Above average — CMS composite of the measures below.
The next survey window likely opens around December 2026
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Skyland Care Center during CMS and state inspections, most recent first.
The facility failed to implement an effective infection surveillance plan, affecting all 89 residents. The Infection Preventionist (IP) did not track infections not treated with antibiotics, missing viral, gastrointestinal, and respiratory illnesses. The IP was unfamiliar with standardized infection definitions and did not include symptoms or lab results in reports. The Director of Nursing (DON) and Administrator acknowledged the need to track all infections to monitor trends and outbreaks.
Two residents in a LTC facility experienced misappropriation of controlled medications. One resident with severe cognitive impairment had Hydromorphone pills unaccounted for, with a nurse observed on camera accessing and discarding medication. Another resident, cognitively intact, was involved in a narcotic diversion incident where a nurse forged signatures and admitted to taking Oxycodone pills. Both incidents revealed failures in safeguarding medications and ensuring accurate narcotic counts.
A facility failed to complete a PASRR Level II for a resident diagnosed with PTSD. The SSD, responsible for PASRR, was unaware of the diagnosis and relied on nurses for updates. The MDS Coordinator added the diagnosis but did not handle PASRR. The SSD and Administrator believed PTSD did not require a PASRR Level II based on a seminar and list used by the SSD.
Inadequate Infection Surveillance in LTC Facility
Penalty
Summary
The facility failed to implement an effective infection surveillance plan, which had the potential to affect all 89 residents. The policy required the Infection Preventionist (IP) to conduct ongoing surveillance for Healthcare-Associated Infections (HAIs) and other significant infections. However, the IP did not track infections that were not treated with antibiotics or anti-infective medications, as these were not automatically triggered in the electronic infection control program. This oversight meant that viral infections, gastrointestinal illnesses, and respiratory illnesses not requiring medication were not included in the surveillance report. During an interview, the IP admitted to not tracking infections that were not treated with medication and was unfamiliar with standardized infection definitions. The IP relied on the electronic system to trigger new infection cases based on medication orders, which excluded certain infections from being tracked. The IP also did not collect data related to infection symptoms or include diagnostic and laboratory results in the surveillance report, which are essential for identifying infection trends or outbreaks. The Director of Nursing (DON) and the Administrator both acknowledged that all infections should be tracked, not just those treated with medication, to monitor for trends or potential outbreaks. The DON was aware of standardized definitions for infections but noted that the facility did not currently use them, relying instead on provider diagnoses. The Administrator emphasized the importance of tracking all infections to implement interventions if necessary, highlighting a gap in the facility's infection control practices.
Misappropriation of Controlled Medications in LTC Facility
Penalty
Summary
The facility failed to protect residents' rights to be free from misappropriation of controlled medications, affecting two residents. Resident #348, who had severe cognitive impairment and was on a scheduled pain medication regimen, had four Hydromorphone pills unaccounted for. The facility's investigation revealed that Nurse #6 was observed on security camera footage accessing the narcotic drawer, removing a pill, and later discarding the medication card. Despite the negative drug screens for both Nurse #6 and Nurse #7, Nurse #6 was terminated following the investigation. The Director of Nursing (DON) confirmed discrepancies in the narcotic count and believed Nurse #6 either took or disposed of the pills. Resident #147, who was cognitively intact and prescribed Oxycodone for pain, was involved in a separate incident of narcotic diversion. Nurse #2 discovered that her signature was forged on the narcotic count sheet for a medication administration she did not perform. Further review showed that Nurse #1 had signed out Oxycodone for a future date. Upon confrontation, Nurse #1 admitted to taking four Oxycodone pills and was subsequently terminated. The DON and Assistant Director of Nursing (ADON) were involved in the investigation, and law enforcement was notified. Both incidents highlight the facility's failure to safeguard residents' medications and ensure accurate narcotic counts. The lack of proper oversight and discrepancies in medication administration records contributed to the misappropriation of controlled substances. The facility's policies on abuse, neglect, and misappropriation were not effectively enforced, leading to these deficiencies.
Failure to Complete PASRR Level II for Resident with PTSD
Penalty
Summary
The facility failed to ensure a Preadmission Screening and Resident Review (PASRR) Level II was completed for a resident who was diagnosed with post-traumatic stress disorder (PTSD). The resident was admitted with a PASRR Level I, and the PTSD diagnosis was added to the resident's medical record. The Social Services Director (SSD), responsible for PASRR, was unaware of the PTSD diagnosis and stated that she would have applied for a PASRR Level II if she had known. The SSD relied on nurses to notify her of new mental health diagnoses, but this did not occur in this case. The Minimum Data Set (MDS) Coordinator added the PTSD diagnosis to the resident's record based on a note from the psychiatric provider but did not handle PASRR, which was the SSD's responsibility. The SSD mentioned that the new psychiatric provider did not consistently notify her of new mental health diagnoses. The SSD and the Administrator both believed that PTSD was not included in the list of diagnoses requiring a PASRR Level II, based on information from a seminar and a list used by the SSD.
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Illustrative
What surveyors actually found near you
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
Illustrative
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Illustrative
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Nursing homes near Sylva
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Vero Health & Rehab Of Sylva | 0.1 mi | ★★★★★ | 7 | 0 |
| Tsali Care Center | 9.9 mi | ★★★★★ | 0 | 0 |
| Maggie Valley Health And Rehabilitation Center | 11.6 mi | ★★★★★ | 4 | 0 |
| Autumn Care Of Waynesville | 12.7 mi | ★★★★★ | 1 | 0 |
| Mountain View Manor Nursing Center | 14.7 mi | ★★★★★ | 0 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.