Skyland Terrace and Rehabilitation

516 Wall Street, Waynesville, NC 28786 (opens Google Maps) · Haywood County · (828) 452-3154· 90 certified beds · avg 83 residents/day · certified since Jan 24, 1992 · 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 Feb 19, 2026

Serious findings on record

most recent Dec 6, 2024

$8,512

Fines, last 3 years

3.62

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)

▲ Actual harm, isolated · 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): Actual harm was cited, below immediate jeopardy. 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: Dec 19, 2024 (Deficient, Provider has date of correction)

Inspection findings in the public record

Showing the latest 3 of 13 inspection findings. Open the full record below to read every finding.

Feb 19, 2026D · Potential for more than minimal harm, isolated
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. F-0578
Feb 19, 2026D · Potential for more than minimal harm, 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
Feb 19, 2026D · Potential for more than minimal harm, isolated
The facility did not develop and follow policies and procedures for offering residents flu and pneumonia vaccinations. F-0883

View all 13 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
Feb 19, 2026	D · Potential for more than minimal harm, isolated	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. · F-0578
Feb 19, 2026	D · Potential for more than minimal harm, 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
Feb 19, 2026	D · Potential for more than minimal harm, isolated	The facility did not develop and follow policies and procedures for offering residents flu and pneumonia vaccinations. · F-0883
Apr 30, 2025	D · Potential for more than minimal harm, isolated	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 · F-0600
Dec 6, 2024	▲ G · Actual harm, isolated	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. · F-0745
Dec 6, 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
Dec 6, 2024	D · Potential for more than minimal harm, isolated	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 · F-0686
Dec 6, 2024	D · Potential for more than minimal harm, isolated	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. · F-0812
Jul 14, 2023	E · Potential for more than minimal harm, pattern	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. · F-0756
Jul 14, 2023	E · Potential for more than minimal harm, pattern	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. · F-0760
Jul 14, 2023	E · Potential for more than minimal harm, pattern	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. · F-0812
Jul 14, 2023	D · Potential for more than minimal harm, isolated	The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. · F-0641
Jul 14, 2023	D · Potential for more than minimal harm, isolated	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. · F-0757

Inspection trend by year

Citations from standard inspections stayed about the same across the last two inspection cycles (4 → 3).

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

All citationsSerious citations (G–L)

2023

2024

2025

2026

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

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)

How to file a complaint about care →

1 fine totaling $8,512.

Every penalty CMS publishes for this facility in the 3-year window is listed —none excluded. The count and the dollar total come from two different CMS datasets and agree for this facility. Penalties older than the window are dropped by CMS before publication, not by us.

Date	Type	Amount / length
Dec 6, 2024	Fine	$8,512

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)

3.62

4.01

3.95

Registered Nurse hours

0.69

0.64

0.69

Weekend total nurse staffing

3.20

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)	3.62	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 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 3.39, RN 0.65, weekend 3.00.Comparing with Medicare Care Compare? Care Compare shows the raw figure (3.39 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: 3/5 · 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 Terrace and Rehabilitation. 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%	10/01/2022
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

All 7 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.

"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?"

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 53% 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
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

Compare this facility with the 3 closest →

All facilities in Waynesville →

Facility data as of CMS processing date 2026-08-01. CCN 345411.

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 Terrace and Rehabilitation

516 Wall Street, Waynesville, NC 28786 · (828) 452-3154

Health inspection rating 4/5 · CMS overall 4/5· Fines (3y): $8,512

Most serious findings on record:

▲ Dec 6, 2024 (F-0745, Actual harm, isolated): 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.

Questions for the administrator:

☐ "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?"
☐ "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 53% 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 345411 · Verify at medicare.gov/care-compare · Printed from The Care File (thecarefile.com)