Haywood County, North Carolina · Nursing home
Skyland Terrace and Rehabilitation
4 of 5 overall from CMS
516 Wall Street, Waynesville, NC 28786
At a glance
- Overall rating 4 of 5 Above the state average of 2.9
- Nurse time per resident, per day 3.39 hours Below the state average of 3.85
- Nursing staff who left in a year 53.3% Above the state average of 49.0%
- Health citations, last 3 inspection cycles 13 1 at the harm level or above
- Fines in 3 years $8,512 1 fine
- Certified beds in use 92.7% of 90 beds, on an average day
Arrows only show whether a figure is above or below the state average. They are not a judgment of the home.
Skyland Terrace and Rehabilitation is a 90-bed nursing home in Waynesville, North Carolina (Haywood County). CMS rates it 4 of 5 stars overall as of Sep 2026. It reports 3.39 nurse staffing hours per resident per day, below the North Carolina average of 3.85. CMS lists 1 fine totaling $8,512 in the past three years.
- Certified beds
- 90
- Residents per day (average)
- 83.4
- Certified since
- 1992 (34 yrs)
For profit - Corporation Participates in Medicare and Medicaid
Bed use is this site's calculation: average residents per day divided by certified beds. It is an average, so it does not show today's openings.
Terms used on this page
- CMS
- The Centers for Medicare & Medicaid Services, the federal agency that publishes the ratings, staffing figures, inspection results and penalties shown here.
- Certified beds
- The number of federally certified beds CMS lists for the home.
- Deficiency or citation
- A federal requirement that inspectors found the home did not meet. Each one gets a letter from A to L for how serious it was and how many residents were affected. What the letters mean
- Actual harm
- Letters G, H and I: actual harm to a resident that is not immediate jeopardy.
- Immediate jeopardy
- Letters J, K and L: the problem caused, or was likely to cause, serious injury, harm, impairment or death to a resident.
- Inspection cycle
- A standard inspection plus the complaint and infection-control citations CMS assigns to it. This page shows the three most recent cycles.
- Special Focus Facility (SFF)
- A home CMS has placed under closer oversight because of its inspection record. More about the program
Questions to ask Skyland Terrace and Rehabilitation
Chosen from this home's public data.
- CMS lists 1 fine totaling $8,512 in the past three years. What changed after the most recent one?Penalties in CMS data
- Nursing staff turnover is 53.3%, above the North Carolina average of 49.0%. How often would the same aides care for my relative?Turnover in CMS data
- Reported nurse staffing is 3.00 hours per resident on weekends against 3.39 overall. Who covers Saturdays and Sundays?Weekend staffing in CMS data
More in what to ask on a nursing home tour.
CMS star ratings
- Overall 4 of 5 North Carolina average 2.9
- Health inspections 4 of 5 North Carolina average 2.9
- Staffing 3 of 5 North Carolina average 2.7
- Quality measures 3 of 5 North Carolina average 3.3
The vertical line marks the North Carolina average. Ratings run from 1 to 5. How to read CMS star ratings
Nurse staffing
Hours of care per resident per day, as the home reported to CMS.
What these roles do
Nurse aides give most hands-on daily care, such as help with bathing, dressing and meals. Licensed practical nurses give medications and routine nursing care. Registered nurses assess residents and direct their care.
- All nursing staff 3.39 h North Carolina average 3.85
- Nurse aides 1.98 h North Carolina average 2.34
- Licensed practical nurses 0.77 h North Carolina average 0.89
- Registered nurses 0.65 h North Carolina average 0.62
- All staff, weekends 3.00 h North Carolina average 3.42
How much nurse staffing is enough? All bars share one scale, 0 to 13 hours. The vertical line marks the North Carolina average; the national average for all nursing staff is 3.86 hours.
- Nursing staff turnover53.3%
- North Carolina average49.0%
- Registered nurse turnover40.0%
- North Carolina average45.6%
- Administrators who left0
Quality measures
CMS calculates these from residents' assessments and Medicare claims. They are shown as published, next to the North Carolina and national averages. marks the measures CMS uses in its quality star rating; for those, the rating gives more points for a lower rate.
