Federal inspection record · CMS data as of October 1, 2026
Twin Oaks Health & Rehabilitation Center
1123 North Bolton Street, Jacksonville, TX · (903) 586-9031
- Certified beds
- 116
- Residents per day
- 63
- Ownership
- For-Profit
- Chain
- Creative Solutions In Healthcare
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- January 7, 1999
1
How this home got 2 stars
The overall rating isn't an average. CMS starts from the inspection rating and nudges it at most two steps. Here is the arithmetic for this home, using CMS's own rules.
-
Health inspections
★★★★★starting point
Everything starts from what state inspectors found on site. This is a ranking against other homes in Texas.
-
Staffing
★★★★★−1 star
Only a 5-star staffing rating adds a star, and only a 1-star rating removes one. Ratings of 2 to 4 change nothing.
-
Quality measures
★★★★★no change
Same rule: 5 stars adds one, 1 star takes one away. These measures are mostly reported by the home itself.
-
Overall
★★★★★2 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among Texas homes
Twin Oaks Health & Rehabilitation Center carries 79.25 inspection points. That is fewer than 45% of Texas's 1,166 rated homes.
Inspectors' citations earn points by how serious and how widespread they were (the grid below). CMS then ranks every home in Texas: the 10% with the fewest points get 5 stars, the 20% with the most get 1 star, and the middle 70% split evenly into 2, 3 and 4.
- 5★ 0–26 pts
- 4★ 26–51 pts
- 3★ 51–85 pts
- 2★ 85–145.75 pts
- 1★ over 145.75 pts
Bars show every rated home in Texas by its weighted inspection score. CMS recalibrates the cut points monthly but holds a home's rating until its own score changes, so a home can sit just outside today's band.
3
What inspectors found
34 health citations on record since 2023. Each one gets a letter: the row says how badly residents were affected, the column how many.
Immediate jeopardyResidents at risk of serious injury or death
Actual harmA resident was hurt
Potential for harmNo one was hurt, but could have been
Minimal harmPaperwork-level problems
Read the rows, not the total. Most citations nationwide are a D: one problem, nobody hurt. Rows G–I mean a resident was harmed; J–L mean inspectors found residents in immediate danger of serious injury or death.
Small numbers in each cell are the inspection points CMS assigns per citation. Those points are what the state curve above ranks.
Harm and immediate-jeopardy citations (2)
-
J
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
-
J
Provide safe, appropriate pain management for a resident who requires such services.
Everything else, by area of care
Environmental5F
- F
Have policies on smoking.
- D
Make sure that a working call system is available in each resident's bathroom and bathing area.
- D
Put firmly secured handrails on each side of hallways.
- D
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
- E
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
Nutrition and Dietary4F
- E
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- E
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Resident Rights4E
- D
Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged.
- E
Reasonably accommodate the needs and preferences of each resident.
- D
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
- D
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
Infection Control4E
- E
Provide and implement an infection prevention and control program.
- E
Develop and implement policies and procedures for flu and pneumonia vaccinations.
- E
Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.
- E
Provide and implement an infection prevention and control program.
Pharmacy Service4E
- D
Ensure that residents are free from significant medication errors.
- D
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.
- E
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.
- D
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Freedom from Abuse, Neglect, and Exploitation4E
- D
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- E
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
- E
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
- E
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Resident Assessment and Care Planning3E
- D
Ensure each resident receives an accurate assessment.
- D
PASARR screening for Mental disorders or Intellectual Disabilities
- E
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Quality of Life and Care3E
- E
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- E
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D
Provide care and assistance to perform activities of daily living for any resident who is unable.
Nursing and Physician Services1C
- C
Post nurse staffing information every day.
Inspection history
2025-12-31
5 health deficiencies · 7 fire-safety deficiencies
Top issue: Nutrition and Dietary (2 deficiencies)
2024-09-25
14 health deficiencies · 6 fire-safety deficiencies
Top issue: Environmental (4 deficiencies)
2023-07-26
15 health deficiencies · 2 fire-safety deficiencies
Top issue: Freedom from Abuse and Neglect and Exploitation (4 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 2 h 51 min of nursing staff time a day, 24 min of it from a registered nurse.
This home
2 h 51 min
Texas average
3 h 25 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 47% of nursing staff and 64% of registered nurses left in the past year, along with 3 administrators.
Reported hours from payroll data the home submits to CMS, divided by its daily resident count. Not adjusted for how sick residents are.
