nursing home in Jacksonville, TX
Twin Oaks Health & Rehabilitation Center
1123 North Bolton Street, Jacksonville, TX 75766 · (903) 586-9031
★★★★★2
Below average
CMS overall star rating
CMS overall star rating
- Health inspections★★★★★3
- Staffing★★★★★1
- Quality measures★★★★★3
Source: Centers for Medicare & Medicaid Services (CMS), Medicare Care Compare. We refresh our information from this source. About our data
Twin Oaks Health & Rehabilitation Center at a glance
Twin Oaks Health & Rehabilitation Center is a 116-bed for-profit nursing home in Jacksonville, Texas (Cherokee County).
CMS gives it 2 out of 5 stars on its overall star rating, worse than the Texas average of 2.7.
Residents receive about 3 hours of nursing care per day (0.4 of them from registered nurses), worse than the state average of 3.4 hours.
Its most recent standard health inspection (December 31, 2025) found 5 health citations. The Texas average is 9.4.
Federal regulators fined it 1 time in the past three years, totaling $174,431.
Nursing staff turnover is 98% per year (state average 55.3%).
Facility details
- Type
- Nursing home
- Ownership
- For Profit - Corporation
- Beds
- 116
- Certified for
- Medicare and Medicaid
- Chain / affiliated entity
- Creative Solutions in Healthcare
- Medicare-certified since
- January 7, 1999
- Resident/family council
- Resident
- County
- Cherokee County
- CMS Certification Number
- 675183
Ratings
| Measure | This facility | Texas avg. | U.S. avg. | vs. U.S. |
|---|---|---|---|---|
| Overall star rating ⓘ (higher is better) | 2 / 5 | 2.7 / 5 | 3 / 5 | Worse |
| Health inspection rating ⓘ (higher is better) | 3 / 5 | 2.8 / 5 | 2.8 / 5 | Average |
| Staffing rating ⓘ (higher is better) | 1 / 5 | 1.9 / 5 | 2.9 / 5 | Worse |
| Quality measures rating ⓘ (higher is better) | 3 / 5 | 3.7 / 5 | 3.6 / 5 | Worse |
| Long-stay quality rating (higher is better) | 3 / 5 | 4 / 5 | 3.8 / 5 | Worse |
| Short-stay (rehab) quality rating (higher is better) | 3 / 5 | 3.2 / 5 | 3.3 / 5 | Average |
Staffing
| Measure | This facility | Texas avg. | U.S. avg. | vs. U.S. |
|---|---|---|---|---|
| Total nurse staff hours per resident per day ⓘ (higher is better) | 2.97 hrs | 3.39 hrs | 3.86 hrs | Worse |
| Registered nurse hours per resident per day (higher is better) | 0.39 hrs | 0.43 hrs | 0.69 hrs | Worse |
| Nurse aide hours per resident per day (higher is better) | 1.83 hrs | 2.01 hrs | 2.32 hrs | Worse |
| Weekend nurse staff hours per resident per day (higher is better) | 2.43 hrs | 2.98 hrs | 3.42 hrs | Worse |
| Nursing staff turnover (yearly) (lower is better) | 98% | 55.3% | 45.8% | Worse |
| Registered nurse turnover (yearly) (lower is better) | 100% | 54.6% | 42.9% | Worse |
| Administrators who left in the past year (lower is better) | 3 | 1 | 1 | Worse |
Inspections
| Measure | This facility | Texas avg. | U.S. avg. | vs. U.S. |
|---|---|---|---|---|
| Health citations in the most recent inspection (lower is better) | 5 | 9 | 9 | Better |