Long-stay residents
| Measure | This home | North Carolina | U.S. |
|---|---|---|---|
| ★ Percentage of long-stay residents whose need for help with daily activities has increased | 23.9% | 15.6% | 13.9% |
| Percentage of long-stay residents who lose too much weight | 9.9% | 7.2% | 5.2% |
| ★ Percentage of long-stay residents with a catheter inserted and left in their bladder | 1.8% | 0.7% | 0.8% |
| ★ Percentage of long-stay residents with a urinary tract infection | 1.3% | 2.3% | 1.6% |
| Percentage of long-stay residents who have depressive symptoms | 7.3% | 5.9% | 12.8% |
| Percentage of long-stay residents who were physically restrained | 0.0% | 0.0% | 0.1% |
| ★ Percentage of long-stay residents experiencing one or more falls with major injury | 3.4% | 3.5% | 3.2% |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 96.9% | 92.0% | 93.6% |
| ★ Percentage of long-stay residents whose ability to walk independently worsened | 14.9% | 18.3% | 14.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 27.6% | 21.3% | 19.5% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 100.0% | 94.1% | 95.5% |
| ★ Percentage of long-stay residents with pressure ulcers | 3.8% | 5.5% | 4.6% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 30.1% | 20.7% | 19.0% |
| ★ Percentage of long-stay residents who received an antipsychotic medication | 11.8% | 14.0% | 15.4% |
| ★ Number of hospitalizations per 1000 long-stay resident days | 1.91 | 1.78 | 1.90 |
| ★ Number of outpatient emergency department visits per 1000 long-stay resident days | 2.59 | 1.80 | 1.78 |
Short-stay residents
| Measure | This home | North Carolina | U.S. |
|---|---|---|---|
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 68.5% | 80.6% | 82.0% |
| ★ Percentage of short-stay residents who newly received an antipsychotic medication | 0.0% | 1.4% | 1.6% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 66.7% | 78.1% | 79.8% |
| ★ Percentage of short-stay residents who were rehospitalized after a nursing home admission | 5.7% | 22.9% | 23.8% |
| ★ Percentage of short-stay residents who had an outpatient emergency department visit | 11.3% | 12.9% | 12.0% |
Measure periods: April 2025 to March 2026 for most measures; July 2024 to June 2025 for the flu vaccine measures; January to December 2025 for the hospital and emergency department measures, which CMS risk-adjusts. See the measures on Medicare.gov
Inspection history
Inspectors cited 13 health deficiencies in the three most recent inspection cycles. Of these, 1 involved actual harm; the rest were graded as no actual harm. 3 were cited in connection with a complaint investigation. The most recent citation at the harm level or above was on Dec 6, 2024: Provide medically-related social services to help each resident achieve the highest possible quality of life.
| Standard inspection | Health | Fire safety |
|---|---|---|
| Feb 19, 2026 | 3 | 4 |
| Dec 6, 2024 | 5 | 2 |
| Jul 14, 2023 | 5 | 0 |
North Carolina homes averaged 4.7 health deficiencies in the latest cycle; the national average is 9.2. Each cycle's health count covers the standard inspection on that date plus the complaint and infection-control citations CMS assigns to that cycle.
Health citations, three most recent inspection cycles (13)
-
DPotential for more than minimal harm, isolated
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.
Resident Rights · Deficient, Provider has date of correction (Mar 4, 2026)
-
DPotential for more than minimal harm, isolated
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care · Deficient, Provider has date of correction (Mar 4, 2026)
-
DPotential for more than minimal harm, isolated
Develop and implement policies and procedures for flu and pneumonia vaccinations.
Infection Control · Deficient, Provider has date of correction (Mar 4, 2026)
-
DPotential for more than minimal harm, isolated
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Complaint investigation · Freedom from Abuse, Neglect, and Exploitation · Deficient, Provider has date of correction (May 17, 2025)
-
GActual harm, isolated
Provide medically-related social services to help each resident achieve the highest possible quality of life.
Quality of Life and Care · Deficient, Provider has date of correction (Dec 19, 2024)
Show 8 more
-
DPotential for more than minimal harm, isolated
Protect each resident from the wrongful use of the resident's belongings or money.
Complaint investigation · Freedom from Abuse, Neglect, and Exploitation · Deficient, Provider has date of correction (Dec 20, 2024)
-
DPotential for more than minimal harm, isolated
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Complaint investigation · Quality of Life and Care · Deficient, Provider has date of correction (Dec 11, 2024)
-
DPotential for more than minimal harm, isolated
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary · Deficient, Provider has date of correction (Dec 11, 2024)
-
EPotential for more than minimal harm, pattern
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Pharmacy Service · Deficient, Provider has date of correction (Jul 31, 2023)
-
EPotential for more than minimal harm, pattern
Ensure that residents are free from significant medication errors.
