Tuff Memorial Home
Hills, Minnesota
Skilled nursing facility in Hills, MN with 48 certified beds and a 4-star CMS overall rating.
Tuff Memorial Home is a skilled nursing facility in Hills, Minnesota (Rock County), with 48 Medicare/Medicaid-certified beds.
Address: 505 East 4th Street, Hills, MN 56138. Phone: (507) 962-3275.
Ownership: Non profit - Corporation. Certified for Medicare and Medicaid. Automatic sprinkler systems in all required areas. Has both a resident and family council.
CMS Five-Star ratings (source: Medicare Care Compare): overall 4 of 5, health inspections 5, staffing 1, quality measures 4.
Levels of care
- Skilled nursing
Facility details
- Street address
- 505 East 4th Street
- City
- Hills
- State
- Minnesota
- ZIP code
- 56138
- Phone
- (507) 962-3275
- Levels of care
- Skilled nursing
- Payment options accepted
- Medicare, Medicaid
- Cms Ccn
- 245548
- County
- Rock
- Ownership Type
- Non profit - Corporation
- Provider Type
- Medicare and Medicaid
- Certified Beds
- 48
- Avg Daily Residents
- 38.6
- Continuing Care Community
- No
- Resident Family Council
- Both
- Sprinklers All Areas
- Yes
- Medicare Medicaid Approved Date
- 1991-03-01
- Overall Rating
- 4
- Health Inspection Rating
- 5
- Staffing Rating
- 1
- Quality Measure Rating
- 4
- Latitude
- 43.5259
- Longitude
- -96.353
Medicare & Medicaid quality data
Published by the Centers for Medicare & Medicaid Services (CMS) [1] , data as of October 1, 2026. CMS ID 245548. Ratings compare this home with other nursing homes; they are not a pass or fail.
CMS overall rating
4 / 5
Above average- Certified beds
- 48
- Residents per day
- 40
- Ownership
- Non profit - Corporation
- Health citations (latest)
- 0
- Fines
- 5 ($22,376)
Star ratings
CMS rates every certified nursing home from 1 to 5 stars in three areas and combines them into an overall rating. The ratings compare homes with each other: 5 is much above average, 3 is average, 1 is much below average.
Overall rating
Above averageThe headline score, from 1 to 5 stars.
✓ Better than the state average. State 3.2 · National 3.0
How is this scored?
Three steps: start with the health inspection stars; add one star if staffing is 5 stars (subtract one if it is 1 star); then add one star if quality measures are 5 stars (subtract one if 1 star). It never goes above 5 or below 1, and a home with 1 health inspection star can gain at most one star from the other two. It compares homes with each other; it is not a pass/fail grade. [11]
Health inspections
Much above averageHow the home did in recent state inspections and complaint investigations.
✓ Better than the state average. State 2.8 · National 2.8
How is this scored?
Based on the two most recent annual inspections plus 36 months of complaint and infection-control inspections, and on how many revisits were needed to confirm fixes. Each citation is weighted by scope and severity. Homes are then ranked within their own state: the best 10% (lowest scores) earn 5 stars, the middle 70% earn 2, 3 or 4 stars in equal shares, and the worst 20% earn 1 star. [11]
Staffing
Much below averageHow many nurses care for each resident, and how stable the nursing team is.
✗ Worse than the state average. State 4.2 · National 3.0
How is this scored?
Six measures: three of staffing level (total nurse, registered nurse and weekend nurse hours per resident per day, adjusted for how much care residents need) and three of turnover (nursing staff, RNs and administrators). The hours come from payroll records submitted to CMS each quarter; turnover uses six quarters of that data. [11]
Quality measures
AverageHow residents are actually doing.
✗ Worse than the state average. State 3.2 · National 3.7
How is this scored?
Scores 15 quality measures drawn from resident assessments (the Minimum Data Set) and Medicare claims, such as falls with major injury, pressure ulcers, rehospitalizations and medication use. Long-stay and short-stay residents are rated separately and combined. [11]
This home State average National average
- Long-stay quality
- Residents who live in the home: outcomes such as falls, pressure ulcers and medication use.