| Citations from complaint investigations (latest cycle) (lower is better) | 0 | 4 | 3 | Better |
| Weighted health inspection score ⓘ (lower is better) | 79.3 | 102 | 80.6 | Average |
Penalties
| Measure | This facility | Texas avg. | U.S. avg. | vs. U.S. |
|---|---|---|---|---|
| Fines in the past 3 years (lower is better) | 1 | 1 | 1 | Worse |
| Total fines in the past 3 years (lower is better) | $174,431 | $44,141 | $30,972 | Worse |
| All federal penalties in the past 3 years (lower is better) | 1 | 2 | 1 | Average |
Size
| Measure | This facility | Texas avg. | U.S. avg. | vs. U.S. |
|---|---|---|---|---|
| Certified beds | 116 | 113 | 107 | |
| Average residents per day | 61 | 76 | 86 | |
| Occupancy | 52.6% | 67.6% | 80.9% |
Long-stay residents
| Measure | This facility | Texas avg. | U.S. avg. | vs. U.S. |
|---|---|---|---|---|
| Long-stay residents with a fall causing major injury (lower is better) | 2.5% | 3.3% | 3.2% | Better |
| Long-stay residents with pressure ulcers (lower is better) | 6.5% | 3.8% | 4.6% | Worse |
| Long-stay residents given antipsychotic medication (lower is better) | 25.6% | 9.6% | 15.4% | Worse |
| Long-stay residents with a urinary tract infection (lower is better) | 0% | 0.8% | 1.6% | Better |
| Long-stay residents with a catheter left in the bladder (lower is better) | 0% | 0.3% | 0.8% | Better |
| Long-stay residents needing more help with daily activities (lower is better) | 16.8% | 15.8% | 13.9% | Worse |
| Long-stay residents whose walking worsened (lower is better) | 7% | 14% | 14.1% | Better |
| Long-stay residents who lose too much weight (lower is better) | 0% | 3% | 5.2% | Better |
| Long-stay residents with depressive symptoms (lower is better) | 3.7% | 2.4% | 12.8% | Better |
| Long-stay residents who were physically restrained (lower is better) | 0% | 0% | 0.1% | Better |
| Long-stay residents given anti-anxiety or sleep medication (lower is better) | 18.2% | 18% | 19.5% | Better |
| Long-stay residents with new or worse incontinence (lower is better) | 15.8% | 13.4% | 19% | Better |
| Long-stay residents given a flu vaccine (higher is better) | 97.3% | 98% | 95.5% | Average |
| Long-stay residents given a pneumonia vaccine (higher is better) | 100% | 96.6% | 93.6% | Better |
Short-stay residents
| Measure | This facility | Texas avg. | U.S. avg. | vs. U.S. |
|---|---|---|---|---|
| Short-stay residents newly given antipsychotic medication (lower is better) | 0% | 1.5% | 1.6% | Better |
| Short-stay residents given a flu vaccine (higher is better) | 88.2% | 88% | 79.8% | Better |
| Short-stay residents given a pneumonia vaccine (higher is better) | 100% | 88.9% | 82% | Better |
Inspection citations
State inspectors cited this home for 34 health deficiencies and 15 fire safety deficiencies in the inspection records CMS currently publishes. 2 citations involved actual harm, including 2 rated "immediate jeopardy".
