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Nursing HomeMedicaid Investigative

Twin Oaks Health & Rehabilitation Center

Below-average Medicare ratings — review the inspection history and ask the administrator about recent corrections before visiting.

1123 North Bolton Street, Jacksonville, TX 75766116 bedsLicensed & Active
2/5
Medicare
Inspection
Quality
Staffing
Google rating
4.6/5

based on 37 Google reviews

5
4
3
2
1

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3/ 10
moderate Risk

Quality Concerns Identified

Medicare inspection and quality data reveal areas that families should carefully evaluate before choosing this facility.

  • Low staffing rating (2/5 stars)
  • High staff turnover (65%)
  • High RN turnover (67%)

Above average in Texas · Below recommended RN staffing · $174,431 in fines

Source: Medicare data

What this means for your family

This facility is highly regarded for its compassionate staff and its ability to help families navigate the complexities of Medicaid and hospital admissions. However, families should closely monitor clinical care and staffing levels, as there have been specific reports of medical neglect and understaffing during certain periods.

Google Reviews

Google Reviews

37 reviews analyzed
Families often praise the facility for its compassionate, family-like atmosphere and the exceptional efforts of the admissions and marketing staff in navigating insurance and Medicaid hurdles. While many residents enjoy the social activities and friendly nursing staff, there are significant concerns regarding chronic understaffing and inconsistent medical care quality reported by some family members.

Quality Themes

Tap a score for details
Food5.0Staff9.0CleanN/AActivities9.0MedsN/AMemoryN/AComms9.0ValueN/A

Strengths

  • Compassionate and caring nursing staff
  • Exceptional admissions and marketing support
  • Engaging resident activities and social events
  • Welcoming, family-oriented atmosphere

Concerns

  • Chronic understaffing and medical care quality
  • Inconsistent food quality (mentioned by 2 reviewers)

Rating Trends

Tap a year to see what changed

234'16(1)'18(5)'21(3)'23(5)'25(14)

Distribution

5
32
4
1
3
1
2
0
1
3

How They Respond to Reviews

8%response rate
Generic

The owner uses templated, scripted responses that rely heavily on directing dissatisfied reviewers to a corporate customer care line. While they acknowledge the sentiment of the reviews, they rarely address specific complaints like staffing or food quality directly in the text.

Questions for Your Tour

  • 1It is wonderful to see how much the team values feedback from the community; how does the administration use family input to improve the facility?
  • 2We are looking for a very hands-on environment, so could you tell us more about how the nursing team manages their daily rounds and resident care?
  • 3What specific steps are being taken to ensure there is always enough staff available to assist residents with their immediate needs?
  • 4We love the idea of a family-oriented atmosphere; what kind of social events or group activities do the residents participate in together?
  • 5How does the kitchen team ensure that meal quality and nutritional variety remain consistent for every resident?
  • 6In the event of a medical emergency during the night, what is the protocol for ensuring a doctor or supervisor is notified immediately?

Personalized based on this facility's data


Key Review Excerpts

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.

Long-term resident's family · 2024★★★★★

The Marketing Director, Erica was awesome! Everything she told me about is here and then some!

Current resident · 2021★★★★★

They are chronically very short staffed. The food is terrible. Medical care is very sub par. I am shocked at how to many times he has been sick since he's been here.

Rehab patient's family · 2024☆☆☆☆
Source: 37 Google reviews

Staffing

Staffing Hours

per resident/day · Medicare 2026
RN Hours
0.36hrs
48%
Registered nurses for medical care
Total Nursing
2.98hrs
73%
All nurses + aides combined

Both RN and total nursing hours are below national benchmarks. This can mean less clinical attention per resident, so ask about their staffing plan.

Quality Measures

Quality Measures

Resident outcomes compared with national, state, and local averages · 17 measures

Medicare Rating
3/ 5
Better Than Avg

10

measures

Worse Than Avg

3

measures

Mixed Results

4

measures

Long-Stay Residents
💊

Residents on antipsychotic medication

↓ Lower is better
This Facility27.3%
Worse than Avg
Here
27.3%
US
15.4%
TX
9.4%
Cherokee
17.7%
😔

Residents with depression symptoms

↓ Lower is better
This Facility3.6%
Mixed vs Avgs
Here
3.6%
US
12.1%
TX
2.5%
Cherokee
3.0%
🚶

Residents whose walking got worse

↓ Lower is better
This Facility8.2%
Better than Avg
Here
8.2%
US
15.3%
TX
14.9%
Cherokee
16.6%
💉

Residents vaccinated for pneumonia

↑ Higher is better
This Facility100.0%
Better than Avg
Here
100.0%
US
93.4%
TX
96.9%
Cherokee
92.5%
⚖️

Residents who lost too much weight

↓ Lower is better
This Facility0.0%
Better than Avg
Here
0.0%
US
5.3%
TX
3.2%
Cherokee
5.0%
🛏️

Residents needing more daily help over time

↓ Lower is better
This Facility19.4%
Worse than Avg
Here
19.4%
US
14.4%
TX
16.1%
Cherokee
15.4%
Short-Stay Residents (Rehab / Post-Acute)
💉

Short-stay residents vaccinated for pneumonia

↑ Higher is better
This Facility99.2%
Better than Avg
Here
99.2%
US
81.8%
TX
89.2%
Cherokee
81.4%
💉

Short-stay residents vaccinated for the flu

↑ Higher is better
This Facility88.2%
Better than Avg
Here
88.2%
US
79.7%
TX
88.0%
Cherokee
75.1%
💊

Short-stay residents newly given antipsychotics

↓ Lower is better
This Facility0.0%
Better than Avg
Here
0.0%
US
1.6%
TX
1.5%
Cherokee
2.5%
Source: Medicare quality measures

US average from Medicare published data

Inspection History

Medicare Inspection History

3-year lookback · Medicare 2026

5deficiencies
1penalties
Near state avg (9.1)
12 complaint-triggered
$174,431 in fines

Families have filed 11 complaint reports triggering federal inspections, revealing concerning patterns in care quality, medication management, and facility safety. The facility has recurring issues with food service and dietary care, infection control, and fire safety systems that persist across multiple surveys. While most deficiencies show correction dates, the pattern of repeated violations in critical areas like resident protection and medication errors suggests ongoing operational challenges that families should carefully consider.

