Texas › Lipscomb County › Booker
Twin Oaks Manor
112 Pioneer Dr, Booker, TX 79005
Ratings are based on the most recent data available; a facility's ratings may have changed since the last update. The health inspection rating is based on the three most recent standard surveys and complaint investigations. CMS processed this record on 1 Aug 2026. View the Care Compare record.
Certified for 40 beds, Twin Oaks Manor serves Booker in Lipscomb County, Texas and has taken Medicare and Medicaid residents since 1988.
CMS gives it 3 of 5 stars overall, equal to the Texas median; the health inspection rating is 4, staffing 4 and quality measures 1.
Inspectors recorded 18 health deficiencies across the three most recent survey cycles (6, 4, 8 by cycle, most recent first), none at the actual-harm level. That is 45.0 per 100 beds, more than the state median of 22.5.
CMS lists no fines or payment denials against the facility in the period covered.
Reported nurse staffing is 5.8 hours per resident per day (1.1 RN), above the Texas median of 3.3; nursing staff turnover is 74.1%.
Compared with county, state and nation
| Measure | This facility | Lipscomb Co. median | Texas median | US average |
|---|---|---|---|---|
| Overall star rating | 3 | 3 | 3 | 3.0 |
| Health citations, 3 cycles | 18 | 18 | 25 | 28.7 |
| Citations per 100 beds | 45.0 | 45.0 | 22.5 | 26.8 |
| Total nurse hours per resident day | 5.8 | 5.8 | 3.3 | 3.9 |
| RN hours per resident day | 1.1 | 1.1 | 0.4 | 0.7 |
| Nursing staff turnover | 74.1% | 74.1% | 52.1% | 45.8% |
| Fines listed | $0 | $0 | $16,801 | — |
County and state figures are medians across facilities (1 in the county, 1177 in the state); the US column is the CMS national average where CMS publishes one.
Citations by survey cycle
Dark bar: this facility. Grey bar: Texas average per facility for the same cycle, as published by CMS. Standard health survey dates: 11 Jun 2026, 30 Apr 2025.
Severity mix: D ×10 E ×7 F ×1
Health deficiencies
Every health citation in the current CMS record (three survey cycles), most recent first. Tag text is the CMS requirement summary, not the inspection narrative.
Scope and severity letters (A–L)
| Survey date | Tag | What the tag requires | Severity | Type | Corrected |
|---|---|---|---|---|---|
| 11 Jun 2026 | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | E | Standard survey | 25 Jul 2026 |
| 11 Jun 2026 | F0605 | Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function. | E | Standard survey | 25 Jul 2026 |
| 11 Jun 2026 | F0801 | 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. | E | Standard survey | 25 Jul 2026 |
| 11 Jun 2026 | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | Standard survey | 25 Jul 2026 |
| 11 Jun 2026 | F0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | Standard survey | 25 Jul 2026 |
| 11 Jun 2026 | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | D | Standard survey | 25 Jul 2026 |
| 30 Apr 2025 | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | Standard survey | 14 Jun 2025 |
| 30 Apr 2025 | F0761 | 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. | D | Standard survey | 14 Jun 2025 |
| 30 Apr 2025 | F0801 | 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. | D | Standard survey | 14 Jun 2025 |
| 30 Apr 2025 | F0880 | Provide and implement an infection prevention and control program. | D | Standard survey | 14 Jun 2025 |
| 14 Mar 2024 | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | Standard survey | 27 Apr 2024 |
| 14 Mar 2024 | F0700 | 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. | E | Standard survey | 27 Apr 2024 |
| 14 Mar 2024 | F0641 | Ensure each resident receives an accurate assessment. | D | Standard survey | 27 Apr 2024 |
| 14 Mar 2024 | F0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | Standard survey | 27 Apr 2024 |
| 14 Mar 2024 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | Standard survey | 27 Apr 2024 |
| 14 Mar 2024 | F0758 | 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. | D | Standard survey | 27 Apr 2024 |
| 14 Mar 2024 | F0761 | 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. | D | Standard survey | 27 Apr 2024 |
| 11 Dec 2023 | F0880 | Provide and implement an infection prevention and control program. | E | Complaint investigation | 16 Dec 2023 |
Penalties
CMS lists no fines or payment denials for this facility in the period covered.
Staffing
Hours per resident per day as reported through the Payroll-Based Journal; grey bars are the Texas average. Turnover: nursing staff 74.1%, RNs 85.7%; — administrators left in the reporting year.
Quality measures
| Measure | Residents | This facility | Texas median | US median |
|---|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased | Long Stay | 27.6% | 14.9% | 12.6% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | Long Stay | 2.5% | 0.0% | 0.3% |
| Percentage of long-stay residents with a urinary tract infection | Long Stay | 6.4% | 0.3% | 0.9% |
| Percentage of long-stay residents experiencing one or more falls with major injury | Long Stay | 4.4% | 3.0% | 2.8% |
| Percentage of long-stay residents whose ability to walk independently worsened | Long Stay | 28.1% | 12.4% | 12.5% |
| Percentage of long-stay residents with pressure ulcers | Long Stay | 0.7% | 3.4% | 4.2% |
| Percentage of long-stay residents who received an antipsychotic medication | Long Stay | 24.0% | 8.3% | 13.4% |
Four-quarter averages for the measures CMS uses in the quality-measure star rating (2025Q2-2026Q1). Lower is better for every measure listed. Medians are computed across facilities on this site.
Ownership
Ownership type: government, hospital district. Legal business name: Legal Business Name Not Available.
No organisations are listed in the CMS ownership record for this facility.
Only organisations are shown. CMS also records individual owners, officers and managing employees; this site does not publish people's names.
Questions and answers
How many deficiencies has Twin Oaks Manor been cited for?
18 health deficiencies across the three most recent survey cycles, 0 at the actual-harm or immediate-jeopardy level. The Texas median is 25 per facility.
Has Twin Oaks Manor been fined?
CMS lists no fines against the facility in the period covered.
How does staffing at Twin Oaks Manor compare?
Reported total nurse staffing is 5.8 hours per resident per day against a Texas median of 3.3 and a national average of 3.9.
Who operates Twin Oaks Manor?
Ownership type is government, hospital district. Individual owners and managers are not listed on this site.
When was Twin Oaks Manor last inspected?
The most recent survey or investigation in the CMS record is dated 11 Jun 2026; the most recent standard health survey was 11 Jun 2026.
Where does this data come from?
All figures are from the Centers for Medicare & Medicaid Services Care Compare datasets (provider information, health deficiencies, penalties, ownership and quality measures), processed 1 Aug 2026. Ratings and citations may change; the Care Compare record is authoritative.
Provenance
Source: Centers for Medicare & Medicaid Services, Care Compare nursing home datasets (provider information, health deficiencies, penalties, ownership, MDS quality measures, state and national averages), public domain, processed by CMS on 1 Aug 2026. Facility record: Care Compare. Errors in processing are corrected at the next daily build; see corrections.