| Date | Citation | Severity | Status |
|---|---|---|---|
| December 31, 2025 Fire safety | Properly select, install, inspect, or maintain portable fire extinguishes. Smoke Deficiencies · Tag K0355 | E Potential harm, pattern | Corrected January 5, 2026 |
| December 31, 2025 Fire safety | Install smoke barrier doors that can resist smoke for at least 20 minutes. Smoke Deficiencies · Tag K0374 | E Potential harm, pattern | Corrected January 5, 2026 |
| December 31, 2025 Fire safety | Ensure smoke barriers are constructed to a 1 hour fire resistance rating. Smoke Deficiencies · Tag K0372 | E Potential harm, pattern | Corrected January 5, 2026 |
| December 31, 2025 Fire safety | Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. Smoke Deficiencies · Tag K0321 | E Potential harm, pattern | Corrected January 5, 2026 |
| December 31, 2025 Fire safety | Ensure precautions for handling oxygen cylinders and equipment are correctly followed. Gas, Vacuum, and Electrical Systems Deficiencies · Tag K0929 | E Potential harm, pattern | Corrected January 5, 2026 |
| December 31, 2025 Fire safety | Have properly installed electrical wiring and gas equipment. Services Deficiencies · Tag K0511 | E Potential harm, pattern | Corrected January 5, 2026 |
| December 31, 2025 Fire safety | Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. Services Deficiencies · Tag K0521 | C No harm, widespread | No revisit needed |
| December 31, 2025 Standard | 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 F0812 | E Potential harm, pattern | Corrected January 5, 2026 |
| December 31, 2025 Standard | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. Nutrition and Dietary Deficiencies · Tag F0804 | E Potential harm, pattern | Corrected January 5, 2026 |
| December 31, 2025 Standard | Ensure each resident receives an accurate assessment. Resident Assessment and Care Planning Deficiencies · Tag F0641 | D Potential harm, isolated | Corrected January 5, 2026 |
| December 31, 2025 Standard | PASARR screening for Mental disorders or Intellectual Disabilities Resident Assessment and Care Planning Deficiencies · Tag F0645 | D Potential harm, isolated | Corrected January 5, 2026 |
| December 31, 2025 Standard | Post nurse staffing information every day. Nursing and Physician Services Deficiencies · Tag F0732 | C No harm, widespread | Corrected January 5, 2026 |
| April 15, 2025 Complaint | 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. Resident Rights Deficiencies · Tag F0622 | D Potential harm, isolated | Corrected May 4, 2025 |
| September 25, 2024 Fire safety | Ensure smoke barriers are constructed to a 1 hour fire resistance rating. Smoke Deficiencies · Tag K0372 | F Potential harm, widespread | Corrected October 18, 2024 |
| September 25, 2024 Fire safety | Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. Smoke Deficiencies · Tag K0321 | E Potential harm, pattern | Corrected October 18, 2024 |
| September 25, 2024 Fire safety | Ensure proper usage of power strips and extension cords. Gas, Vacuum, and Electrical Systems Deficiencies · Tag K0920 | E Potential harm, pattern | Corrected October 9, 2024 |
| September 25, 2024 Fire safety | Have properly installed electrical wiring and gas equipment. Services Deficiencies · Tag K0511 | E Potential harm, pattern | Corrected October 18, 2024 |
| September 25, 2024 Fire safety | Install smoke barrier doors that can resist smoke for at least 20 minutes. Smoke Deficiencies · Tag K0374 | E Potential harm, pattern | Corrected October 18, 2024 |
| September 25, 2024 Fire safety | Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. Services Deficiencies · Tag K0521 | C No harm, widespread | Waiver has been granted |
| September 25, 2024 Standard | Have policies on smoking. Environmental Deficiencies · Tag F0926 | F Potential harm, widespread | Corrected September 26, 2024 |
| September 25, 2024 Complaint | 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 F0812 | F Potential harm, widespread | Corrected September 26, 2024 |
| September 25, 2024 Standard | Provide and implement an infection prevention and control program. Infection Control Deficiencies · Tag F0880 | E Potential harm, pattern | Corrected September 26, 2024 |
| September 25, 2024 Standard | 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 F0689 | E Potential harm, pattern | Corrected September 26, 2024 |
| September 25, 2024 Standard | Reasonably accommodate the needs and preferences of each resident. Resident Rights Deficiencies · Tag F0558 | E Potential harm, pattern | Corrected September 26, 2024 |
| September 25, 2024 Standard | 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. Infection Control Deficiencies · Tag F0887 | E Potential harm, pattern | Corrected September 26, 2024 |
