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Nursing homeFAID #14002

Twin Oaks Health & Rehabilitation Center

1123 North Bolton Street, JACKSONVILLE, TX, 75766
(903) 586-9031
www.twinoakscare.com
116 licensed beds

CMS rates Twin Oaks Health & Rehabilitation Center 2 out of 5 overall. Federal inspectors issued 49 citations across 10 inspections in the last three years, with $174,431 in fines. Listing last updated 2026-11-06.

★★★★★2/5CMS Five-Star overall3/5 health inspections1/5 staffing3/5 quality measuresSource: CMS Care Compare

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Photo of Twin Oaks Health & Rehabilitation Center
Photo via Google · Twin Oaks Health & Rehabilitation Center

Address

1123 North Bolton Street
Jacksonville, TX 75766
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Public record summary

What we can show you for free.
Bed capacity
116
CMS facility ID
675183
Care type
Nursing home
County
Cherokee
Facility name
Twin Oaks Health & Rehabilitation Center
Street address
1123 North Bolton Street
City / state / ZIP
Jacksonville, TX 75766
Phone
(903) 586-9031
Website
www.twinoakscare.com

About this facility — Twin Oaks Health & Rehabilitation Center

Twin Oaks Health & Rehabilitation Center is a Medicare/Medicaid-certified skilled nursing facility in Jacksonville, Texas. It is licensed for 116 beds — close to the median for skilled nursing facilities in Texas (120 beds).

It is one of 8 senior care facilities in Jacksonville and 1,179 skilled nursing facilities across Texas. Families comparing options should weigh inspection history, ownership record, and litigation — not just the tour — before deciding.

It is listed as part of Creative Solutions in Healthcare, a group of 150 facilities on this site.

Federal inspectors have cited Twin Oaks Health & Rehabilitation Center 49 times across 10 inspections in the last three years, including 4 food-safety citations, and CMS has imposed $174,431 in fines. Every citation is listed, dated, and graded in the inspection record below.

This listing draws on federal CMS Nursing Home Compare records, and was last updated on November 6, 2026. Background reports are compiled from primary sources — state inspection files, federal CMS data, corporate registrations, and court records — at the time of order.

Facility background

What the public record shows.

Ownership & operator

Parent company
Creative Solutions In Healthcare
Ownership type
For profit - Corporation

Registered owners & officers

Liberty County Hospital District No 1
Direct owner — 100% stake — since 2022
Blake, Gary
Operational control · Additional disclosable party — since 2022
Blake, Malisa
Operational control — since 2022
Fregia, Milton
Governing body — since 2022
Gardner, Shannon
Governing body — since 2022
Gardzina, Margaret
Governing body — since 2024
Hekimian, Khoren
Additional disclosable party — since 2025
Henry, Paul
Governing body — since 2009
Huggins, Linda
Director — since 2022
Jacksonville Iii Enterprises Llc
Operational control · Additional disclosable party — since 2022
Stratton, Charles
Governing body · Officer — since 2005
Williamson, Rose
Additional disclosable party — since 2025
Willig, Zachary
Director — since 2025

Regulatory standing

Federal court records
4 naming its parent company — view the cases (a listed case is not a finding of wrongdoing)
Licensed / certified since
1999-01-07
CMS overall rating
2 of 5 stars
Health deficiencies
5 at the last standard inspection
Federal fines
$174,431 total
Last standard inspection
2025-12-31
Nurse staffing
2.9 hours per resident per day

Cost & payer profile (FY2023 cost report)

Average billed charges
$205 per day (≈ $6,230/month). Private-pay prices typically track billed charges; Medicare and Medicaid pay set rates.
Payer mix (resident days)
62% Medicaid · 6% Medicare · 32% private/other
Occupancy
66% (fiscal year 2023)
Vs. state median
26% below the TX median of $277/day — full state cost breakdown

Services & coverage

Licensed beds
116
Medicare
Accepted
Medicaid
Accepted
Wheelchair accessible
entrance and parking
Visiting hours
Daily Open 24 hours
Compiled from CMS Nursing Home Compare; owners/officers from the CMS Ownership dataset; cost & occupancy from the facility's own CMS cost report; hours/accessibility via Google · last verified 2026-11-06. Facilities can submit a correction.

Inspection record

Every citation, dated and graded.

