Home / North Carolina / Sylva
Skyland Care Center
193 Asheville Highway, Sylva, NC 28779 · Jackson County · (828) 586-8935
94 certified beds, about 90 residents a day · For profit - Corporation · Medicare and Medicaid since 1991
Certified for Medicaid Certified for Medicare
Overall
4 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
3 of 5
CMS Care Compare ratings, data as of September 1, 2026 · CCN 345400 · See it on Medicare.gov · Compare with other homes
The record in brief
At its most recent standard inspection, on January 23, 2026, inspectors cited 0 health deficiencies (the North Carolina average is 4.7, the national average 9.2).
Of 10 health citations since June 2023, 2 were rated as actual harm or immediate jeopardy to residents (2 immediate jeopardy).
CMS lists no fines against this home in the last three years.
Nurses and nurse aides worked 3.51 hours per resident per day, against 3.85 across North Carolina and 3.86 nationally. Registered nurses accounted for 0.56 of those hours.
46.0% of nursing staff left within the year CMS measured (North Carolina average 49.0%).
Health inspections
Federal rules call for a standard inspection at least every 15 months, plus a visit whenever a complaint is filed. Each mark below is one citation, colored by how serious inspectors rated it. How to read a citation.
Under each citation, the quoted text is the inspector's own summary from the federal statement of deficiencies (CMS form 2567), word for word apart from a privacy scrub; CMS removes residents' and staff names before it publishes the text. The full notes are on Medicare.gov.
706/23
311/24
001/26
Potential for minimal harm Potential for more than minimal harm Actual harm Immediate jeopardy Found on a complaint visit
Where its citations fall on CMS's grid
CMS rates every citation by how much harm it caused (rows) and how many residents it touched (columns). The count in each box is this home's, across all 10 health citations on file.
Severity
Isolated
Pattern
Widespread
Immediate jeopardy
2J
0K
0L
Actual harm
0G
0H
0I
Potential for more than minimal harm
7D
0E
1F
Potential for minimal harm
0A
0B
0C
January 23, 2026Standard inspection · 0 citations
November 21, 2024Standard inspection, Complaint inspection · 3 citations
- F Provide and implement an infection prevention and control program.
Inspectors wroteBased on record review, and Physician and staff interviews, the facility failed to implement an infection surveillance plan for monitoring and tracking infections in the facility. This practice had the potential to affect 89 of 89 residents in the facility.
- D Protect each resident from the wrongful use of the resident's belongings or money.
Inspectors wroteBased on record review and staff interviews, the facility failed to protect residents' rights to be free from misappropriation of controlled medications for 2 of 2 residents (Resident # 348 & Resident #147) reviewed for misappropriation of residents' property.
- D Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Inspectors wroteBased on record review and staff interviews, the facility failed to ensure a Preadmission Screening and Resident Review (PASRR) Level II was completed for 1 of 2 residents (Resident #74) reviewed for PASRR.
June 30, 2023Standard inspection · 7 citations
- J Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Inspectors wroteBased on record review, review of surveillance video, and interviews with staff, Nurse Practitioner (NP) and Medical Director (MD), the facility failed to assess Resident #287 immediately after a fall from the contracted transportation van. On 12/12/22 Resident #287 was rolled out of the back of the contracted transportation van in her wheelchair and fell to the ground landing on her left side and hitting the back of her head. The Contracted Transporter lifted Resident #287 back into her wheelchair and wheeled her into the facility without being assessed by a licensed professional. The Resident complained of mid back pain at 7 out of 10 (10 being the worst pain) and bruising was noted on her right forearm. Resident #287 was sent to the emergency department for evaluation and diagnosed with a compression fracture of the L1 vertebrae. [...]
- J Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Inspectors wroteBased on observations, record reviews, video surveillance review, and staff and Nurse Practitioner interviews the facility contracted van driver failed to ensure the lift gate was in the elevated position before unloading a resident from the back of a facility contracted van. On 12/12/22 Resident #287 was rolled out of the back of the contracted transportation van in her wheelchair and fell to the ground landing on her left side and hitting the back of her head. The Resident complained of mid back pain at 7 out of 10 (10 being the worst pain) and bruising was noted on her right forearm. Resident #287 was sent to the emergency department for evaluation and diagnosed with a compression fracture of the L1 vertebrae. This occurred for 1 of 3 residents sampled for accidents (Resident #287). [...]
- D Allow residents to self-administer drugs if determined clinically appropriate.
Inspectors wroteBased on observations, record review, resident and staff interviews, the facility failed to assess the ability of a resident to self-administer medications for 1 of 1 sampled resident observed with medications at bedside (Resident #53).
- D Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Inspectors wroteBased on record review and staff interviews the facility failed to develop a baseline care plan within 48 hours of admission that addressed a resident's immediate needs for 1 of 4 sampled residents reviewed for baseline care plans (Resident #82).
