Tuff Memorial Home
505 East 4th Street, Hills, MN 56138 · Rock County · 48 certified beds · avg 39 residents/day · certified since Mar 1, 1991
What health inspectors found (on-site government inspections — the most independent evidence available)
Health inspection rating: ★★★★★5/5 · CMS overall rating: 4/5
The health inspection star above is graded on a curve within each state — a set share of each state's facilities gets each star level — so a facility can have few citations and still rate 2–3 stars if others in its state did even better. The overall rating combines that inspection score with staffing and self-reported quality measures.
All citations in the current public record (6)
CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed.
| Date | Severity | What the facility was cited for |
|---|---|---|
| Aug 27, 2025 | F · Potential for harm, facility-wide | The facility did not run an ongoing quality assurance committee that reviews care problems and creates plans to fix them. |
| Aug 27, 2025 | E · Potential for harm, repeated | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. |
| Aug 27, 2025 | D · Potential for harm, one-off | The facility did not keep its building and grounds safe, functional, clean, and comfortable for residents, staff, and visitors. |
| Jul 30, 2024 | D · Potential for harm, one-off | The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. |
| Jul 30, 2024 | D · Potential for harm, one-off | The facility did not have a working program to monitor how antibiotics are used. Tracking antibiotic use helps make sure these drugs are given only when needed and remain effective. |
| Dec 11, 2023 | D · Potential for harm, one-off | The facility transferred or discharged a resident without a valid reason, or failed to provide the required documentation and information when moving a resident out. · from a complaint |
Inspection trend by year
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2023 | 1 | 0 | D |
| 2024 | 2 | 0 | D |
| 2025 | 3 | 0 | F |
Counts reflect the current CMS public record (~3 inspection cycles plus complaint investigations); years with no surveys show no row. Inspection frequency varies, so compare severity as well as counts.
Fines and enforcement (last 3 years)
11 fines totaling $40,240, plus 1 Medicare payment denial period.
| Date | Type | Amount / length |
|---|---|---|
| Nov 13, 2023 | Fine | $4,545 |
| Nov 6, 2023 | Fine | $4,545 |
| Oct 30, 2023 | Fine | $4,545 |
| Oct 23, 2023 | Fine | $4,545 |
| Oct 17, 2023 | Fine | $4,196 |
| Oct 10, 2023 | Fine | $3,846 |
| Oct 2, 2023 | Fine | $3,529 |
| Sep 27, 2023 | Payment Denial | 6 days from Dec 27, 2023 |
| Sep 25, 2023 | Fine | $3,147 |
| Sep 18, 2023 | Fine | $2,797 |
| Sep 11, 2023 | Fine | $2,447 |
| Sep 5, 2023 | Fine | $2,098 |
Nurse staffing (from payroll records, adjusted for how much care residents need)
| Measure | This facility | Minnesota avg | U.S. avg | Where it stands |
|---|---|---|---|---|
| Total nurse staffing (hours per resident per day) | 0.00 | 4.83 | 3.95 | — |
| Registered Nurse hours | 0.00 | 1.22 | 0.69 | — |
| Weekend total nurse staffing | 0.00 | 4.27 | 3.50 | — |
| Weekend RN hours (not acuity-adjusted) | 0.00 | 0.69 | 0.48 | — |
| Total nursing staff turnover (%) | 39.5 | 42.2 | 45.8 | top 50% in Minnesota; top 35% in the U.S. |
| RN turnover (%) | 14.3 | 38.6 | 42.9 | top 10% in Minnesota; top 7% in the U.S. |
Hours are per resident per day, case-mix adjusted by CMS so facilities caring for sicker residents can be compared fairly (same basis as the CMS staffing star). "Top X%" means better than most facilities: more staffing hours, or lower turnover. Raw (unadjusted) reported hours: total 0.00, RN 0.00, weekend 0.00. Staffing rating: 1/5.
Self-reported quality measures
Note: these ratings are based on data the facility reports about itself to CMS. They are not independently verified by inspectors, and can look better than inspection findings. Give more weight to the inspection results above.
