Skyland Care Center

193 Asheville Highway, Sylva, NC 28779 (opens Google Maps) · Jackson County · (828) 586-8935· 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)

inspected Jan 23, 2026

Serious findings on record

most recent Jun 30, 2023

Fines, last 3 years

3.47

Nurse hours/resident/day (adjusted)

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

New to these records? How to read an inspection report →

Health inspection rating: ★★★★☆4/5 · CMS overall rating: 4/5 · how star ratings work →

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 quality measures from resident assessments and claims.

Most serious findings (actual harm or immediate jeopardy)

▲ Immediate jeopardy, isolated · 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): Immediate jeopardy to resident health or safety was cited. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

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

▲ Immediate jeopardy, isolated · 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)

Inspection findings in the public record

Showing the latest 3 of 10 inspection findings. Open the full record below to read every finding.

Nov 21, 2024F · Potential for more than minimal harm, widespread
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 F-0880
Nov 21, 2024D · Potential for more than minimal harm, isolated
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 F-0602
Nov 21, 2024D · Potential for more than minimal harm, isolated
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 F-0644

View all 10 inspection findingsShow only the latest 3 findings

CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed — that window is CMS's, not ours. Within it, every citation CMS publishes for this facility is listed here: none excluded.

Date	Severity	What the facility was cited for
Nov 21, 2024	F · Potential for more than minimal harm, widespread	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 · F-0880
Nov 21, 2024	D · Potential for more than minimal harm, isolated	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 · F-0602
Nov 21, 2024	D · Potential for more than minimal harm, isolated	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 · F-0644
Jun 30, 2023	▲ J · Immediate jeopardy, isolated	The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. · F-0684
Jun 30, 2023	▲ J · Immediate jeopardy, isolated	The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · F-0689
Jun 30, 2023	D · Potential for more than minimal harm, isolated	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. · F-0554
Jun 30, 2023	D · Potential for more than minimal harm, isolated	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. · F-0655
Jun 30, 2023	D · Potential for more than minimal harm, isolated	The facility provided care that did not meet professional standards of quality — the accepted standards that nurses and other clinicians are expected to follow. · F-0658
Jun 30, 2023	D · Potential for more than minimal harm, isolated	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. · F-0808
Jun 30, 2023	D · Potential for more than minimal harm, isolated	The facility did not run an ongoing quality assurance committee that reviews care problems and creates plans to fix them. · F-0867

Inspection trend by year

Citations by recorded inspection yearPublished citation counts, not a quality score · Source: CMS, 2026-08-01

All citationsSerious citations (G–L)

2023

2024

All bars start at zero. Exact values and supporting details remain below.

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)

How to file a complaint about care →

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

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

What these staffing numbers mean →

Nurse time, in contextAdjusted hours per resident per day · Source: CMS, 2026-08-01

This facilityNorth Carolina averageU.S. average

Total nurse staffing (hours per resident per day)

3.47

4.01

3.95

Registered Nurse hours

0.55

0.64

0.69

Weekend total nurse staffing

2.92

3.56

3.50

All bars start at zero. Exact values and supporting details remain below.

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 for the most recent quarter of payroll data in this CMS release (2026-08-01) — the same quarter for every facility — 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.Comparing with Medicare Care Compare? Care Compare shows the raw figure (3.51 here, displayed there as hours and minutes), not the adjusted one above. Both are correct; they answer different questions. Staffing rating: 3/5.

Quality measures: assessments & claims

Note: CMS combines facility-reported resident assessments (MDS) with claims-based measures. These are different sources from on-site inspection findings. Read the measures alongside inspection and staffing records; a high QM rating does not establish that a home is safe.

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

Costs & payment

Price evidence · separate from quality

No verified facility-specific private-pay price is available in our data for Skyland Care Center. CMS inspection and staffing records do not tell us what this home will charge you.

Calculate a stay from a quote you receive

Use a written private-pay quote. This worksheet adds only the amounts you enter; it does not calculate Medicare, Medicaid or insurance benefits.

Formula: (room rate + daily extras) × days + one-time charges. A 30-day scenario is not a calendar-month quote. Refundable deposits, rate changes and charges you omit are not automatically included. Entries are not saved or sent to our server.

Before you compare prices

Request the room type, effective date and itemized daily rate in writing.
Ask about therapy, medicines, supplies, care-level charges, deposits, refunds and annual increases.
Confirm insurance or Medicaid eligibility and bed availability directly; certification alone does not guarantee either.

Understand who pays for care · How we handle price evidence · Report an incorrect price

Who owns this facility

How to read ownership records →

Ownership records as published by CMS on 2026-08-01. CMS records when an owner joined but not when they left. Listed here and no longer involved? Tell us →

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

All 11 owning or managing parties CMS has on file are shown — none excluded.

Questions to ask on your visit

Full visit checklist →

Print visit checklist

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?"

Also worth asking anywhere

"Your weekend nurse staffing is reported below the North Carolina midpoint — how does the weekend schedule differ from a weekday?"
"Can I see the plan of correction for the findings in your most recent state inspection?"
"CMS reports 46% total nursing staff turnover here — who on the care team has been with you longest?"
"Can I visit again unannounced, at a mealtime or on a weekend?"

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.

This page is the printable visit checklist. If your browser did not open the print dialog automatically, use File → Print (Ctrl/⌘-P).

The Care File

Visit checklist — Skyland Care Center

193 Asheville Highway, Sylva, NC 28779 · (828) 586-8935

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

Most serious findings on record:

▲ Jun 30, 2023 (F-0684, Immediate jeopardy, isolated): 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, isolated): 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?"
☐ "Your weekend nurse staffing is reported below the North Carolina midpoint — how does the weekend schedule differ from a weekday?"
☐ "Can I see the plan of correction for the findings in your most recent state inspection?"
☐ "CMS reports 46% total nursing staff turnover here — who on the care team has been with you longest?"
☐ "Can I visit again unannounced, at a mealtime or on a weekend?"

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)