1123 North Bolton Street, Jacksonville, TX 75766 (opens Google Maps) · Cherokee County · (903) 586-9031· 116 certified beds · avg 61 residents/day · certified since Jan 7, 1999 · Medicare and Medicaid certified
Certified for both programmes. Certification means the facility can bill Medicaid — it does not mean a Medicaid-funded bed is free right now, so ask directly. Who pays for nursing home care →
Part of chain: CREATIVE SOLUTIONS IN HEALTHCARE (149 facilities, chain avg rating 2.1★)
New to these records? How to read an inspection report →
Health inspection rating: ★★★☆☆3/5 · CMS overall rating: 2/5 · how star ratings work →
The health inspection star above is graded on a curve within each state — a set share of each state's facilities gets each star level — so a facility can have few citations and still rate 2–3 stars if others in its state did even better. The overall rating combines that inspection score with staffing and quality measures from resident assessments and claims.
▲ Immediate jeopardy, isolated · Jan 18, 2024 · F-0580 · triggered by a complaint
The facility did not immediately notify the resident, their doctor, and a family member when something significant happened — such as an injury, a decline in health, or a room change. Families and doctors are entitled to know right away.
Why it matters: A family could learn about a serious injury or decline days later, after the chance to act has passed.
Severity (J): Immediate jeopardy to resident health or safety was cited. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.
Corrected: Jan 19, 2024 (Deficient, Provider has date of correction)
▲ Immediate jeopardy, isolated · Jan 18, 2024 · F-0697 · triggered by a complaint
The facility did not provide safe and appropriate pain management for a resident who needed it.
Why it matters: Untreated pain causes needless suffering and can lead to depression, poor sleep, and declining health.
Severity (J): Immediate jeopardy to resident health or safety was cited. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.
Corrected: Jan 19, 2024 (Deficient, Provider has date of correction)
Showing the latest 3 of 34 inspection findings. Open the full record below to read every finding.
The facility did not serve food and drinks that were appetizing, attractive, and at a safe and pleasant temperature. F-0804
The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. F-0812
The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. F-0641
CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed — that window is CMS's, not ours. Within it, every citation CMS publishes for this facility is listed here: none excluded.
| Date | Severity | What the facility was cited for |
|---|---|---|
| Dec 31, 2025 | E · Potential for more than minimal harm, pattern | The facility did not serve food and drinks that were appetizing, attractive, and at a safe and pleasant temperature. · F-0804 |
| Dec 31, 2025 | E · Potential for more than minimal harm, pattern | The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. · F-0812 |
| Dec 31, 2025 | D · Potential for more than minimal harm, isolated | The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. · F-0641 |
| Dec 31, 2025 | D · Potential for more than minimal harm, isolated | The facility did not properly complete the required screening (called PASARR) that identifies whether a person entering a nursing home has a mental illness or intellectual disability and needs specialized services. · F-0645 |
| Dec 31, 2025 | C · Potential for minimal harm, widespread | The facility did not post its nurse staffing information every day. Nursing homes must publicly display how many nurses and aides are on duty each day. · F-0732 |
| Apr 15, 2025 | D · Potential for more than minimal harm, isolated | The facility transferred or discharged a resident without a valid reason, or failed to provide the required documentation and information when moving a resident out. · from a complaint · F-0622 |
| Sep 25, 2024 | F · Potential for more than minimal harm, widespread | The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. · from a complaint · F-0812 |
| Sep 25, 2024 | F · Potential for more than minimal harm, widespread | The facility did not have policies on smoking. · F-0926 |
| Sep 25, 2024 | E · Potential for more than minimal harm, pattern | The facility did not make reasonable adjustments to fit each resident's individual needs and preferences — things like call buttons within reach, preferred wake-up times, or accessible room setups. · F-0558 |
| Sep 25, 2024 | E · Potential for more than minimal harm, pattern | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · F-0689 |
| Sep 25, 2024 | E · Potential for more than minimal harm, pattern | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. · F-0880 |
| Sep 25, 2024 | E · Potential for more than minimal harm, pattern | The facility did not develop and follow policies and procedures for offering residents flu and pneumonia vaccinations. · F-0883 |
