Tuff Memorial Home
505 East 4th Street, Hills, MN 56138 · Rock County · (507) 962-3275
48 certified beds, about 39 residents a day · Non profit - Corporation · Medicare and Medicaid since 1991
CMS Care Compare ratings, data as of September 1, 2026 · CCN 245548 · See it on Medicare.gov · Compare with other homes
The record in brief
At its most recent standard inspection, on May 26, 2026, inspectors cited 0 health deficiencies (the Minnesota average is 7.1, the national average 9.2).
None of its 6 health citations since December 2023 was rated as actual harm or immediate jeopardy.
CMS lists 9 fines totaling $35,695 in the last three years; the largest was $4,545, and the latest is dated November 13, 2023.
39.5% of nursing staff left within the year CMS measured (Minnesota average 42.2%).
Health inspections
Federal rules call for a standard inspection at least every 15 months, plus a visit whenever a complaint is filed. Each mark below is one citation, colored by how serious inspectors rated it. How to read a citation.
Under each citation, the quoted text is the inspector's own summary from the federal statement of deficiencies (CMS form 2567), word for word apart from a privacy scrub; CMS removes residents' and staff names before it publishes the text. The full notes are on Medicare.gov.
Where its citations fall on CMS's grid
CMS rates every citation by how much harm it caused (rows) and how many residents it touched (columns). The count in each box is this home's, across all 6 health citations on file.
May 26, 2026Standard inspection · 0 citations · risk-based survey (a shorter visit CMS gives only to higher performing homes)
August 27, 2025Standard inspection · 3 citations
- F Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Inspectors wroteBased on interview and document review, the facility failed to have evidence of measurable goals and documentation of an analysis and evaluation of the data, submitted to the QAPI committee to ensure Performance Improvement Projects (PIPS) areas identified had oversight and a documented action plan. This had the potential to affect all 40 residents living in the facility.
- E Provide and implement an infection prevention and control program.
Inspectors wroteBased on observation, interview, and document review, the facility failed to establish criteria for employee illness and appropriate return to work for 3 of 3 sampled staff (nurse aide (NA)-A and NA-B, and trained medication aide (TMA)-A). In addition, the facility failed to ensure staff performed appropriate hand hygiene while assisting 5 of 5 residents (R2, R11, R16, R21, and R35) with meals in the dining room. The facility also failed to ensure staff were following manufacturer's instructions by rinsing and air-drying nebulizer administration sets following treatment and between use for 1 of 1 (R27) resident observed.
- D Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Inspectors wroteBased on observation, interview, and document review, the facility failed to maintain 1 of 13 ceiling vents in a sanitary manner.
July 30, 2024Standard inspection · 2 citations
- D Ensure each resident receives an accurate assessment.
Inspectors wroteBased on observation, interview and document review, the facility failed to ensure resident status was accurately identified in the Minimum Data Set (MDS) assessment for 1 of 1 resident (R32) reviewed for prosthetics.
- D Implement a program that monitors antibiotic use.
Inspectors wroteBased on interview and document review, the facility failed to develop an antibiotic stewardship program which included development of protocols and a system to monitor antibiotic use, to ensure appropriate antibiotics were utilized to prevent antibiotic resistance for 1 of 5 resident (R12) who had an order for an antibiotic with no end date.
December 11, 2023Complaint inspection · 1 citation
- D 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.
Inspectors wroteBased on interview and document review, the facility failed to appropriately discharge 1 of 1 resident (R1) with known neurocognitive disorder (decreased mental function due to a medical disease other than a psychiatric illness), with behaviors. The facility also failed to ensure policies related to Discharge and Transfer were reviewed yearly for appropriateness and accuracy.
Fire safety inspections
7 fire safety citations on file: 2 on May 26, 2026, 2 on August 27, 2025, 3 on July 30, 2024.
Every fire safety citation7 citations
- E Ensure proper usage of power strips and extension cords.
- D Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
- F Provide a written emergency evacuation plan.
- F Have simulated fire drills held at unexpected times.
- E Have approved installation, maintenance and testing program for fire alarm systems.
- D Install emergency lighting that can last at least 1 1/2 hours.
- D Have proper medical gas storage and administration areas.
