Skyland Terrace and Rehabilitation — nursing home in Waynesville, NC

Facility type: Nursing home · SNF / NF
CMS provider type: Medicare and Medicaid
Certified beds: 90 CMS-certified beds (not state-licensed beds)
Licensed beds: State licensure is issued by the state survey agency. State license records are not yet ingested for this facility; the federal CMS certification is shown instead.
Average residents per day: 81.1 CMS, MDS-derived
CMS Certification Number: 345411
Certification status: Active CMS certification Verified
First approved (Medicare/Medicaid): Jan 24, 1992
Ownership type: For profit - Corporation
Operator (legal business name): Coolgate Inc
CMS chain: Not part of a CMS-reported chain
Phone: (828) 452-3154
Resident & family council: Resident
Sprinklers in all required areas: Yes
Official profile: Medicare Care Compare ↗

Inspection record · CMS window

Verified

Inspections

7

latest Feb 19, 2026

Citations

19

13 health · 6 fire

Harm or worse

1

no immediate jeopardy

Severity	Isolated	Pattern	Widespread
Immediate jeopardy	J·	K·	L·
Actual harm	G1	H·	I·
Potential harm	D11	E4	F3
Minimal	A·	B·	C·

CMS publishes about the three most recent standard surveys plus complaint and infection-control inspections from the prior three years. Older findings leave the dataset; their absence is not evidence they never happened.

CMS Five-Star ratings

Federal · CMS

Overall

Health inspections

Staffing

Quality measures

Penalties · about the last 3 years

Fines

1

$8,512

Payment denials

0

Latest

Dec 6, 2024

Federal certification

Federal · CMS

Authority: Centers for Medicare & Medicaid Services (CMS), surveyed by the state survey agency
CCN: 345411
Program: Medicare and Medicaid
Medicare (SNF): Certified
Medicaid (NF): Certified
Certified beds: 90
First approved: Jan 24, 1992
Located in a hospital: No
Status: Active CMS certification as of CMS release Oct 1, 2026
Evidence: Verified

State license

State licensure is issued by the state survey agency. State license records are not yet ingested for this facility; the federal CMS certification is shown instead. State coverage for North Carolina.

Federal certification and the state license are different records. A nursing home is licensed by the state and, separately, certified by CMS to bill Medicare and/or Medicaid. We link them by the CCN when the state publishes it; otherwise by exact address, house number and street, or exact name within the same ZIP, and label that link as inferred. Never by name alone.

CMS publishes about the three most recent standard surveys plus complaint and infection-control inspections from the prior three years. Older findings leave the dataset; their absence is not evidence they never happened.

Date	Domain	Survey types	Citations	Most severe	Open
Feb 19, 2026	Fire safety	Fire Safety Standard	4	Potential harm	—	Open →
Feb 19, 2026	Health	Health Standard	3	Potential harm	—	Open →
Apr 30, 2025	Health	Health Complaint	1	Potential harm	—	Open →
Dec 6, 2024	Health	Health Complaint, Health Standard	4	Actual harm	—	Open →
Jul 14, 2023	Fire safety	Fire Safety Standard	2	Potential harm	—	Open →
Jul 14, 2023	Health	Health Standard	5	Potential harm	—	Open →
Dec 16, 2021	Fire safety	Fire Safety Standard	0	No citations	—	Open →

Enforcement

Penalties

Civil money penalties and denials of payment for new admissions, as published by CMS (about the last three years). Amounts may change on appeal.

Date	Type	Amount	Payment denial	Record
Dec 6, 2024	Civil money penalty (fine)	$8,512	—	345411\|Fine\|42614

Scope × severity

Severity	Isolated	Pattern	Widespread
Immediate jeopardy	J·	K·	L·
Actual harm	G1	H·	I·
Potential harm	D11	E4	F3
Minimal	A·	B·	C·

