Government - Hospital district · 40 certified beds · CMS number 45F197
Twin Oaks Manor, Booker, TX
CMS records 18 health deficiencies at Twin Oaks Manor in Booker, Texas in its last 3 inspection cycles; the Texas median is 25. Its most recent standard inspection was on Jun 11, 2026. The highest severity cited is F (no actual harm, potential for more than minimal harm). CMS lists no fines or payment denials in the last three years.
- 18deficiencies, 3 cycles (TX median 25)
- 6in the latest cycle (TX median 8)
- Fhighest severity · Potential for harm
- $0fines, last 3 years
- 3CMS overall rating (of 5)
Inspections and deficiencies
CMS findings for Twin Oaks Manor as of Sep 1, 2026, grouped by inspection cycle (3 cycles); each is a requirement inspectors found not met, and Twin Oaks Manor may since have corrected or disputed it. Severity letters · Inspection cycles · Care Compare
Most recent cycle (6 deficiencies)
Standard inspection Jun 11, 2026. CMS counts 6 health deficiencies and 4 fire safety deficiencies in this cycle.
Jun 11, 2026 · Standard inspection
6 deficiencies, highest E
F812 · Food safety and sanitation
Requirement cited (CMS): Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Jul 25, 2026
F801 · Qualified dietitian and food staff
Requirement cited (CMS): 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.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Jul 25, 2026
F695 · Respiratory and oxygen care
Requirement cited (CMS): Provide safe and appropriate respiratory care for a resident when needed.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jul 25, 2026
F656 · Comprehensive person-centered care plan
Requirement cited (CMS): Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jul 25, 2026
F605 · Limits on psychotropic drugs and chemical restraints
Requirement cited (CMS): Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Jul 25, 2026
F550 · Dignity and the right to exercise rights
Requirement cited (CMS): Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Jul 25, 2026
Previous cycle: 4 deficiencies (standard inspection Apr 30, 2025)
Standard inspection Apr 30, 2025. CMS counts 4 health deficiencies and 1 fire safety deficiency in this cycle.
Apr 30, 2025 · Standard inspection
4 deficiencies, highest E
F880 · Infection prevention and control program
Requirement cited (CMS): Provide and implement an infection prevention and control program.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jun 14, 2025
F812 · Food safety and sanitation
Requirement cited (CMS): Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Jun 14, 2025
F801 · Qualified dietitian and food staff
Requirement cited (CMS): 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.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jun 14, 2025
F761 · Drug labeling and secure storage
Requirement cited (CMS): 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.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Jun 14, 2025
Earlier cycle: 8 deficiencies (standard inspection Mar 14, 2024)
Standard inspection Mar 14, 2024. CMS counts 8 health deficiencies and 1 fire safety deficiency in this cycle.
Mar 14, 2024 · Standard inspection
7 deficiencies, highest F
F812 · Food safety and sanitation
Requirement cited (CMS): Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- Severity
- F No actual harm, potential for more than minimal harm, widespread
- Status
- Correction date Apr 27, 2024
F761 · Drug labeling and secure storage
Requirement cited (CMS): 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.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Apr 27, 2024
F758 · Psychotropic drug safeguards
Requirement cited (CMS): 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.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Apr 27, 2024
F700 · Bed rail safety
Requirement cited (CMS): 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.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Apr 27, 2024
F689 · Accident prevention and supervision
Requirement cited (CMS): Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Apr 27, 2024
F656 · Comprehensive person-centered care plan
Requirement cited (CMS): Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Apr 27, 2024
F641 · Accurate resident assessments
Requirement cited (CMS): Ensure each resident receives an accurate assessment.
- Severity
- D No actual harm, potential for more than minimal harm, isolated
- Status
- Correction date Apr 27, 2024
Dec 11, 2023 · Complaint inspection
1 deficiency, highest E
F880 · Infection prevention and control program
Requirement cited (CMS): Provide and implement an infection prevention and control program.
- Severity
- E No actual harm, potential for more than minimal harm, pattern
- Status
- Correction date Dec 16, 2023
Tags cited in more than one inspection
5 tags cited on more than one inspection date at Twin Oaks Manor; each date counts once and does not mean the same incident. PNC = past non-compliance.
| Tag | Inspections | Dates |
|---|---|---|
| F812 Food safety and sanitation | 3 | Jun 11, 2026; Apr 30, 2025; Mar 14, 2024 |
| F656 Comprehensive person-centered care plan | 2 | Jun 11, 2026; Mar 14, 2024 |
| F761 Drug labeling and secure storage | 2 | Apr 30, 2025; Mar 14, 2024 |
| F801 Qualified dietitian and food staff | 2 | Jun 11, 2026; Apr 30, 2025 |
| F880 Infection prevention and control program | 2 | Apr 30, 2025; Dec 11, 2023 |
Fines and payment denials
CMS lists no fines or payment denials for this nursing home in the last three years.
Staffing and CMS ratings
- Total nurse staff hours per resident per day
- 5.80 h (above the Texas median of 3.27 h)
- RN hours per resident per day
- 1.09 h (above the Texas median of 0.38 h)
- Weekend nurse staff hours per resident per day
- 5.06 h
- Nursing staff turnover
- 74.1% (Texas median 52.1%)
- Administrators who left
- not reported
- CMS overall rating
- 3 of 5
- Health inspection rating
- 4 of 5
- Staffing rating
- 4 of 5
- Quality measure rating
- 1 of 5
CMS figures for Twin Oaks Manor, copied as published; Texas medians are ours.
Facility details
- Address
- 112 Pioneer Dr, Booker, TX 79005
- Phone
- (806) 658-9786
- County
- Lipscomb
- Accepts
- Medicaid
- Ownership
- Government - Hospital district
- Chain (CMS)
- Not part of a chain in CMS data
- Certified beds
- 40
- Average residents per day
- 40.4
- In Medicare/Medicaid since
- Apr 15, 1988
- Inside a hospital
- No
- Continuing care retirement community
- No
- Resident and family council
- Resident
- Sprinklers in all required areas
- Yes
Questions to ask on a visit
Based on the tags cited most often here.
- When was the kitchen last inspected, and how are food temperatures checked? (F812, cited 3 times)
- How are a resident's goals and preferences written into the care plan? (F656, cited 2 times)
- How are medications stored and secured on each unit? (F761, cited 2 times)
- How often does the dietitian see residents, especially those with weight changes? (F801, cited 2 times)
Source
CMS Provider Data Catalog: Provider Information, Health Deficiencies, Penalties, Survey Summary. Processed by CMS Sep 1, 2026; next update Oct 28, 2026.