- D Ensure services provided by the nursing facility meet professional standards of quality.
Inspectors wroteBased on observations, record review, and interviews with staff the facility failed to assure a nurse assessed a new skin tear and determined treatment for 1 of 4 residents reviewed for skin conditions (Resident #13).
- 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.
Inspectors wroteBased on observations, record review, and interviews with the Speech/Language Pathologist and staff the facility failed to provide a therapeutic diet as ordered by the physician for 1 of 3 residents reviewed for nutrition (Resident #38).
- D Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Inspectors wroteBased on observations, record review, and staff interviews, the facility's Quality Assessment and Assurance (QAA) Committee failed to maintain implemented procedures and monitor the interventions the committee put into place following a recertification survey completed on 08/26/21. This failure was for a deficiency originally cited in the area of Quality of Care (F684) on 08/26/21. This continued failure during two federal surveys of record showed a pattern of the facility's inability to sustain an effective QAA Program.
Fire safety inspections
8 fire safety citations on file: 4 on January 23, 2026, 1 on November 21, 2024, 3 on June 30, 2023.
Every fire safety citation8 citations
- 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.
Fines and payment denials
CMS lists no fines or payment denials against this home in the last three years. The national average is 0.9 fines per home.
Staffing
Hours of care per resident per day, from the payroll records every home sends CMS. Higher means more staff time with each resident.
| Measure | This home | North Carolina | United States |
|---|---|---|---|
| All nursing staff (RN, LPN and aides) | 3.51 | 3.85 | 3.86 |
| Registered nurses | 0.56 | 0.62 | 0.69 |
| All nursing staff on weekends | 2.96 | 3.42 | 3.42 |
| Nurse aides | 2.20 | ||
| Licensed practical nurses | 0.75 | ||
| Nursing staff turnover (share who left in a year) | 46.0% | 49.0% | 45.8% |
| Registered nurse turnover | 31.3% | 45.6% | 42.9% |
| Administrators who left | 0 |
CMS expects 3.88 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.
Staffing by quarter, from daily payroll records
Every nursing home sends CMS its staff hours for each day (the Payroll Based Journal). Here they are added up by quarter. The latest quarter is the one behind the figures above. In January to March 2026, nursing staff hours per resident were 3.74 on weekdays and 2.96 on weekends, 21% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 6.2% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 3.53 in April to June 2025 to 3.51 in January to March 2026.
| Quarter | All nursing staff | Registered nurses | Weekdays | Weekends | Contract staff share | Days with no RN hours | Residents a day |
|---|---|---|---|---|---|---|---|
| Jan to Mar 2026 | 3.51 | 0.56 | 3.74 | 2.96 | 6.2% | 0 of 90 | 90 |
| Oct to Dec 2025 | 3.48 | 0.55 | 3.75 | 2.79 | 10.9% | 0 of 92 | 90 |
| Jul to Sep 2025 | 3.57 | 0.60 | 3.79 | 3.03 | 12.3% | 0 of 92 | 88 |
| Apr to Jun 2025 | 3.53 | 0.55 | 3.73 | 3.03 | 11.0% | 0 of 91 | 90 |
| United States, Jan to Mar 2026 | 3.75 | 0.62 | 3.92 | 3.33 | 5.3% | 0.5% of days | |
| North Carolina, Jan to Mar 2026 | 3.65 | 0.53 | 3.82 | 3.25 | 8.0% | 0.7% of days |
Hours per resident per day: staff hours in the quarter divided by resident days (the daily census CMS derives from resident assessments). Registered nurses include the director of nursing and RNs with administrative duties; aides include nurse aides in training and medication aides, as in CMS's own staffing measure. How these are calculated.
Quality measures
The measures CMS uses for the quality star. Lower is better for every one of them.
| Measure | This home | North Carolina | US |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased Long Stay residents, 2025Q2-2026Q1 | 31.7 | 15.6 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 0.8 | 0.7 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 5.6 | 2.3 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 6.8 | 3.5 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 0.0 | 1.4 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 21.2 | 18.3 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 5.1 | 5.5 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 11.0 | 14.0 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 19.1 | 22.9 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 18.1 | 12.9 | 12.0 |
| Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 1.6 | 1.8 | 1.9 |
| Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 4.0 | 1.8 | 1.8 |
Owners and operators
Legal business name: BT2, INC..