| Sep 25, 2024 | E · Potential for more than minimal harm, pattern | The facility did not educate residents and staff about COVID-19 vaccination, offer the vaccine to those eligible after that education, or properly document everyone's vaccination status. · F-0887 |
| Sep 25, 2024 | D · Potential for more than minimal harm, isolated | The facility did not treat residents with dignity and respect, or did not honor their rights to make their own decisions and communicate freely. This is one of the most fundamental resident rights. · from a complaint · F-0550 |
| Sep 25, 2024 | D · Potential for more than minimal harm, isolated | The facility did not keep residents free from significant medication errors — such as giving the wrong drug, the wrong dose, or missing a critical medication. · F-0760 |
| Sep 25, 2024 | D · Potential for more than minimal harm, isolated | The facility did not label drugs according to professional standards or did not store them in locked compartments, with controlled drugs (medications with a high risk of misuse) kept under a separate lock. · F-0761 |
| Sep 25, 2024 | D · Potential for more than minimal harm, isolated | The facility did not have a working call system — the button or cord residents use to summon help — in each resident's bathroom and bathing area. · F-0919 |
| Sep 25, 2024 | D · Potential for more than minimal harm, isolated | The facility did not have firmly secured handrails on both sides of its hallways. · F-0924 |
| Sep 25, 2024 | D · Potential for more than minimal harm, isolated | The facility did not maintain an effective pest control program to prevent or deal with mice, insects, or other pests. · from a complaint · F-0925 |
| Jan 18, 2024 | ▲ J · Immediate jeopardy, isolated | The facility did not immediately notify the resident, their doctor, and a family member when something significant happened — such as an injury, a decline in health, or a room change. Families and doctors are entitled to know right away. · from a complaint · F-0580 |
| Jan 18, 2024 | ▲ J · Immediate jeopardy, isolated | The facility did not provide safe and appropriate pain management for a resident who needed it. · from a complaint · F-0697 |
| Jan 18, 2024 | D · Potential for more than minimal harm, isolated | The facility did not report suspected abuse, neglect, or theft to the proper authorities quickly enough, or did not report the results of its investigation. · from a complaint · F-0609 |
| Oct 29, 2023 | E · Potential for more than minimal harm, pattern | The facility did not protect residents from abuse or neglect. This covers physical, mental, and sexual abuse, physical punishment, and neglect, by anyone — staff, other residents, or visitors. · from a complaint · F-0600 |
| Oct 29, 2023 | E · Potential for more than minimal harm, pattern | The facility did not develop and follow policies and procedures to prevent abuse, neglect, and theft. These written safeguards are the foundation of resident protection. · from a complaint · F-0607 |
| Jul 26, 2023 | E · Potential for more than minimal harm, pattern | The facility did not develop and follow policies and procedures to prevent abuse, neglect, and theft. These written safeguards are the foundation of resident protection. · F-0607 |
| Jul 26, 2023 | E · Potential for more than minimal harm, pattern | The facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines. · F-0656 |
| Jul 26, 2023 | E · Potential for more than minimal harm, pattern | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · F-0689 |
| Jul 26, 2023 | E · Potential for more than minimal harm, pattern | The facility did not label drugs according to professional standards or did not store them in locked compartments, with controlled drugs (medications with a high risk of misuse) kept under a separate lock. · F-0761 |
| Jul 26, 2023 | E · Potential for more than minimal harm, pattern | The facility did not serve food and drinks that were appetizing, attractive, and at a safe and pleasant temperature. · F-0804 |
| Jul 26, 2023 | E · Potential for more than minimal harm, pattern | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. · F-0880 |
| Jul 26, 2023 | E · Potential for more than minimal harm, pattern | The facility did not maintain an effective pest control program to prevent or deal with mice, insects, or other pests. · F-0925 |
| Jul 26, 2023 | D · Potential for more than minimal harm, isolated | The facility did not honor residents' right to voice complaints without discrimination or retaliation, or did not have a working complaint process that resolves issues promptly. · F-0585 |
| Jul 26, 2023 | D · Potential for more than minimal harm, isolated | The facility did not provide the help residents need with basic daily activities — like bathing, dressing, eating, and using the bathroom — for residents who cannot do these things on their own. · F-0677 |
| Jul 26, 2023 | D · Potential for more than minimal harm, isolated | The facility did not provide pharmacy services that meet each resident's needs, or did not employ or contract with a licensed pharmacist. · F-0755 |
Citations from standard inspections decreased between the last two inspection cycles (13 → 5).