How to read the numbers on this page
- Star ratings — 1 to 5 (no stars = not rated)
- 5 is much above average and 1 is much below average, compared with other nursing homes. A home with too little data may have no rating.
- Health inspection score — 0 and up, lower is better
- Points added up from citations (see the scope and severity grid) and revisits. 0 means a clean record; the state table shows which scores earn which stars.
- Quality measure percentages — 0 to 100%
- The share of residents with an outcome, such as a fall with major injury. For most measures a lower percentage is better; for vaccination measures a higher percentage is better.
- Nurse hours per resident per day — Hours, higher is better
- Paid nursing time divided by residents. For example 4.0 means each resident gets about four hours of nursing care a day, shared across all shifts.
- Staff turnover — 0 to 100%, lower is better
- The share of nursing staff who left during the year. High turnover can mean less continuity of care.
- Case-mix index — Around 1.0 is typical
- How much care the residents need. Above 1 means sicker or more dependent residents who need more staff time.
- Fines — Dollars; payment denials in days
- Penalties CMS imposed for serious or repeated problems. A payment denial stops Medicare/Medicaid payment for new admissions.
Sources: Nursing Home Provider Information [1] ; Nursing Home State & National Averages [9] ; Design for Care Compare Nursing Home Five-Star Quality Rating System: Technical Users' Guide [11]
Staffing & turnover
More nursing time per resident and a steadier team are both signs of better care. Hours come from payroll records the home submits to CMS each quarter.
Compared with MN and the nation
This home State average National average
- Nursing staff turnover (%, lower is better)
- 35.3%
✓ Better than the state average. State 42.1% · National 45.3%
- RN turnover (%, lower is better)
- 28.6%
✓ Better than the state average. State 39.3% · National 42.5%
- Administrators who left (people, lower is better)
- 1
✗ Worse than the state average. State 1 · National 1
Turnover is the share of nursing staff who left over the year. The case-mix index shows how much care residents need: about 1.0 is typical, higher means more dependent residents.
Sources: Nursing Home Provider Information [1] ; Nursing Home State & National Averages [9] ; Design for Care Compare Nursing Home Five-Star Quality Rating System: Technical Users' Guide [11]
Inspections
State inspectors visit each home about once a year and investigate complaints. Every problem they cite is a deficiency, lettered A to L by how serious and how widespread it was.
Health inspection score
8.0 points — in MN that earns (Much above average).
Lower is better. The score adds up points for every citation (more for serious, widespread problems) and for revisits needed to confirm fixes, then weights recent inspections most. [11]
Score needed for each star in MN [10]
- 5 ★ (this home)
- 0.000-9.000
- 4 ★
- 9.001-30.000
- 3 ★
- 30.001-54.000
- 2 ★
- 54.001-92.000
- 1 ★
- >92.000
| Period | Inspection | Citations (complaint) | Citation points | Revisits | Revisit points | Total |
|---|---|---|---|---|---|---|
| Most recent cycle | May 26, 2026 | 0 (0) | 0 | 0 | 0 | 0 |
| Prior cycles (2 and 3) | Aug 27, 2025 | 4 (1) | 32 | 1 | 0 | 32 |
Health citations per inspection
May 26, 2026
Aug 27, 2025
Jul 30, 2024
State average for that cycle. Fewer is better.
Fire-safety citations per inspection
May 26, 2026
Aug 27, 2025
Jul 30, 2024
State average for that cycle. Fewer is better.
What the latest fire-safety inspection cited
- Gas and Vacuum and Electrical Systems 1
- Miscellaneous 1
How serious were the citations?
Each health citation gets a letter. The number in each cell is how many of this home's citations got that letter; the points show what each letter adds to the health inspection score. Citations where care was substandard score higher than shown. [11]
| Isolated (a few residents) | Pattern (some residents) | Widespread (many residents) | |
|---|---|---|---|
| Immediate jeopardy to resident health or safety | J · 50 pts 0 | K · 100 pts 0 | L · 150 pts 0 |
| Actual harm, not immediate jeopardy | G · 20 pts 0 | H · 35 pts 0 | I · 45 pts 0 |
| No actual harm, potential for more than minimal harm | D · 4 pts 4 | E · 8 pts 1 | F · 16 pts 1 |
| No actual harm, potential for minimal harm only | A · 0 pts 0 | B · 0 pts 0 | C · 0 pts 0 |
Darker cells mean more citations. Counts cover every health citation CMS lists for this home.