Dec 31, 2025Routine
12
0804ModerateCorrected

Nutrition and Dietary Deficiencies

Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.

0812ModerateCorrected

Nutrition and Dietary Deficiencies

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

0321ModerateCorrected

Smoke Deficiencies

Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

0355ModerateCorrected

Smoke Deficiencies

Properly select, install, inspect, or maintain portable fire extinguishes.

0372ModerateCorrected

Smoke Deficiencies

Ensure smoke barriers are constructed to a 1 hour fire resistance rating.

0374ModerateCorrected

Smoke Deficiencies

Install smoke barrier doors that can resist smoke for at least 20 minutes.

0511ModerateCorrected

Services Deficiencies

Have properly installed electrical wiring and gas equipment.

0929ModerateCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Ensure precautions for handling oxygen cylinders and equipment are correctly followed.

0641MinorCorrected

Resident Assessment and Care Planning Deficiencies

Ensure each resident receives an accurate assessment.

0645MinorCorrected

Resident Assessment and Care Planning Deficiencies

PASARR screening for Mental disorders or Intellectual Disabilities

0732MinorCorrected

Nursing and Physician Services Deficiencies

Post nurse staffing information every day.

0521Minor

Services Deficiencies

Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

Apr 15, 2025Complaint
2
0622MinorCorrected

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.

0622MinorCorrected

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.

Sep 25, 2024Routine
16
0926ModerateCorrected

Environmental Deficiencies

Have policies on smoking.

0372ModerateCorrected

Smoke Deficiencies

Ensure smoke barriers are constructed to a 1 hour fire resistance rating.

0558ModerateCorrected

Resident Rights Deficiencies

Reasonably accommodate the needs and preferences of each resident.

0689ModerateCorrected

Quality of Life and Care Deficiencies

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

0880ModerateCorrected

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

0883ModerateCorrected

Infection Control Deficiencies

Develop and implement policies and procedures for flu and pneumonia vaccinations.

0887ModerateCorrected

Infection Control Deficiencies

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.

0321ModerateCorrected

Smoke Deficiencies

Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

0374ModerateCorrected

Smoke Deficiencies

Install smoke barrier doors that can resist smoke for at least 20 minutes.

0511ModerateCorrected

Services Deficiencies

Have properly installed electrical wiring and gas equipment.

0920ModerateCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Ensure proper usage of power strips and extension cords.

0760MinorCorrected

Pharmacy Service Deficiencies

Ensure that residents are free from significant medication errors.

0761MinorCorrected

Pharmacy Service Deficiencies

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.

0919MinorCorrected

Environmental Deficiencies

Make sure that a working call system is available in each resident's bathroom and bathing area.

0924MinorCorrected

Environmental Deficiencies

Put firmly secured handrails on each side of hallways.

0521Minor

Services Deficiencies

Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

Sep 25, 2024Complaint
3
0812ModerateCorrected

Nutrition and Dietary Deficiencies

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

0550MinorCorrected

Resident Rights Deficiencies

Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

0925MinorCorrected

Environmental Deficiencies

Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.

Jan 18, 2024Complaint
3
0580SevereCorrected

Resident Rights Deficiencies

Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.

0697SevereCorrected

Quality of Life and Care Deficiencies

Provide safe, appropriate pain management for a resident who requires such services.

0609MinorCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

Oct 29, 2023Complaint
2
0600Moderate

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

0607Moderate

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Develop and implement policies and procedures to prevent abuse, neglect, and theft.

Federal Penalties

Fine

Jan 18, 2024

$174,431

Ownership & Operations

Who Operates This Facility

Owner / Operator

Kirbyville I Enterprises, LLC

Organization Type

for profit

Management Company

JACKSONVILLE III ENTERPRISES, LLC

Administrator

LINNEA W ROBISON

Chain Affiliation

Chain Name

Creative Solutions in Healthcare

Chain Size

149 facilities nationwide

Chain avg rating: 2.7/5 · Rank 53 of 148

Ownership & Management

Owners

Liberty County Hospital District no. 1

Owner · Organization

100%

Key personnel

Fregia, MiltonManaging Control - Governing BodyGardner, ShannonManaging Control - Governing BodyGardzina, MargaretManaging Control - Governing BodyHenry, PaulManaging Control - Governing BodyStratton, CharlesManaging Control - Governing Body
Source: Medicare provider data

Contact

Get in Touch

Contact this facility directly and verify the details that matter most to your family.

References & Resources

EveryPlace is a research directory. Facility information is compiled from public sources — Medicare.gov, state licensing portals, Google Places, and publicly available street-level imagery. Listings do not constitute endorsement, recommendation, or advertisement, and we do not accept payment for placement. Families should verify all details directly with the facility and the original sources linked above before making any care decisions. See our Research Policy for our editorial standards, correction process, and image-removal policy.

Safer Alternatives Nearby

Based on current clinical data, we identified 6 nearby facilities within 10 miles that may offer a stronger care environment. We encourage families to compare options carefully.

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