Cycle 1
Health 2024-12-06 · Fire 2023-07-14
5 health deficiencies
Top issue: Freedom from Abuse and Neglect and Exploitation (2 deficiencies)
2 fire-safety deficiencies
Top issue: Services (1 deficiency)
Waynesville, NC
Skyland Terrace and Rehabilitation
3-star overall rating with 3-star inspections with $8,512 in total fines with 5 recent health deficiencies with 2 fire-safety deficiencies in the latest cycle
516 Wall Street, Waynesville, NC
(828) 452-3154
Overall
3 / 5
CMS overall stars
Health inspections
3 / 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
90
Certified beds
Average residents
83
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
No chain reported
Operator or chain grouping
Approved since
1992-01-24
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
0.53
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
2.36
Nurse aide staffing · state 2.33 · national 2.35
Total nurse hours
3.68
All reported nurse hours · state 3.78 · national 3.89
Licensed hours
1.32
RN + LPN hours · state 1.45 · national 1.54
Weekend hours
3.36
Weekend nurse staffing · state 3.34 · national 3.43
Weekend RN hours
0.38
Weekend registered nurse coverage · state 0.38 · national 0.47
Physical therapist
0.12
Reported PT staffing · state 0.09 · national 0.07
Adjusted RN hours
0.60
CMS adjusted RN staffing hours
Adjusted total hours
4.12
CMS adjusted total nurse staffing hours
Case-mix index
1.22
Higher values indicate more complex resident acuity
RN turnover
31%
Annual RN turnover · state 48% · national 45%
Total nurse turnover
57%
Annual nurse turnover · state 50% · national 46%
SNF VBP
Value-based purchasing
Program rank
7,587
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
29.35
Composite VBP score used to determine payment impact.
Payment multiplier
0.9854
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
2.44
Baseline 18.25% · Performance 20.30% · Measure score 2.44 · Achievement 2.44 · Improvement 0
Healthcare-associated infections
5.05
Baseline 5.99% · Performance 6.33% · Measure score 5.05 · Achievement 5.05 · Improvement 0
Total nurse turnover
0.96
Performance 59.76% · Measure score 0.96 · Achievement 0.96 · This facility did not have sufficient data to calculate a baseline period measure result.
Adjusted total nurse staffing
3.29
Baseline 3.66 hours · Performance 4.01 hours · Measure score 3.29 · Achievement 3.29 · Improvement 1.16
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 9.97% |
10.72%
0.8 pts better
|
No Different than the National Rate · Eligible stays 91 · Observed rate 8.79% · Lower 95% interval 7.48% |
| Discharge to community | 43.18% |
50.57%
7.4 pts worse
|
No Different than the National Rate · Eligible stays 73 · Observed rate 38.36% · Lower 95% interval 33.96% |
| Medicare spending per beneficiary | 1.11 |
1.02
0.1 pts worse
|
|
| Drug regimen review with follow-up | 96.3% |
95.27%
1 pts better
|
Numerator 52 · Denominator 54 |
| Falls with major injury | 0% |
0.77%
0.8 pts better
|
Numerator 0 · Denominator 54 |
| Discharge self-care score | 46.15% |
53.69%
7.5 pts worse
|
Numerator 18 · Denominator 39 |
| Discharge mobility score | 53.85% |
50.94%
2.9 pts better
|
Numerator 21 · Denominator 39 |
| Pressure ulcers or injuries, new or worsened | 0% |
2.29%
2.3 pts better
|
Numerator 0 · Denominator 54 · Adjusted rate 0% |
| Healthcare-associated infections requiring hospitalization | 6.32% |
7.12%
0.8 pts better
|
No Different than the National Rate · Eligible stays 58 · Observed rate 3.45% · Lower 95% interval 3.24% |
| Staff COVID-19 vaccination coverage | 0% |
8.2%
8.2 pts worse
|
Numerator 0 · Denominator 204 |
| Staff flu vaccination coverage | 50% |
42%
8 pts better
|
Numerator 102 · Denominator 204 |
| Discharge function score | 53.85% |
56.45%
2.6 pts worse
|
Numerator 21 · Denominator 39 |
| Transfer of health information to provider | Not Available |
95.95%
|
Numerator Not Available · Denominator 12 · Too few residents or stays to report publicly. |
| 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 | 18.18% |
