Twin Oaks Manor
112 Pioneer Dr, Booker, TX 79005
Twin Oaks Manor, a 40-bed government - hospital district nursing facility in Booker, TX, holds a 3-star CMS overall rating - right around the 3.0-star national average, ranking #393 of 1,165 rated homes in TX on CMS overall stars (with health+staffing+quality tie-breaks), with nurse staffing above the national norm. No recent finding reached the actual-harm level.
CMS combines health inspections, nurse-staffing levels, and clinical quality measures into the overall star rating, read the components below; they often tell a sharper story than the headline.
Phone: 8066589786
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- 3 / 5
- Average · CMS overall · nat'l 3.0
- #393 of 1,165
- In-state rank among rated TX homes
- 5.80
- Well above average · nurse hrs/day · nat'l 3.86
- 18
- Inspection findings
The verdict
Twin Oaks Manor, a 40-bed government - hospital district nursing facility in Booker, TX, holds a 3-star CMS overall rating - right around the 3.0-star national average, ranking #393 of 1,165 rated homes in TX on CMS overall stars (with health+staffing+quality tie-breaks), with nurse staffing above the national norm. No recent finding reached the actual-harm level.
- 3 / 5
- CMS overall · national 3.0
- #393 of 1,165
- In-state rank among rated TX homes
- 5.80
- Nurse hrs/resident-day · national 3.86
- 18
- Inspection findings on file
CMS force-curves overall stars within each state; read health, staffing, and quality sub-ratings alongside the headline.
In-state ownership mix · peer inventory
How 1,177 TX nursing homes split by ownership sector
This facility is recorded as Government - Hospital district. Sector buckets collapse CMS ownership_type into For-profit, Nonprofit, and Government, orthogonal to the RN/LPN/CNA hour bar below.
Health Inspection
Staffing
Quality Measures
Long-Stay Quality
Facility Information
- Provider Number
- 45F197
- Ownership
- Government - Hospital district
- Provider Type
- Medicaid
- Beds
- 40
- Residents
- 40
- In Hospital
- No
- County
- Lipscomb
- Last Inspection
- Jun 11, 2026
Staffing Data
How the 5.80 total nursing hours per resident-day are staffed:
- RN Hours
- 1.09 (nat'l avg: 0.69)
- LPN Hours
- 0.47
- CNA Hours
- 4.23
- Total Nursing Hours
- 5.80 (nat'l avg: 3.86)
- PT Hours
- 0.00
- Nursing Turnover
- 74.1%
- RN Turnover
- 85.7%
What the CMS Record Reveals About Twin Oaks Manor
According to CMS Nursing Home Compare, Twin Oaks Manor ranks #393 of 1,165 rated nursing homes in TX on overall stars (tie-broken by health+staffing+quality, then fewer fines). Twin Oaks Manor operates 40 certified beds in Booker, TX with approximately 40 residents currently in care, and carries a CMS overall rating of 3 out of 5 stars (health inspection 4★ · staffing 4★ · quality 1★).
The inspection file contains 18 deficiency records from recent surveys, all falling in the no-harm or minimal-harm bands of the CMS scope-and-severity grid. This provider's enforcement record shows no fines or payment denials to date. Reported nurse staffing runs 5.80 total hours per resident day (national average 3.86); RN hours specifically are 1.09 per resident day.
Classified as "Government - Hospital district" ownership and operating as a "Medicaid" provider, Twin Oaks Manor falls into a category where comparative context matters. Reported nursing staff turnover at this facility is 74.1% (CMS payroll-based measure).
Why sub-scores and the CMS methodology matter
The overall score is a composite of three weighted sub-ratings published by the Centers for Medicare & Medicaid Services: health inspection results, staffing levels, and quality measures. 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.
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. The staffing metric in particular is the one most strongly tied to resident outcomes in peer-reviewed literature.