Quality measures rating: 4/5 · long-stay residents: 4/5 · short-stay residents: —/5
Who owns this facility
Non profit - Corporation
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Bethlehem Lutheran Church | Organization | Direct Ownership Interest | NOT APPLICABLE | 04/01/2023 |
| First Lutheran | Organization | Direct Ownership Interest | NOT APPLICABLE | 04/01/2023 |
| Grace Lutheran Church | Organization | Direct Ownership Interest | NOT APPLICABLE | 04/01/2023 |
| Palisade Lutheran | Organization | Direct Ownership Interest | NOT APPLICABLE | 04/01/2023 |
| Gayer, Tracy | Individual | Corporate Officer | NOT APPLICABLE | 02/01/2019 |
| Green, Larry | Individual | Corporate Officer | NOT APPLICABLE | 02/01/2019 |
| Kendall, Kathryn | Individual | Operational/Managerial Control | NOT APPLICABLE | 05/27/2024 |
| Kendall, Kathryn | Individual | ADP of the SNF | NOT APPLICABLE | 05/27/2024 |
| Leenderts, Bonnie | Individual | Corporate Officer | NOT APPLICABLE | 01/01/2018 |
| Petterson, Jeff | Individual | Corporate Officer | NOT APPLICABLE | 01/01/2018 |
| Pope & Conner Consulting INC | Organization | ADP of the SNF | NOT APPLICABLE | 01/01/2021 |
| Thone, Jennifer | Individual | Operational/Managerial Control | NOT APPLICABLE | 05/27/2021 |
| Thone, Jennifer | Individual | ADP of the SNF | NOT APPLICABLE | 02/01/2019 |
| Westphal, Catherine | Individual | Corporate Officer | NOT APPLICABLE | 02/01/2019 |
| Wipfli LLP | Organization | ADP of the SNF | NOT APPLICABLE | 09/01/2023 |
Questions to ask on your visit
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
- "How does your quality committee work, and can you give an example of a problem it recently identified and fixed?"
- "Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
- "Can we tour the whole building today, including resident bathrooms and common areas, not just the lobby?"
- "Who completes resident assessments here, and how do you check them for accuracy?"
- "Who oversees antibiotic use here, and how do you decide when an antibiotic is really needed?"
- "Under what circumstances would you discharge or transfer a resident, and what notice and appeal rights would we have?"
- "What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
- "Can I see the results and plan of correction from your most recent state inspection?"
Nearby facilities (within 20 miles)
| Facility | Distance | City | Overall | Inspection | Flags |
|---|---|---|---|---|---|
| Bethany Home - Brandon | 10.3 mi | Brandon, SD | ★☆☆☆☆ | 1/5 | abuse |
| Good Samaritan Society - Mary Jane Brown | 11.0 mi | Luverne, MN | ★☆☆☆☆ | 2/5 | |
| Lyon Specialty Care | 11.4 mi | Rock Rapids, IA | ★★★★☆ | 4/5 | |
| MN Veterans Home-Luverne | 12.1 mi | Luverne, MN | ★★★★★ | 4/5 | |
| Palisade Healthcare Center | 15.0 mi | Garretson, SD | ★☆☆☆☆ | 1/5 | abuse |
| Fellowship Village | 15.6 mi | Inwood, IA | ★★★★☆ | 4/5 | |
| Avera Prince of Peace | 16.7 mi | Sioux Falls, SD | ★★★★☆ | 3/5 | |
| Parkview Manor Nursing Home | 16.8 mi | Ellsworth, MN | ★☆☆☆☆ | 2/5 | |
| Good Samaritan Society Sioux Falls Center | 19.0 mi | Sioux Falls, SD | ★★☆☆☆ | 2/5 | abuse |
| Good Samaritan Society Canton | 19.1 mi | Canton, SD | ★★☆☆☆ | 3/5 |
Compare this facility with the 3 closest →
Facility data as of CMS processing date 2026-08-01. CCN 245548.