Your report for Tuff Memorial Home
Overall Score
CMS Five-Star Quality Rating- Much below average
- Below average
- Average
- Above average
- Much above average
Where it ranks
- MinnesotaAbove 74% of peers337 rated homes · average 3.2★
- United StatesAbove 80% of peers14,574 rated homes · average 3.0★
How the rating is built
- Health inspectionsStarting point4★+1.2 vs MN avg
- StaffingCan add or remove a star5★+0.9 vs MN avg
- Quality measuresCan add or remove a star5★+1.8 vs MN avg
CMS starts from the health inspection stars, then adds or subtracts a star for staffing and for quality measures. Stars are assigned relative to other facilities in the same state.
Ratings & measures
Tap a row to see what it meansHealth inspection ratingCMS stars from the last three on-site inspection cycles4★Above 65% of peersMN avg2.8★U.S. avg2.8★
Stars assigned from the last three standard surveys and every complaint investigation in that window, weighted toward the most recent and the most serious findings. CMS assigns these stars relative to other facilities in the same state.
It carries the most weight in the overall rating and is the only domain based on what trained inspectors saw on site rather than what the facility reported.
Staffing ratingCMS stars from payroll-reported hours and turnover5★Above 56% of peersMN avg4.1★U.S. avg2.9★
Nurse and aide hours per resident day from payroll records CMS collects every quarter, adjusted for how much care residents need, plus staff turnover and weekend coverage.
More hours and lower turnover are the strongest predictors of fewer falls, pressure sores, and avoidable hospital stays.
Quality measures ratingCMS stars from clinical outcomes and resident assessments5★Above 87% of peersMN avg3.2★U.S. avg3.6★
Clinical outcomes from resident assessments and Medicare claims: falls with injury, pressure ulcers, hospitalizations, antipsychotic use, and more, for both short-stay and long-stay residents.
It shows whether care is working, but part of it comes from the facility’s own assessments, so read it alongside the inspection results.
Total nurse hoursPer resident per day, all nursing staff3.92hrsAbove only 36% of peersMN avg4.23Benchmark4.10
All licensed nurse and aide hours worked, divided by the number of residents, on an average day. Reported from payroll, not self-reported.
Federal research links 4.1 hours a day to fewer avoidable harms. Below about 3 hours, residents wait longer for help with basics like toileting and repositioning.
RN hoursPer resident per day, registered nurses only0.70hrsAbove only 17% of peersMN avg1.06Benchmark0.75
Registered nurse hours only. RNs assess residents, manage medications, and catch changes in condition; LPNs and aides deliver most hands-on care.
RN coverage is the staffing measure most tied to fewer hospital transfers and infections, and it is where thinly staffed facilities cut first.
Nursing staff turnoverShare of nursing staff who left within a year · lower is better43%Above only 46% of peersMN avg42%RN turnover14%
The share of nursing staff who left within the past year, from the same payroll data.
High turnover means residents are cared for by people who do not know them, and it is one of the strongest predictors of inspection problems.
Fines in the last three yearsCivil money penalties imposed by CMS · lower is better$44,434Above only 12% of peersMN avg$19,953Fines · denials12 · 1
Civil money penalties CMS imposed after serious or uncorrected deficiencies, and denials of Medicare payment for new admissions.
Penalties follow the worst inspection findings. A recent fine is the clearest sign that inspectors found real harm.
Inspection history
Last three inspection cyclesCitations by monthAug 2023 – Aug 2025
- No actual harm (D–F)
- Actual harm (G–I)
- Immediate jeopardy (J–L)
- $Fine or payment denial
Showing
Click a month or a year to filter the findings below. Arrow keys move between months; Esc clears.
