Total health inspections
4
South Dakota average 4.5
Last Health inspection on Aug 2025
Mix of rehab and long-term care
This home supports both short-term rehab and long-term care, with residents staying for a wide range of durations.
Tuff Memorial Home
Nursing Home · Sioux Falls, SD
CMS overall rating
The Overall CMS Rating is scored from 1 to 5 stars and combines results from health inspections, staffing levels, and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
The Overall CMS Rating is scored from 1 to 5 stars and combines results from health inspections, staffing levels, and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
Tuff Memorial Home
Nursing Home · Sioux Falls, SD
CMS overall rating
The Overall CMS Rating is scored from 1 to 5 stars and combines results from health inspections, staffing levels, and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
The Overall CMS Rating is scored from 1 to 5 stars and combines results from health inspections, staffing levels, and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
Tuff Memorial Home accepts Medicare, Medicaid, and private pay.
Overview of Tuff Memorial Home
Tuff Memorial Home, located in Hills, Minnesota, just outside of Sioux Falls, is an exceptional senior living community that goes above and beyond to provide unparalleled care to its residents. This haven of support and compassion not only offers comprehensive senior living services but also stands as a memory care center. Their specialized care is designed to cater to the specific needs of residents dealing with memory loss, providing them with a safe and nurturing environment where they can thrive.
With a focus on creating a familiar and comforting atmosphere, Tuff Memorial Home is thoughtfully designed to support residents’ cognitive functioning. Every aspect, from the layout of the center to the engaging activities offered, is carefully curated to stimulate memory, foster meaningful connections, and preserve a sense of identity and purpose. By incorporating tailored therapies, engaging social interactions, and memory-enhancing programs, Tuff Memorial Home ensures that residents receive the highest quality of care. Families can find peace of mind knowing that their loved ones are in a secure and nurturing environment where their memory care needs are met with compassion and expertise.
Quality ratings
The Overall CMS Rating combines results from health inspections, staffing levels and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
Based on the results of the facility's three most recent standard inspections and any complaint investigations. CMS reviews the number, scope, and severity of deficiencies, with more recent findings weighted more heavily.
Measures average nursing staff hours per resident per day, including Registered Nurses (RNs) and total nursing staff. Ratings are adjusted based on the level of care residents require and are compared to state and national benchmarks.
Based on clinical and physical health indicators reported to CMS, such as hospital readmissions, falls, pressure ulcers, and improvements in mobility. These measures reflect how well residents' health needs are being managed.
Staffing hours breakdown
Daily nursing hours per resident by staff type, reported to CMS. Higher is generally better — compare this facility to state and national averages to see where staffing stands.
Total nursing care / resident
This home is ranked 25th out of 59 homes in South Dakota.
Total adjusted nursing hours per resident per day, combining RN, LPN, and aide time. CMS adjusts this for case-mix so facilities can be fairly compared.
This home is ranked 25th out of 59 homes in South Dakota.Total adjusted nursing hours per resident per day, combining RN, LPN, and aide time. CMS adjusts this for case-mix so facilities can be fairly compared.
4h 47m per day
Rank #25 / 59Nurse hours — State benchmarkedThis home is ranked 25th out of 59 homes in Minnesota.Shows adjusted nurse hours per resident per day benchmarked to the Minnesota average, with a ranking across 59 Minnesota SNFs. More hours mean more direct care. The national average is about 3.5 hrs; below 3.0 is a red flag.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
vs South Dakota avg
+10%
| Staff type | Hours / Day / Resident | vs state avg |
|---|---|---|
|
Total Nursing (Weekend)
Combined nursing hours (RN + LPN + Nurse Aide) per resident per day on weekends. Staffing often drops on weekends — this figure reveals whether the facility maintains adequate coverage outside of weekday hours.
| 3h 14m per day |
Capacity and availability
This home usually has availability
Occupancy lower than 85% suggests more openings may be available.
Occupancy rate
78%
Rank #36 / 60Occupancy rate — State benchmarkedThis home is ranked 36th out of 60 homes in Minnesota.Shows this facility's occupancy rate versus the Minnesota average, with its Statewide rank out of 60. Higher occupancy signals strong local demand and financial stability.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Avg. Length of Stay
285 days
Occupancy rate
78%
Rank #36 / 60Occupancy rate — State benchmarkedThis home is ranked 36th out of 60 homes in Minnesota.Shows this facility's occupancy rate versus the Minnesota average, with its Statewide rank out of 60. Higher occupancy signals strong local demand and financial stability.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Avg. Length of Stay
285 days
Who this home usually serves
Show admissions and discharges
TYPE OF STAY
Breakdown by payment type
Medicare
31% of new residents, usually for short-term rehab.
