Twin Oaks Manor
112 Pioneer Dr, Booker, TX 79005 · Lipscomb County
Government · 40 certified beds · 101% occupancy · (806) 658-9786
Twin Oaks Manor reviews: what the government record shows
The U.S. government (CMS) rates Twin Oaks Manor 3 out of 5 stars overall, average. Its nurse staffing is at or above the Texas median.
Updated September 2026 from the latest CMS data release. Ellery Care shows the government's own inspection and safety record, not consumer reviews.
At a glance
- CMS overall rating
- 3 of 5 stars
- Nurse staffing
- 5.80 hrs/resident/day (+77% vs TX median)
- Antipsychotic drug use
- 24% of long-stay residents (TX median 8.3%)
- Falls with major injury
- 4.4% of long-stay residents (TX median 3%)
- Federal fines (3 yrs)
- None on record
- Inspection findings
- 18 cited
- Federal abuse-warning flag
- No
Source: CMS Care Compare (Nursing Homes), dataset 4pq5-n9py, retrieved 2026-09-05.
What this means for your family
A mixed record. The strengths and concerns below are worth weighing against a visit.
Strengths
- ✓Nurse staffing of 5.80 hrs/resident/day is at or above the Texas median of 3.27.
- ✓No federal fines on record in roughly the last three years.
Questions to ask on your visit
- ·What does a typical day look like for a resident with my parent's needs?
Touring in person? Our free nursing-home tour checklist has 30 questions to ask and the red flags to watch for, printable to take with you.
A plain-English read of this home's public record. Not advice — always visit in person.
Common questions about Twin Oaks Manor
Is Twin Oaks Manor a good nursing home?
Twin Oaks Manor in Booker, Texas holds a 3 of 5 star CMS overall rating. A mixed record. The strengths and concerns below are worth weighing against a visit.
How is Twin Oaks Manor staffed?
Twin Oaks Manor reports 5.80 nurse hours per resident per day, at or above the Texas median of 3.27 hours per resident per day.
Has Twin Oaks Manor been fined or flagged for abuse?
Twin Oaks Manor has no federal fines on record in roughly the last three years, and does not currently carry a federal abuse-warning flag.
CMS quality ratings
Source: CMS Care Compare (Nursing Homes), dataset 4pq5-n9py, retrieved 2026-09-05. Stars are CMS's own five-star ratings.
Nurse staffing
Staffing is the single strongest predictor of nursing home quality, and the number pay-to-play referral sites rarely show you.
5.80 nurse hours per resident per day. 77% above the Texas median of 3.27.
Nursing staff turnover: 74.1% · RN turnover: 85.7%
Safety & compliance flags
No CMS warning flags on record.
Recent inspection findings
The specific problems state inspectors cited, the detail behind the star ratings, and what referral sites never show. Findings CMS records as corrected are marked.
- Potential for harmTag F0550 · Jun 11, 2026Corrected Jul 25, 2026
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Rights Deficiencies
- Potential for harmTag F0605 · Jun 11, 2026Corrected Jul 25, 2026
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
Freedom from Abuse, Neglect, and Exploitation Deficiencies
- Potential for harmTag F0801 · Jun 11, 2026Corrected Jul 25, 2026
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
- Potential for harmTag F0812 · Jun 11, 2026Corrected Jul 25, 2026
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies
- Potential for harmTag F0656 · Jun 11, 2026Corrected Jul 25, 2026
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
- Potential for harmTag F0695 · Jun 11, 2026Corrected Jul 25, 2026
Provide safe and appropriate respiratory care for a resident when needed.
Quality of Life and Care Deficiencies
- Potential for harmTag F0812 · Apr 30, 2025Corrected Jun 14, 2025
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies
- Potential for harmTag F0761 · Apr 30, 2025Corrected Jun 14, 2025
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
- Potential for harmTag F0801 · Apr 30, 2025Corrected Jun 14, 2025
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
- Potential for harmTag F0880 · Apr 30, 2025Corrected Jun 14, 2025
Provide and implement an infection prevention and control program.
Infection Control Deficiencies
Showing the 10 most recent and serious of 18 findings. See the full inspection history on Medicare.gov.
Antipsychotic drug use
The share of long-stay residents given antipsychotic medication. These drugs are sometimes used to sedate residents with dementia, a practice CMS and resident advocates watch closely. Lower is better.
This is above the national median. Ask how the home decides to start these medications and how often it reviews them.
Source: CMS MDS Quality Measures, long-stay antipsychotic measure, retrieved 2026-09-05. See the Texas study
Preventable harm
Two injuries that good staffing and attentive care are meant to prevent: serious falls and pressure ulcers (bedsores). These are the outcomes families fear most, and they rarely appear on referral sites. Lower is better on both.
The serious-fall rate here is above the national median. It is worth asking how the home prevents falls and whether recent injuries prompted any changes.
Source: CMS MDS Quality Measures, long-stay falls and pressure-ulcer measures, period 2025Q2-2026Q1, retrieved 2026-09-05. Texas falls study · bedsore study
Federal fines and penalties
Money CMS has fined this home, plus other federal penalties, over roughly the last three years. Fines follow serious or repeated violations.
No federal fines are on record for this home in roughly the last three years, a good sign.
Ownership
This home is government (government - hospital district). It is independently operated, not part of a multi-facility chain.