Skyland Terrace and Rehabilitation
A nursing home in Waynesville, North Carolina 28786
516 Wall Street, Waynesville, North Carolina 28786. (828) 452-3154.
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The short answer
Record last released by CMS on Oct 28, 2026.
- 4of 5 CMS’s overall rating
- 3 health citations at the latest inspection cycle North Carolina average: 4.6
- 3.27 nurse hours per resident per day North Carolina average: 3.87
- 1 fine in the last three years (needs attention)
Each figure’s source sits beside it, in its section below.
What these words mean7
- Star ratings
- CMS rates some kinds of place from 1 to 5 stars, more stars meaning better on CMS’s own measures for that kind: for a nursing home, its health inspections, staffing and quality measures. A rating is CMS’s summary of those measures; it doesn’t promise good care. Source: CMS, Care Compare and the Five-Star Quality Rating System.
- Inspection (survey)
- A visit by state inspectors, often unannounced, who check a place against the rules it must meet. For nursing homes and other places Medicare pays, CMS calls these visits surveys: a standard survey of a nursing home comes at least every 15 months, and a complaint survey whenever a complaint calls for one. Source: CMS; 42 CFR 488.308.
- Deficiency, citation, violation
- What inspectors write up when a place didn’t meet a rule: the rule, what they saw, and when. CMS calls it a deficiency; states may say citation or violation. It is the inspectors’ finding, not a court’s, and the place is usually asked for a plan to correct it. Source: CMS, statement of deficiencies (Form CMS-2567); each state’s licensing agency.
- Scope and severity (A to L)
- CMS grades each nursing home deficiency with a letter. A to C: no actual harm, with potential for minimal harm. D to F: no actual harm, but potential for more. G to I: actual harm. J to L: immediate jeopardy. Within each band, the letter rises as more residents were affected or could be: one or a few, a pattern, or widespread. Source: CMS, nursing home scope and severity grid (State Operations Manual, chapter 7).
- Nurse staffing hours
- The hours registered nurses, licensed practical nurses and nurse aides worked, per resident per day, from the payroll records each home sends CMS. Source: CMS, Payroll-Based Journal.
- Fines and payment denials
- A fine (civil money penalty) is money CMS makes a nursing home pay when it falls short of federal rules. A payment denial means Medicare and Medicaid stop paying for new admissions until the home meets the rules again. Source: CMS; 42 CFR 488.430 and 488.417.
- Capacity
- The most people the licence or certification lets the place care for at once: residents, children, beds or apartments, as the state counts them. It isn’t how many are there now. Source: Each state’s licensing agency.
What did inspectors find?
3 health citations at the latest inspection cycle
The North Carolina average is 4.6.
Last standard inspection Feb 19, 2026.
Most serious in three years: actual harm (G), at a standard inspection on Dec 6, 2024
CMS, Provider Information, State and US Averages and Health Deficiencies. Released Oct 28, 2026. Updated monthly.
When those citations happened
8 citations in 3 months of the last 36. Last cited Feb 2026. Most serious: actual harm (G). The last 3 years, to Nov 5, 2026.
| Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2023 | Dec | |||||||||||
| 2024 | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec |
| 2025 | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec |
| 2026 | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov |
Hover or focus a month to read it.
Hearth Record drew this from the dates and levels in the source’s own records.
All 8 citations in the last three years
Grouped by inspection, newest first. Each carries CMS grades each nursing home deficiency with a letter. A to C: no actual harm, with potential for minimal harm. D to F: no actual harm, but potential for more. G to I: actual harm. J to L: immediate jeopardy. Within each band, the letter rises as more residents were affected or could be: one or a few, a pattern, or widespread. Source: CMS, nursing home scope and severity grid (State Operations Manual, chapter 7)., from A, the least serious, to L, the most. 3 came from complaint inspections.
CMS, Health Deficiencies. Released Oct 28, 2026. Updated monthly.
Feb 19, 2026: standard inspection3 citations
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Honor the resident’s right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
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Provide appropriate treatment and care according to orders, resident’s preferences and goals.
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Develop and implement policies and procedures for flu and pneumonia vaccinations.
Apr 30, 2025: complaint inspection1 citation
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Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Dec 6, 2024: standard inspection2 citations
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Provide medically-related social services to help each resident achieve the highest possible quality of life.
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Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Dec 6, 2024: standard and complaint inspection2 citations
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Protect each resident from the wrongful use of the resident’s belongings or money.
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Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Is it certified, and in good standing?
- Certified for Medicare and Medicaid since Jan 24, 1992.
- Not on CMS’s special focus list.
- No abuse icon from CMS.
- No change of ownership in the last 12 months.
- CMS lists its ownership as for profit, corporation.
