BOOKER HOSPITAL DISTRICT DBA: TWIN OAKS MANOR

112 PIONEER DR, BOOKER, TX 79005

Provider number (CCN)
45F197
Certification
Medicaid
Ownership
Government - Hospital district
Certified beds
40
Phone
(806) 658-9786
CMS data as of
July 1, 2026
B

What the records show

CMS rates BOOKER HOSPITAL DISTRICT DBA: TWIN OAKS MANOR 3 out of 5 stars overall, with 4 of 5 for health inspections, 4 of 5 for staffing, 1 of 5 for quality measures. Federal inspectors cited 12 health deficiencies across the last three survey cycles, most recently surveyed in 2025. CMS lists no fines or payment denials for this facility in the covered period.

Reviews, Ratings and Official Records

This page reviews BOOKER HOSPITAL DISTRICT DBA: TWIN OAKS MANOR using federal government records — CMS star ratings, health-inspection findings, staffing data and enforcement actions. NursingHomeGrade does not collect, host or publish resident or family testimonials, and no star rating below is a consumer review score.

At or above the 2024 benchmark — above average inspection record.

Ratings and Grade Breakdown

RN Staffing
Registered nurse time each resident receives daily. 2024 federal benchmark: 0.55 hrs. Repealed February 2026.
1.09 — At or above the repealed 0.55 hr benchmark

The 0.55 hour RN standard was repealed effective February 2, 2026 and is not currently enforced. We still grade against it. Why

Health Deficiencies (last 3 survey cycles)
Violations found during federal inspections, with how many remain open and how many involved actual harm.
Total 12
Outstanding 0
Actual harm or worse (G–L) 0
CMS Ratings
Federal five-star ratings published by CMS. These are regulatory ratings, not consumer review scores.
Overall: ★★★☆☆ (3/5)
Health inspection: ★★★★☆ (4/5)
Quality: ★☆☆☆☆ (1/5)
Staffing: ★★★★☆ (4/5)
NursingHomeGrade Score
70/100

Loaded into NursingHomeGrade on August 7, 2026. This is the load date, not the date CMS published the underlying survey data — see release dates.

CMS scores each facility from one to five stars — one is in the bottom fifth of facilities in its state on health inspections, five is in the top tenth. Our own A–F grade is a separate 0–100 score built from staffing hours, inspection citations, and the severity and correction status of those citations, weighted as described in our grading methodology.

Staffing Compared With State and National Levels

Registered nurse hours per resident per day compared with state and national levels
This facility1.09 hrs
TX median0.38 hrs
National average0.69 hrs

Registered nurse turnover: 85.7% · Total nursing staff turnover: 74.1%

Staffing figures are the values CMS published in its file processed July 1, 2026, drawn from payroll-based journal reporting.

Audit and Inspection Reports

BOOKER HOSPITAL DISTRICT DBA: TWIN OAKS MANOR is a Government - Hospital district facility. The records on this page are the federal health-inspection and enforcement records CMS publishes. We do not hold, and have not reviewed, any separate financial or performance audit issued by a county, state or independent auditor — if one exists for this facility, it is not part of the data described below.

Source records: CMS Care Compare profile for provider 45F197 ↗ · the federal files we load and when.

Inspection Deficiencies

Health inspections identify violations of federal standards. Severity ranges from no actual harm (A–F) to immediate jeopardy (J–L).

12 deficiencies found. 12 corrected. None involved actual harm.

Most recent inspection (April 30, 2025)

D Potential harm — isolated F0880 Status: Corrected

Provide and implement an infection prevention and control program.

Infection Control Deficiencies — Deficient, Provider has date of correction, corrected June 14, 2025

E Potential harm — pattern F0812 Status: Corrected

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

Nutrition and Dietary Deficiencies — Deficient, Provider has date of correction, corrected June 14, 2025

D Potential harm — isolated F0801 Status: Corrected

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.

Nutrition and Dietary Deficiencies — Deficient, Provider has date of correction, corrected June 14, 2025

D Potential harm — isolated F0761 Status: Corrected

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.

Pharmacy Service Deficiencies — Deficient, Provider has date of correction, corrected June 14, 2025

Inspection cycle 2 (March 14, 2024)

F Potential harm — widespread F0812 Status: Corrected

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

Nutrition and Dietary Deficiencies — Deficient, Provider has date of correction, corrected April 27, 2024

D Potential harm — isolated F0758 Status: Corrected

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.

Pharmacy Service Deficiencies — Deficient, Provider has date of correction, corrected April 27, 2024

D Potential harm — isolated F0761 Status: Corrected

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.

Pharmacy Service Deficiencies — Deficient, Provider has date of correction, corrected April 27, 2024

E Potential harm — pattern F0700 Status: Corrected

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.

Quality of Life and Care Deficiencies — Deficient, Provider has date of correction, corrected April 27, 2024

D Potential harm — isolated F0689 Status: Corrected

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Quality of Life and Care Deficiencies — Deficient, Provider has date of correction, corrected April 27, 2024

D Potential harm — isolated F0641 Status: Corrected

Ensure each resident receives an accurate assessment.

Resident Assessment and Care Planning Deficiencies — Deficient, Provider has date of correction, corrected April 27, 2024

D Potential harm — isolated F0656 Status: Corrected

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

Resident Assessment and Care Planning Deficiencies — Deficient, Provider has date of correction, corrected April 27, 2024

Inspection cycle 3 (December 11, 2023)

E Potential harm — pattern F0880 Status: Corrected

Provide and implement an infection prevention and control program.

Infection Control Deficiencies — Deficient, Provider has date of correction, corrected December 16, 2023

Fines and Enforcement Actions

CMS lists no fines and no payment denials for BOOKER HOSPITAL DISTRICT DBA: TWIN OAKS MANOR in the enforcement records covering the last three years, as published in the file processed July 1, 2026.

Ownership and Contact Information

Facility name
BOOKER HOSPITAL DISTRICT DBA: TWIN OAKS MANOR
Legal business name
Legal Business Name Not Available
Address
112 PIONEER DR, BOOKER, TX 79005
Phone
(806) 658-9786
Provider number (CCN)
45F197
Ownership type
Government - Hospital district
Medicare/Medicaid certified since
April 15, 1988
Official record
CMS Care Compare profile ↗
Details verified against CMS data dated
July 1, 2026

The federal nursing-home files publish no email address for certified facilities, so none is listed here. We do not guess or construct contact addresses. Contact details above are reproduced from CMS Provider Information; call the facility to confirm before relying on them.

How We Stay Independent

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Sources and Methodology

The NursingHomeGrade score is our own calculation from these federal files — it is not a CMS rating and not a consumer review score. See exactly how the score is calculated · full methodology · source files and load dates.

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