By concept

Date	Tag	Deficiency	Scope / severity	Correction	Flags
Feb 19, 2026	K-0291	Install emergency lighting that can last at least 1 1/2 hours. Egress Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected May 13, 2026
Feb 19, 2026	K-0345	Have approved installation, maintenance and testing program for fire alarm systems. Smoke Deficiencies · Environment & life safety	D · Potential harm Isolated	Corrected May 21, 2026
Feb 19, 2026	K-0511	Have properly installed electrical wiring and gas equipment. Services Deficiencies · Environment & life safety	E · Potential harm Pattern	Corrected May 11, 2026
Feb 19, 2026	K-0521	Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. Services Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Jun 21, 2026
Feb 19, 2026	F-0578	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 Deficiencies · Resident rights & abuse/neglect	D · Potential harm Isolated	Corrected Mar 4, 2026
Feb 19, 2026	F-0684	Provide appropriate treatment and care according to orders, resident’s preferences and goals. Quality of Life and Care Deficiencies · Clinical care	D · Potential harm Isolated	Corrected Mar 4, 2026
Feb 19, 2026	F-0883	Develop and implement policies and procedures for flu and pneumonia vaccinations. Infection Control Deficiencies · Infection prevention	D · Potential harm Isolated	Corrected Mar 4, 2026
Apr 30, 2025	F-0600	Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Resident rights & abuse/neglect	D · Potential harm Isolated	Corrected May 17, 2025	Complaint
Dec 6, 2024	F-0745	Provide medically-related social services to help each resident achieve the highest possible quality of life. Quality of Life and Care Deficiencies · Clinical care	G · Actual harm Isolated	Corrected Dec 19, 2024
Dec 6, 2024	F-0602	Protect each resident from the wrongful use of the resident's belongings or money. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Resident rights & abuse/neglect	D · Potential harm Isolated	Corrected Dec 20, 2024	Complaint
Dec 6, 2024	F-0686	Provide appropriate pressure ulcer care and prevent new ulcers from developing. Quality of Life and Care Deficiencies · Clinical care	D · Potential harm Isolated	Corrected Dec 11, 2024	Complaint
Dec 6, 2024	F-0812	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Nutrition and Dietary Deficiencies · Food, nutrition & hydration	D · Potential harm Isolated	Corrected Dec 11, 2024
Jul 14, 2023	K-0345	Have approved installation, maintenance and testing program for fire alarm systems. Smoke Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Oct 6, 2023
Jul 14, 2023	K-0521	Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. Services Deficiencies · Environment & life safety	F · Potential harm Widespread	Corrected Oct 6, 2023
Jul 14, 2023	F-0641	Ensure each resident receives an accurate assessment. Resident Assessment and Care Planning Deficiencies · Clinical care	D · Potential harm Isolated	Corrected Jul 31, 2023
Jul 14, 2023	F-0756	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 Deficiencies · Medication management	E · Potential harm Pattern	Corrected Jul 31, 2023
Jul 14, 2023	F-0757	Ensure each resident’s drug regimen must be free from unnecessary drugs. Pharmacy Service Deficiencies · Medication management	D · Potential harm Isolated	Corrected Jul 31, 2023
Jul 14, 2023	F-0760	Ensure that residents are free from significant medication errors. Pharmacy Service Deficiencies · Medication management	E · Potential harm Pattern	Corrected Jul 31, 2023
Jul 14, 2023	F-0812	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Nutrition and Dietary Deficiencies · Food, nutrition & hydration	E · Potential harm Pattern	Corrected Jul 31, 2023

“Corrected” does not erase a citation: the historical finding stays listed with its disposition. Narrative statements of deficiencies are not part of the CMS dataset; see Care Compare for the official inspection report.

Five-Star ratings

Federal · CMS

Overallstate 3

Health inspectionsstate 2.9

Staffingstate 2.7

Quality measuresstate 3.5

Long-stay QM

Short-stay QM

CMS ratings apply to CMS-certified nursing homes only and are relative within each state. They are not a guarantee of any individual resident’s experience.

Nurse staffing · hours per resident per day

Total nurse staffing3.27

State avg 3.87US avg 3.90

Registered nurse (RN)0.80

State avg 0.62US avg 0.69

Licensed practical nurse0.58

State avg 0.88US avg 0.86

Nurse aide1.89

State avg 2.37US avg 2.35

Weekend total nurse2.85

State avg 3.40US avg 3.43

Reported from Payroll-Based Journal (PBJ) data, as published by CMS. Case-mix adjusted total: 3.54 (case-mix index 1.29).

