Booker, TX

Booker Hospital District DBA: Twin Oaks Manor

2-star overall rating with 4-star inspections with 4 recent health deficiencies with 1 fire-safety deficiencies in the latest cycle

112 Pioneer Dr, Booker, TX

(806) 658-9786

Compare this facility

Overall

2 / 5

CMS overall stars

Health inspections

4 / 5

Survey and complaint cycles

Staffing

1 / 5

RN + nurse staffing

Quality measures

1 / 5

Resident outcomes and process measures

Quick facts

Facility snapshot

Beds

40

Certified beds

Average residents

39

Average occupied residents

Ownership

Government

Publicly displayed owner type

Chain

No chain reported

Operator or chain grouping

Approved since

1988-04-15

CMS approved date

Coverage

Medicaid

Participation flags

Changed ownership

No

Within the last 12 months

Family council

Yes

Resident and family council reported

Sprinklers

Yes

Automatic sprinklers in all required areas

Staffing

Hours and turnover

RN hours / resident day

0.14

Registered nurse staffing · state 0.44 · national 0.68

LPN hours / resident day

0.17

Licensed practical nurse staffing · state 0.95 · national 0.87

Aide hours / resident day

1.28

Nurse aide staffing · state 2.01 · national 2.35

Total nurse hours

1.59

All reported nurse hours · state 3.40 · national 3.89

Licensed hours

0.31

RN + LPN hours · state 1.38 · national 1.54

Weekend hours

1.90

Weekend nurse staffing · state 2.99 · national 3.43

Weekend RN hours

0.06

Weekend registered nurse coverage · state 0.34 · national 0.47

Physical therapist

0.00

Reported PT staffing

Adjusted RN hours

0.18

CMS adjusted RN staffing hours

Adjusted total hours

2.01

CMS adjusted total nurse staffing hours

Case-mix index

1.08

Higher values indicate more complex resident acuity

RN turnover

86%

Annual RN turnover · state 52% · national 45%

Total nurse turnover

74%

Annual nurse turnover · state 52% · national 46%

SNF QRP

Medicare quality reporting measures

Measure	Facility	National	Note
Potentially preventable 30-day readmission	Not Available	10.72%	Not Available · Eligible stays Not Available · Observed rate Not Available · Lower 95% interval Not Available · This provider is not required to submit SNF QRP data.
Discharge to community	Not Available	50.57%	Not Available · Eligible stays Not Available · Observed rate Not Available · Lower 95% interval Not Available · This provider is not required to submit SNF QRP data.
Medicare spending per beneficiary	Not Available	1.02	This provider is not required to submit SNF QRP data.
Drug regimen review with follow-up	Not Available	95.27%	Numerator Not Available · Denominator Not Available · This provider is not required to submit SNF QRP data.
Falls with major injury	Not Available	0.77%	Numerator Not Available · Denominator Not Available · This provider is not required to submit SNF QRP data.
Discharge self-care score	Not Available	53.69%	Numerator Not Available · Denominator Not Available · This provider is not required to submit SNF QRP data.
Discharge mobility score	Not Available	50.94%	Numerator Not Available · Denominator Not Available · This provider is not required to submit SNF QRP data.
Pressure ulcers or injuries, new or worsened	Not Available	2.29%	Numerator Not Available · Denominator Not Available · Adjusted rate Not Available · This provider is not required to submit SNF QRP data.
Healthcare-associated infections requiring hospitalization	Not Available	7.12%	Not Available · Eligible stays Not Available · Observed rate Not Available · Lower 95% interval Not Available · This provider is not required to submit SNF QRP data.
Staff COVID-19 vaccination coverage	Not Available	8.2%	Numerator Not Available · Denominator Not Available · This provider is not required to submit SNF QRP data.
Staff flu vaccination coverage	Not Available	42%	Numerator Not Available · Denominator Not Available · This provider is not required to submit SNF QRP data.
Discharge function score	Not Available	56.45%	Numerator Not Available · Denominator Not Available · This provider is not required to submit SNF QRP data.
Transfer of health information to provider	Not Available	95.95%	Numerator Not Available · Denominator Not Available · This provider is not required to submit SNF QRP data.
Transfer of health information to patient	Not Available	96.28%	Numerator Not Available · Denominator Not Available · This provider is not required to submit SNF QRP data.
Resident COVID-19 vaccinations up to date	Not Available	25.2%	Numerator Not Available · Denominator Not Available · This provider is not required to submit SNF QRP data.