Fines and payment denials
| Date | Penalty | Amount or length |
|---|---|---|
| November 13, 2023 | Fine | $4,545 |
| November 6, 2023 | Fine | $4,545 |
| October 30, 2023 | Fine | $4,545 |
| October 23, 2023 | Fine | $4,545 |
| October 17, 2023 | Fine | $4,196 |
| October 10, 2023 | Fine | $3,846 |
| October 2, 2023 | Fine | $3,529 |
| September 27, 2023 | Payment Denial | 6 days from December 27, 2023 |
| September 25, 2023 | Fine | $3,147 |
| September 18, 2023 | Fine | $2,797 |
A payment denial means Medicare and Medicaid stopped paying for new admissions for that period.
Staffing
Hours of care per resident per day, from the payroll records every home sends CMS. Higher means more staff time with each resident.
| Measure | This home | Minnesota | United States |
|---|---|---|---|
| All nursing staff (RN, LPN and aides) | not reported | 4.19 | 3.86 |
| Registered nurses | not reported | 1.06 | 0.69 |
| All nursing staff on weekends | not reported | 3.71 | 3.42 |
| Nurse aides | not reported | ||
| Licensed practical nurses | not reported | ||
| Nursing staff turnover (share who left in a year) | 39.5% | 42.2% | 45.8% |
| Registered nurse turnover | 14.3% | 38.6% | 42.9% |
| Administrators who left | 1 |
CMS note on this home's staffing data: The accuracy of the staffing data for this measure could not be validated by CMS.
Staffing by quarter, from daily payroll records
Every nursing home sends CMS its staff hours for each day (the Payroll Based Journal). Here they are added up by quarter. The latest quarter is the one behind the figures above. In January to March 2026, nursing staff hours per resident were 4.24 on weekdays and 3.25 on weekends, 23% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 3.1% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 4.06 in April to June 2025 to 3.95 in January to March 2026.
| Quarter | All nursing staff | Registered nurses | Weekdays | Weekends | Contract staff share | Days with no RN hours | Residents a day |
|---|---|---|---|---|---|---|---|
| Jan to Mar 2026 | 3.95 | 0.74 | 4.24 | 3.25 | 3.1% | 0 of 90 | 39 |
| Oct to Dec 2025 | 3.96 | 0.72 | 4.22 | 3.28 | 4.0% | 0 of 92 | 38 |
| Jul to Sep 2025 | 3.92 | 0.70 | 4.18 | 3.27 | 2.9% | 0 of 92 | 40 |
| Apr to Jun 2025 | 4.06 | 0.71 | 4.39 | 3.24 | 5.1% | 0 of 91 | 37 |
| United States, Jan to Mar 2026 | 3.75 | 0.62 | 3.92 | 3.33 | 5.3% | 0.5% of days | |
| Minnesota, Jan to Mar 2026 | 4.19 | 1.05 | 4.38 | 3.73 | 5.2% | 0.8% of days |
Hours per resident per day: staff hours in the quarter divided by resident days (the daily census CMS derives from resident assessments). Registered nurses include the director of nursing and RNs with administrative duties; aides include nurse aides in training and medication aides, as in CMS's own staffing measure. How these are calculated.
Quality measures
The measures CMS uses for the quality star. Lower is better for every one of them.
| Measure | This home | Minnesota | US |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased Long Stay residents, 2025Q2-2026Q1 | 25.2 | 18.2 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 0.0 | 1.9 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 4.0 | 2.6 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 7.2 | 4.0 | 3.2 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 16.2 | 20.5 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 2.7 | 5.2 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 13.8 | 17.1 | 15.4 |
| Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 1.1 | 1.6 | 1.9 |
| Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 1.1 | 1.9 | 1.8 |
Owners and operators
Legal business name: TUFF MEMORIAL HOME.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Bethlehem Lutheran Church | Direct ownership interest | Organization | 04/01/2023 | |
| First Lutheran | Direct ownership interest | Organization | 04/01/2023 | |
| Grace Lutheran Church | Direct ownership interest | Organization | 04/01/2023 | |
| Palisade Lutheran | Direct ownership interest | Organization | 04/01/2023 | |
| Gayer, Tracy | Corporate officer | Individual | 02/01/2019 | |
| Green, Larry | Corporate officer | Individual | 02/01/2019 | |
| Leenderts, Bonnie | Corporate officer | Individual | 01/01/2018 | |
| Petterson, Jeff | Corporate officer | Individual | 01/01/2018 | |
| Westphal, Catherine | Corporate officer | Individual | 02/01/2019 | |
| Kendall, Kathryn | Operational/managerial control | Individual | 05/27/2024 | |
| Thone, Jennifer | Operational/managerial control | Individual | 05/27/2021 | |
| Pope & Conner Consulting Inc | Adp of the SNF | Organization | 01/01/2021 | |
| Wipfli LLP | Adp of the SNF | Organization | 09/01/2023 | |
| Kendall, Kathryn | Adp of the SNF | Individual | 05/27/2024 | |
| Thone, Jennifer | Adp of the SNF | Individual | 02/01/2019 |
As listed in the CMS ownership file, which names owners with a 5% or greater stake and the people and companies with operational or managerial control.