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 the same record on Medicare.gov Care Compare and with the facility or your state survey agency before making placement decisions.
Deficiency History (18 most recent)
Provide safe and appropriate respiratory care for a resident when needed.
Category: Quality of Life and Care Deficiencies
Corrected: Jul 25, 2026
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: Jul 25, 2026
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: Jul 25, 2026
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: Jul 25, 2026
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
Category: Freedom from Abuse, Neglect, and Exploitation Deficiencies
Corrected: Jul 25, 2026
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Category: Resident Rights Deficiencies
Corrected: Jul 25, 2026
Provide and implement an infection prevention and control program.
Category: Infection Control 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: 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: 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
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
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
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
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 | 27.6% | Yes |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | Long Stay | 2.5% | Yes |
| Percentage of long-stay residents with a urinary tract infection | Long Stay | 6.4% | Yes |
| Percentage of long-stay residents experiencing one or more falls with major injury | Long Stay | 4.4% | Yes |
| Percentage of long-stay residents whose ability to walk independently worsened | Long Stay | 28.1% | Yes |
| Percentage of long-stay residents with pressure ulcers | Long Stay | 0.7% | Yes |
| Percentage of long-stay residents who received an antipsychotic medication | Long Stay | 24.0% | Yes |
| Percentage of short-stay residents who newly received an antipsychotic medication | Short Stay | N/A | Yes |
| Percentage of long-stay residents who lose too much weight | Long Stay | 10.8% | No |
| 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 assessed and appropriately given the pneumococcal vaccine | Long Stay | 77.2% | No |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | Long Stay | 8.2% | No |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | Long Stay | 97.1% | No |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | Long Stay | 35.0% | No |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | Short Stay | N/A | No |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | Short Stay | N/A | No |
Penalty History
No penalties on record.
Nationwide facilities with similar scale or staffing
Two data-derived peer sets for Twin Oaks Manor, both outside TX so the neighborhoods are not the same-state geography list below.
Similar bed count
Nearest CMS certified bed counts outside TX (40 beds here).
Similar staffing hours
Nearest CMS adjusted total nurse hours per resident day outside TX (7.54 here).
Nearby Nursing Homes in TX
1,176 other nursing homes are on record in TX; 6 are shown here.
600 Maple Ave.
Burleson, TX
Accel at College Station
College Station, TX
Accel at Willow Bend
Plano, TX
Advanced Health & Rehab Center of Garland
Garland, TX
Advanced Rehabilitation & Healthcare of Burleson
Burleson, TX
Advanced Rehabilitation & Healthcare of Live Oak
Live Oak, TX
Understanding Nursing Home Data
What the CMS records show for Twin Oaks Manor
The health, staffing, and quality sub-ratings above often diverge from the CMS overall headline. Use those components and the inspection findings to read the full file, not the overall star alone.
- The TX registry aggregates state averages and the highest-rated homes in this cohort. View TX registry
- Peer homes near 40 beds show how CMS stars vary at a similar scale in TX. Compare a similar-size peer
- CMS publishes separate fields for inspections, nurse staffing hours, and quality measures; the guide explains how each star is computed. How CMS ratings work
CMS refreshes Nursing Home Compare quarterly (current extract: August 2026). PlainNursing describes published records; it does not establish suitability, availability, admissions, or individual outcomes.
Frequently Asked Questions
What is the overall CMS rating for Twin Oaks Manor?
Where does Twin Oaks Manor rank among nursing homes in TX?
What are the staffing levels at Twin Oaks Manor?
How many beds does Twin Oaks Manor have?
Does Twin Oaks Manor have any deficiencies on record?
Has Twin Oaks Manor received any fines or penalties?
Who owns Twin Oaks Manor?
When was Twin Oaks Manor last inspected?
What quality measures are tracked for 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. Verify the same CCN on Medicare.gov Care Compare and with the facility or your state health department.
Read our methodology - how this data is sourced, computed, and verified.