25.2%
7 pts worse
|
Numerator 4 · Denominator 22 |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 1.5 |
1.8
0.3 pts better
|
1.9
0.4 pts better
|
Long Stay · 20240701-20250630 · Adjusted 1.5 · Observed 1.6 · Expected 1.9 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 2.1 |
1.8
0.3 pts worse
|
1.8
0.3 pts worse
|
Long Stay · 20240701-20250630 · Adjusted 2.1 · Observed 2.2 · Expected 1.7 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 99.3% |
91.5%
7.8 pts better
|
93.4%
5.9 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 98.6% · Q3 100.0% · Q4 98.8% · 4Q avg 99.3% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 100.0% |
94.1%
5.9 pts better
|
95.5%
4.5 pts better
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 100.0% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 3.6% |
3.6%
About the same
|
3.3%
0.3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 2.9% · Q2 4.1% · Q3 4.9% · Q4 2.5% · 4Q avg 3.6% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 8.4% |
4.8%
3.6 pts worse
|
11.4%
3 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 15.2% · Q2 6.0% · Q3 8.0% · Q4 5.2% · 4Q avg 8.4% |
| Percentage of long-stay residents who lose too much weight | 8.1% |
7.2%
0.9 pts worse
|
5.4%
2.7 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 9.5% · Q2 6.2% · Q3 13.5% · Q4 2.9% · 4Q avg 8.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 25.4% |
21.6%
3.8 pts worse
|
19.6%
5.8 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 20.9% · Q2 30.4% · Q3 29.5% · Q4 20.8% · 4Q avg 25.4% |
| Percentage of long-stay residents who received an antipsychotic medication | 18.7% |
15.0%
3.7 pts worse
|
16.7%
2 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 21.1% · Q2 22.4% · Q3 15.9% · Q4 16.4% · 4Q avg 18.7% · 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 | 14.0% |
21.5%
7.5 pts better
|
16.3%
2.3 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 25.2% · Q2 15.3% · Q3 10.4% · Q4 7.2% · 4Q avg 14.0% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 21.9% |
16.8%
5.1 pts worse
|
14.9%
7 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 29.0% · Q2 25.0% · Q3 18.3% · Q4 16.7% · 4Q avg 21.9% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 2.6% |
0.9%
1.7 pts worse
|
1.0%
1.6 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 1.1% · Q2 3.3% · Q3 1.9% · Q4 4.0% · 4Q avg 2.6% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 2.1% |
2.6%
0.5 pts better
|
1.7%
0.4 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 3.0% · Q2 1.5% · Q3 1.3% · Q4 2.7% · 4Q avg 2.1% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 29.4% |
21.2%
8.2 pts worse
|
19.8%
9.6 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 28.2% · Q2 30.1% · Q3 34.0% · Q4 25.2% · 4Q avg 29.4% |
| Percentage of long-stay residents with pressure ulcers | 6.7% |
6.0%
0.7 pts worse
|
5.1%
1.6 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 9.2% · Q2 10.6% · Q3 5.8% · Q4 1.8% · 4Q avg 6.7% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 75.2% |
79.9%
4.7 pts worse
|
81.7%
6.5 pts worse
|
Short Stay · 2024Q4-2025Q3 · Q1 78.7% · Q2 78.3% · Q3 61.9% · Q4 73.9% · 4Q avg 75.2% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 19.4% |
13.2%
6.2 pts worse
|
12.0%
7.4 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 19.4% · Observed 17.6% · 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% · 4Q avg 0.0% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 66.7% |
78.1%
11.4 pts worse
|
79.7%
13 pts worse
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 66.7% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 20.8% |
22.9%
2.1 pts better
|
23.9%
3.1 pts better
|
Short Stay · 20240701-20250630 · Adjusted 20.8% · Observed 19.6% · Expected 22.4% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2023-07-14 · Fire 2021-12-16
5 health deficiencies
Top issue: Pharmacy Service (3 deficiencies)
0 fire-safety deficiencies
No concentrated fire-safety issue counts in this cycle.
