Skyland Care Center

Name: Skyland Care Center
Address: 193 Asheville Highway, Sylva, NC, 28779, US
Telephone: 8285868935

193 Asheville Highway, Sylva, NC 28779 · Jackson County · 94 certified beds · avg 90 residents/day · certified since Sep 3, 1991 · Medicare and Medicaid certified

Certified for both programmes. Certification means the facility can bill Medicaid — it does not mean a Medicaid-funded bed is free right now, so ask directly. Who pays for nursing home care →

4/5

Health inspection rating (on-site)

Serious findings on record

Fines, last 3 years

3.47

Nurse hours/resident/day (adjusted)

What health inspectors found (on-site government inspections — the most independent evidence available)

Health inspection rating: ★★★★☆4/5 · CMS overall rating: 4/5

The health inspection star above is graded on a curve within each state — a set share of each state's facilities gets each star level — so a facility can have few citations and still rate 2–3 stars if others in its state did even better. The overall rating combines that inspection score with staffing and self-reported quality measures.

Most serious findings (actual harm or immediate jeopardy)

▲ Immediate jeopardy, one-off · Jun 30, 2023 · F-0684

The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals.

Why it matters: Care that strays from doctor's orders or ignores the resident's wishes can lead to declining health and avoidable harm.

Severity (J): Inspectors found a situation that put a resident's life or safety in immediate danger, affecting one or a few residents. The facility must fix it immediately — these citations often come with large fines.

Corrected: Jul 18, 2023 (Deficient, Provider has date of correction)

▲ Immediate jeopardy, one-off · Jun 30, 2023 · F-0689

The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.

Why it matters: This is one of the most common citations and directly relates to falls and injuries, which can be devastating for older adults.

Corrected: Jul 18, 2023 (Deficient, Provider has date of correction)

All citations in the current public record (10)

CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed.

Date	Severity	What the facility was cited for
Nov 21, 2024	F · Potential for harm, facility-wide	The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. · from a complaint
Nov 21, 2024	D · Potential for harm, one-off	The facility did not protect residents from misuse of their belongings or money — this is called misappropriation, and it includes theft or improper use of a resident's property or funds. · from a complaint
Nov 21, 2024	D · Potential for harm, one-off	The facility did not coordinate resident assessments with the state's pre-admission screening program for mental illness and intellectual disabilities, or failed to refer residents for the special services they need. · from a complaint
Jun 30, 2023	▲ J · Immediate jeopardy, one-off	The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals.
Jun 30, 2023	▲ J · Immediate jeopardy, one-off	The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.
Jun 30, 2023	D · Potential for harm, one-off	The facility did not allow residents to take their own medications when a clinical review showed they could do so safely. Residents have this right if their care team determines it's appropriate.
Jun 30, 2023	D · Potential for harm, one-off	The facility did not create and follow a basic care plan covering a new resident's most immediate needs within 48 hours of admission. The first days are when a new resident is most vulnerable.
Jun 30, 2023	D · Potential for harm, one-off	The facility provided care that did not meet professional standards of quality — the accepted standards that nurses and other clinicians are expected to follow.
Jun 30, 2023	D · Potential for harm, one-off	The facility did not make sure special medical diets — like low-sodium or diabetic diets — were properly ordered by the resident's doctor or managed by a qualified dietitian as state law allows.
Jun 30, 2023	D · Potential for harm, one-off	The facility did not run an ongoing quality assurance committee that reviews care problems and creates plans to fix them.

Inspection trend by year

Year	Citations	Serious (G–L)	Worst severity that year
2023	7	2	J ▲
2024	3	0	F

Counts reflect the current CMS public record (~3 inspection cycles plus complaint investigations); years with no surveys show no row. Inspection frequency varies, so compare severity as well as counts.

Fines and enforcement (last 3 years)

No fines or payment denials in the published 3-year window.

Nurse staffing (from payroll records, adjusted for how much care residents need)

Measure	This facility	North Carolina avg	U.S. avg	Where it stands
Total nurse staffing (hours per resident per day)	3.47	4.01	3.95	bottom 34% in North Carolina; bottom 35% in the U.S.
Registered Nurse hours	0.55	0.64	0.69	top 46% in North Carolina; bottom 45% in the U.S.
Weekend total nurse staffing	2.92	3.56	3.50	bottom 22% in North Carolina; bottom 27% in the U.S.
Weekend RN hours (not acuity-adjusted)	0.42	0.41	0.48	top 33% in North Carolina; top 45% in the U.S.
Total nursing staff turnover (%)	46.0	49.0	45.8	top 43% in North Carolina; bottom 47% in the U.S.
RN turnover (%)	31.3	45.7	42.9	top 26% in North Carolina; top 32% in the U.S.

Hours are per resident per day, case-mix adjusted by CMS so facilities caring for sicker residents can be compared fairly (same basis as the CMS staffing star). "Top X%" means better than most facilities: more staffing hours, or lower turnover. Raw (unadjusted) reported hours: total 3.51, RN 0.56, weekend 2.96. Staffing rating: 3/5.