Questions to ask on a visit
Chosen from this home's own inspection record.
- What changed in infection control since the last inspection, and who on staff is the infection preventionist?Inspectors cited 2 problems in this area, most recently on August 27, 2025: "Provide and implement an infection prevention and control program."
- Who is the administrator and director of nursing, and how long have they been in the job?Inspectors cited 1 problem in this area, most recently on August 27, 2025: "Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action."
- Can we see a resident room, a shower room and the dining room on this visit?Inspectors cited 1 problem in this area, most recently on August 27, 2025: "Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public."
- When is the care plan meeting, and can family attend it?Inspectors cited 1 problem in this area, most recently on July 30, 2024: "Ensure each resident receives an accurate assessment."
- How long has the current administrator been here?CMS counts 1 administrator who left in the period it measured.
Other nursing homes nearby
- Bethany Home - Brandon Brandon, 10.3 mi · 1 of 5 stars · 27 citations
- Good Samaritan Society - Mary Jane Brown Luverne, 11 mi · 1 of 5 stars · 32 citations
- Lyon Specialty Care Rock Rapids, 11.4 mi · 4 of 5 stars · 18 citations
- Mn Veterans Home-Luverne Luverne, 12.1 mi · 5 of 5 stars · 10 citations
- Palisade Healthcare Center Garretson, 15 mi · 1 of 5 stars · 29 citations
- Fellowship Village Inwood, 15.6 mi · 4 of 5 stars · 6 citations
- Avera Prince of Peace Sioux Falls, 16.7 mi · 4 of 5 stars · 17 citations
- Parkview Manor Nursing Home Ellsworth, 16.8 mi · 1 of 5 stars · 21 citations
Minnesota contacts for a concern about a nursing home
These are the official offices in Minnesota. NursingHomeClear cannot take or act on complaints.
- Inspections and complaints: Minnesota Department of Health, Health Regulation Division, the state agency that inspects nursing homes for CMS and takes complaints about care.
- State inspection reports: MDH Nursing and Boarding Care Home Survey and Complaint Inspection Findings, where Minnesota publishes its own records on licensed homes.
Common questions
- What is Tuff Memorial Home's Medicare star rating?
- CMS rates Tuff Memorial Home 4 out of 5 stars overall, with 5 for health inspections, 1 for staffing and 4 for quality measures (CMS data as of September 1, 2026).
- How many deficiencies did Tuff Memorial Home get at its last inspection?
- 0 health deficiencies at the standard inspection on May 26, 2026. The Minnesota average is 7.1.
- Has Tuff Memorial Home been fined?
- Yes. CMS lists 9 fines totaling $35,695 in the last three years.
- Does Tuff Memorial Home accept Medicaid?
- It is certified to take Medicaid (CMS lists it as "Medicare and Medicaid"). Certification does not mean a Medicaid bed is open: ask the admissions office.
- Who owns Tuff Memorial Home?
- CMS lists 15 owners and managers. Legal business name: TUFF MEMORIAL HOME.
Sources
- Ratings, staffing and fines: CMS Provider Information, released September 30, 2026, data as of September 1, 2026.
- Citations: CMS Health Deficiencies and Fire Safety Deficiencies.
- Owners: CMS Ownership. Penalties: CMS Penalties.
- Staffing by quarter: CMS Payroll Based Journal Daily Nurse Staffing, April 2025 to March 2026, summed by NursingHomeClear.
- Inspector summaries: CMS Full Statement of Deficiencies (CMS-2567 text), data as of September 1, 2026. Each quote is the part of the statement before the detailed findings.
- Inspection reports with the inspectors' full notes are on this home's Medicare.gov page.
- Something wrong on this page? Ask for a correction. We fix errors in our copy of the data; findings themselves can only be changed by CMS and the state.
- NursingHomeClear is independent and not affiliated with CMS, Medicare or any state agency. This page reports federal records; it does not rate, recommend or endorse any home, and it is not medical or legal advice.