All states › Texas › Booker › Twin Oaks Manor
112 Pioneer Dr Booker, TX 79005 · Lipscomb County
CMS certification number 45F197 · See this home on Medicare Care Compare
Is Twin Oaks Manor a good nursing home? Reviews, ratings and inspection record
There are no official resident reviews of nursing homes: Medicare's Care Compare publishes inspections, staffing and quality data instead. Here is what that record shows for Twin Oaks Manor as of October 2026.
CMS rates it 3 out of 5 stars overall, about the same as the Texas average of 2.8.
Online reviews from families and residents are on Google Maps and other sites; they reflect individual experiences and aren't checked by CMS. The full inspection reports, including what inspectors observed, are on Medicare Care Compare.
Staffing
Nursing staff spend about 5.72 hours per resident per day at Twin Oaks Manor, above the Texas median of 3.30 (US median: 3.72). About 1.04 of those hours are from registered nurses. On weekends it falls to 5.00 hours, 12% below its all-week average. 69.4% of nursing staff left within a year (Texas median 50.2%). High turnover can mean residents see unfamiliar caregivers; ask how long the nurses on the unit have worked there.
About this nursing home
Paying for care at Twin Oaks Manor: Medicare and Medicaid
Twin Oaks Manor is certified for Medicaid but not Medicare, so Medicare won't pay for a rehab stay here after a hospital discharge. It can serve long-term residents covered by Texas Medicaid.
Health inspections
The most recent standard inspection was on June 11, 2026 and found 6 deficiencies. In total, inspectors issued 18 citations in the last three years.
Each citation has a scope and severity letter from A to L. A–C: potential for minimal harm. D–F: potential for more than minimal harm. G–I: actual harm. J–L: immediate jeopardy to resident health or safety.
What the inspections found
Over the last three years, inspectors issued 18 citations at Twin Oaks Manor across 4 inspection dates, 1 of them from complaint investigations. None were at the actual-harm or immediate-jeopardy levels; 18 were "potential for more than minimal harm" (D–F) and 0 were minimal (A–C). The most common areas cited were nutrition and dietary (5) and pharmacy service (3). The most serious was cited under the CMS rule to "procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards" (tag F0812, level F, March 14, 2024). 1 citation was under CMS's abuse, neglect and exploitation rules.
June 11, 2026 · 6 citations
EHonor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
EPrevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
EEmploy sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
EProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
DDevelop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
DProvide safe and appropriate respiratory care for a resident when needed.
April 30, 2025 · 4 citations
EProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
DEnsure 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.
DEmploy sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
DProvide and implement an infection prevention and control program.
March 14, 2024 · 7 citations
FProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
ETry 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.
DEnsure each resident receives an accurate assessment.
DDevelop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
DEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
DImplement 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.
DEnsure 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.
December 11, 2023 · 1 citation · includes complaint inspection
EProvide and implement an infection prevention and control program.
Questions to ask on a tour of Twin Oaks Manor
- CMS cited the home under its abuse and neglect rules on June 11, 2026. How are staff trained, and how are concerns reported?
- Nursing staff turnover was 69.4% a year. How many of the staff come from agencies?
- Do you have a Medicaid bed open now, and will you admit someone whose Medicaid application is still pending?
- When is the first care-plan meeting, and can family attend?
Questions come from this home's CMS data: its inspections, staffing and ownership record.
Fines and payment denials
CMS reports no fines or payment denials for this home in the last three years.
Rating history
| CMS month | Overall | Inspection | Staffing | Quality |
|---|---|---|---|---|
| October 2026 | 3/5 | 4/5 | 4/5 | 1/5 |
| August 2026 | 3/5 | 4/5 | 4/5 | 1/5 |
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Location
Hospitals near Twin Oaks Manor
The Medicare-certified hospitals closest to this nursing home, with their CMS data. Ask the home which hospital it usually sends residents to.
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15.7 mi
Ochiltree General Hospital PerrytonEmergency roomMedian ER visit 1h 28m for patients treated and sent home
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24.3 mi
Beaver County Memorial Hospital BeaverEmergency roomMedian ER visit 1h 54m for patients treated and sent home
Hospital ratings, ER visit times and more at Hospitals In Each State
Source: CMS Care Compare. Distances are approximate.
Nearby nursing homes
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Source: CMS Provider Data Catalog (provider information, health deficiencies, penalties), October 2026. Inspection citations and penalties cover the last three years. Nursing Homes In Each State is independent and not affiliated with CMS or Medicare. About the data · Report a problem with this listing. Is this your nursing home? Feature it here.