Twin Oaks Health & Rehabilitation Center
1123 NORTH BOLTON STREET, Jacksonville, TX, 75766
Federal Quality Data
Official records from CMS Care Compare — reported by the facility and audited by the Centers for Medicare & Medicaid Services. We present them unmodified. Refreshed March 2026.
CMS Star Ratings
Facility & Staffing
- Ownership
- For profit - Corporation · Chain: Creative Solutions In Healthcare
- Certified beds
- 116 · avg 65 residents/day
- Total nursing staff turnover
- 65.4% — higher than most Texas nursing homesTexas avg: 51.5% · National avg: 46.4% · per CMS Care Compare
- RN turnover
- 66.7% — higher than most Texas nursing homesTexas avg: 50.5% · National avg: 43.6% · per CMS Care Compare
- Administrators who left
- 2 departed — near the Texas averageTexas avg: 0.6 · National avg: 0.5 · per CMS Care Compare
Enforcement & Citations
- Fines (past 3 years)
- 1 fine · $174,431 total
State licensing & capacity
- License number
- 308535
- Service type
- Medicare/medicaid
- Licensed capacity
- 116 beds
- Bed type breakdown
- 18 Medicare-only · 98 Medicaid/Medicare
- Current license effective
- April 1, 2025
- Current license expires
- April 1, 2028
- Initial license date
- August 29, 1972
Texas HHSC licensing registry · as of April 16, 2026
Ownership & operations
- Licensee
- Liberty County Hospital District No 1 (HOSPITAL DISTRICT/AUTHORITY)
- Operator / manager
- Jacksonville Iii Enterprises, Llc
- Administrator
- Linnea W Robison
Texas HHSC licensing registry · as of April 16, 2026
Federal ownership record
Chain affiliation
Part of the Creative Solutions in Healthcare chain — 149 facilities. Chain-wide average overall rating 2.7 / 5.
Disclosed owners (13 on record)
- Jacksonville Iii Enterprises Llc
Adp of The Snf · since 2025
- Khoren Hekimian
Adp of The Snf · since 2025
- Rose Williamson
Adp of The Snf · since 2025
- Zachary Willig
Corporate Director · since 2025
- Margaret Gardzina
Managing Control - Governing Body · since 2024
- Shannon Gardner
Managing Control - Governing Body · since 2022
+ 7 additional owners on the federal record.
Recent change of ownership
April 2022 (4 years ago) · acquired from Twin Oaks Health And Rehabilitation Center
Transaction type: Change of Ownership
Source: CMS Provider Enrollment data — SNF Enrollments + All Owners + Chain Performance Measures + Change of Ownership, as of April 2026.
Federal inspection record
Immediate-jeopardy citations (CMS scope/severity J–L) are the most serious category federal inspectors issue — meaning a deficiency placed residents in immediate risk of serious harm. Ask the facility for the corrective-action plan filed with CMS, and consider contacting your state long-term care ombudsman for context.
Recent health-deficiency citations (most recent 8 of 34)
- E0812·Dec 31, 2025
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- E0804·Dec 31, 2025
Nutrition and Dietary Deficiencies
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
- C0732·Dec 31, 2025
Nursing and Physician Services Deficiencies
Post nurse staffing information every day.
- D0645·Dec 31, 2025
Resident Assessment and Care Planning Deficiencies
PASARR screening for Mental disorders or Intellectual Disabilities
- D0641·Dec 31, 2025
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
- D0622·Apr 15, 2025Complaint
Resident Rights Deficiencies
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.
- D0925·Sep 25, 2024Complaint
Environmental Deficiencies
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
- F0812·Sep 25, 2024Complaint
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Federal penalties
By year
- 20241 fine · $174K
Most recent events
- Jan 18, 2024Fine · $174K
Fire-safety citations
15 Life-Safety-Code citations on file. Most recent: Dec 31, 2025. Fire-safety inspections cover building-level Life Safety Code compliance, separate from the resident-care health survey.
Source: CMS Provider Data Catalog — Health Deficiencies, Fire Safety Deficiencies, and Penalties datasets, snapshot Mar 1, 2026.
About this community
Twin Oaks Health & Rehabilitation Center is a 116-bed nursing home in Jacksonville, Texas, accepting Medicare and Medicaid. CMS rates it 3 stars overall, with staffing rated 2 stars — each resident receives about 183 minutes of nursing care per day. One CMS fine totaling $174,431 has been issued, well above the Texas median of $20,699. The facility is currently operating at roughly 56% of licensed capacity.
Written from CMS Care Compare and state licensing records · last updated April 19, 2026
What the data says
CMS rates staffing here at 2 stars. Each resident receives about 183 minutes of nursing care per day — roughly 58 minutes less than at a 4-star-staffing facility in Texas. About 32% of Texas nursing homes share this staffing rating.
Roughly 7 in 10 nursing staff left in the past year. Texas's 75th-percentile cutoff is 60% annual turnover — this facility's 65% rate exceeds it. A long-stay resident will likely go through two or three primary caregivers over the course of a year.
Two administrators have turned over in the past year. That level of leadership instability is felt by residents and staff alike.
One CMS fine totaling $174,431 has been issued since the facility's last processing date. About 30% of Texas nursing homes have received no fines at all; the Texas median for facilities that do have fines is $20,699. This fine is roughly 8 times that median.
The facility is operating at approximately 56% of its 116 licensed beds, with an average of 64.6 residents per day. That figure, combined with the other signals in this record, is what separates an ordinary low-occupancy facility from one where the pattern warrants closer examination.
Written from CMS Care Compare and state licensing records · last updated April 19, 2026
Questions to ask when you tour
What drove the $174,000 fine
Ask what the CMS citation was for, what corrective steps were taken, and whether a follow-up inspection has since cleared the deficiency.
Current administrator tenure
Two administrators left in the past year — ask how long the current administrator has been in place and whether the management team is fully staffed.
Staffing on nights and weekends
Weekend nursing hours here run about 2.6 hours per resident per day; ask specifically how many nurses and aides are on the floor overnight and on Saturdays and Sundays.
Why occupancy is at 56%
With fewer than 65 of 116 beds filled, ask whether recent admissions have slowed and how staffing levels are adjusted as census fluctuates.
Caregiver consistency for residents
With roughly 7 in 10 nursing staff turning over in the past year, ask how the facility assigns consistent aides to the same residents across shifts.
Resident Council activity
A Resident Council meets here but no Family Council exists — ask how family members can formally raise concerns outside of direct conversations with staff.
Where this information comes from
- License, capacity, ownership, administrator: Texas HHSC licensing registry, snapshot as of April 16, 2026.
- Star ratings, staffing, fines, deficiencies: CMS Care Compare, processed March 1, 2026.
- Summary, insights, and tour questions: Written from the state licensing and CMS records above, last updated April 19, 2026.
Read our methodology for how this information is collected and verified.