Skyland Terrace and Rehabilitation
516 Wall Street, Waynesville, NC 28786 · Haywood County · 90 certified beds · avg 83 residents/day · certified since Jan 24, 1992
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)
▲ Actual harm, one-off · Dec 6, 2024 · F-0745
The facility did not provide the social services residents need — such as counseling, help with adjustment, or connecting to outside resources — to achieve the best possible quality of life.
Why it matters: Without social services support, residents can struggle emotionally and miss out on help they're entitled to.
Severity (G): One or a few residents were actually harmed — physically or emotionally — though not put in immediate danger of serious injury or death.
Corrected: Dec 19, 2024 (Deficient, Provider has date of correction)
All citations in the current public record (13)
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 |
|---|---|---|
| Feb 19, 2026 | D · Potential for harm, one-off | The facility did not honor residents' rights to request, refuse, or stop treatment, to decline participation in medical research, or to make an advance directive — a written statement of their wishes for future medical care. |
| Feb 19, 2026 | D · Potential for harm, 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. |
| Feb 19, 2026 | D · Potential for harm, one-off | The facility did not develop and follow policies and procedures for offering residents flu and pneumonia vaccinations. |
| Apr 30, 2025 | D · Potential for harm, one-off | The facility did not protect residents from abuse or neglect. This covers physical, mental, and sexual abuse, physical punishment, and neglect, by anyone — staff, other residents, or visitors. · from a complaint |
| Dec 6, 2024 | ▲ G · Actual harm, one-off | The facility did not provide the social services residents need — such as counseling, help with adjustment, or connecting to outside resources — to achieve the best possible quality of life. |
| Dec 6, 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 |
| Dec 6, 2024 | D · Potential for harm, one-off | The facility did not provide proper care for pressure ulcers (bedsores) or did not do enough to prevent new ones from forming. Bedsores develop when residents stay in one position too long without help moving. · from a complaint |
| Dec 6, 2024 | D · Potential for harm, one-off | The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. |
| Jul 14, 2023 | E · Potential for harm, repeated | The facility did not have a licensed pharmacist review each resident's complete medication regimen and medical chart every month, or did not follow its own rules for reporting medication problems. |
| Jul 14, 2023 | E · Potential for harm, repeated | The facility did not keep residents free from significant medication errors — such as giving the wrong drug, the wrong dose, or missing a critical medication. |
| Jul 14, 2023 | E · Potential for harm, repeated | The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. |
| Jul 14, 2023 | D · Potential for harm, one-off | The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. |
| Jul 14, 2023 | D · Potential for harm, one-off | The facility did not keep residents' medications free from unnecessary drugs. Residents should only take medicines they truly need, at the right dose, for a clear reason. |
Inspection trend by year
Citations from standard inspections stayed about the same across the last two inspection cycles (4 → 3).
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2023 | 5 | 0 | E |
| 2024 | 4 | 1 | G ▲ |
| 2025 | 1 | 0 | D |
| 2026 | 3 | 0 | D |
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)
1 fine totaling $8,512.
| Date | Type | Amount / length |
|---|---|---|
| Dec 6, 2024 | Fine | $8,512 |
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) | 3.62 | 4.01 | 3.95 | bottom 46% in North Carolina; bottom 43% in the U.S. |
| Registered Nurse hours | 0.69 | 0.64 | 0.69 | top 27% in North Carolina; top 37% in the U.S. |
| Weekend total nurse staffing | 3.20 | 3.56 | 3.50 | bottom 46% in North Carolina; bottom 41% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.38 | 0.41 | 0.48 | top 39% in North Carolina; bottom 47% in the U.S. |
| Total nursing staff turnover (%) | 53.3 | 49.0 | 45.8 | bottom 38% in North Carolina; bottom 29% in the U.S. |
| RN turnover (%) | 40.0 | 45.7 | 42.9 | top 39% in North Carolina; top 46% 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 3.39, RN 0.65, weekend 3.00. 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: 3/5 · 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% | 10/01/2022 |
| Gatewood, Thomas | Individual | 5% or Greater Direct Ownership Interest | 51% | 10/01/2022 |
| Cooley, Mistie | Individual | Managing Control - Governing Body | NOT APPLICABLE | 10/01/2022 |
| Cooley, Mistie | Individual | Corporate Officer | NOT APPLICABLE | 10/01/2022 |
| Cooley, Mistie | Individual | Operational/Managerial Control | NOT APPLICABLE | 01/19/2025 |
| Gatewood, Thomas | Individual | Corporate Officer | NOT APPLICABLE | 10/01/2022 |
| Gatewood, Thomas | Individual | Operational/Managerial Control | NOT APPLICABLE | 01/19/2025 |
Questions to ask on your visit
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
- "Who provides social services here, and how would they support my family member's emotional and social needs?"
- "How do you record and honor each resident's treatment wishes and advance directives, and how do staff know about them?"
- "How do you make sure each resident's care follows the doctor's orders, and what changed after this citation?"
- "What percentage of your residents and staff are vaccinated against flu and pneumonia, and how do you offer the vaccines?"
- "Tell me about this abuse or neglect citation — what happened, and what specific changes did you make afterward?"
- "What safeguards do you have to protect residents' money and belongings, and what happens when something goes missing?"
- "How do you prevent bedsores for residents who can't move themselves, and how often are at-risk residents repositioned?"
- "What did your most recent kitchen inspection find, and can I see how food is stored and prepared?"
- "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 |
|---|---|---|---|---|---|
| Autumn Care of Waynesville | 2.9 mi | Waynesville, NC | ★☆☆☆☆ | 1/5 | |
| Smoky Mountain Health and Rehabilitation Center | 3.6 mi | Waynesville, NC | ★★★☆☆ | 3/5 | |
| Silver Bluff | 5.8 mi | Canton, NC | ★★★☆☆ | 3/5 | |
| Maggie Valley Health and Rehabilitation Center | 6.8 mi | Maggie Valley, NC | ★★☆☆☆ | 2/5 | |
| Vero Health & Rehab of Sylva | 15.2 mi | Sylva, NC | ★☆☆☆☆ | 1/5 | |
| Skyland Care Center | 15.3 mi | Sylva, NC | ★★★★☆ | 4/5 | |
| Pisgah Manor Health Care Center | 18.1 mi | Candler, NC | ★★☆☆☆ | 2/5 |
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Facility data as of CMS processing date 2026-08-01. CCN 345411.