Staff turnover

Total nursing staff turnover61.5%

State avg 48.7%US avg 45.3%

Registered nurse turnover30.0%

State avg 45.7%US avg 42.5%

Administrators who left0

State avg 1US avg 1

Health survey score

Cycle 1 standard survey: Feb 19, 2026
Cycle 1 health score: 12
Total weighted score: 18

Operating entity

Coolgate Inc

CMS legal business name of the certified provider. Operates this facility only.

VerifiedLinked by exact legal name

CMS chain

Not part of a CMS-reported chain.

Ownership disclosures

Disclosures

7

Organizations

0

Individuals

7

Direct & indirect ownership

Owners of record

Name	Type	Role (Carefield group)	CMS role text	Share	Since
Thomas Gatewood	Individual	Direct owner	5% OR GREATER DIRECT OWNERSHIP INTEREST	51%	Oct 1, 2022
Mistie Cooley	Individual	Direct owner	5% OR GREATER DIRECT OWNERSHIP INTEREST	49%	Oct 1, 2022

CMS Ownership file

All disclosed roles

Operator, owners, managers, officers and lenders are distinct roles and are never flattened into one entity. Organizations link across facilities by exact normalized legal name; individuals are listed per facility only.

Name	Type	Role (Carefield group)	CMS role text	Share	Since
Thomas Gatewood	Individual	Direct owner	5% OR GREATER DIRECT OWNERSHIP INTEREST	51%	Oct 1, 2022
Mistie Cooley	Individual	Direct owner	5% OR GREATER DIRECT OWNERSHIP INTEREST	49%	Oct 1, 2022
Mistie Cooley	Individual	Operational / managerial control	MANAGING CONTROL - GOVERNING BODY	not provided	Oct 1, 2022
Mistie Cooley	Individual	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	Jan 19, 2025
Thomas Gatewood	Individual	Operational / managerial control	OPERATIONAL/MANAGERIAL CONTROL	not provided	Jan 19, 2025
Mistie Cooley	Individual	Corporate officer / director	CORPORATE OFFICER	not provided	Oct 1, 2022
Thomas Gatewood	Individual	Corporate officer / director	CORPORATE OFFICER	not provided	Oct 1, 2022

No building or property record is linked to this facility yet. Parcel, assessor and building-permit joins will be added only where a valid site match exists.

Coordinates as published by CMS.

Address: 516 Wall Street, Waynesville, NC 28786
ZIP: 28786
County: Haywood County FIPS 37087
State: North Carolina
Urban / rural (CMS): Rural

Within ~25 km

Nearby nursing homes

Facility	Distance	Beds	Last inspection	Citations (window)	Fines
Autumn Care of Waynesville 360 Old Balsam Road, Waynesville, NC 28786 CCN 345110	4.6 km	90	Jun 4, 2026	513 IJ2 harm9 open	$107k
Smoky Mountain Health and Rehabilitation Center 1349 Crabtree Road, Waynesville, NC 28785 CCN 345396	5.8 km	50	Mar 19, 2026	19	—
Silver Bluff 100 Silver Bluff Drive, Canton, NC 28716 CCN 345341	9.4 km	131	Jan 8, 2026	342 IJ1 open	—
Maggie Valley Health and Rehabilitation Center 75 Fisher Loop, Maggie Valley, NC 28751 CCN 345102	10.9 km	114	Mar 19, 2026	231 IJ1 harm	$51k

Source	Record	Facts	Evidence	Source release	Retrieved
CMS Provider Information US-CMS	345411	name, address, phone, certification, certified_beds, ownership_type, legal_business_name, chain	Verified	Oct 1, 2026	Nov 7, 2026
CMS Provider Information US-CMS	345411	ratings, staffing, health_survey_score Five-Star ratings and PBJ staffing apply to the CMS-certified universe only.	Verified	Oct 1, 2026	Nov 7, 2026

Record-level source links for CCN 345411

First seen by Carefield Nov 7, 2026 · last changed Nov 7, 2026. This record as JSON · Report a correction