All bars start at zero. Exact values and supporting details remain below.
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2023 | 12 | 0 | E |
| 2024 | 16 | 2 | J ▲ |
| 2025 | 6 | 0 | E |
Counts reflect the current CMS public record (~3 inspection cycles plus complaint investigations); years with no surveys show no row. Inspection frequency varies, so compare severity as well as counts.
How to file a complaint about care →
1 fine totaling $174,431.
Every penalty CMS publishes for this facility in the 3-year window is listed —none excluded. The count and the dollar total come from two different CMS datasets and agree for this facility. Penalties older than the window are dropped by CMS before publication, not by us.
| Date | Type | Amount / length |
|---|---|---|
| Jan 18, 2024 | Fine | $174,431 |
What these staffing numbers mean →
All bars start at zero. Exact values and supporting details remain below.
| Measure | This facility | Texas avg | U.S. avg | Where it stands |
|---|---|---|---|---|
| Total nurse staffing (hours per resident per day) | 3.27 | 3.46 | 3.95 | bottom 46% in Texas; bottom 25% in the U.S. |
| Registered Nurse hours | 0.43 | 0.44 | 0.69 | top 39% in Texas; bottom 27% in the U.S. |
| Weekend total nurse staffing | 2.68 | 3.04 | 3.50 | bottom 28% in Texas; bottom 15% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.30 | 0.34 | 0.48 | top 47% in Texas; bottom 33% in the U.S. |
| Total nursing staff turnover (%) | 98.0 | 55.3 | 45.8 | bottom 2% in Texas; bottom 1% in the U.S. |
| RN turnover (%) | 100.0 | 54.6 | 42.9 | bottom 8% in Texas; bottom 1% in the U.S. |
Hours are per resident per day for the most recent quarter of payroll data in this CMS release (2026-08-01) — the same quarter for every facility — case-mix adjusted by CMS so facilities caring for sicker residents can be compared fairly (same basis as the CMS staffing star). "Top X%" means better than most facilities: more staffing hours, or lower turnover. Raw (unadjusted) reported hours: total 2.97, RN 0.39, weekend 2.43.Comparing with Medicare Care Compare? Care Compare shows the raw figure (2.97 here, displayed there as hours and minutes), not the adjusted one above. Both are correct; they answer different questions. Staffing rating: 1/5.
Note: CMS combines facility-reported resident assessments (MDS) with claims-based measures. These are different sources from on-site inspection findings. Read the measures alongside inspection and staffing records; a high QM rating does not establish that a home is safe.
Quality measures rating: 3/5 · long-stay residents: 3/5 · short-stay residents: 3/5
Price evidence · separate from quality
No verified facility-specific private-pay price is available in our data for Twin Oaks Health & Rehabilitation Center. CMS inspection and staffing records do not tell us what this home will charge you.
Use a written private-pay quote. This worksheet adds only the amounts you enter; it does not calculate Medicare, Medicaid or insurance benefits.
