Twin Oaks Health & Rehabilitation Center
Jacksonville, Cherokee County, Texas · CCN 675183 · For-profit (Corporation) · part of Creative Solutions In Healthcare (149 facilities, chain average 2.1 stars)
CMS rates Twin Oaks Health & Rehabilitation Center 2 of 5 overall as of August 2026. 116 certified beds, 61 residents a day on average. 34 citations on record from the current inspection cycles, 2 at immediate jeopardy; 1 fine totalling $174,431.
CMS’s ratings
The Five-Star Quality Rating System, as CMS publishes it. Where CMS gives no rating, the reason CMS gives is printed instead.
| Overall | ★★☆☆☆ 2 of 5 |
|---|---|
| Health inspections | ★★★☆☆ 3 of 5 |
| Staffing | ★☆☆☆☆ 1 of 5 |
| Quality measures | ★★★☆☆ 3 of 5 |
| Quality: long-stay / short-stay | 3 / 3 of 5 |
Staffing
| Total nurse staffing | 2.96912 hours per resident per day |
|---|---|
| Registered nurses | 0.393 hours per resident per day |
| Weekend total | 2.42903 hours per resident per day |
| Nursing staff turnover | 98% (registered nurses 100%) |
| Administrators who left | 3 |
Citations from health inspections
Each is a finding by a state surveyor on the date shown, in CMS’s words. The severity is CMS’s scope-and-severity grid, spelled out: harm on the left, how widespread on the right.
| Survey | Finding | Severity | Status |
|---|---|---|---|
| 2025-12-31 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. Nutrition and Dietary Deficiencies · tag F0804 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2026-01-05 |
| 2025-12-31 | 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 No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2026-01-05 |
| 2025-12-31 | Ensure each resident receives an accurate assessment. Resident Assessment and Care Planning Deficiencies · tag F0641 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2026-01-05 |
| 2025-12-31 | PASARR screening for Mental disorders or Intellectual Disabilities Resident Assessment and Care Planning Deficiencies · tag F0645 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2026-01-05 |
| 2025-12-31 | Post nurse staffing information every day. Nursing and Physician Services Deficiencies · tag F0732 |
C No actual harm, with potential for minimal harm; widespread | Deficient, Provider has date of correction 2026-01-05 |
| 2025-04-15 complaint survey |
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 No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2025-05-04 |
| 2024-09-25 complaint survey |
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 No actual harm, with potential for more than minimal harm; widespread | Deficient, Provider has date of correction 2024-09-26 |
| 2024-09-25 | Have policies on smoking. Environmental Deficiencies · tag F0926 |
F No actual harm, with potential for more than minimal harm; widespread | Deficient, Provider has date of correction 2024-09-26 |
| 2024-09-25 | Reasonably accommodate the needs and preferences of each resident. Resident Rights Deficiencies · tag F0558 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2024-09-26 |
| 2024-09-25 | 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 No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2024-09-26 |
| 2024-09-25 | Provide and implement an infection prevention and control program. Infection Control Deficiencies · tag F0880 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2024-09-26 |
| 2024-09-25 | Develop and implement policies and procedures for flu and pneumonia vaccinations. Infection Control Deficiencies · tag F0883 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2024-09-26 |
| 2024-09-25 | 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 No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2024-09-26 |
| 2024-09-25 complaint survey |
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 No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2024-09-26 |
| 2024-09-25 | Ensure that residents are free from significant medication errors. Pharmacy Service Deficiencies · tag F0760 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2024-09-26 |
| 2024-09-25 | 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 No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2024-09-26 |
| 2024-09-25 | Make sure that a working call system is available in each resident's bathroom and bathing area. Environmental Deficiencies · tag F0919 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2024-09-26 |
| 2024-09-25 | Put firmly secured handrails on each side of hallways. Environmental Deficiencies · tag F0924 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2024-09-26 |
| 2024-09-25 complaint survey |
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. Environmental Deficiencies · tag F0925 |
D No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2024-09-26 |
| 2024-01-18 complaint survey |