Aug 27, 2025Cycle 1worst F · no actual harm
- F867Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.AdministrationF · widespreadCorrected Sep 19, 2025
- F880Provide and implement an infection prevention and control program.Infection ControlE · patternCorrected Sep 19, 2025
- F921Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.EnvironmentalD · isolatedCorrected Sep 19, 2025
Jul 30, 2024Cycle 2worst D · no actual harm
- F641Ensure each resident receives an accurate assessment.Resident Assessment and Care PlanningD · isolatedCorrected Aug 19, 2024
- F881Implement a program that monitors antibiotic use.Infection ControlD · isolatedCorrected Aug 19, 2024
Dec 11, 2023Cycle 3worst D · no actual harm
- F622Not 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 RightsD · isolatedCorrected Jan 2, 2024
Sep 27, 2023Cycle 3worst F · no actual harmpayment denial, $3,147, $2,797, $2,447, $2,098
- Conduct mandatory training, for all staff, on the facilityâs Quality Assurance and Performance Improvement Program.AdministrationF · widespreadCorrected Dec 15, 2023
- F883Develop and implement policies and procedures for flu and pneumonia vaccinations.Infection ControlE · patternCorrected Dec 15, 2023
- F657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.Resident Assessment and Care PlanningD · isolatedCorrected Dec 15, 2023
- F761Ensure 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 ServiceD · isolatedCorrected Dec 15, 2023
- F851Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.AdministrationF · widespreadCorrected Dec 15, 2023
- F865Have a plan that describes the process for conducting QAPI and QAA activities.AdministrationF · widespreadCorrected Dec 15, 2023
- F867Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.AdministrationF · widespreadCorrected Dec 15, 2023
Staffing
From quarterly payroll reportsHours per resident per day
- All nursing staffRNs, LPNs and aides combined3.92hrs
- Registered nursesRN hours only0.70hrs
- Licensed practical nursesLPN hours0.27hrs
- Nurse aidesCNA hours2.96hrs
- Weekend nursingAll staff on Saturdays and Sundays3.27hrs
- Minnesota average
- Research benchmark (4.10 total, 0.75 RN)
Turnover & capacity
- Nursing staff turnoverShare who left within a year · lower is better43%Above only 46% of peersMN avg 42%
- RN turnoverRegistered nurses only14%Not ranked by CMS
- Administrators who leftIn the past year1Leadership changed
- Occupancy48 certified beds · ~40 residents a day84%Above only 44% of peersMN avg 83%
Fines & penalties
Roughly the past three yearsEnforcement summary
- $44,434In fines
- 12Fines
- 1Payment denial
- $19,953MN avg in fines
Actions on record
- Nov 13, 2023Civil money penalty$4,545
- Nov 6, 2023Civil money penalty$4,545
- Oct 30, 2023Civil money penalty$4,545
- Oct 23, 2023Civil money penalty$4,545
- Oct 17, 2023Civil money penalty$4,196
- Oct 10, 2023Civil money penalty$3,846
- Oct 2, 2023Civil money penalty$3,529
- Sep 27, 2023Denial of payment for new admissionsfrom Dec 27, 2023
- Sep 25, 2023Civil money penalty$3,147
- Sep 18, 2023Civil money penalty$2,797
- Sep 11, 2023Civil money penalty$2,447
- Sep 5, 2023Civil money penalty$2,098
- Aug 14, 2023Civil money penalty$4,194
Ownership
As filed with CMSStructure
- Ownership type
- Non profit - Other
- Chain
- Independent
- Certification
- Medicare and Medicaid
- Location type
- Urban
- Ownership change
- None in the last 12 months
People and entities on file
- Alex Dysthe
- Eli Ripley
- Jo Ellen Benson
- Brenda Beyer
- Cathy Bryan
- Tracy Gayer
- Linda Hengeveld
- Val Saarloos
- Gregory Spath
- Catherine Westphal
- Alex Dysthe
Person Organization
Sources & notes
Public data, updated quarterlyData sources
- CMS Care Compare · Provider InformationStar ratings, staffing hours, turnover, penalties and flags · processed February 2026.
- CMS Health CitationsEvery deficiency from the last three inspection cycles, with scope, severity and inspection cycle.
- CMS Penalties and Ownership filesCivil money penalties, payment denials, and the owners and managers on file.
Notes
- CMS Certification Number 245548 · 505 EAST 4TH STREET, HILLS, MN, 56138.
- Percentiles compare this facility with every rated nursing home in Minnesota and Rock County. Turnover and fines are inverted so a high percentile is always good.
- This is an informational summary of public data, not medical, legal, or placement advice. Facilities cannot pay to change it; a facility that believes a record is wrong can dispute it with CMS.
