BOOKER HOSPITAL DISTRICT DBA: TWIN OAKS MANOR
Open-data reference.
BOOKER HOSPITAL DISTRICT DBA: TWIN OAKS MANOR is a government - hospital district facility in BOOKER, TX with 40 certified beds and a 2-star overall CMS rating. The facility has 12 deficiency records on file.
112 PIONEER DR, BOOKER, TX 79005
Phone: 8066589786
Overall Rating
Health Inspection
Staffing
Quality Measures
Long-Stay Quality
Facility Information
- Provider Number
- 45F197
- Ownership
- Government - Hospital district
- Provider Type
- Medicaid
- Beds
- 40
- Residents
- 39
- In Hospital
- No
- County
- Lipscomb
- Last Inspection
- Apr 30, 2025
Staffing Data
- RN Hours
- 0.14 (nat'l avg: 0.68)
- LPN Hours
- 0.17
- CNA Hours
- 1.28
- Total Nursing Hours
- 1.59 (nat'l avg: 3.89)
- PT Hours
- 0.00
- Nursing Turnover
- 74.1%
- RN Turnover
- 85.7%
What the CMS Record Reveals About BOOKER HOSPITAL DISTRICT DBA: TWIN OAKS MANOR
BOOKER HOSPITAL DISTRICT DBA: TWIN OAKS MANOR operates 40 certified beds in BOOKER, TX with approximately 39 residents currently in care, and carries a CMS overall rating of 2 out of 5 stars. The overall score is a composite of three weighted sub-ratings published by the Centers for Medicare & Medicaid Services: health inspection results (4★), staffing levels (1★), and quality measures (1★). Because CMS caps the overall score at the health-inspection tier and then adjusts up or down based on staffing and quality, the sub-scores often tell a sharper story than the headline star count alone — a 3-star facility with weak inspection history reads differently from one held back by thin staffing.
The inspection file contains 12 deficiency records from recent surveys, all falling in the no-harm or minimal-harm bands of the CMS scope-and-severity grid. No fines or payment denials have been assessed against this provider, suggesting issues — if any — did not rise to the enforcement threshold. Staffing is reported at 1.59 total nursing hours per resident day (national average 3.89), with RN coverage at 0.14 per resident day — the single staffing metric most strongly tied to resident outcomes in peer-reviewed literature.
Classified as "Government - Hospital district" ownership and operating as a "Medicaid" provider, BOOKER HOSPITAL DISTRICT DBA: TWIN OAKS MANOR falls into a category where comparative context matters. National research consistently shows that ownership structure, staffing hours, and turnover are the three operational levers that correlate most strongly with resident outcomes — ratings and fines are lagging indicators of those upstream choices. Reported nursing turnover at this facility is 74.1%, above the level where continuity of care typically begins to suffer. For families evaluating this facility, the CMS record should be read alongside a site visit, direct conversation with current residents and their families, and review of the state health department's most recent inspection report — the star rating is a starting point, not a verdict. All data on this page is sourced from CMS Provider Data and the Nursing Home Compare program; always verify details directly with the facility or your state survey agency before making placement decisions.
Deficiency History (12 most recent)
Provide and implement an infection prevention and control program.
Category: Infection Control Deficiencies
Corrected: Jun 14, 2025
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Category: Nutrition and Dietary Deficiencies
Corrected: Jun 14, 2025
Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
Category: Nutrition and Dietary Deficiencies
Corrected: Jun 14, 2025
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Category: Pharmacy Service Deficiencies
Corrected: Jun 14, 2025
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Category: Nutrition and Dietary Deficiencies
Corrected: Apr 27, 2024
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Category: Pharmacy Service Deficiencies
Corrected: Apr 27, 2024
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Category: Pharmacy Service Deficiencies
Corrected: Apr 27, 2024
Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
Category: Quality of Life and Care Deficiencies
Corrected: Apr 27, 2024
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Category: Quality of Life and Care Deficiencies
Corrected: Apr 27, 2024
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Category: Resident Assessment and Care Planning Deficiencies
Corrected: Apr 27, 2024
Ensure each resident receives an accurate assessment.
Category: Resident Assessment and Care Planning Deficiencies
Corrected: Apr 27, 2024
Provide and implement an infection prevention and control program.
Category: Infection Control Deficiencies
Corrected: Dec 16, 2023
Quality Measures
| Measure | Type | Score | Used in Rating |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased | Long Stay | 35.4% | Yes |
| Percentage of long-stay residents who lose too much weight | Long Stay | 5.8% | No |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | Long Stay | 3.1% | Yes |
| Percentage of long-stay residents with a urinary tract infection | Long Stay | 2.9% | Yes |
| Percentage of long-stay residents who have depressive symptoms | Long Stay | 0.0% | No |
| Percentage of long-stay residents who were physically restrained | Long Stay | 0.0% | No |
| Percentage of long-stay residents experiencing one or more falls with major injury | Long Stay | 5.6% | Yes |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | Long Stay | 81.7% | No |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | Short Stay | 42.9% | No |
| Percentage of short-stay residents who newly received an antipsychotic medication | Short Stay | N/A | Yes |
| Percentage of long-stay residents whose ability to walk independently worsened | Long Stay | 37.4% | Yes |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | Long Stay | 7.0% | No |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | Long Stay | 97.1% | No |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | Short Stay | N/A | No |
| Percentage of long-stay residents with pressure ulcers | Long Stay | 0.8% | Yes |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | Long Stay | 38.3% | No |
| Percentage of long-stay residents who received an antipsychotic medication | Long Stay | 17.5% | Yes |
Penalty History
No penalties on record.
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Understanding Nursing Home Data
Related Data from Other Sources
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County Health Data
Health outcomes, access, and quality metrics for Lipscomb on PlainHealth
Frequently Asked Questions
What is the overall CMS rating for BOOKER HOSPITAL DISTRICT DBA: TWIN OAKS MANOR?
What are the staffing levels at BOOKER HOSPITAL DISTRICT DBA: TWIN OAKS MANOR?
How many beds does BOOKER HOSPITAL DISTRICT DBA: TWIN OAKS MANOR have?
Does BOOKER HOSPITAL DISTRICT DBA: TWIN OAKS MANOR have any deficiencies on record?
Has BOOKER HOSPITAL DISTRICT DBA: TWIN OAKS MANOR received any fines or penalties?
Who owns BOOKER HOSPITAL DISTRICT DBA: TWIN OAKS MANOR?
When was BOOKER HOSPITAL DISTRICT DBA: TWIN OAKS MANOR last inspected?
What quality measures are tracked for BOOKER HOSPITAL DISTRICT DBA: TWIN OAKS MANOR?
Data Sources
Data source: CMS Nursing Home Compare. Ratings, staffing, deficiency, quality measure, and penalty data are from CMS Provider Data. For informational purposes only. Always verify information directly with the facility or your state health department.
Read our methodology — how this data is sourced, computed, and verified.