Kitchen & food safety

Federal surveyors inspect the kitchen at every standard visit. This facility has 4 food-safety citations on its three-year record — flagged below among the inspections.
2025-12-31Health inspection5 citations
F-0641
D · No harm found
Ensure each resident receives an accurate assessment.
Corrected 2026-01-05
F-0645
D · No harm found
PASARR screening for Mental disorders or Intellectual Disabilities
Corrected 2026-01-05
F-0732
C · No harm found
Post nurse staffing information every day.
Corrected 2026-01-05
F-0804
E · No harm foundFood safety
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Corrected 2026-01-05
F-0812
E · No harm foundFood safety
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2026-01-05
2025-04-15Health inspectionComplaint-triggered1 citation
F-0622
D · No harm foundFrom a 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.
Corrected 2025-05-04
7 earlier / fire-safety inspections (43 citations)
2024-09-25Health inspectionComplaint-triggered13 citations
F-0550
D · No harm foundFrom a complaint
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Corrected 2024-09-26
F-0558
E · No harm found
Reasonably accommodate the needs and preferences of each resident.
Corrected 2024-09-26
F-0689
E · No harm found
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2024-09-26
F-0760
D · No harm found
Ensure that residents are free from significant medication errors.
Corrected 2024-09-26
F-0761
D · No harm found
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 2024-09-26
F-0812
F · No harm foundFood safetyFrom a complaint
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2024-09-26
F-0880
E · No harm found
Provide and implement an infection prevention and control program.
Corrected 2024-09-26
F-0883
E · No harm found
Develop and implement policies and procedures for flu and pneumonia vaccinations.
Corrected 2024-09-26
F-0887
E · No harm found
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.
Corrected 2024-09-26
F-0919
D · No harm found
Make sure that a working call system is available in each resident's bathroom and bathing area.
Corrected 2024-09-26
F-0924
D · No harm found
Put firmly secured handrails on each side of hallways.
Corrected 2024-09-26
F-0925
D · No harm foundFrom a complaint
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
Corrected 2024-09-26
F-0926
F · No harm found
Have policies on smoking.
Corrected 2024-09-26
2024-01-18Health inspectionComplaint-triggered3 citations
F-0580
J · Immediate jeopardyFrom a complaint
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Corrected 2024-01-19
F-0609
D · No harm foundFrom a complaint
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Corrected 2024-01-19
F-0697
J · Immediate jeopardyFrom a complaint
Provide safe, appropriate pain management for a resident who requires such services.
Corrected 2024-01-19
2023-10-29Health inspectionComplaint-triggered2 citations
F-0600
E · No harm foundFrom a complaint
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected 2023-09-14
F-0607
E · No harm foundFrom a complaint
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Corrected 2023-09-14
2023-07-26Health inspection10 citations
F-0585
D · No harm found
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.
Corrected 2023-08-18
F-0607
E · No harm found
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Corrected 2023-08-18
F-0656
E · No harm found
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected 2023-08-18
F-0677
D · No harm found
Provide care and assistance to perform activities of daily living for any resident who is unable.
Corrected 2023-08-18
F-0689
E · No harm found
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2023-08-18
F-0755
D · No harm found
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected 2023-08-18
F-0761
E · No harm found
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 2023-08-18
F-0804
E · No harm foundFood safety
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Corrected 2023-08-18
F-0880
E · No harm found
Provide and implement an infection prevention and control program.
Corrected 2023-08-18
F-0925
E · No harm found
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
Corrected 2023-08-18
2025-12-31Fire-safety inspection7 citations
K-0321
E · No harm found
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Corrected 2026-01-05
K-0355
E · No harm found
Properly select, install, inspect, or maintain portable fire extinguishes.
Corrected 2026-01-05
K-0372
E · No harm found
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Corrected 2026-01-05
K-0374
E · No harm found
Install smoke barrier doors that can resist smoke for at least 20 minutes.
Corrected 2026-01-05
K-0511
E · No harm found
Have properly installed electrical wiring and gas equipment.
Corrected 2026-01-05
K-0521
C · No harm found
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
K-0929
E · No harm found
Ensure precautions for handling oxygen cylinders and equipment are correctly followed.
Corrected 2026-01-05
2024-09-25Fire-safety inspection6 citations
K-0321
E · No harm found
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Corrected 2024-10-18
K-0372
F · No harm found
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Corrected 2024-10-18
K-0374
E · No harm found
Install smoke barrier doors that can resist smoke for at least 20 minutes.
Corrected 2024-10-18
K-0511
E · No harm found
Have properly installed electrical wiring and gas equipment.
Corrected 2024-10-18
K-0521
C · No harm found
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
K-0920
E · No harm found
Ensure proper usage of power strips and extension cords.
Corrected 2024-10-09
2023-07-26Fire-safety inspection2 citations
K-0321
E · No harm found
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Corrected 2023-09-01
K-0521
C · No harm found
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

Federal penalties

2024-01-18Fine$174,431
Citations and penalties from the CMS Provider Data Catalog (three-year survey window, refreshed monthly). Severity codes follow the federal scope/severity grid; “Immediate jeopardy” is the most serious grade CMS issues. CCN 675183.

Quality of care & staffing

How it compares in Texas.
Inspection citations, 3 years
49
More than 78% of nursing homes in the state
State median: 33
Federal fines, 3 years
$174,431
More than 93% of nursing homes in the state
State median: $15,642
Nurse staffing, hours per resident per day
2.9
Higher than 9% of nursing homes in the state
State median: 3.3
Nursing staff turnover, annual
47%
Higher than 39% of nursing homes in the state
State median: 50%

Resident outcomes

On 17 federal quality measures, this facility does better than the Texas average on 7 and worse on 4. Differences within 10% of the average are shown as near average.