All health citations (6) [2]
Inspection on Aug 27, 2025 · 3 citations
-
F
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
F0867 · Administration Deficiencies · Deficient, Provider has date of correction (Sep 19, 2025)
-
E
Provide and implement an infection prevention and control program.
F0880 · Infection Control Deficiencies · Deficient, Provider has date of correction (Sep 19, 2025)
-
D
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
F0921 · Environmental Deficiencies · Deficient, Provider has date of correction (Sep 19, 2025)
Inspection on Jul 30, 2024 · 2 citations
-
D
Implement a program that monitors antibiotic use.
F0881 · Infection Control Deficiencies · Deficient, Provider has date of correction (Aug 19, 2024)
-
D
Ensure each resident receives an accurate assessment.
F0641 · Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction (Aug 19, 2024)
Inspection on Dec 11, 2023 · 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.
F0622 · Resident Rights Deficiencies · Deficient, Provider has date of correction (Jan 2, 2024) · From a complaint
All fire-safety citations (7) [3]
Inspection on May 26, 2026 · 2 citations
-
E
Ensure proper usage of power strips and extension cords.
K0920 · Gas, Vacuum, and Electrical Systems Deficiencies · Deficient, Provider has date of correction (Jun 5, 2026)
-
D
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
K0741 · Miscellaneous Deficiencies · Deficient, Provider has date of correction (Jun 5, 2026)
Inspection on Aug 27, 2025 · 2 citations
-
F
Provide a written emergency evacuation plan.
K0711 · Miscellaneous Deficiencies · Deficient, Provider has date of correction (Sep 19, 2025)
-
F
Have simulated fire drills held at unexpected times.
K0712 · Miscellaneous Deficiencies · Deficient, Provider has date of correction (Sep 19, 2025)
Inspection on Jul 30, 2024 · 3 citations
-
E
Have approved installation, maintenance and testing program for fire alarm systems.
K0345 · Smoke Deficiencies · Deficient, Provider has date of correction (Aug 19, 2024)
-
D
Install emergency lighting that can last at least 1 1/2 hours.
K0291 · Egress Deficiencies · Deficient, Provider has date of correction (Aug 19, 2024)
-
D
Have proper medical gas storage and administration areas.
K0923 · Gas, Vacuum, and Electrical Systems Deficiencies · Deficient, Provider has date of correction (Aug 19, 2024)
Sources: Nursing Home Provider Information [1] ; Nursing Home Survey Summary [4] ; Nursing Home Health Deficiencies [2] ; Nursing Home Fire Safety Deficiencies [3] ; Nursing Home Health Inspection Cut Points [10] ; Design for Care Compare Nursing Home Five-Star Quality Rating System: Technical Users' Guide [11]
Fines & penalties
CMS can fine a home or stop Medicare and Medicaid payments for new admissions when problems are serious or keep recurring. Most homes have none.
- Fines
- 5 State avg 0.7 · National 0.9
- Total fined
- $22,376 State avg 24,560 · National 30,351
- Payment denials
- 0 Periods with no Medicare/Medicaid payment for new admissions
Fines by year
| Date | Type | Amount | Payment denial |
|---|---|---|---|
| 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 | — |
Sources: Nursing Home Provider Information [1] ; Nursing Home Penalties [5] ; Nursing Home State & National Averages [9]
Resident quality measures
These measure what actually happens to residents, as a percentage from 0 to 100 (or events per 1,000 resident days). For almost all of them a lower number is better; the vaccination measures are the exception and are marked. A star means the measure counts toward the quality star rating.
This home State average National average
Long-stay residents (14) [7]
Residents who live in the home. From their regular health assessments (the Minimum Data Set), averaged over four quarters. Period: 2025Q3-2026Q2.
- Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine Higher is better
- 99.4
✓ Better than the state average. State 97.3 · National 93.7
- Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine Higher is better
- 100.0
✓ Better than the state average. State 96.4 · National 95.3
- Percentage of long-stay residents experiencing one or more falls with major injury ★ Lower is better
- 5.7
✗ Worse than the state average. State 4.1 · National 3.2
- Percentage of long-stay residents who have depressive symptoms Lower is better
- 0.0
✓ Better than the state average. State 4.1 · National 13.5
- Percentage of long-stay residents who lose too much weight Lower is better
- 5.0
✗ Worse than the state average. State 3.9 · National 5.1
- Percentage of long-stay residents who received an antianxiety or hypnotic medication Lower is better
- 9.7
✓ Better than the state average. State 12.7 · National 19.5
- Percentage of long-stay residents who received an antipsychotic medication ★ Lower is better
- 13.9
✓ Better than the state average. State 17.2 · National 15.4
- Percentage of long-stay residents who were physically restrained Lower is better
- 0.0
✓ Better than the state average. State 0.1 · National 0.1
- Percentage of long-stay residents whose ability to walk independently worsened ★ Lower is better
- 14.2
✓ Better than the state average. State 18.8 · National 12.7
- Percentage of long-stay residents whose need for help with daily activities has increased ★ Lower is better
- 22.5
✗ Worse than the state average. State 18.2 · National 13.5
- Percentage of long-stay residents with a catheter inserted and left in their bladder ★ Lower is better
- 0.0
✓ Better than the state average. State 1.7 · National 0.7
- Percentage of long-stay residents with a urinary tract infection ★ Lower is better
- 5.2
✗ Worse than the state average. State 2.6 · National 1.5
- Percentage of long-stay residents with new or worsened bowel or bladder incontinence Lower is better
- 35.7
✗ Worse than the state average. State 23.7 · National 18.3
- Percentage of long-stay residents with pressure ulcers ★ Lower is better
- 3.3
✓ Better than the state average. State 5.1 · National 4.5
Short-stay residents (3) [7]
Residents staying for rehab or recovery. From their health assessments, averaged over four quarters. Period: 2025Q3-2026Q2.
Long-stay residents: hospital use (2) [8]
Hospital stays and emergency visits found in Medicare claims, adjusted for how sick residents were. Period: 20250401-20260331.
Short-stay residents: hospital use (2) [8]
Rehospitalizations and emergency visits after admission, found in Medicare claims and adjusted for how sick residents were. Period: 20250401-20260331.
Sources: Nursing Home MDS Quality Measures [7] ; Nursing Home Medicare Claims Quality Measures [8] ; Nursing Home State & National Averages [9] ; Design for Care Compare Nursing Home Five-Star Quality Rating System: Technical Users' Guide [11]
Ownership & operator
Who owns and runs a home can matter: for-profit, non-profit and chain-owned homes tend to differ on staffing and inspection results.
- Ownership type
- Non profit - Corporation
- Legal business name
- TUFF MEMORIAL HOME
- Certified for
- Medicare and Medicaid
- Certified beds
- 48
- Residents per day (average)
- 39.9
- In Medicare/Medicaid since
- Mar 1, 1991
- Resident and family council
- Both
- Sprinklers in all required areas
- Yes
- County
- Rock
- Located in a hospital
- No
Owners, officers and managers (15) [6]
Direct Ownership Interest
- BETHLEHEM LUTHERAN CHURCH (organization, NOT APPLICABLE, since 04/01/2023)
- FIRST LUTHERAN (organization, NOT APPLICABLE, since 04/01/2023)
- GRACE LUTHERAN CHURCH (organization, NOT APPLICABLE, since 04/01/2023)
- PALISADE LUTHERAN (organization, NOT APPLICABLE, since 04/01/2023)
Corporate Officer
- GAYER, TRACY (individual, NOT APPLICABLE, since 02/01/2019)
- GREEN, LARRY (individual, NOT APPLICABLE, since 02/01/2019)
- LEENDERTS, BONNIE (individual, NOT APPLICABLE, since 01/01/2018)
- PETTERSON, JEFF (individual, NOT APPLICABLE, since 01/01/2018)
- WESTPHAL, CATHERINE (individual, NOT APPLICABLE, since 02/01/2019)
Adp Of The Snf
- KENDALL, KATHRYN (individual, NOT APPLICABLE, since 05/27/2024)
- POPE & CONNER CONSULTING INC (organization, NOT APPLICABLE, since 01/01/2021)
- THONE, JENNIFER (individual, NOT APPLICABLE, since 02/01/2019)
- WIPFLI LLP (organization, NOT APPLICABLE, since 09/01/2023)
Operational/Managerial Control
- KENDALL, KATHRYN (individual, NOT APPLICABLE, since 05/27/2024)
- THONE, JENNIFER (individual, NOT APPLICABLE, since 05/27/2021)
Sources: Nursing Home Provider Information [1] ; Nursing Home Ownership [6]
Sources
All figures on this page come from the U.S. government's published nursing home data, as of October 1, 2026. We reproduce them without change except for rounding and layout; ratings, scores and flags are CMS's, not ours. Averages and comparisons use the state and national figures CMS publishes in the same release.