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 to resident health or safety; isolated | Deficient, Provider has date of correction 2024-01-19 |
| 2024-01-18 complaint survey |
Provide safe, appropriate pain management for a resident who requires such services. Quality of Life and Care Deficiencies · tag F0697 |
J Immediate jeopardy to resident health or safety; isolated | Deficient, Provider has date of correction 2024-01-19 |
| 2024-01-18 complaint survey |
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 No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2024-01-19 |
| 2023-10-29 complaint survey |
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 No actual harm, with potential for more than minimal harm; pattern | Past Non-Compliance 2023-09-14 |
| 2023-10-29 complaint survey |
Develop and implement policies and procedures to prevent abuse, neglect, and theft. Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0607 |
E No actual harm, with potential for more than minimal harm; pattern | Past Non-Compliance 2023-09-14 |
| 2023-07-26 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0607 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2023-08-18 |
| 2023-07-26 | 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 No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2023-08-18 |
| 2023-07-26 | 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 No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2023-08-18 |
| 2023-07-26 | 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 No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2023-08-18 |
| 2023-07-26 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. Nutrition and Dietary Deficiencies · tag F0804 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2023-08-18 |
| 2023-07-26 | Provide and implement an infection prevention and control program. Infection Control Deficiencies · tag F0880 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2023-08-18 |
| 2023-07-26 | Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. Environmental Deficiencies · tag F0925 |
E No actual harm, with potential for more than minimal harm; pattern | Deficient, Provider has date of correction 2023-08-18 |
| 2023-07-26 | 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 No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2023-08-18 |
| 2023-07-26 | 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 No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2023-08-18 |
| 2023-07-26 | 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 No actual harm, with potential for more than minimal harm; isolated | Deficient, Provider has date of correction 2023-08-18 |
Fines and payment denials
| Date | Penalty | Amount |
|---|---|---|
| 2024-01-18 | Fine | $174,431 |
Who owns and runs it
Every owner, officer and manager CMS lists, as filed. These are the names in CMS’s ownership record; anyone named in the ownership record can ask about it on the about page.
| Name | Role | Share | Since |
|---|---|---|---|
| Liberty County Hospital District No 1 Organization | 5% or greater direct ownership interest | 100% | 2022-04-01 |
| Jacksonville III Enterprises LLC Organization | adp of the snf | — | 2025-04-11 |
| Jacksonville III Enterprises LLC Organization | operational/managerial control | — | 2022-04-01 |
| Blake, Gary Individual | adp of the snf | — | 2022-04-01 |
| Hekimian, Khoren Individual | adp of the snf | — | 2025-04-11 |
| Williamson, Rose Individual | adp of the snf | — | 2025-04-11 |
| Huggins, Linda Individual | corporate director | — | 2022-04-01 |
| Willig, Zachary Individual | corporate director | — | 2025-01-01 |
| Stratton, Charles Individual | corporate officer | — | 2005-05-01 |
| Fregia, Milton Individual | managing control - governing body | — | 2022-05-07 |
| Gardner, Shannon Individual | managing control - governing body | — | 2022-08-22 |
| Gardzina, Margaret Individual | managing control - governing body | — | 2024-02-26 |
| Henry, Paul Individual | managing control - governing body | — | 2009-05-09 |
| Stratton, Charles Individual | managing control - governing body | — | 2005-05-01 |
| Blake, Gary Individual | operational/managerial control | — | 2022-04-01 |
| Blake, Malisa Individual | operational/managerial control | — | 2022-04-01 |
What changed
Nothing has changed in this record since it was first loaded. The next CMS refresh is the next chance.
Tell me when this record changes
One email when the monthly CMS refresh brings a new citation, a fine or payment denial, a rating change, a flag, or a change of ownership for Twin Oaks Health & Rehabilitation Center.
Source: Centers for Medicare & Medicaid Services, Provider Data Catalog (public domain), files dated 2026-08-01. Ratings are CMS’s; citations are state surveyors’ findings; nothing here is estimated or a recommendation. Every nursing home in Cherokee County.