Greater Direct Ownership Interest · Individual
Reid, Paula
W-2 Managing Employee · Individual
Nearby options
Other facilities in reach
#1
Jml Care Center Inc
Falmouth, MA
2-star overall rating with 3-star inspections with 10 recent health deficiencies with 2 fire-safety deficiencies in the latest cycle
#2
Bourne Manor Extended Care Facility
Bourne, MA
1-star overall rating with 2-star inspections with $48,575 in total fines with 3 recent health deficiencies with 7 fire-safety deficiencies in the latest cycle
#3
Royal Nursing Center, LLC
Falmouth, MA
3-star overall rating with 3-star inspections with $8,278 in total fines with 7 recent health deficiencies with 5 fire-safety deficiencies in the latest cycle
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