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Cooley, Mistie | 5% or greater direct ownership interest | Individual | 49% | 10/01/2013 |
| Gatewood, Thomas | 5% or greater direct ownership interest | Individual | 51% | 10/01/2016 |
| Cooley, Mistie | Managing control - governing body | Individual | 10/01/2013 | |
| Gatewood, Thomas | Managing control - governing body | Individual | 10/01/2003 | |
| Cooley, Mistie | Corporate officer | Individual | 10/01/2013 | |
| Gatewood, Thomas | Corporate officer | Individual | 10/01/2003 | |
| Cooley, Mistie | Operational/managerial control | Individual | 10/01/2013 | |
| Dills, Melissa | Operational/managerial control | Individual | 12/16/2022 | |
| Vargas, Carlos | Operational/managerial control | Individual | 08/01/2012 | |
| Dills, Melissa | Adp of the SNF | Individual | 12/16/2022 | |
| Vargas, Carlos | Adp of the SNF | Individual | 08/01/2012 |
As listed in the CMS ownership file, which names owners with a 5% or greater stake and the people and companies with operational or managerial control.
Questions to ask on a visit
Chosen from this home's own inspection record.
- When is the care plan meeting, and can family attend it?Inspectors cited 3 problems in this area, most recently on November 21, 2024: "Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed."
- How do you prevent falls and pressure injuries, and how are families told when one happens?Inspectors cited 2 problems in this area, most recently on June 30, 2023: "Provide appropriate treatment and care according to orders, resident’s preferences and goals."
- What changed in infection control since the last inspection, and who on staff is the infection preventionist?Inspectors cited 1 problem in this area, most recently on November 21, 2024: "Provide and implement an infection prevention and control program."
- How are allegations of abuse or neglect reported and investigated, and who tells the family?Inspectors cited 1 problem in this area, most recently on November 21, 2024: "Protect each resident from the wrongful use of the resident's belongings or money."
- Who is on the floor on Saturday and Sunday, and how many residents does each aide care for?Weekend nurse staffing here was 2.96 hours per resident per day, below the North Carolina average of 3.42.
Other nursing homes nearby
- Vero Health & Rehab of Sylva Sylva, 0.1 mi · 1 of 5 stars · 53 citations
- Tsali Care Center Cherokee, 9.9 mi · 2 of 5 stars · 82 citations
- Maggie Valley Health and Rehabilitation Center Maggie Valley, 11.6 mi · 2 of 5 stars · 17 citations
- Autumn Care of Waynesville Waynesville, 12.7 mi · 1 of 5 stars · 31 citations
- Mountain View of Bryson City Bryson City, 14.7 mi · 1 of 5 stars · 37 citations
- Skyland Terrace and Rehabilitation Waynesville, 15.3 mi · 4 of 5 stars · 13 citations
- Smoky Mountain Health and Rehabilitation Center Waynesville, 18.4 mi · 3 of 5 stars · 10 citations
- Macon Valley Nursing and Rehabilitation Center Franklin, 19.1 mi · 2 of 5 stars · 14 citations
North Carolina contacts for a concern about a nursing home
These are the official offices in North Carolina. NursingHomeClear cannot take or act on complaints.
- Inspections and complaints: NC Division of Health Service Regulation, Nursing Home Licensure and Certification Section, the state agency that inspects nursing homes for CMS and takes complaints about care.
- Resident advocate: North Carolina Long-Term Care Ombudsman Program. The long-term care ombudsman is a free, confidential advocate for residents and families, set up under the federal Older Americans Act.
- State inspection reports: NC DHSR Regulated Facilities search (Statements of Deficiencies), where North Carolina publishes its own records on licensed homes.
Common questions
- What is Skyland Care Center's Medicare star rating?
- CMS rates Skyland Care Center 4 out of 5 stars overall, with 4 for health inspections, 3 for staffing and 3 for quality measures (CMS data as of September 1, 2026).
- How many deficiencies did Skyland Care Center get at its last inspection?
- 0 health deficiencies at the standard inspection on January 23, 2026. The North Carolina average is 4.7.
- Has Skyland Care Center been fined?
- CMS lists no fines in the last three years.
- Does Skyland Care Center accept Medicaid?
- It is certified to take Medicaid (CMS lists it as "Medicare and Medicaid"). Certification does not mean a Medicaid bed is open: ask the admissions office.
- Who owns Skyland Care Center?
- CMS lists 11 owners and managers. Legal business name: BT2, INC..
Sources
- Ratings, staffing and fines: CMS Provider Information, released September 30, 2026, data as of September 1, 2026.
- Citations: CMS Health Deficiencies and Fire Safety Deficiencies.
- Owners: CMS Ownership. Penalties: CMS Penalties.
- Staffing by quarter: CMS Payroll Based Journal Daily Nurse Staffing, April 2025 to March 2026, summed by NursingHomeClear.
- Inspector summaries: CMS Full Statement of Deficiencies (CMS-2567 text), data as of September 1, 2026. Each quote is the part of the statement before the detailed findings.
- Inspection reports with the inspectors' full notes are on this home's Medicare.gov page.
- Something wrong on this page? Ask for a correction. We fix errors in our copy of the data; findings themselves can only be changed by CMS and the state.
- NursingHomeClear is independent and not affiliated with CMS, Medicare or any state agency. This page reports federal records; it does not rate, recommend or endorse any home, and it is not medical or legal advice.