Cycle 3
Health 2021-12-16 · Fire 2020-02-21
6 health deficiencies
Top issue: Infection Control (2 deficiencies)
0 fire-safety deficiencies
No concentrated fire-safety issue counts in this cycle.
Fire safety
Fire-safety citations
F · Potential for more than minimal harm
2023-07-14
K345 · Smoke Deficiencies
Fire Safety
Have approved installation, maintenance and testing program for fire alarm systems.
Corrected 2023-10-06
F · Potential for more than minimal harm
2023-07-14
K521 · Services Deficiencies
Fire Safety
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
Corrected 2023-10-06
Inspection history
Recent health citations
D · Potential for more than minimal harm
2025-04-30
F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected 2025-05-17
G · Actual harm
2024-12-06
F745 · Quality of Life and Care Deficiencies
Health
Provide medically-related social services to help each resident achieve the highest possible quality of life.
Corrected 2024-12-19
D · Potential for more than minimal harm
2024-12-06
F602 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Protect each resident from the wrongful use of the resident's belongings or money.
Corrected 2024-12-20
D · Potential for more than minimal harm
2024-12-06
F686 · Quality of Life and Care Deficiencies
Health
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Corrected 2024-12-11
D · Potential for more than minimal harm
2024-12-06
F812 · Nutrition and Dietary Deficiencies
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2024-12-11
E · Potential for more than minimal harm
2023-07-14
F756 · Pharmacy Service Deficiencies
Health
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Corrected 2023-07-31
E · Potential for more than minimal harm
2023-07-14
F760 · Pharmacy Service Deficiencies
Health
Ensure that residents are free from significant medication errors.
Corrected 2023-07-31
E · Potential for more than minimal harm
2023-07-14
F812 · Nutrition and Dietary Deficiencies
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2023-07-31
D · Potential for more than minimal harm
2023-07-14
F641 · Resident Assessment and Care Planning Deficiencies
Health
Ensure each resident receives an accurate assessment.
Corrected 2023-07-31
D · Potential for more than minimal harm
2023-07-14
F757 · Pharmacy Service Deficiencies
Health
Ensure each resident’s drug regimen must be free from unnecessary drugs.
Corrected 2023-07-31
G · Actual harm
2021-12-16
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 2022-01-28
F · Potential for more than minimal harm
2021-12-16
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2022-01-28
E · Potential for more than minimal harm
2021-12-16
F761 · Pharmacy Service Deficiencies
Health
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Corrected 2022-01-28
E · Potential for more than minimal harm
2021-12-16
F887 · Infection Control Deficiencies
Health
Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.
Corrected 2022-01-28
D · Potential for more than minimal harm
2021-12-16
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 2022-01-28
D · Potential for more than minimal harm
2021-12-16
F726 · Nursing and Physician Services Deficiencies
Health
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Corrected 2022-01-28
Penalties and ownership
What sits behind the stars
$8,512
2024-12-06
Fine
Fine · fine $8,512
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
Gatewood, Thomas
Operational/Managerial Control · Individual
Gatewood, Thomas
Corporate Officer · Individual
Nearby options
Other facilities in reach
#1
Autumn Care of Waynesville
Waynesville, NC
1-star overall rating with 1-star inspections with abuse icon flag with $107,387 in total fines with 6 recent health deficiencies with 3 fire-safety deficiencies in the latest cycle
#2
Smoky Mountain Health and Rehabilitation Center
Waynesville, NC
4-star overall rating with 4-star inspections with 4 recent health deficiencies with 5 fire-safety deficiencies in the latest cycle
#3
Silver Bluff
Canton, NC
3-star overall rating with 3-star inspections with $34,902 in total fines with 5 recent health deficiencies with 5 fire-safety deficiencies in the latest cycle
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