73/100
Above average
Twin Oaks Manor
112 Pioneer Dr, Booker, TX 79005
- 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%.
Our read on Twin Oaks Manor
Twin Oaks Manor is a 40-bed hospital-district home in Booker, and the staffing numbers are genuinely strong: 5.80 nurse hours per resident day, about half again the national average. Weekends dip roughly 13% below weekdays, which is worth asking about, since that's often when families visit. The bigger concern is turnover, 74.1% versus 45.8% nationally, meaning most of the people caring for residents this year likely won't be there next year. Inspections look solid (4 of 5 stars, 12 deficiencies, none at harm level, none abuse-related) and the most recent visit was April 2025. Quality measure scores sit at 1 of 5, so ask what specifically is driving those.
Written from the CMS figures for this home shown further down this page. Nothing here is paid for or supplied by the home.
How this grade was calculated
Every point is shown. Nothing is weighted behind the scenes, the full formula is on How we grade.
A full pentagon is full marks. The shape shows what kind of good or bad a home is, two homes can share a score and look nothing alike.
Inspection safety
30/30Citations from state health inspections over the last three surveys, weighted by how much harm CMS says they caused.
- →No citations recorded in the last 3 years
Staffing
29/30Nursing 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
2/15How 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
2/15The 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
10/10Fines 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 detailHours of nursing care each resident receives per day. The marker on each bar is the national average.
RNs are the licence level most likely to catch a resident deteriorating.
The shift most families visit, and the one thinned first.
The share of nursing staff who left over the last year.
Recent inspection findings
Last standard health inspection: June 11, 2026 (4 months ago). No citations were recorded.
No health-inspection citations on record for this facility in the current CMS release.
What families say
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Common questions about Twin Oaks Manor
What is the ElderGrade for Twin Oaks Manor? +
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 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 Twin Oaks Manor been cited for harming residents? +
No. None of the 0 citations on record were scored at the levels CMS uses to indicate actual harm or immediate jeopardy.
Does Twin Oaks Manor accept Medicaid? +
Yes, 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.
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