Long-stay residentsThis facilityStateUSCompared with state
Need for help with daily activities has increased19.1%15.8%13.5%Worse than state
Lose too much weight0.0%2.9%5.1%Better than state
With a catheter inserted and left in their bladder0.0%0.3%0.7%Better than state
With a urinary tract infection0.0%0.8%1.5%Better than state
Have depressive symptoms3.7%2.3%13.5%Worse than state
Were physically restrained0.0%0.0%0.1%Better than state
Experiencing one or more falls with major injury3.0%3.2%3.2%Near state average
Assessed and appropriately given the pneumococcal vaccine100.0%96.4%93.7%Near state average
Ability to walk independently worsened8.7%12.9%12.7%Better than state
Received an antianxiety or hypnotic medication19.5%17.8%19.5%Near state average
Assessed and appropriately given the seasonal influenza vaccine100.0%97.0%95.3%Near state average
With pressure ulcers4.8%3.7%4.5%Worse than state
With new or worsened bowel or bladder incontinence12.6%12.5%18.3%Near state average
Received an antipsychotic medication25.2%9.8%15.4%Worse than state
Short-stay residentsThis facilityStateUSCompared with state
Assessed and appropriately given the pneumococcal vaccine100.0%88.7%82.3%Better than state
Newly received an antipsychotic medication0.0%1.4%1.5%Better than state
Were assessed and appropriately given the seasonal influenza vaccine93.3%85.4%80.1%Near state average
Source: CMS MDS and Medicare claims quality measures, measure period 2025Q3-2026Q2. Averages are computed from all nursing homes reporting each measure.

Cited more than once

The same rule cited at separate inspections can point to a problem that wasn't fully fixed.

  • K-0321 3 inspections. Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
  • K-0521 3 inspections. Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
  • F-0804 2 inspections. Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
  • F-0812 2 inspections. Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
  • K-0372 2 inspections. Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
  • K-0374 2 inspections. Install smoke barrier doors that can resist smoke for at least 20 minutes.

What its owners also hold

  • Liberty County Hospital District No 1 has an ownership stake on file at 35 nursing homes, averaging 2.9 of 5 on CMS's overall rating.
Source: CMS ownership filings. Shows organizations with an ownership stake; people are left out.

Verify & compare

Where to check, and what's nearby.

Who to contact in Texas

  • Licensing: Texas Health and Human Services
  • File a complaint: 800-458-9858 · Online
  • Long-Term Care Ombudsman: 800-252-2412. A free advocate for residents and families.
  • Adult Protective Services: 800-252-5400. Some states send facility cases to licensing instead. In an emergency, call 911.
  • Eldercare Locator: 800-677-1116, a federal service for local aging help.

Nearest emergency hospitals

  • Ut Health East Texas Jacksonville Hospital, about 1.2 miles.
  • Christus Mother Frances Hospital- Jacksonville, about 3.2 miles.
  • Baylor Scott & White Texas Spine & Joint Hospital, about 24 miles. CMS rating 5 of 5.
Source: CMS Hospital General Information. Straight-line distance.

Nearby facilities with inspection records

Visitor reviews

What people say on Google.
4.638 ratings on Google
★★★★★Tiffany C · 2026-06-25 · via Google

“Our family is forever grateful for the care, compassion, and love the staff at Twin Oaks Nursing & Rehabilitation has shown my mother-in-law. She has always been treated with love, kindness, dignity, and respect, and that means more to our family than words can express. The nurses, CMAs, CNAs, Aides, therapy staff, dietary team, housekeeping, activities, maintenance, and administration all played…”

★★★★★Keyosha Sasser · 2025-06-13 · via Google

“My father has been in each nursing facility here in Jacksonville. By far, hands down, I should’ve had him here first. Each department is elite and always great with communication and feedback. The residents are awesome always super cool to hang with.”

★★★★★Toni Voir · 2024-07-25 · via Google

“I wish I could give Erica and her team a 100+ stars. Twin Oaks was the only establishment that took my mom in because of Medicaid issues. Erica was so helpful, kind and understanding as my sister and I were stressed out thinking my mom had no place to go. My mom is very happy at Twin Oaks, loves the food and the staff. Thank you Erica and your Staff for helping us. You guys are incredible!!!!!”

Ratings and reviews are from Google and reflect visitor opinions, not our verification. See all reviews on Google

Inside your report

What unlocks when you order.

Ownership & corporate history

Primary tier
Prior operators & transfers
Corporate network & affiliates
,
Owners' other facilities
· · 2 more

Inspection citations — last 5 years

Locked
The 49 citations above are shown free. The report takes each one and explains it in plain English — what the tag requires, how serious the scope/severity grade really is, whether it recurred across surveys — plus the five-year pattern a single inspection can't show.

Civil & criminal lawsuits

Advanced tier only
Active civil suits
#
Federal dockets
CDC infection data
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Citations, owner history, lawsuits — decoded into one PDF.
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Original records

Sources we pull for this facility.
Source
CMS Nursing Home Compare
data.cms.gov Provider Data Catalog
Last verified 2026-11-06
Source
Google Business Profile
Photos, reviews & hours
Displayed with attribution · refreshed on re-run
Source
Secretary of State filings
Entity & officer search
Pulled when a report is ordered
Source
PACER federal dockets
pacer.uscourts.gov
Pulled when a report is ordered