Quality measures

Resident outcomes and process scores

Measure	Facility	State	National	Note
Number of hospitalizations per 1000 long-stay resident days	1.4	2.1 0.7 pts better	1.9 0.5 pts better	Long Stay · 20240701-20250630 · Adjusted 1.4 · Observed 1.3 · Expected 1.8 · Used in QM five-star
Number of outpatient emergency department visits per 1000 long-stay resident days	1.2	2.1 0.9 pts better	1.8 0.6 pts better	Long Stay · 20240701-20250630 · Adjusted 1.2 · Observed 1.1 · Expected 1.6 · Used in QM five-star
Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine	81.7%	97.1% 15.4 pts worse	93.4% 11.7 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 84.4% · Q2 78.8% · Q3 82.1% · Q4 81.6% · 4Q avg 81.7%
Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine	97.1%	97.9% 0.8 pts worse	95.5% 1.6 pts better	Long Stay · 2024Q3-2025Q2 · 4Q avg 97.1%
Percentage of long-stay residents experiencing one or more falls with major injury	5.6%	3.3% 2.3 pts worse	3.3% 2.3 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 9.4% · Q2 9.1% · Q3 2.6% · Q4 2.6% · 4Q avg 5.6% · Used in QM five-star
Percentage of long-stay residents who have depressive symptoms	0.0%	2.7% 2.7 pts better	11.4% 11.4 pts better	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q3 0.0% · 4Q avg 0.0%
Percentage of long-stay residents who lose too much weight	5.8%	3.3% 2.5 pts worse	5.4% 0.4 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 3.1% · Q3 10.5% · Q4 7.9% · 4Q avg 5.8%
Percentage of long-stay residents who received an antianxiety or hypnotic medication	7.0%	18.9% 11.9 pts better	19.6% 12.6 pts better	Long Stay · 2024Q4-2025Q3 · Q1 9.4% · Q2 6.1% · Q3 5.1% · Q4 7.9% · 4Q avg 7.0%
Percentage of long-stay residents who received an antipsychotic medication	17.5%	10.8% 6.7 pts worse	16.7% 0.8 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 14.8% · Q2 10.7% · Q3 18.8% · Q4 24.2% · 4Q avg 17.5% · Used in QM five-star
Percentage of long-stay residents who were physically restrained	0.0%	0.0% About the same	0.1% 0.1 pts better	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0%
Percentage of long-stay residents whose ability to walk independently worsened	37.4%	15.4% 22 pts worse	16.3% 21.1 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 37.8% · Q3 44.4% · Q4 26.1% · 4Q avg 37.4% · Used in QM five-star
Percentage of long-stay residents whose need for help with daily activities has increased	35.4%	16.1% 19.3 pts worse	14.9% 20.5 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 46.4% · Q2 37.9% · Q3 34.3% · Q4 25.7% · 4Q avg 35.4% · Used in QM five-star
Percentage of long-stay residents with a catheter inserted and left in their bladder	3.1%	0.5% 2.6 pts worse	1.0% 2.1 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 3.8% · Q2 3.4% · Q3 2.8% · Q4 2.7% · 4Q avg 3.1% · Used in QM five-star
Percentage of long-stay residents with a urinary tract infection	2.9%	0.8% 2.1 pts worse	1.7% 1.2 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 5.3% · Q4 5.3% · 4Q avg 2.9% · Used in QM five-star
Percentage of long-stay residents with new or worsened bowel or bladder incontinence	38.3%	15.0% 23.3 pts worse	19.8% 18.5 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 43.1% · Q2 35.5% · Q3 34.1% · Q4 40.9% · 4Q avg 38.3%
Percentage of long-stay residents with pressure ulcers	0.8%	4.2% 3.4 pts better	5.1% 4.3 pts better	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 2.9% · 4Q avg 0.8% · Used in QM five-star
Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine	42.9%	89.7% 46.8 pts worse	81.7% 38.8 pts worse	Short Stay · 2024Q4-2025Q3 · 4Q avg 42.9%

Survey summary

Recent inspection cycles

Cycle 1 Health 2025-04-30 · Fire 2025-04-30

4 health deficiencies

Top issue: Nutrition and Dietary (2 deficiencies)

1 fire-safety deficiencies

Top issue: Emergency Preparedness (1 deficiency)

Cycle 2 Health 2024-03-14 · Fire 2024-03-14

7 health deficiencies

Top issue: Pharmacy Service (2 deficiencies)

1 fire-safety deficiencies

Top issue: Smoke (1 deficiency)

Cycle 3 Health 2023-01-27 · Fire 2023-01-27

1 health deficiencies

Top issue: Infection Control (1 deficiency)

0 fire-safety deficiencies

No concentrated fire-safety issue counts in this cycle.

Fire safety

Fire-safety citations

F · Potential for more than minimal harm 2025-04-30

E4 · Emergency Preparedness Deficiencies

Fire Safety

Develop and maintain an Emergency Preparedness Program (EP).

Corrected 2025-04-30

D · Potential for more than minimal harm 2024-03-14

K363 · Smoke Deficiencies

Fire Safety

Install corridor and hallway doors that block smoke.

Corrected 2024-04-26

Inspection history

Recent health citations

E · Potential for more than minimal harm 2025-04-30

F812 · Nutrition and Dietary Deficiencies

Health

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Corrected 2025-06-14

D · Potential for more than minimal harm 2025-04-30

F761 · Pharmacy Service Deficiencies

Health

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.

Corrected 2025-06-14

D · Potential for more than minimal harm 2025-04-30

F801 · Nutrition and Dietary Deficiencies

Health

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.

Corrected 2025-06-14

D · Potential for more than minimal harm 2025-04-30

F880 · Infection Control Deficiencies

Health

Provide and implement an infection prevention and control program.

Corrected 2025-06-14

F · Potential for more than minimal harm 2024-03-14

F812 · Nutrition and Dietary Deficiencies

Health

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Corrected 2024-04-27

E · Potential for more than minimal harm 2024-03-14

F700 · Quality of Life and Care Deficiencies

Health

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.

Corrected 2024-04-27

D · Potential for more than minimal harm 2024-03-14

F641 · Resident Assessment and Care Planning Deficiencies

Health

Ensure each resident receives an accurate assessment.

Corrected 2024-04-27

D · Potential for more than minimal harm 2024-03-14

F656 · Resident Assessment and Care Planning Deficiencies

Health

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

Corrected 2024-04-27

D · Potential for more than minimal harm 2024-03-14

F689 · Quality of Life and Care Deficiencies

Health

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Corrected 2024-04-27

D · Potential for more than minimal harm 2024-03-14

F758 · Pharmacy Service Deficiencies

Health

Implement 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.

Corrected 2024-04-27

D · Potential for more than minimal harm 2024-03-14

F761 · Pharmacy Service Deficiencies

Health

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.

Corrected 2024-04-27

E · Potential for more than minimal harm 2023-12-11