- 90 certified beds.
CMS, Provider Information. Released Oct 28, 2026. Updated monthly.
Has it been fined or penalized?
- 1 fine in the last three years, $8,512 in all.
- No Medicare payment denials in the last three years.
- 3 citations in the last three years came from complaint inspections.
CMS, Penalties and Health Deficiencies. Released Oct 28, 2026. Updated monthly.
| Date | Kind | Amount |
|---|---|---|
| Dec 6, 2024 | Fine | $8,512 |
Who does the caring?
3.27 nurse hours per resident per day
The North Carolina average is 3.87.
CMS publishes staffing about four months after the fact.
CMS, Provider Information and State and US Averages. Released Oct 28, 2026. Updated monthly.
| Measure | This home | North Carolina average |
|---|---|---|
| Nurse hours per resident per day | 3.27 | 3.87 |
| Of which registered nurses | 0.80 | 0.62 |
| At weekends | 2.85 | 3.40 |
| Nursing staff turnover | 61.5% | 48.7% |
| Registered nurse turnover | 30% | 45.7% |
| Administrators who left | 0 | Not given |
Who owns it?
- 15 owners or officers are people: Thomas Elijah Gatewood (owns 5% or more directly, 51%); Thomas Elijah Gatewood (corporate officer, 51%); Mistie Cooley (owns 5% or more directly, 49%); Mistie Cooley (corporate officer, 49%); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); Mistie Cooley (runs it (operational or managerial control)); Mistie Cooley (on the governing body (managing control)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); Thomas Elijah Gatewood (runs it (operational or managerial control)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)).
- No private-equity firm among the owners CMS lists.
- No real-estate investment trust among the owners CMS lists.
CMS, All Owners. Checked Nov 5, 2026. Updated monthly.
CMS, Provider Information. Released Oct 28, 2026. Updated monthly.
How do residents fare?
- CMS rates its quality measures 3 of 5 (North Carolina average 3.5).
CMS, Provider Information and State and US Averages. Released Oct 28, 2026. Updated monthly.
| Measure | Rating |
|---|---|
| Overall rating | 4 of 5 |
| Health inspections | 4 of 5 |
| Staffing | 3 of 5 |
| Quality measures | 3 of 5 |
How does it compare nearby?
- Among the 12 nearest homes, within 22.4 miles, this one had the 7th most health citations at the latest inspection cycle (3; the middle value was 3.5).
CMS, Provider Information. Released Oct 28, 2026. Updated monthly.
| Place | Miles away | Citations, latest cycle |
|---|---|---|
| Skyland Terrace and Rehabilitation This nursing home | 3 | |
| Autumn Care of Waynesville | 2.9 | 6 |
| Smoky Mountain Health and Rehabilitation Center | 3.6 | 3 |
| Silver Bluff | 5.8 | 5 |
| Maggie Valley Health and Rehabilitation Center | 6.8 | 4 |
| Vero Health & Rehab of Sylva | 15.2 | 7 |
| Skyland Care Center | 15.3 | 0 |
| Pisgah Manor Health Care Center | 18.1 | 3 |
| Tsali Care Center | 20.2 | 27 |
| The Oaks-Brevard | 22.1 | 4 |
| Aston Park Health Care Center | 22.3 | 2 |
| Transylvania Regional Hospital | 22.4 | 2 |
What the record doesn’t say
- Complaints that didn’t lead to a citation aren’t published.
- Inspections reach CMS’s data about six weeks after they happen, and staffing about four months after.
- CMS publishes the inspectors’ full written findings in a separate monthly file, which isn’t loaded yet.
- Fines and Medicare payment denials are the only enforcement CMS publishes; state licence actions aren’t included.
Sources
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Centers for Medicare & Medicaid Services, Provider Information (4pq5-n9py).
Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, Health Deficiencies (r5ix-sfxw).
Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, Penalties (g6vv-u9sr).
Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, All Owners (afe44b85-cc6d-40d7-b5df-00ae8910d1d2).
Checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, State and US Averages (xcdc-v8bm).
Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
If you believe something here is wrong, a correction starts with the agency whose record this copies: CMS. CMS’s own record is on Care Compare. If Hearth Record copied something wrongly, it will fix it and log the correction publicly, with its date: how corrections work.
This copy of the record was made on Nov 5, 2026.
From the home
The public record above comes first. Anything the home adds will appear here, below it, and say who wrote it.
Replies
None. Replies aren’t open yet. When they open, the home will be able to answer any finding for free, and the reply will show beside that finding, unedited and dated.
Paid listing
None. Paid listings aren’t open yet. When they open, anything paid for will say “Paid by the home”, and paying will never change a finding, a rating or the order of results.