Booker Hospital District Dba: Twin Oaks Manor
Nursing Home · 112 Pioneer Dr, Booker, TX 79005 · 8066589786
B
graded on 75% of our rubric
Why you can trust this grade. HearthGrades is independent and free to use. Every grade is computed from public CMS and state records on a fixed, published rubric — safety inspections, staffing, clinical outcomes, enforcement and financial stability. This provider was graded on 75% of that rubric. No facility can pay to change its grade or where it appears, and we take no money from the providers we grade. See the full methodology.
Scores by dimension
| Dimension | Score | Data confidence |
|---|---|---|
| Safety & compliance | 4.0 / 5 | high |
| Staffing | 3.4 / 5 | high |
| Clinical outcomes | 1.6 / 5 | high |
| Enforcement | 5.0 / 5 | high |
| Financial stability | 4.8 / 5 | med |
Key facts
| Care type | Nursing Home |
| Beds | 40 |
| Ownership | Government - Hospital District |
| Operator | Legal Business Name Not Available |
| Certified since | 1988-04-15 |
| CMS overall star | 3 / 5 |
| Accepts Medicaid | Yes |
Inspection & enforcement record
- Health-inspection citations: 0 immediate jeopardy · 0 actual harm · 12 potential for harm · 0 minor
- Federal fines: $0 · payment denials: 0 · penalty actions: 0
Recent inspection findings
The 8 most recent health-inspection deficiencies on file with CMS, newest first. Severity is the CMS scope/severity scale (A–L); G and above mean actual harm or immediate jeopardy. "Corrected" shows the date the facility certified the fix.
| Date | Finding | Severity | Status |
|---|---|---|---|
| 2025-04-30 | 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, tag 0761) | D | corrected 2025-06-14 |
| 2025-04-30 | 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, tag 0801) | D | corrected 2025-06-14 |
| 2025-04-30 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. (Nutrition and Dietary Deficiencies, tag 0812) | E | corrected 2025-06-14 |
| 2025-04-30 | Provide and implement an infection prevention and control program. (Infection Control Deficiencies, tag 0880) | D | corrected 2025-06-14 |
| 2024-03-14 | Ensure each resident receives an accurate assessment. (Resident Assessment and Care Planning Deficiencies, tag 0641) | D | corrected 2024-04-27 |
| 2024-03-14 | 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, tag 0656) | D | corrected 2024-04-27 |
| 2024-03-14 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. (Quality of Life and Care Deficiencies, tag 0689) | D | corrected 2024-04-27 |
| 2024-03-14 | Try 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. (Quality of Life and Care Deficiencies, tag 0700) | E | corrected 2024-04-27 |
Staffing
Nurse hours per resident per day (CMS Payroll-Based Journal) — the strongest objective predictor of care. "Expected" is what CMS's case-mix model says this facility's resident acuity calls for.
- Total nurse staffing: 5.66 hrs/resident/day (expected 2.98 for this facility's resident acuity — at or above expected) (US median 3.69 · TX 3.27)
- Registered-nurse staffing: 0.99 hrs/resident/day (expected 0.52 for this facility's resident acuity — at or above expected) (US median 0.58)
- Breakdown: nurse aide 4.33 · LPN 0.34 hrs/resident/day
- Weekend total staffing: 5.25 hrs/resident/day (expected 2.64 for this facility's resident acuity — at or above expected)
- Annual nursing-staff turnover: 72.2% · RN turnover 85.7% (US median 45.3% · lower is better)
- Resident acuity (nursing case-mix index): 1.07 (1.0 ≈ national average; higher = more care-intensive residents)
Clinical outcomes — the measures behind the score
The 7 CMS MDS quality measures (2025Q1-2025Q4) driving this facility's clinical score — the same measures behind the CMS QM star. All are adverse-event rates: lower is better. Worst first. The quarterly column shows the four most recent quarters (Q1→Q4); benchmarks are the national percentile and the TX state median.
| Measure | 4-qtr avg | Quarterly (Q1→Q4) | Benchmark |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased (long stay) | 32.4% | 37.9 → 34.3 → 25.7 → 32.4 | worse than 97% of US homes · TX median 14.8% |
| Percentage of long-stay residents whose ability to walk independently worsened (long stay) | 35.9% | · → 44.4 → 26.1 → 32.1 | worse than 97% of US homes · TX median 13% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder (long stay) | 2.8% | 3.4 → 2.8 → 2.7 → 2.4 | worse than 92% of US homes · TX median 0% |
| Percentage of long-stay residents with a urinary tract infection (long stay) | 4.7% | 0 → 5.3 → 5.3 → 7.5 | worse than 92% of US homes · TX median 0.3% |
| Percentage of long-stay residents who received an antipsychotic medication (long stay) | 21.6% | 12 → 20.7 → 26.7 → 25 | worse than 78% of US homes · TX median 8.1% |
| Percentage of long-stay residents experiencing one or more falls with major injury (long stay) | 4.7% | 9.1 → 2.6 → 2.6 → 5 | worse than 77% of US homes · TX median 3% |
| Percentage of long-stay residents with pressure ulcers (long stay) | 0.7% | 0 → 0 → 2.9 → 0 | better than 96% of US homes · TX median 3.4% |
What this costs
- This facility's reported charges: no recent federal cost report on file — typically a new certification, an exempt unit, or a filing CMS hasn't processed yet
- Texas median (quoted rates): $185/day semi-private · $250/day private (national: $315 · $355)
- Accepts Medicaid: yes
- This facility's quoted rate: not public. This facility's quoted private rate isn't published by any federal or state source. Medicare covers short rehab stays (up to 100 days, copays after day 20); long-term stays are private pay until savings spend down to Medicaid. How to get the real number →
Market medians: CareScout Cost of Care Survey 2025 (collected July–November 2025), state-level — individual providers vary widely around a median. Facility-level prices aren't published by any government source; how to get a real quote.
Full interactive report card → CMS Care Compare ↗
Source: CMS Provider Information + Health Deficiencies + Penalties (as of 2026-05). Part of our Lipscomb County nursing homes coverage. Spot an error? Tell us.