- 1. Centers for Medicare & Medicaid Services, Provider Data Catalog. Nursing Home Provider Information. Star ratings, staffing, turnover, inspection scores, fines, chain and flag data. https://data.cms.gov/provider-data/dataset/4pq5-n9py
- 2. Centers for Medicare & Medicaid Services, Provider Data Catalog. Nursing Home Health Deficiencies. Each health deficiency cited, with scope and severity. https://data.cms.gov/provider-data/dataset/r5ix-sfxw
- 3. Centers for Medicare & Medicaid Services, Provider Data Catalog. Nursing Home Fire Safety Deficiencies. Each fire-safety deficiency cited. https://data.cms.gov/provider-data/dataset/ifjz-ge4w
- 4. Centers for Medicare & Medicaid Services, Provider Data Catalog. Nursing Home Survey Summary. Deficiency totals by inspection cycle and category. https://data.cms.gov/provider-data/dataset/tbry-pc2d
- 5. Centers for Medicare & Medicaid Services, Provider Data Catalog. Nursing Home Penalties. Fines and payment denials. https://data.cms.gov/provider-data/dataset/g6vv-u9sr
- 6. Centers for Medicare & Medicaid Services, Provider Data Catalog. Nursing Home Ownership. Owners, officers, directors and managers. https://data.cms.gov/provider-data/dataset/y2hd-n93e
- 7. Centers for Medicare & Medicaid Services, Provider Data Catalog. Nursing Home MDS Quality Measures. Quarterly quality measure scores from resident assessments. https://data.cms.gov/provider-data/dataset/djen-97ju
- 8. Centers for Medicare & Medicaid Services, Provider Data Catalog. Nursing Home Medicare Claims Quality Measures. Risk-adjusted quality measures from Medicare claims. https://data.cms.gov/provider-data/dataset/ijh5-nb2v
- 9. Centers for Medicare & Medicaid Services, Provider Data Catalog. Nursing Home State & National Averages. State and national averages used for comparison. https://data.cms.gov/provider-data/dataset/xcdc-v8bm
- 10. Centers for Medicare & Medicaid Services, Provider Data Catalog. Nursing Home Health Inspection Cut Points. Score ranges that earn each health inspection star in a state. https://data.cms.gov/provider-data/dataset/hicp-9999
- 11. Centers for Medicare & Medicaid Services. Design for Care Compare Nursing Home Five-Star Quality Rating System: Technical Users' Guide. How the star ratings, scope and severity points, and abuse and Special Focus flags are defined. https://www.cms.gov/medicare/provider-enrollment-and-certification/certificationandcomplianc/downloads/usersguide.pdf
- 12. Centers for Medicare & Medicaid Services. Medicare Care Compare. CMS's own consumer site, with the latest figures. https://www.medicare.gov/care-compare/
Attendant Homes is not affiliated with or endorsed by CMS. The data describes past inspections and reported figures and can be out of date or contain errors; it is not a recommendation. Confirm current information with the facility and on Medicare Care Compare [12] .
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