Twin Oaks Manor

Name: Twin Oaks Manor
Address: 112 PIONEER DR, Booker, TX, 79005, US
Telephone: 8066589786

112 Pioneer Dr, Booker, TX 79005 · Lipscomb County · 40 certified beds · avg 40 residents/day · certified since Apr 15, 1988

4/5

Health inspection rating (on-site)

Serious findings on record

Fines, last 3 years

7.54

Nurse hours/resident/day (adjusted)

What health inspectors found (on-site government inspections — the most independent evidence available)

Health inspection rating: ★★★★☆4/5 · CMS overall rating: 3/5

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 self-reported quality measures.

All citations in the current public record (18)

CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed.

Date	Severity	What the facility was cited for
Jun 11, 2026	E · Potential for harm, repeated	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.
Jun 11, 2026	E · Potential for harm, repeated	The facility gave residents unnecessary mind-altering (psychotropic) medications, or used drugs in a way that restrained residents by dulling their ability to think, move, or function.
Jun 11, 2026	E · Potential for harm, repeated	The facility did not employ enough qualified food and nutrition staff, including a qualified dietician, to properly run its food service.
Jun 11, 2026	E · Potential for harm, repeated	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.
Jun 11, 2026	D · Potential for harm, one-off	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.
Jun 11, 2026	D · Potential for harm, one-off	The facility did not provide safe and appropriate respiratory care — such as oxygen, breathing treatments, or care for residents on breathing equipment — for residents who needed it.
Apr 30, 2025	E · Potential for harm, repeated	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.
Apr 30, 2025	D · Potential for harm, one-off	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.
Apr 30, 2025	D · Potential for harm, one-off	The facility did not employ enough qualified food and nutrition staff, including a qualified dietician, to properly run its food service.
Apr 30, 2025	D · Potential for harm, one-off	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.
Mar 14, 2024	F · Potential for harm, facility-wide	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.
Mar 14, 2024	E · Potential for harm, repeated	The facility used bed rails without first trying safer alternatives, or without assessing the resident's safety risk, discussing the risks and benefits with the resident or family, getting consent, and installing the rails correctly.
Mar 14, 2024	D · Potential for harm, one-off	The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives.
Mar 14, 2024	D · Potential for harm, one-off	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.
Mar 14, 2024	D · Potential for harm, one-off	The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.
Mar 14, 2024	D · Potential for harm, one-off	The facility did not try to gradually reduce doses of mood- and mind-altering medications or use non-drug approaches first, as required, or used 'as needed' psychiatric drugs without proper limits.
Mar 14, 2024	D · Potential for harm, one-off	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.
Dec 11, 2023	E · Potential for harm, repeated	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. · from a complaint

Inspection trend by year

Citations from standard inspections increased between the last two inspection cycles (4 → 6).

Year	Citations	Worst severity that year
2023	1	E
2024	7	F
2025	4	E
2026	6	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.

Fines and enforcement (last 3 years)

No fines or payment denials in the published 3-year window.

Nurse staffing (from payroll records, adjusted for how much care residents need)

Measure	This facility	Texas avg	U.S. avg	Where it stands
Total nurse staffing (hours per resident per day)	7.54	3.46	3.95	top 1% in Texas; top 1% in the U.S.
Registered Nurse hours	1.42	0.44	0.69	top 1% in Texas; top 6% in the U.S.
Weekend total nurse staffing	6.58	3.04	3.50	top 1% in Texas; top 1% in the U.S.
Weekend RN hours (not acuity-adjusted)	0.66	0.34	0.48	top 5% in Texas; top 18% in the U.S.
Total nursing staff turnover (%)	74.1	55.3	45.8	bottom 16% in Texas; bottom 4% in the U.S.
RN turnover (%)	85.7	54.6	42.9	bottom 14% in Texas; bottom 3% in the U.S.

Hours are per resident per day, 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 5.80, RN 1.09, weekend 5.06. Staffing rating: 4/5.

Self-reported quality measures

Note: these ratings are based on data the facility reports about itself to CMS. They are not independently verified by inspectors, and can look better than inspection findings. Give more weight to the inspection results above.

Quality measures rating: 1/5 · long-stay residents: 1/5 · short-stay residents: —/5

Who owns this facility

Government - Hospital district

Owner / manager	Type	Role	Stake	Since
		Ownership Data Not Available

Questions to ask on your visit

Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.

"Can you give me examples of how your staff protect residents' dignity in everyday care, like bathing and dressing?"
"What percentage of your residents are on antipsychotic or sedating medications, and how do you work to reduce that?"
"Do you have a qualified dietician on staff, and how involved are they in each resident's nutrition plan?"
"What did your most recent kitchen inspection find, and can I see how food is stored and prepared?"
"Can you show me an example care plan, and how are families included when it's created and updated?"
"How many residents here use oxygen or breathing equipment, and who checks that equipment each shift?"
"Can you show me how medications are stored and secured on the units, including controlled drugs?"
"Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
"What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
"Can I see the results and plan of correction from your most recent state inspection?"

Nearby facilities (within 20 miles)

Facility	Distance	City	Overall	Inspection	Flags
Capstone Healthcare of Perryton	15.8 mi	Perryton, TX	★★★★★	5/5

Compare this facility with the 1 closest →

All facilities in Booker →

Facility data as of CMS processing date 2026-08-01. CCN 45F197.

The Care File

Visit checklist — Twin Oaks Manor

112 Pioneer Dr, Booker, TX 79005 · 8066589786

Health inspection rating 4/5 · CMS overall 3/5· Fines (3y): $0

Questions for the administrator:

☐ "Can you give me examples of how your staff protect residents' dignity in everyday care, like bathing and dressing?"
☐ "What percentage of your residents are on antipsychotic or sedating medications, and how do you work to reduce that?"
☐ "Do you have a qualified dietician on staff, and how involved are they in each resident's nutrition plan?"
☐ "What did your most recent kitchen inspection find, and can I see how food is stored and prepared?"
☐ "Can you show me an example care plan, and how are families included when it's created and updated?"
☐ "How many residents here use oxygen or breathing equipment, and who checks that equipment each shift?"
☐ "Can you show me how medications are stored and secured on the units, including controlled drugs?"
☐ "Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
☐ "What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
☐ "Can I see the results and plan of correction from your most recent state inspection?"

While you're there, notice:

☐ Smell and cleanliness in hallways, not just the lobby
☐ How staff speak to residents; call lights answered promptly
☐ Residents up, dressed, and engaged (visit mealtimes and a weekend if you can)

Data: CMS Provider Data Catalog, version 2026-08-01 · CCN 45F197 · Verify at medicare.gov/care-compare · Printed from The Care File (thecarefile.com)