Self-reported quality measures

Note: these ratings are based on data the facility reports about itself to CMS. They are not independently verified by inspectors, and can look better than inspection findings. Give more weight to the inspection results above.

Quality measures rating: 3/5 · long-stay residents: 1/5 · short-stay residents: 4/5

Who owns this facility

For profit - Corporation

Owner / manager	Type	Role	Stake	Since
Cooley, Mistie	Individual	5% or Greater Direct Ownership Interest	49%	10/01/2013
Gatewood, Thomas	Individual	5% or Greater Direct Ownership Interest	51%	10/01/2016
Cooley, Mistie	Individual	Managing Control - Governing Body	NOT APPLICABLE	10/01/2013
Cooley, Mistie	Individual	Corporate Officer	NOT APPLICABLE	10/01/2013
Cooley, Mistie	Individual	Operational/Managerial Control	NOT APPLICABLE	10/01/2013
Dills, Melissa	Individual	Operational/Managerial Control	NOT APPLICABLE	12/16/2022
Dills, Melissa	Individual	ADP of the SNF	NOT APPLICABLE	12/16/2022
Gatewood, Thomas	Individual	Managing Control - Governing Body	NOT APPLICABLE	10/01/2003
Gatewood, Thomas	Individual	Corporate Officer	NOT APPLICABLE	10/01/2003
Vargas, Carlos	Individual	Operational/Managerial Control	NOT APPLICABLE	08/01/2012
Vargas, Carlos	Individual	ADP of the SNF	NOT APPLICABLE	08/01/2012

Questions to ask on your visit

Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.

"How do you make sure each resident's care follows the doctor's orders, and what changed after this citation?"
"What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
"Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
"What safeguards do you have to protect residents' money and belongings, and what happens when something goes missing?"
"How do you identify and arrange specialized services for residents with mental health conditions or disabilities?"
"If my family member is able to manage their own medications, would you allow it, and how is that decided?"
"What does the care plan for a brand-new resident cover in the first 48 hours, and who writes it?"
"Can you tell me what this citation involved and what steps you took to bring care back up to standard?"
"What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
"Can I see the results and plan of correction from your most recent state inspection?"

Nearby facilities (within 20 miles)

Facility	Distance	City	Overall	Inspection	Flags
Vero Health & Rehab of Sylva	0.1 mi	Sylva, NC	★☆☆☆☆	1/5
Tsali Care Center	9.9 mi	Cherokee, NC	★★☆☆☆	1/5	SFF
Maggie Valley Health and Rehabilitation Center	11.6 mi	Maggie Valley, NC	★★☆☆☆	2/5
Autumn Care of Waynesville	12.7 mi	Waynesville, NC	★☆☆☆☆	1/5
Mountain View Manor Nursing Center	14.7 mi	Bryson City, NC	★☆☆☆☆	2/5
Skyland Terrace and Rehabilitation	15.3 mi	Waynesville, NC	★★★★☆	4/5
Smoky Mountain Health and Rehabilitation Center	18.4 mi	Waynesville, NC	★★★☆☆	3/5
Macon Valley Nursing and Rehabilitation Center	19.1 mi	Franklin, NC	★★☆☆☆	2/5	abuse

Compare this facility with the 3 closest →

All facilities in Sylva →

Facility data as of CMS processing date 2026-08-01. CCN 345400.

The Care File

Visit checklist — Skyland Care Center

193 Asheville Highway, Sylva, NC 28779 · 8285868935

Health inspection rating 4/5 · CMS overall 4/5· Fines (3y): $0

Most serious findings on record:

▲ Jun 30, 2023 (F-0684, Immediate jeopardy, one-off): The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals.
▲ Jun 30, 2023 (F-0689, Immediate jeopardy, one-off): The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.

Questions for the administrator:

☐ "How do you make sure each resident's care follows the doctor's orders, and what changed after this citation?"
☐ "What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
☐ "Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
☐ "What safeguards do you have to protect residents' money and belongings, and what happens when something goes missing?"
☐ "How do you identify and arrange specialized services for residents with mental health conditions or disabilities?"
☐ "If my family member is able to manage their own medications, would you allow it, and how is that decided?"
☐ "What does the care plan for a brand-new resident cover in the first 48 hours, and who writes it?"
☐ "Can you tell me what this citation involved and what steps you took to bring care back up to standard?"
☐ "What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
☐ "Can I see the results and plan of correction from your most recent state inspection?"

While you're there, notice:

☐ Smell and cleanliness in hallways, not just the lobby
☐ How staff speak to residents; call lights answered promptly
☐ Residents up, dressed, and engaged (visit mealtimes and a weekend if you can)

Data: CMS Provider Data Catalog, version 2026-08-01 · CCN 345400 · Verify at medicare.gov/care-compare · Printed from The Care File (thecarefile.com)