Cycle 1
Health 2026-01-23 · Fire 2024-11-21
0 health deficiencies
No concentrated health issue counts in this cycle.
1 fire-safety deficiencies
Top issue: Smoke (1 deficiency)
Sylva, NC
Skyland Care Center
2-star overall rating with 2-star inspections with $15,593 in total fines with 1 fire-safety deficiencies in the latest cycle
193 Asheville Highway, Sylva, NC
(828) 586-8935
Overall
2 / 5
CMS overall stars
Health inspections
2 / 5
Survey and complaint cycles
Staffing
4 / 5
RN + nurse staffing
Quality measures
3 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
94
Certified beds
Average residents
88
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
No chain reported
Operator or chain grouping
Approved since
1991-09-03
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
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
0.60
Registered nurse staffing · state 0.59 · national 0.68
LPN hours / resident day
0.78
Licensed practical nurse staffing · state 0.87 · national 0.87
Aide hours / resident day
2.19
Nurse aide staffing · state 2.33 · national 2.35
Total nurse hours
3.57
All reported nurse hours · state 3.78 · national 3.89
Licensed hours
1.39
RN + LPN hours · state 1.45 · national 1.54
Weekend hours
3.03
Weekend nurse staffing · state 3.34 · national 3.43
Weekend RN hours
0.64
Weekend registered nurse coverage · state 0.38 · national 0.47
Physical therapist
0.02
Reported PT staffing · state 0.09 · national 0.07
Adjusted RN hours
0.69
CMS adjusted RN staffing hours
Adjusted total hours
4.06
CMS adjusted total nurse staffing hours
Case-mix index
1.20
Higher values indicate more complex resident acuity
RN turnover
41%
Annual RN turnover · state 48% · national 45%
Total nurse turnover
49%
Annual nurse turnover · state 50% · national 46%
SNF VBP
Value-based purchasing
Program rank
2,477
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
49.55
Composite VBP score used to determine payment impact.
Payment multiplier
1.0035
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
4.08
Baseline 18.98% · Performance 19.54% · Measure score 4.08 · Achievement 4.08 · Improvement 0
Healthcare-associated infections
5.14
Baseline 7.79% · Performance 6.30% · Measure score 5.14 · Achievement 5.14 · Improvement 4.83
Total nurse turnover
6.91
Baseline 41.11% · Performance 35.45% · Measure score 6.91 · Achievement 6.91 · Improvement 2.98
Adjusted total nurse staffing
3.70
Baseline 3.40 hours · Performance 4.13 hours · Measure score 3.70 · Achievement 3.70 · Improvement 2.58
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 10.33% |
10.72%
0.4 pts better
|
No Different than the National Rate · Eligible stays 223 · Observed rate 9.87% · Lower 95% interval 7.75% |
| Discharge to community | 51.51% |
50.57%
0.9 pts better
|
No Different than the National Rate · Eligible stays 208 · Observed rate 46.63% · Lower 95% interval 45.99% |
| Medicare spending per beneficiary | 1.07 |
1.02
0.1 pts worse
|
|
| Drug regimen review with follow-up | 100% |
95.27%
4.7 pts better
|
Numerator 100 · Denominator 100 |
| Falls with major injury | 3% |
0.77%
2.2 pts worse
|
Numerator 3 · Denominator 100 |
| Discharge self-care score | 61.84% |
53.69%
8.2 pts better
|
Numerator 47 · Denominator 76 |
| Discharge mobility score | 65.79% |
50.94%
14.9 pts better
|
Numerator 50 · Denominator 76 |
| Pressure ulcers or injuries, new or worsened | 2% |
2.29%
0.3 pts better
|
Numerator 2 · Denominator 100 · Adjusted rate 2.1% |
| Healthcare-associated infections requiring hospitalization | 6.3% |
7.12%
0.8 pts better
|
No Different than the National Rate · Eligible stays 145 · Observed rate 4.83% · Lower 95% interval 3.65% |
| Staff COVID-19 vaccination coverage | 1.75% |
8.2%
6.4 pts worse
|
Numerator 3 · Denominator 171 |
| Staff flu vaccination coverage | 85.64% |
42%
43.6 pts better
|
Numerator 155 · Denominator 181 |
| Discharge function score | 64.47% |
56.45%
8 pts better
|
Numerator 49 · Denominator 76 |
| Transfer of health information to provider | 96.92% |
95.95%
1 pts better
|
Numerator 63 · Denominator 65 |
| Transfer of health information to patient | Not Available |
96.28%
|
Numerator Not Available · Denominator 15 · Too few residents or stays to report publicly. |
| Resident COVID-19 vaccinations up to date | 19.23% |
25.2%
6 pts worse
|
Numerator 10 · Denominator 52 |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 1.4 |
1.8
0.4 pts better
|
1.9
0.5 pts better