| September 25, 2024 Standard | Develop and implement policies and procedures for flu and pneumonia vaccinations. Infection Control Deficiencies · Tag F0883 | E Potential harm, pattern | Corrected September 26, 2024 |
| September 25, 2024 Complaint | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Resident Rights Deficiencies · Tag F0550 | D Potential harm, isolated | Corrected September 26, 2024 |
| September 25, 2024 Standard | Put firmly secured handrails on each side of hallways. Environmental Deficiencies · Tag F0924 | D Potential harm, isolated | Corrected September 26, 2024 |
| September 25, 2024 Complaint | Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. Environmental Deficiencies · Tag F0925 | D Potential harm, isolated | Corrected September 26, 2024 |
| September 25, 2024 Standard | Make sure that a working call system is available in each resident's bathroom and bathing area. Environmental Deficiencies · Tag F0919 | D Potential harm, isolated | Corrected September 26, 2024 |
| September 25, 2024 Standard | Ensure that residents are free from significant medication errors. Pharmacy Service Deficiencies · Tag F0760 | D Potential harm, isolated | Corrected September 26, 2024 |
| September 25, 2024 Standard | 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 F0761 | D Potential harm, isolated | Corrected September 26, 2024 |
| January 18, 2024 Complaint | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. Resident Rights Deficiencies · Tag F0580 | J Immediate jeopardy, isolated | Corrected January 19, 2024 |
| January 18, 2024 Complaint | Provide safe, appropriate pain management for a resident who requires such services. Quality of Life and Care Deficiencies · Tag F0697 | J Immediate jeopardy, isolated | Corrected January 19, 2024 |
| January 18, 2024 Complaint | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0609 | D Potential harm, isolated | Corrected January 19, 2024 |
| October 29, 2023 Complaint | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0600 | E Potential harm, pattern | Corrected September 14, 2023 |
| October 29, 2023 Complaint | Develop and implement policies and procedures to prevent abuse, neglect, and theft. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0607 | E Potential harm, pattern | Corrected September 14, 2023 |
| July 26, 2023 Fire safety | Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. Smoke Deficiencies · Tag K0321 | E Potential harm, pattern | Corrected September 1, 2023 |
| July 26, 2023 Fire safety | Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. Services Deficiencies · Tag K0521 | C No harm, widespread | Waiver has been granted |
| July 26, 2023 Standard | 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 F0761 | E Potential harm, pattern | Corrected August 18, 2023 |
| July 26, 2023 Standard | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. Nutrition and Dietary Deficiencies · Tag F0804 | E Potential harm, pattern | Corrected August 18, 2023 |
| July 26, 2023 Standard | Provide and implement an infection prevention and control program. Infection Control Deficiencies · Tag F0880 | E Potential harm, pattern | Corrected August 18, 2023 |
| July 26, 2023 Standard | Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. Environmental Deficiencies · Tag F0925 | E Potential harm, pattern | Corrected August 18, 2023 |
| July 26, 2023 Standard | 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 F0689 | E Potential harm, pattern | Corrected August 18, 2023 |
| July 26, 2023 Standard | 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 F0656 | E Potential harm, pattern | Corrected August 18, 2023 |
| July 26, 2023 Standard | Develop and implement policies and procedures to prevent abuse, neglect, and theft. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0607 | E Potential harm, pattern | Corrected August 18, 2023 |
| July 26, 2023 Standard | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Pharmacy Service Deficiencies · Tag F0755 | D Potential harm, isolated | Corrected August 18, 2023 |
| July 26, 2023 Standard | Provide care and assistance to perform activities of daily living for any resident who is unable. Quality of Life and Care Deficiencies · Tag F0677 | D Potential harm, isolated | Corrected August 18, 2023 |
| July 26, 2023 Standard | 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. Resident Rights Deficiencies · Tag F0585 | D Potential harm, isolated | Corrected August 18, 2023 |
Severity letters follow the CMS scope-and-severity grid: A–C no actual harm with 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. How to read inspection citations.
Fines and payment denials
CMS reports 1 federal penalty in the past three years, including $174,431 in fines.
| Date | Penalty | Amount / length |
|---|---|---|
| January 18, 2024 | Fine | $174,431 |
Owners and managers
Individuals and organizations reported to CMS as owning or operating this nursing home.