Pharmacy Service · Deficient, Provider has date of correction (Jul 31, 2023)
-
EPotential for more than minimal harm, pattern
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary · Deficient, Provider has date of correction (Jul 31, 2023)
-
DPotential for more than minimal harm, isolated
Ensure each resident receives an accurate assessment.
Resident Assessment and Care Planning · Deficient, Provider has date of correction (Jul 31, 2023)
-
DPotential for more than minimal harm, isolated
Ensure each resident’s drug regimen must be free from unnecessary drugs.
Pharmacy Service · Deficient, Provider has date of correction (Jul 31, 2023)
What severity letters A to L mean
Each sentence above is the requirement that was not met, in CMS's wording. For the inspection results as Medicare publishes them, open this home's page on Medicare.gov and look under "Health inspections".
Penalties, past three years
| Date | Type | Amount |
|---|---|---|
| Dec 6, 2024 | Fine | $8,512 |
North Carolina homes averaged 1.2 fines and $36,617 in fine amounts; the national averages are 0.9 and $30,972.
Cost
Not in the public data. CMS does not publish what a nursing home charges.
Ask the home for its daily private-pay rate and whether a bed is open for your coverage. See what Medicare covers and how Medicaid pays for a nursing home.
Compared within North Carolina
Common questions
What is the CMS star rating for Skyland Terrace and Rehabilitation?
Skyland Terrace and Rehabilitation has an overall rating of 4 of 5 stars from CMS as of Sep 2026. Its health inspection rating is 4, staffing is 3 and quality measures is 3.
How many beds does Skyland Terrace and Rehabilitation have?
Skyland Terrace and Rehabilitation has 90 certified beds. It averages 83.4 residents per day, about 92.7% of its certified beds.
How much nursing care do residents get at Skyland Terrace and Rehabilitation?
The home reports 3.39 hours of nurse staffing per resident per day, including 0.65 hours from registered nurses. The North Carolina average is 3.85 hours and 0.62 hours from registered nurses.
Has Skyland Terrace and Rehabilitation been fined?
Yes. CMS lists 1 fine totaling $8,512 in the past three years.
Does Skyland Terrace and Rehabilitation accept Medicare or Medicaid?
CMS lists its participation as "Medicare and Medicaid". Ask the home whether a bed is open for your coverage.
Guides for families looking at this home
- Understanding the recordWhat to ask on a nursing home tourQuestions that turn a home's public record into a useful conversation when you tour, plus what to look for yourself.
- Understanding the recordInspection severity letters A to LHow inspectors grade each deficiency by harm and by how many residents were affected.
- Understanding the recordHow to read CMS star ratingsWhat the overall, health inspection, staffing and quality measure ratings cover, and what they leave out.
Nearest nursing homes
- 1 of 5 Autumn Care of Waynesville 90beds 92.6%in use 3.43nurse hours a day
- 3 of 5 Smoky Mountain Health and Rehabilitation Center 50beds 80.2%in use 3.93nurse hours a day
- 3 of 5 Silver Bluff 131beds 87.9%in use 3.25nurse hours a day
Sorted by straight-line distance. This is not a ranking or a recommendation. Compare all homes in Haywood County
Who to call in North Carolina
These offices serve residents of every nursing home in North Carolina.
- Long-term care ombudsman North Carolina Long-Term Care Ombudsman Program 919-855-3400 (Office of the State Long-Term Care Ombudsman, Raleigh. Regional ombudsmen (16 offices in Area Agencies on Aging) are listed by county in a document linked from the program page.) An advocate for residents and their families.
- File a complaint about a nursing home Complaint Intake Unit (Complaint Hotline) 1-800-624-3004 (Within N.C.; or 919-855-4500. Hours: 9 a.m.-12 p.m. and 1-4 p.m. weekdays, except holidays. Also by fax (919-715-7724), mail (Complaint Intake Unit, 2711 Mail Service Center, Raleigh, NC 27699-2711) or email; a printable complaint form is on the page.) The state agency that inspects nursing homes.
North Carolina staffing, bed-hold and Medicaid rules · Residents' rights in every state
Source: CMS Provider Data Catalog, nursing home datasets processed Sep 1, 2026. CMS Certification Number 345411. See this home's official record on Medicare.gov
See something shown incorrectly? Tell us. This site shows each record as CMS publishes it and cannot change the underlying record.