ElderGrade
B

73/100

Above average

Booker Hospital District Dba: Twin Oaks Manor

112 Pioneer Dr, Booker, TX 79005

CMS 3/5 stars (806) 658-9786
Certified beds
40
Occupancy
100%
Ownership
Government
Accepts
Medicaid

What to ask about before you visit

These are findings in the public CMS record for this home. They are not our opinion — each one comes straight from a federal inspection or enforcement file.

  • Nursing staff turnover of 74%

    High turnover means residents rarely see the same caregiver twice. The national average is about 50%.

How this grade was calculated

Every point is shown. Nothing is weighted behind the scenes — the full formula is on How we grade.

Inspection safety

30/30

Citations from state health inspections over the last three surveys, weighted by how much harm CMS says they caused.

Staffing

29/30

Nursing hours per resident per day, adjusted for how sick the residents are, plus RN cover and weekend consistency.

  • 7.54 total nurse hours per resident per day (national median 3.77)
  • 1.09 RN hours per resident per day
  • Weekend staffing drops 13% against weekdays

Staff stability

2/15

How much of the nursing team leaves in a year. High turnover means a resident rarely sees the same face twice.

  • 74% of nursing staff left in the last year

Resident outcomes

2/15

The CMS quality-measure rating, built from resident outcomes like falls, pressure ulcers, infections and antipsychotic use.

  • 1 of 5 stars on the CMS quality-measure rating

Enforcement history

10/10

Fines and payment denials CMS has imposed. A denial of payment means CMS stopped paying for new admissions.

  • No federal fines on record

Staffing, against the national average

Full detail

Hours of nursing care each resident receives per day. The marker on each bar is the national average.

Total nurse hours per resident per day 5.80 hrs
National average 3.86 hrs Better than average
Registered nurse (RN) hours 1.09 hrs
National average 0.69 hrs Better than average

RNs are the licence level most likely to catch a resident deteriorating.

Weekend nurse hours 5.06 hrs
National average 3.42 hrs Better than average

The shift most families visit, and the one thinned first.

Nursing staff turnover 74.10%
National average 45.80% Below average

The share of nursing staff who left over the last year.

Recent inspection findings

All 12 citations

Last standard health inspection: April 30, 2025 (1 year ago).

E Apr 30, 2025 F0812

Nutrition and Dietary Deficiencies

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

No actual harm, potential for more than minimal harm

D Apr 30, 2025 F0761

Pharmacy Service Deficiencies

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...

No actual harm, potential for more than minimal harm

D Apr 30, 2025 F0801

Nutrition and Dietary Deficiencies

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.

No actual harm, potential for more than minimal harm

D Apr 30, 2025 F0880

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

No actual harm, potential for more than minimal harm

F Mar 14, 2024 F0812

Nutrition and Dietary Deficiencies

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

No actual harm, potential for more than minimal harm

E Mar 14, 2024 F0700

Quality of Life and Care Deficiencies

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) Cor...

No actual harm, potential for more than minimal harm

D Mar 14, 2024 F0641

Resident Assessment and Care Planning Deficiencies

Ensure each resident receives an accurate assessment.

No actual harm, potential for more than minimal harm

D Mar 14, 2024 F0656

Resident Assessment and Care Planning Deficiencies

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

No actual harm, potential for more than minimal harm

What families say

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Common questions about Booker Hospital District Dba: Twin Oaks Manor

What is the ElderGrade for Booker Hospital District Dba: Twin Oaks Manor? +

Booker Hospital District Dba: Twin Oaks Manor holds an ElderGrade of B (73 out of 100), which we describe as "above average". The grade combines its inspection citations, nurse staffing levels, staff turnover, resident outcomes and enforcement history from the federal CMS record.

How many nursing hours does each resident get at Booker Hospital District Dba: Twin Oaks Manor? +

Residents receive an average of 5.80 nursing hours per day across all nursing staff, against a national average of 3.86 hours.

Has Booker Hospital District Dba: Twin Oaks Manor been cited for harming residents? +

No. None of the 12 citations on record were scored at the levels CMS uses to indicate actual harm or immediate jeopardy.

Does Booker Hospital District Dba: Twin Oaks Manor accept Medicaid? +

Yes, Booker Hospital District Dba: Twin Oaks Manor is certified to accept Medicaid, which is the programme that pays for long-term custodial care once a resident meets their state's income and asset limits.