| Name | Role | Share | Since |
|---|---|---|---|
| LIBERTY COUNTY HOSPITAL DISTRICT NO 1 Organization | 5% or greater direct ownership interest | 100% | 04/01/2022 |
| BLAKE, GARY Individual | adp of the snf | NOT APPLICABLE | 04/01/2022 |
| HEKIMIAN, KHOREN Individual | adp of the snf | NOT APPLICABLE | 04/11/2025 |
| JACKSONVILLE III ENTERPRISES LLC Organization | adp of the snf | NOT APPLICABLE | 04/11/2025 |
| WILLIAMSON, ROSE Individual | adp of the snf | NOT APPLICABLE | 04/11/2025 |
| HUGGINS, LINDA Individual | corporate director | NOT APPLICABLE | 04/01/2022 |
| WILLIG, ZACHARY Individual | corporate director | NOT APPLICABLE | 01/01/2025 |
| STRATTON, CHARLES Individual | corporate officer | NOT APPLICABLE | 05/01/2005 |
| FREGIA, MILTON Individual | managing control - governing body | NOT APPLICABLE | 05/07/2022 |
| GARDNER, SHANNON Individual | managing control - governing body | NOT APPLICABLE | 08/22/2022 |
| GARDZINA, MARGARET Individual | managing control - governing body | NOT APPLICABLE | 02/26/2024 |
| HENRY, PAUL Individual | managing control - governing body | NOT APPLICABLE | 05/09/2009 |
| STRATTON, CHARLES Individual | managing control - governing body | NOT APPLICABLE | 05/01/2005 |
| BLAKE, GARY Individual | operational/managerial control | NOT APPLICABLE | 04/01/2022 |
| BLAKE, MALISA Individual | operational/managerial control | NOT APPLICABLE | 04/01/2022 |
| JACKSONVILLE III ENTERPRISES LLC Organization | operational/managerial control | NOT APPLICABLE | 04/01/2022 |
Other nursing homes near Twin Oaks Health & Rehabilitation Center
Avir at Jacksonville
305 Bonita St, Jacksonville, TX 75766 · 2.1 mi
For-profit · 53 beds · Part of Avir Health Group
- New owner (last 12 months)
★★★★★5Much above averageLegacy at Jacksonville
810 Bellaire Street, Jacksonville, TX 75766 · 3.1 mi
For-profit · 101 beds · Part of Southwest LTC
★★★★★3AverageBluebonnet Point Wellness
151 Heritage Springs Drive, Bullard, TX 75757 · 13.2 mi
For-profit · 119 beds · Part of Creative Solutions in Healthcare
★★★★★1Much below average- ★★★★★2Below average
The Arbors Healthcare and Rehabilitation Center
1884 Loop 343 West, Rusk, TX 75785 · 15.1 mi
For-profit · 110 beds · Part of Creative Solutions in Healthcare
★★★★★2Below averageOak Brook Health Care Center
107 Stacy Dr., Whitehouse, TX 75791 · 16.7 mi
Government · 120 beds · Part of Caring Healthcare Group
★★★★★3Average
All nursing homes in Jacksonville, TX · Compare side by side
Frequently asked questions
What is Twin Oaks Health & Rehabilitation Center's rating?
Twin Oaks Health & Rehabilitation Center has 2 out of 5 stars on the CMS overall star rating. The average for Texas nursing homes is 2.7 stars.
How many inspection citations did Twin Oaks Health & Rehabilitation Center receive?
Its most recent standard health inspection found 5 citations, compared with a Texas average of 9.4. Every citation is listed on this page with its severity.
Does Twin Oaks Health & Rehabilitation Center accept Medicare and Medicaid?
CMS lists it as certified for: Medicare and Medicaid. Call the facility to confirm bed availability and whether it accepts your specific plan.
Who owns Twin Oaks Health & Rehabilitation Center?
It is for profit - corporation and part of Creative Solutions in Healthcare. The ownership section on this page lists the owners and managers reported to CMS.
Where is Twin Oaks Health & Rehabilitation Center and how do I contact it?
Twin Oaks Health & Rehabilitation Center is at 1123 North Bolton Street, Jacksonville, TX 75766. Phone: (903) 586-9031.
About this data
Ratings and measures come from the Centers for Medicare & Medicaid Services (CMS), Medicare Care Compare. They're based on state inspections, patient surveys and facility reports, and they describe the past. Facilities change, so visit in person and confirm details directly. About our data · Spotted an error? Let us know.