Typical stay
22 days
Private pay
36% of new residents, often for short stays.
Typical stay
7 - 8 months
Medicaid
33% of new residents, often for long-term daily care.
Typical stay
8 - 9 months
Finances and operations
Voluntary non-profit community
Operated by a church.
Home revenue
$4.3M
Surplus of revenue
$284.1K
Voluntary non-profit community
Operated by a church.
Home revenue
$4.3M Rank #55 / 59Revenue — State benchmarkedThis home is ranked 55th out of 59 homes in Minnesota.Shows this facility's annual revenue compared to the Minnesota SNF average. Higher revenue generally means more resources for staffing and capital — read alongside Payroll %.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Surplus of revenue
$284.1K
Payroll costs
The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
Rank #54 / 59Payroll — State benchmarkedThis home is ranked 54th out of 59 homes in Minnesota.Shows total annual staff payroll benchmarked to the Minnesota average. Higher payroll investment relative to peers often signals better staffing and less reliance on cheaper contract labor.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
$2.9M
The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
Rank #54 / 59Payroll — State benchmarkedThis home is ranked 54th out of 59 homes in Minnesota.Shows total annual staff payroll benchmarked to the Minnesota average. Higher payroll investment relative to peers often signals better staffing and less reliance on cheaper contract labor.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Other operating costs
All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
$1.1M
All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
Total costs
$4.0M
Walk Score: 8 / 100 Rank #54 / 59Walk Score — State benchmarkedThis home is ranked 54th out of 59 homes in Minnesota.Shows how walkable this facility's neighborhood is compared to the average Walk Score across Minnesota SNFs. Higher scores benefit residents, families, and staff.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Car-dependent. Most errands require a car, with limited nearby walkable options.
About this community
Wheelchair Accessible
Accept Medicaid
Accept Medicare
Rehabilitation Services
Respite Care
24-Hour Staffing
Minimum Age50
HousekeepingYes
Linen ServiceYes
Utilities IncludedYes
Religious ServicesYes, Sunday morning services in the chapel.
Food DescriptionNutritious meals tailored to individual needs, including regular, liberalized, and modified diets.
Health Inspection History
Inspections
Total health citations
13
Rank #10 / 59Health citations — State benchmarkedThis home is ranked 10th out of 59 homes in Minnesota.Shows this facility's total health deficiency citations benchmarked to the Minnesota State average, with a ranking across all 59 MN SNFs. Lower citation counts earn a better rank.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
South Dakota average 14.8
Citations per inspection
3.25
Rank #17 / 59Citations per inspection — State benchmarkedThis home is ranked 17th out of 59 homes in Minnesota.Shows average deficiency citations per CMS inspection for this facility versus the Minnesota mean across 59 SNFs with citation data. Lower is better.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
South Dakota average 3.34
Health citations are formal notices following inspections when they fail to comply with safety and care standards.
12 of 13 citations resulted from standard inspections; and 1 of 13 resulted from complaint investigations.
Breakdown of citation severity (last 3 years)
Critical Health citations
0
100% better than South Dakota averageSouth Dakota average: 0.3
Serious Health citations
0
100% better than South Dakota averageSouth Dakota average: 1.8
Citations history (last 3 years)
Administration moderate citation
Aug 27, 2025
Corrected
Environmental moderate citation
Aug 27, 2025
Corrected
Infection Control moderate citation
Aug 27, 2025
Corrected
Infection Control moderate citation
Jul 30, 2024
Corrected
Financial Assistance for
Nursing Home in South Dakota
Tuff Memorial Home is located in Sioux Falls, South Dakota.
Here are the financial assistance programs available to residents in South Dakota.
Staffing Data
Reporting period: April 1 – June 30, 2025 (Q2 2025). Source: CMS Payroll-Based Journal report.
Total staff
75
Employees
60
Contractors
15
Staff to resident ratio
1.88:1
0% compared with South Dakota average
Avg staff/day
24
Average shift
7.6 hours
0% compared with South Dakota average
Total staff hours (quarter)
16,613
Nursing staff breakdown
Q2 2025 · Apr 1 – Jun 30
This data comes from the CMS Payroll-Based Journal report covering April 1 – June 30, 2025.
Registered Nurse
Manages medical care and health needs.
Total count
8
Average shift length
Average shift length. Calculated as total hours divided by days worked and average staff per day.
9.7 hours
Average shift length. Calculated as total hours divided by days worked and average staff per day.
