Cycle 1
Health 2025-08-27 · Fire 2025-08-27
3 health deficiencies
Top issue: Administration (1 deficiency)
2 fire-safety deficiencies
Top issue: Miscellaneous (2 deficiencies)
Hills, MN
Tuff Memorial Home
5-star overall rating with 4-star inspections with $44,434 in total fines with 3 recent health deficiencies with 2 fire-safety deficiencies in the latest cycle
505 East 4th Street, Hills, MN
(507) 962-3275
Overall
5 / 5
CMS overall stars
Health inspections
4 / 5
Survey and complaint cycles
Staffing
5 / 5
RN + nurse staffing
Quality measures
5 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
48
Certified beds
Average residents
40
Average occupied residents
Ownership
Non-Profit
Publicly displayed owner type
Chain
No chain reported
Operator or chain grouping
Approved since
1991-03-01
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Changed ownership
No
Within the last 12 months
Family council
Yes
Resident and family council reported
Sprinklers
Yes
Automatic sprinklers in all required areas
Staffing
Hours and turnover
RN hours / resident day
0.70
Registered nurse staffing · state 1.06 · national 0.68
LPN hours / resident day
0.27
Licensed practical nurse staffing · state 0.62 · national 0.87
Aide hours / resident day
2.96
Nurse aide staffing · state 2.56 · national 2.35
Total nurse hours
3.92
All reported nurse hours · state 4.23 · national 3.89
Licensed hours
0.96
RN + LPN hours · state 1.68 · national 1.54
Weekend hours
3.27
Weekend nurse staffing · state 3.68 · national 3.43
Weekend RN hours
0.37
Weekend registered nurse coverage · state 0.68 · national 0.47
Physical therapist
0.01
Reported PT staffing · state 0.08 · national 0.07
Adjusted RN hours
0.82
CMS adjusted RN staffing hours
Adjusted total hours
4.63
CMS adjusted total nurse staffing hours
Case-mix index
1.16
Higher values indicate more complex resident acuity
RN turnover
14%
Annual RN turnover · state 39% · national 45%
Total nurse turnover
43%
Annual nurse turnover · state 42% · national 46%
SNF VBP
Value-based purchasing
Program rank
5,524
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
35.90
Composite VBP score used to determine payment impact.
Payment multiplier
0.9894
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
Not reported
This facility did not meet this measure's case minimum policy requirement and therefore no measure data is publicly reported.
Healthcare-associated infections
Not reported
This facility did not meet this measure's case minimum policy requirement and therefore no measure data is publicly reported.
Total nurse turnover
3.66
Performance 48.72% · Measure score 3.66 · Achievement 3.66 · This facility did not have sufficient data to calculate a baseline period measure result.
Adjusted total nurse staffing
3.52
Baseline 4.13 hours · Performance 4.08 hours · Measure score 3.52 · Achievement 3.52 · Improvement 0
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | Not Available |
10.72%
|
Not Available · Eligible stays 15 · Observed rate Not Available · Lower 95% interval Not Available · Too few residents or stays to report publicly. |
| Discharge to community | Not Available |
50.57%
|
Not Available · Eligible stays 8 · Observed rate Not Available · Lower 95% interval Not Available · Too few residents or stays to report publicly. |
| Medicare spending per beneficiary | Not Available |
1.02
|
Too few residents or stays to report publicly. |
| Drug regimen review with follow-up | Not Available |
95.27%
|
Numerator Not Available · Denominator 14 · Too few residents or stays to report publicly. |
| Falls with major injury | Not Available |
0.77%
|
Numerator Not Available · Denominator 14 · Too few residents or stays to report publicly. |
| Discharge self-care score | Not Available |
53.69%
|
Numerator Not Available · Denominator 13 · Too few residents or stays to report publicly. |
| Discharge mobility score | Not Available |
50.94%
|
Numerator Not Available · Denominator 13 · Too few residents or stays to report publicly. |
| Pressure ulcers or injuries, new or worsened | Not Available |
2.29%
|
Numerator Not Available · Denominator 14 · Adjusted rate Not Available · Too few residents or stays to report publicly. |
| Healthcare-associated infections requiring hospitalization | Not Available |
7.12%
|
Not Available · Eligible stays 11 · Observed rate Not Available · Lower 95% interval Not Available · Too few residents or stays to report publicly. |
| Staff COVID-19 vaccination coverage | 5.38% |
8.2%
2.8 pts worse
|
Numerator 5 · Denominator 93 |
| Staff flu vaccination coverage | 28% |
42%
14 pts worse
|
Numerator 28 · Denominator 100 |
| Discharge function score | Not Available |