|
Long Stay · 20240701-20250630 · Adjusted 1.4 · Observed 1.5 · Expected 2.1 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 3.3 |
1.8
1.5 pts worse
|
1.8
1.5 pts worse
|
Long Stay · 20240701-20250630 · Adjusted 3.3 · Observed 3.4 · Expected 1.7 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 90.4% |
91.5%
1.1 pts worse
|
93.4%
3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 89.5% · Q2 73.8% · Q3 100.0% · Q4 98.7% · 4Q avg 90.4% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 97.6% |
94.1%
3.5 pts better
|
95.5%
2.1 pts better
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 97.6% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 5.4% |
3.6%
1.8 pts worse
|
3.3%
2.1 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 2.6% · Q2 3.8% · Q3 7.5% · Q4 7.7% · 4Q avg 5.4% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 0.3% |
4.8%
4.5 pts better
|
11.4%
11.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 1.4% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.3% |
| Percentage of long-stay residents who lose too much weight | 8.0% |
7.2%
0.8 pts worse
|
5.4%
2.6 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 7.0% · Q2 8.3% · Q3 8.3% · Q4 8.5% · 4Q avg 8.0% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 14.0% |
21.6%
7.6 pts better
|
19.6%
5.6 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 12.7% · Q2 12.2% · Q3 16.2% · Q4 14.9% · 4Q avg 14.0% |
| Percentage of long-stay residents who received an antipsychotic medication | 13.9% |
15.0%
1.1 pts better
|
16.7%
2.8 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 12.9% · Q2 15.3% · Q3 14.9% · Q4 12.7% · 4Q avg 13.9% · Used in QM five-star |
| Percentage of long-stay residents who were physically restrained | 0.0% |
0.0%
About the same
|
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 | 27.9% |
21.5%
6.4 pts worse
|
16.3%
11.6 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 26.4% · Q2 41.5% · Q3 33.9% · Q4 9.2% · 4Q avg 27.9% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 24.7% |
16.8%
7.9 pts worse
|
14.9%
9.8 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 21.5% · Q2 29.2% · Q3 21.4% · Q4 26.8% · 4Q avg 24.7% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 1.9% |
0.9%
1 pts worse
|
1.0%
0.9 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 2.8% · Q2 2.6% · Q3 1.2% · Q4 0.9% · 4Q avg 1.9% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 5.5% |
2.6%
2.9 pts worse
|
1.7%
3.8 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 7.9% · Q2 5.1% · Q3 5.1% · Q4 4.0% · 4Q avg 5.5% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 28.4% |
21.2%
7.2 pts worse
|
19.8%
8.6 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 21.9% · Q2 27.8% · Q3 31.5% · Q4 32.7% · 4Q avg 28.4% |
| Percentage of long-stay residents with pressure ulcers | 6.8% |
6.0%
0.8 pts worse
|
5.1%
1.7 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 6.6% · Q2 6.0% · Q3 8.4% · Q4 6.1% · 4Q avg 6.8% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 84.5% |
79.9%
4.6 pts better
|
81.7%
2.8 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 85.7% · Q2 85.6% · Q3 84.0% · Q4 82.9% · 4Q avg 84.5% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 16.5% |
13.2%
3.3 pts worse
|
12.0%
4.5 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 16.5% · Observed 15.0% · Expected 10.2% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 0.0% |
1.5%
1.5 pts better
|
1.6%
1.6 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 82.6% |
78.1%
4.5 pts better
|
79.7%
2.9 pts better
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 82.6% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 18.8% |
22.9%
4.1 pts better
|
23.9%
5.1 pts better
|
Short Stay · 20240701-20250630 · Adjusted 18.8% · Observed 18.0% · Expected 22.9% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2024-11-21 · Fire 2023-06-30
3 health deficiencies
Top issue: Freedom from Abuse and Neglect and Exploitation (1 deficiency)
3 fire-safety deficiencies
Top issue: Smoke (3 deficiencies)
Cycle 3
Health 2023-06-30 · Fire 2021-08-26
7 health deficiencies
Top issue: Quality of Life and Care (2 deficiencies)
1 fire-safety deficiencies
Top issue: Egress (1 deficiency)
Fire safety
Fire-safety citations
D · Potential for more than minimal harm
2024-11-21
K352 · Smoke Deficiencies
Fire Safety
Properly install and monitor supervisory attachments on automatic sprinkler systems.