9.7 hoursThis role is partially covered by contractors.
Licensed Practical Nurse
Assists with medical care and medications.
Total count
3
Average shift length
Average shift length. Calculated as total hours divided by days worked and average staff per day.
10.9 hours
Average shift length. Calculated as total hours divided by days worked and average staff per day.
10.9 hoursNo contractors work on this role.
Certified Nursing Assistant
Helps with daily care and mobility.
Total count
40
Average shift length
Average shift length. Calculated as total hours divided by days worked and average staff per day.
7.8 hours
Average shift length. Calculated as total hours divided by days worked and average staff per day.
7.8 hoursThis role is partially covered by contractors.
Contractor staffing
Q2 2025 · Apr 1 – Jun 30
This data comes from the CMS Payroll-Based Journal report covering April 1 – June 30, 2025.
Total hours from contractors
6.3%
1,047 contractor hours this quarter
Physical Therapy Assistant: 3
Qualified Social Worker: 2
Respiratory Therapy Technician: 2
Registered Nurse: 1
Certified Nursing Assistant: 1
Occupational Therapy Assistant: 1
Physical Therapy Aide: 1
Speech Language Pathologist: 1
Medical Director: 1
Occupational Therapy Aide: 1
Clinical Nurse Specialist: 1
Staff by category
Q2 2025 · Apr 1 – Jun 30
This data comes from the CMS Payroll-Based Journal report covering April 1 – June 30, 2025.
| Certified Nursing Assistant | 39 | 1 | 40 | 9,929 | 91 | 100% | 7.8 |
| Registered Nurse | 7 | 1 | 8 | 2,170 | 90 | 99% | 9.7 |
| Licensed Practical Nurse | 3 | 0 | 3 | 1,008 | 73 | 80% | 10.9 |
| Other Dietary Services Staff | 6 | 0 | 6 | 988 | 84 | 92% | 6.9 |
| Administrator | 2 | 0 | 2 | 752 | 73 | 80% | 6.8 |
| Mental Health Service Worker | 1 | 0 | 1 | 476 | 57 | 63% | 8.3 |
| Dietitian | 1 | 0 | 1 | 398 | 52 | 57% | 7.7 |
| Medication Aide/Technician | 1 | 0 | 1 | 318 | 25 | 27% | 12.7 |
| Clinical Nurse Specialist | 0 | 1 | 1 | 222 | 26 | 29% | 8.5 |
| Speech Language Pathologist | 0 | 1 | 1 | 135 | 60 | 66% | 2.2 |
| Physical Therapy Assistant | 0 | 3 | 3 | 93 | 35 | 38% | 2.7 |
| Physical Therapy Aide | 0 | 1 | 1 | 37 | 27 | 30% | 1.4 |
| Occupational Therapy Assistant | 0 | 1 | 1 | 32 | 8 | 9% | 4 |
| Respiratory Therapy Technician | 0 | 2 | 2 | 23 | 16 | 18% | 1.4 |
| Qualified Social Worker | 0 | 2 | 2 | 19 | 24 | 26% | 0.8 |
| Occupational Therapy Aide | 0 | 1 | 1 | 10 | 3 | 3% | 3.3 |
| Medical Director | 0 | 1 | 1 | 3 | 21 | 23% | 0.2 |
40 Certified Nursing Assistant
% of Days
100%
8 Registered Nurse
% of Days
99%
3 Licensed Practical Nurse
% of Days
80%
6 Other Dietary Services Staff
% of Days
92%
2 Administrator
% of Days
80%
1 Mental Health Service Worker
% of Days
63%
1 Dietitian
% of Days
57%
1 Medication Aide/Technician
% of Days
27%
1 Clinical Nurse Specialist
% of Days
29%
1 Speech Language Pathologist
% of Days
66%
3 Physical Therapy Assistant
% of Days
38%
1 Physical Therapy Aide
% of Days
30%
1 Occupational Therapy Assistant
% of Days
9%
2 Respiratory Therapy Technician
% of Days
18%
2 Qualified Social Worker
% of Days
26%
1 Occupational Therapy Aide
% of Days
3%
1 Medical Director
% of Days
23%
Facility Characteristics
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
40
Medicaid
19
47.5% of residents
Private pay or other
21
52.5% of residents
Programs & Services
Residents Group
Residents meet regularly to discuss policies, care quality, and activities
Family Member Group
Family members meet regularly to discuss policies, care quality, and activities
Active Family Council
Organized group of family members that meets regularly to discuss facility policies, resident care, and activities.