56.45%
|
Numerator Not Available · Denominator 13 · Too few residents or stays to report publicly. |
| Transfer of health information to provider | Not Available |
95.95%
|
Numerator Not Available · Denominator 1 · Too few residents or stays to report publicly. |
| Transfer of health information to patient | Not Available |
96.28%
|
Numerator Not Available · Denominator 2 · Too few residents or stays to report publicly. |
| Resident COVID-19 vaccinations up to date | Not Available |
25.2%
|
Numerator Not Available · Denominator 7 · Too few residents or stays to report publicly. |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 1.2 |
1.7
0.5 pts better
|
1.9
0.7 pts better
|
Long Stay · 20240701-20250630 · Adjusted 1.2 · Observed 0.9 · Expected 1.4 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 0.4 |
2.0
1.6 pts better
|
1.8
1.4 pts better
|
Long Stay · 20240701-20250630 · Adjusted 0.4 · Observed 0.4 · Expected 1.4 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 100.0% |
97.3%
2.7 pts better
|
93.4%
6.6 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 100.0% · Q3 100.0% · Q4 100.0% · 4Q avg 100.0% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 100.0% |
96.1%
3.9 pts better
|
95.5%
4.5 pts better
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 100.0% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 9.5% |
3.9%
5.6 pts worse
|
3.3%
6.2 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 9.7% · Q2 12.1% · Q3 11.8% · Q4 5.1% · 4Q avg 9.5% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 0.0% |
4.3%
4.3 pts better
|
11.4%
11.4 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% |
| Percentage of long-stay residents who lose too much weight | 3.4% |
4.1%
0.7 pts better
|
5.4%
2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 7.4% · Q2 3.3% · Q3 3.3% · Q4 0.0% · 4Q avg 3.4% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 6.6% |
12.4%
5.8 pts better
|
19.6%
13 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 7.4% · Q2 6.7% · Q3 6.5% · Q4 5.9% · 4Q avg 6.6% |
| Percentage of long-stay residents who received an antipsychotic medication | 13.5% |
17.5%
4 pts better
|
16.7%
3.2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 16.7% · Q2 14.8% · Q3 13.8% · Q4 9.7% · 4Q avg 13.5% · Used in QM five-star |
| Percentage of long-stay residents who were physically restrained | 0.0% |
0.1%
0.1 pts better
|
0.1%
0.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% |
| Percentage of long-stay residents whose ability to walk independently worsened | 11.7% |
22.5%
10.8 pts better
|
16.3%
4.6 pts better
|
Long Stay · 2024Q4-2025Q3 · Q2 8.4% · Q3 15.5% · Q4 14.5% · 4Q avg 11.7% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 15.3% |
18.6%
3.3 pts better
|
14.9%
0.4 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 11.1% · Q2 6.7% · Q3 27.6% · Q4 15.6% · 4Q avg 15.3% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 0.0% |
2.3%
2.3 pts better
|
1.0%
1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 0.7% |
2.6%
1.9 pts better
|
1.7%
1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 3.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.7% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 31.7% |
24.8%
6.9 pts worse
|
19.8%
11.9 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 23.5% · Q2 33.8% · Q3 34.5% · Q4 34.3% · 4Q avg 31.7% |
| Percentage of long-stay residents with pressure ulcers | 1.7% |
5.4%
3.7 pts better
|
5.1%
3.4 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 3.6% · Q2 0.0% · Q3 0.0% · Q4 3.0% · 4Q avg 1.7% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 90.3% |
88.6%
1.7 pts better
|
81.7%
8.6 pts better
|
Short Stay · 2024Q4-2025Q3 · 4Q avg 90.3% |
Survey summary
Recent inspection cycles
Cycle 2
Health 2024-07-30 · Fire 2024-07-30
2 health deficiencies
Top issue: Infection Control (1 deficiency)
3 fire-safety deficiencies
Top issue: Egress (1 deficiency)
Cycle 3
Health 2023-09-27 · Fire 2023-09-27
8 health deficiencies
Top issue: Administration (4 deficiencies)
4 fire-safety deficiencies
Top issue: Emergency Preparedness (3 deficiencies)
Fire safety
Fire-safety citations
F · Potential for more than minimal harm
2025-08-27
K711 · Miscellaneous Deficiencies
Fire Safety
Provide a written emergency evacuation plan.
Corrected 2025-09-19
F · Potential for more than minimal harm
2025-08-27
K712 · Miscellaneous Deficiencies
Fire Safety
Have simulated fire drills held at unexpected times.
Corrected 2025-09-19
E · Potential for more than minimal harm
2024-07-30
K345 · Smoke Deficiencies
Fire Safety
Have approved installation, maintenance and testing program for fire alarm systems.