Formula: (room rate + daily extras) × days + one-time charges. A 30-day scenario is not a calendar-month quote. Refundable deposits, rate changes and charges you omit are not automatically included. Entries are not saved or sent to our server.
Understand who pays for care · How we handle price evidence · Report an incorrect price
How to read ownership records →
Ownership records as published by CMS on 2026-08-01. CMS records when an owner joined but not when they left. Listed here and no longer involved? Tell us →
For profit - Corporation
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Liberty County Hospital District No 1 | Organization | 5% or Greater Direct Ownership Interest | 100% | 04/01/2022 |
| Blake, Gary | Individual | Operational/Managerial Control | NOT APPLICABLE | 04/01/2022 |
| Blake, Gary | Individual | ADP of the SNF | NOT APPLICABLE | 04/01/2022 |
| Blake, Malisa | Individual | Operational/Managerial Control | NOT APPLICABLE | 04/01/2022 |
| Fregia, Milton | Individual | Managing Control - Governing Body | NOT APPLICABLE | 05/07/2022 |
| Gardner, Shannon | Individual | Managing Control - Governing Body | NOT APPLICABLE | 08/22/2022 |
| Gardzina, Margaret | Individual | Managing Control - Governing Body | NOT APPLICABLE | 02/26/2024 |
| Hekimian, Khoren | Individual | ADP of the SNF | NOT APPLICABLE | 04/11/2025 |
| Henry, Paul | Individual | Managing Control - Governing Body | NOT APPLICABLE | 05/09/2009 |
| Huggins, Linda | Individual | Corporate Director | NOT APPLICABLE | 04/01/2022 |
| Jacksonville III Enterprises LLC | Organization | Operational/Managerial Control | NOT APPLICABLE | 04/01/2022 |
| Jacksonville III Enterprises LLC | Organization | ADP of the SNF | NOT APPLICABLE | 04/11/2025 |
| Stratton, Charles | Individual | Managing Control - Governing Body | NOT APPLICABLE | 05/01/2005 |
| Stratton, Charles | Individual | Corporate Officer | NOT APPLICABLE | 05/01/2005 |
| Williamson, Rose | Individual | ADP of the SNF | NOT APPLICABLE | 04/11/2025 |
| Willig, Zachary | Individual | Corporate Director | NOT APPLICABLE | 01/01/2025 |
All 16 owning or managing parties CMS has on file are shown — none excluded.
CMS lists this facility under the chain Creative Solutions in Healthcare — 149 facilities in the current records. Chain membership says who operates these homes. It says nothing about how any individual one of them was inspected; each has its own record.
Listed by state, then facility name — not a ranking. Showing 8 of the 148 others, continuing from this facility's own place in that list.
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
| Facility | Distance | City | Overall | Inspection | Flags |
|---|---|---|---|---|---|
| Avir at Jacksonville | 2.0 mi | Jacksonville, TX | ★★★★★ | 5/5 | |
| Legacy at Jacksonville | 3.1 mi | Jacksonville, TX | ★★★☆☆ | 4/5 | |
| Bluebonnet Point Wellness | 13.2 mi | Bullard, TX | ★☆☆☆☆ | 2/5 | |
| Cherokee Trails Nursing Home | 14.3 mi | Rusk, TX | ★★☆☆☆ | 2/5 | |
| The Arbors Healthcare and Rehabilitation Center | 15.1 mi | Rusk, TX | ★★☆☆☆ | 3/5 | |
| Oak Brook Health Care Center | 16.7 mi | Whitehouse, TX | ★★★☆☆ | 4/5 |
Compare this facility with the 3 closest →
CMS records place this facility in Cherokee, TX — 6 certified facilities there. These are outside the 20-mile list above, or far enough down it not to appear.
Listed by facility name — not a ranking. Homes already in the table above are not repeated here.
Facility data as of CMS processing date 2026-08-01. CCN 675183.
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