Corrected 2025-01-27
D · Potential for more than minimal harm
2023-06-30
K351 · Smoke Deficiencies
Fire Safety
Install an approved automatic sprinkler system.
Corrected 2023-08-21
D · Potential for more than minimal harm
2023-06-30
K363 · Smoke Deficiencies
Fire Safety
Install corridor and hallway doors that block smoke.
Corrected 2023-08-21
D · Potential for more than minimal harm
2023-06-30
K372 · Smoke Deficiencies
Fire Safety
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Corrected 2023-08-21
F · Potential for more than minimal harm
2021-08-26
K211 · Egress Deficiencies
Fire Safety
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Corrected 2021-10-06
Inspection history
Recent health citations
F · Potential for more than minimal harm
2024-11-21
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2024-12-06
D · Potential for more than minimal harm
2024-11-21
F602 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Protect each resident from the wrongful use of the resident's belongings or money.
Corrected 2024-03-31
D · Potential for more than minimal harm
2024-11-21
F644 · Resident Assessment and Care Planning Deficiencies
Health
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Corrected 2024-12-04
J · Immediate jeopardy
2023-06-30
F684 · Quality of Life and Care Deficiencies
Health
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected 2023-07-18
J · Immediate jeopardy
2023-06-30
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 2023-07-18
D · Potential for more than minimal harm
2023-06-30
F554 · Resident Rights Deficiencies
Health
Allow residents to self-administer drugs if determined clinically appropriate.
Corrected 2023-07-18
D · Potential for more than minimal harm
2023-06-30
F655 · Resident Assessment and Care Planning Deficiencies
Health
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Corrected 2023-07-18
D · Potential for more than minimal harm
2023-06-30
F658 · Resident Assessment and Care Planning Deficiencies
Health
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected 2023-07-18
D · Potential for more than minimal harm
2023-06-30
F808 · Nutrition and Dietary Deficiencies
Health
Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law.
Corrected 2023-07-18
D · Potential for more than minimal harm
2023-06-30
F867 · Administration Deficiencies
Health
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Corrected 2023-07-18
Penalties and ownership
What sits behind the stars
$7,796
2023-06-30
Fine
Fine · fine $7,796
Fine
$7,797
2023-06-30
Fine
Fine · fine $7,797
Fine
Ownership
Gatewood, Thomas
5% Or Greater Direct Ownership Interest · Individual
Cooley, Mistie
5% Or Greater Direct Ownership Interest · Individual
Cooley, Mistie
Operational/Managerial Control · Individual
Cooley, Mistie
Corporate Officer · Individual
Dills, Melissa
Operational/Managerial Control · Individual
Gatewood, Thomas
Corporate Officer · Individual
Vargas, Carlos
Operational/Managerial Control · Individual
Nearby options
Other facilities in reach
#1
Vero Health & Rehab of Sylva
Sylva, NC
1-star overall rating with 1-star inspections with $359,818 in total fines with 7 recent health deficiencies with 10 fire-safety deficiencies in the latest cycle
#2
Tsali Care Center
Cherokee, NC
2-star overall rating with 1-star inspections with Special Focus status with $205,165 in total fines with 33 recent health deficiencies with 1 fire-safety deficiencies in the latest cycle
#3
Maggie Valley Nursing and Rehabilitation
Maggie Valley, NC
1-star overall rating with 1-star inspections with abuse icon flag with $69,935 in total fines with 7 recent health deficiencies with 2 fire-safety deficiencies in the latest cycle
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