Corrected 2024-08-19
D · Potential for more than minimal harm
2024-07-30
K291 · Egress Deficiencies
Fire Safety
Install emergency lighting that can last at least 1 1/2 hours.
Corrected 2024-08-19
D · Potential for more than minimal harm
2024-07-30
K923 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have proper medical gas storage and administration areas.
Corrected 2024-08-19
F · Potential for more than minimal harm
2023-09-27
E24 · Emergency Preparedness Deficiencies
Fire Safety
Establish policies and procedures for volunteers.
Corrected 2023-12-15
F · Potential for more than minimal harm
2023-09-27
E36 · Emergency Preparedness Deficiencies
Fire Safety
Establish emergency prep training and testing.
Corrected 2023-12-15
F · Potential for more than minimal harm
2023-09-27
E4 · Emergency Preparedness Deficiencies
Fire Safety
Develop and maintain an Emergency Preparedness Program (EP).
Corrected 2023-12-15
E · Potential for more than minimal harm
2023-09-27
K324 · Smoke Deficiencies
Fire Safety
Provide properly protected cooking facilities.
Corrected 2023-10-20
Inspection history
Recent health citations
F · Potential for more than minimal harm
2025-08-27
F867 · Administration Deficiencies
Health
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Corrected 2025-09-19
E · Potential for more than minimal harm
2025-08-27
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2025-09-19
D · Potential for more than minimal harm
2025-08-27
F921 · Environmental Deficiencies
Health
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Corrected 2025-09-19
D · Potential for more than minimal harm
2024-07-30
F641 · Resident Assessment and Care Planning Deficiencies
Health
Ensure each resident receives an accurate assessment.
Corrected 2024-08-19
D · Potential for more than minimal harm
2024-07-30
F881 · Infection Control Deficiencies
Health
Implement a program that monitors antibiotic use.
Corrected 2024-08-19
D · Potential for more than minimal harm
2023-12-11
F622 · Resident Rights Deficiencies
Health
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.
Corrected 2024-01-02
F · Potential for more than minimal harm
2023-09-27
F851 · Administration Deficiencies
Health
Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.
Corrected 2023-12-15
F · Potential for more than minimal harm
2023-09-27
F865 · Administration Deficiencies
Health
Have a plan that describes the process for conducting QAPI and QAA activities.
Corrected 2023-12-15
F · Potential for more than minimal harm
2023-09-27
F867 · Administration Deficiencies
Health
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Corrected 2023-12-15
F · Potential for more than minimal harm
2023-09-27
F944 · Administration Deficiencies
Health
Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.
Corrected 2023-12-15
E · Potential for more than minimal harm
2023-09-27
F883 · Infection Control Deficiencies
Health
Develop and implement policies and procedures for flu and pneumonia vaccinations.
Corrected 2023-12-15
D · Potential for more than minimal harm
2023-09-27
F657 · Resident Assessment and Care Planning Deficiencies
Health
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected 2023-12-15
D · Potential for more than minimal harm
2023-09-27
F761 · Pharmacy Service Deficiencies
Health
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.
Corrected 2023-12-15
Penalties and ownership
What sits behind the stars
$4,545
2023-11-13
Fine
Fine · fine $4,545
Fine
$4,545
2023-11-06
Fine
Fine · fine $4,545
Fine
$4,545
2023-10-30
Fine
Fine · fine $4,545
Fine
$4,545
2023-10-23
Fine
Fine · fine $4,545
Fine
$4,196
2023-10-17
Fine
Fine · fine $4,196
Fine
$3,846
2023-10-10
Fine
Fine · fine $3,846
Fine
$3,529
2023-10-02
Fine
Fine · fine $3,529
Fine
$0
2023-09-27
Payment Denial
Payment Denial · denial start 2023-12-27 · 6 days
6 day denial
$3,147
2023-09-25
Fine
Fine · fine $3,147
Fine
$2,797
2023-09-18
Fine
Fine · fine $2,797
Fine
$2,447
2023-09-11
Fine
Fine · fine $2,447
Fine
$2,098
2023-09-05
Fine
Fine · fine $2,098
Fine
$4,194
2023-08-14
Fine
Fine · fine $4,194
Fine
Ownership
Benson, Jo Ellen
Corporate Officer · Individual
Beyer, Brenda
Corporate Officer · Individual
Bryan, Cathy
Corporate Officer · Individual
Dysthe, Alex
Corporate Director · Individual
Dysthe, Alex
W-2 Managing Employee · Individual
Gayer, Tracy
Corporate Officer · Individual
Hengeveld, Linda
Corporate Officer · Individual
Ripley, Eli
Corporate Director · Individual
Saarloos, Val
Corporate Officer · Individual
Spath, Gregory
Corporate Officer · Individual
Westphal, Catherine
Corporate Officer · Individual
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#3
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