The home failed to make sure food was safely sourced, stored, prepared, and served according to professional standards. Cited March 2024 — widespread issue, potential for harm.
View the original federal record
F-Tag 812 — 42 CFR §483.60(i) — S/S: F
Nursing home report
BOOKER HOSPITAL DISTRICT DBA: TWIN OAKS MANOR
BOOKER, TX · Medicare-certified · 40 beds
In good standing
Government-run
3 of 5 overall
3/5 stars overall. Twin Oaks Manor has stronger health inspection and staffing ratings (4/5 each) and reported staffing above the federal benchmark (5.66 vs. 4.1 hours/resident/day), but a very low quality measures rating (1/5); there were no fines in the last 24 months.
Facility ratings
Health inspections
Staffing
5.662 hrs/resident/day
Quality measures
Last inspection: April 30, 2025Penalties, last 24 months: $0
Federal guidance recommends at least 4.1 nursing hours per resident each day. This facility reports 5.662.
Staffing detail
- Registered nurses
- 0.99
- Licensed practical nurses
- 0.34
- Nurse aides
- 4.33
- Weekend nursing
- 5.25
Hours per resident per day.
Total staff turnover: 72%
Registered nurse turnover: 86%
Resident outcomes
How often residents experience these outcomes, with the direction over the past year.
Long-stay residents on antipsychotic medication
21.6%Worsening
Residents with a fall causing major injury
4.7%Improving
Residents with pressure ulcers (bedsores)
0.7%Steady
Residents with a urinary tract infection
4.7%Worsening
Residents who lost too much weight
8.1%Worsening
Residents who were physically restrained
0%Steady
Residents needing more help with daily activities
32.4%Improving
Residents whose ability to walk got worse
35.9%Improving
Show all measures
Long-stay residents on antianxiety or sleep medication
7.3%Worsening
Residents with a long-term catheter
2.8%Improving
Residents with new or worsening incontinence
38%Worsening
Residents with depressive symptoms
0%Steady
Long-stay residents given the seasonal flu vaccine
97.1%Steady
Long-stay residents given the pneumonia vaccine
78.7%Worsening
Short-stay residents given the pneumonia vaccine
45.5%Steady
What the inspectors found
The home failed to assess bed rail safety, review the risks and benefits, get informed consent, or properly install and maintain the rail. Cited March 2024 — limited pattern, potential for harm.
View the original federal record
F-Tag 700 — 42 CFR §483.25(n) — S/S: E
The nursing home failed to provide and carry out an infection prevention and control program to help keep residents from getting or spreading infections. Cited December 2023 — limited pattern, potential for harm.
View the original federal record
F-Tag 880 — 42 CFR §483.80(a) — S/S: E
The home failed to properly label and securely store medications and biologicals. Cited April 2025 — isolated incident, potential for harm.
View the original federal record
F-Tag 761 — 42 CFR §483.45(g) — S/S: D
The home failed to have enough qualified staff to properly provide food and nutrition services. Cited April 2025 — isolated incident, potential for harm.
View the original federal record
F-Tag 801 — 42 CFR §483.60 — S/S: D
Recent history
- STAFFING
Reported nurse staffing met or exceeded the federal recommendation.
- INSPECTION
Health inspection found 4 health deficiencies.
See what inspectors found
- INSPECTION
Health inspection found 7 health deficiencies.
See what inspectors found
- INSPECTION
Health inspection found 1 health deficiency.
See what inspectors found
Operator & ownership
- Ownership
- Government - Hospital district
- Occupancy
- 40.5 residents on an average day (101% of 40 beds)
- Resident voice
- Resident council
- Medicare history
- Certified for 38 years
Things at a nursing home change — inspections, staffing, ownership, news.
Source: Centers for Medicare & Medicaid Services — public records, updated monthly. GoodStanding presents official records with plain-language summaries. Always visit a facility in person.