Federal inspection record · CMS data as of October 1, 2026
Skyland Care Center
193 Asheville Highway, Sylva, NC · (828) 586-8935
- Certified beds
- 94
- Residents per day
- 90
- Ownership
- For-Profit
- Chain
- No chain reported
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- September 3, 1991
1
How this home got 4 stars
The overall rating isn't an average. CMS starts from the inspection rating and nudges it at most two steps. Here is the arithmetic for this home, using CMS's own rules.
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Health inspections
★★★★★starting point
Everything starts from what state inspectors found on site. This is a ranking against other homes in North Carolina.
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Staffing
★★★★★no change
Only a 5-star staffing rating adds a star, and only a 1-star rating removes one. Ratings of 2 to 4 change nothing.
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Quality measures
★★★★★no change
Same rule: 5 stars adds one, 1 star takes one away. These measures are mostly reported by the home itself.
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Overall
★★★★★4 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among North Carolina homes
Skyland Care Center carries 6 inspection points. That is fewer than 85% of North Carolina's 415 rated homes.
Inspectors' citations earn points by how serious and how widespread they were (the grid below). CMS then ranks every home in North Carolina: the 10% with the fewest points get 5 stars, the 20% with the most get 1 star, and the middle 70% split evenly into 2, 3 and 4.
- 5★ 0–4 pts
- 4★ 4–15 pts
- 3★ 15–35 pts
- 2★ 35–73.5 pts
- 1★ over 73.5 pts
Bars show every rated home in North Carolina by its weighted inspection score. CMS recalibrates the cut points monthly but holds a home's rating until its own score changes, so a home can sit just outside today's band.
3
What inspectors found
10 health citations on record since 2023. Each one gets a letter: the row says how badly residents were affected, the column how many.
Immediate jeopardyResidents at risk of serious injury or death
Actual harmA resident was hurt
Potential for harmNo one was hurt, but could have been
Minimal harmPaperwork-level problems
Read the rows, not the total. Most citations nationwide are a D: one problem, nobody hurt. Rows G–I mean a resident was harmed; J–L mean inspectors found residents in immediate danger of serious injury or death.
Small numbers in each cell are the inspection points CMS assigns per citation. Those points are what the state curve above ranks.
Harm and immediate-jeopardy citations (2)
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J
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
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J
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Everything else, by area of care
Resident Assessment and Care Planning3D
- D
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
- D
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
- D
Ensure services provided by the nursing facility meet professional standards of quality.
Infection Control1F
- F
Provide and implement an infection prevention and control program.
Freedom from Abuse, Neglect, and Exploitation1D
- D
Protect each resident from the wrongful use of the resident's belongings or money.
Resident Rights1D
- D
Allow residents to self-administer drugs if determined clinically appropriate.
Nutrition and Dietary1D
- D
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.
Administration1D
- D
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Inspection history
2026-01-23
0 health deficiencies · 4 fire-safety deficiencies
No concentrated health issue counts in this cycle.
2024-11-21
3 health deficiencies · 1 fire-safety deficiencies
Top issue: Freedom from Abuse and Neglect and Exploitation (1 deficiency)
2023-06-30
7 health deficiencies · 3 fire-safety deficiencies
Top issue: Quality of Life and Care (2 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 3 h 37 min of nursing staff time a day, 34 min of it from a registered nurse.
This home
3 h 37 min
North Carolina average
3 h 52 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 41% of nursing staff and 14% of registered nurses left in the past year.
Reported hours from payroll data the home submits to CMS, divided by its daily resident count. Not adjusted for how sick residents are.
5
Resident outcomes
Quality measures compared with state and national averages. Most come from assessments the home itself reports.
| Measure | This home | State | U.S. |
|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days0.1 pts better | 1.6 | 1.7 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days2.4 pts worse | 4.1 | 1.7 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine1.7 pts worse | 90.7% | 92.4% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine4.1 pts better | 98.8% | 94.7% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury2.6 pts worse | 6.0% | 3.4% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms6.8 pts better | 0.0% | 6.8% | 13.5% |
| Percentage of long-stay residents who lose too much weight3.1 pts worse | 10.2% | 7.1% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication5 pts better | 16.1% | 21.1% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication3.3 pts better | 10.6% | 13.9% | 15.4% |
| Percentage of long-stay residents who were physically restrainedAbout the same | 0.0% | 0.0% | 0.1% |
| Percentage of long-stay residents whose ability to walk independently worsened0.6 pts better | 16.0% | 16.6% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased15.7 pts worse | 30.7% | 15.0% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder0.1 pts better | 0.5% | 0.6% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection3.6 pts worse | 5.7% | 2.1% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence0.8 pts better | 19.1% | 19.9% | 18.3% |
| Percentage of long-stay residents with pressure ulcers2 pts better | 3.4% | 5.4% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine30.8 pts worse | 50.7% | 81.5% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit8.6 pts worse | 21.3% | 12.7% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication0.6 pts better | 0.8% | 1.4% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine0.4 pts better | 81.5% | 81.1% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission1.9 pts better | 20.3% | 22.2% | 23.4% |
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Who owns and runs it
11 owners and managers reported to CMS. The last column counts how many nursing homes each one is tied to.
Show ownership list
| Name | Role | Share | Homes |
|---|---|---|---|
| Gatewood, Thomas | 5% Or Greater Direct Ownership Interest · Individual | 51% | 3 facilities |
| Cooley, Mistie | 5% Or Greater Direct Ownership Interest · Individual | 49% | 2 facilities |
| Cooley, Mistie | Managing Control - Governing Body · Individual | 0% | 2 facilities |
| Cooley, Mistie | Corporate Officer · Individual | 0% | 2 facilities |
| Cooley, Mistie | Operational/Managerial Control · Individual | 0% | 2 facilities |
| Dills, Melissa | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Dills, Melissa | Adp Of The SNF · Individual | 0% | 1 facilities |
| Gatewood, Thomas | Managing Control - Governing Body · Individual | 0% | 3 facilities |
| Gatewood, Thomas | Corporate Officer · Individual | 0% | 3 facilities |
| Vargas, Carlos | Operational/Managerial Control · Individual | 0% | 2 facilities |
| Vargas, Carlos | Adp Of The SNF · Individual | 0% | 2 facilities |
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Fire safety
8 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke8D
- D
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- D
Provide properly protected cooking facilities.
- D
Install corridor and hallway doors that block smoke.
- D
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- D
Properly install and monitor supervisory attachments on automatic sprinkler systems.
- D
Install an approved automatic sprinkler system.
- D
Install corridor and hallway doors that block smoke.
- D
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
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Other homes nearby
-
Vero Health & Rehab of Sylva
Sylva, NC · Regional Health Properties · Special Focus
★★★★★- Worst citation, 3 yrs
- K
- Nursing / resident / day
- 3 h 47 min
- Fines
- $359,818
-
Tsali Care Center
Cherokee, NC · Special Focus
★★★★★- Worst citation, 3 yrs
- G
- Nursing / resident / day
- 5 h 51 min
- Fines
- $157,555
-
Maggie Valley Health and Rehabilitation Center
Maggie Valley, NC
★★★★★- Worst citation, 3 yrs
- L
- Nursing / resident / day
- 3 h 20 min
- Fines
- $51,012