5
Fines and payment denials
$174,431 in federal fines on record over the past three years.
| Date | Penalty | Amount |
|---|---|---|
| 2024-01-18 | Fine | $174,431 |
6
Resident outcomes
Quality measures compared with state and national averages. Most come from assessments the home itself reports.
| Measure | This home | State | U.S. |
|---|---|---|---|
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine3.6 pts better | 100.0% | 96.4% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine3 pts better | 100.0% | 97.0% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury0.2 pts better | 3.0% | 3.2% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms1.4 pts worse | 3.7% | 2.3% | 13.5% |
| Percentage of long-stay residents who lose too much weight2.9 pts better | 0.0% | 2.9% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication1.7 pts worse | 19.5% | 17.8% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication15.4 pts worse | 25.2% | 9.8% | 15.4% |
| Percentage of long-stay residents who were physically restrainedAbout the same | 0.0% | 0.0% | 0.1% |
| Percentage of long-stay residents whose ability to walk independently worsened4.2 pts better | 8.7% | 12.9% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased3.3 pts worse | 19.1% | 15.8% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder0.3 pts better | 0.0% | 0.3% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection0.8 pts better | 0.0% | 0.8% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence0.1 pts worse | 12.6% | 12.5% | 18.3% |
| Percentage of long-stay residents with pressure ulcers1.1 pts worse | 4.8% | 3.7% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine11.3 pts better | 100.0% | 88.7% | 82.3% |
| Percentage of short-stay residents who newly received an antipsychotic medication1.4 pts better | 0.0% | 1.4% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine7.9 pts better | 93.3% | 85.4% | 80.1% |
·
Who owns and runs it
16 owners and managers reported to CMS. The last column counts how many nursing homes each one is tied to.
Show ownership list
| Name | Role | Share | Homes |
|---|---|---|---|
| Liberty County Hospital District No 1 | 5% Or Greater Direct Ownership Interest · Organization | 100% | 35 facilities |
| Blake, Gary | Operational/Managerial Control · Individual | 0% | 139 facilities |
| Blake, Gary | Adp Of The SNF · Individual | 0% | 139 facilities |
| Blake, Malisa | Operational/Managerial Control · Individual | 0% | 139 facilities |
| Fregia, Milton | Managing Control - Governing Body · Individual | 0% | 10 facilities |
| Gardner, Shannon | Managing Control - Governing Body · Individual | 0% | 10 facilities |
| Gardzina, Margaret | Managing Control - Governing Body · Individual | 0% | 10 facilities |
| Hekimian, Khoren | Adp Of The SNF · Individual | 0% | 11 facilities |
| Henry, Paul | Managing Control - Governing Body · Individual | 0% | 10 facilities |
| Huggins, Linda | Corporate Director · Individual | 0% | 138 facilities |
| Jacksonville Iii Enterprises LLC | Operational/Managerial Control · Organization | 0% | 1 facilities |
| Jacksonville Iii Enterprises LLC | Adp Of The SNF · Organization | 0% | 1 facilities |
| Stratton, Charles | Managing Control - Governing Body · Individual | 0% | 35 facilities |
| Stratton, Charles | Corporate Officer · Individual | 0% | 35 facilities |
| Williamson, Rose | Adp Of The SNF · Individual | 0% | 1 facilities |
| Willig, Zachary | Corporate Director · Individual | 0% | 84 facilities |
·
Fire safety
15 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke8F
- E
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- E
Properly select, install, inspect, or maintain portable fire extinguishes.
- E
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- E
Install smoke barrier doors that can resist smoke for at least 20 minutes.
- F
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- E
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- E
Install smoke barrier doors that can resist smoke for at least 20 minutes.
- E
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Services5E
- E
Have properly installed electrical wiring and gas equipment.
- C
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
- E
Have properly installed electrical wiring and gas equipment.
- C
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
- C
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
Gas, Vacuum, and Electrical Systems2E
- E
Ensure precautions for handling oxygen cylinders and equipment are correctly followed.
- E
Ensure proper usage of power strips and extension cords.
·
Other homes nearby
-
Avir at Jacksonville
Jacksonville, TX · Avir Health Group
★★★★★- Worst citation, 3 yrs
- F
- Nursing / resident / day
- 3 h 8 min
- Fines
- $0
-
Legacy at Jacksonville
Jacksonville, TX · Southwest Ltc
★★★★★- Worst citation, 3 yrs
- G
- Nursing / resident / day
- 3 h 14 min
- Fines
- $27,345
-
Bluebonnet Point Wellness
Bullard, TX · Creative Solutions In Healthcare
★★★★★- Worst citation, 3 yrs
- K
- Nursing / resident / day
- 2 h 53 min
- Fines
- $181,947