Active Resident Council
Organized group of residents that meets regularly to discuss facility policies, quality of life, and activities.
Data sourced from CMS Long-Term Care Facility Characteristics quarterly report. Payer mix reflects the current resident census by primary payment source.
Quality of care over time
These measures show how residents usually do over time at this home, based on health outcomes and preventive care.
High-risk clinical events score
A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline.
9.6
A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline.
9.6
14% better than South Dakota averageSouth Dakota average: 11.1
Functional decline score
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
20.6
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
20.6
9% better than South Dakota averageSouth Dakota average: 22.6
Long-stay resident measures
Need for Help with Daily Activities Increased
Percent of long-stay residents whose need for help with daily activities has increased
17.0%
Percent of long-stay residents whose need for help with daily activities has increased
17.0%
11% better than South Dakota averageSouth Dakota average: 18.9%
Walking Ability Worsened
Percent of long-stay residents whose ability to move independently worsened
12.0%
Percent of long-stay residents whose ability to move independently worsened
12.0%
50% better than South Dakota averageSouth Dakota average: 23.8%
Low Risk Residents with Bowel/Bladder Incontinence
Percent of low risk long-stay residents who lose control of their bowels or bladder
32.9%
Percent of low risk long-stay residents who lose control of their bowels or bladder
32.9%
31% worse than South Dakota averageSouth Dakota average: 25.0%
Falls with Major Injury
Percent of long-stay residents experiencing one or more falls with major injury
10.5%
Percent of long-stay residents experiencing one or more falls with major injury
10.5%
182% worse than South Dakota averageSouth Dakota average: 3.7%
High Risk Residents with Pressure Ulcers
Percent of long-stay high risk residents with pressure ulcers
2.5%
Percent of long-stay high risk residents with pressure ulcers
2.5%
54% better than South Dakota averageSouth Dakota average: 5.4%
Urinary Tract Infection
Percent of long-stay residents with a urinary tract infection
1.5%
Percent of long-stay residents with a urinary tract infection
1.5%
45% better than South Dakota averageSouth Dakota average: 2.7%
Lost Too Much Weight
Percent of long-stay residents who lose too much weight
5.8%
Percent of long-stay residents who lose too much weight
5.8%
41% worse than South Dakota averageSouth Dakota average: 4.1%
Depressive Symptoms
Percent of long-stay residents who have depressive symptoms
0.0%
Percent of long-stay residents who have depressive symptoms
0.0%
100% better than South Dakota averageSouth Dakota average: 4.4%
Antipsychotic Use
Percent of long-stay residents who received an antipsychotic medication
15.5%
Percent of long-stay residents who received an antipsychotic medication
15.5%
10% better than South Dakota averageSouth Dakota average: 17.2%
Pneumococcal Vaccine
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
100.0%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
100.0%
In line with South Dakota averageSouth Dakota average: 97.3%
Influenza Vaccine
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
100.0%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
100.0%
In line with South Dakota averageSouth Dakota average: 96.0%
Short-stay resident measures
Pneumococcal Vaccine
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
87.1%
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
87.1%
In line with South Dakota averageSouth Dakota average: 88.9%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
Penalties and fines
Federal penalties imposed by CMS for regulatory violations, including civil money penalties (fines) and denials of payment for new Medicare/Medicaid admissions.
Source: CMS Penalties Database (Data as of Jan 2026)
Total fines amount
$44K Rank #46 / 59Federal fines — State benchmarkedThis home is ranked 46th out of 59 homes in Minnesota.Shows this facility's cumulative CMS federal fine dollars versus the Minnesota average among facilities with fines, and where it ranks among 59 skilled nursing facilities in the pool. Lower total dollars mean a better rank.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
In line with South Dakota averageSouth Dakota average: $44K
Number of fines
12
498% more fines than South Dakota averageSouth Dakota average: 2.0
Payment Denials
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
1
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
1
130% more payment denials than South Dakota averageSouth Dakota average: 0.4
Fines amount comparison
Fines amount comparison
This facility
$44K
South Dakota average
$44K
Penalty History
Penalties are imposed by CMS for violations of federal nursing home regulations.
13 penalties in the past 3 years
Multiple penalties were reported in the last 3 years.
Civil Money Penalty
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Nov 13, 2023
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Nov 13, 2023
$5K
Civil Money Penalty
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Nov 6, 2023
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Nov 6, 2023
$5K
Civil Money Penalty
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Oct 30, 2023
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Oct 30, 2023
$5K
Civil Money Penalty
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Oct 23, 2023
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Oct 23, 2023
$5K
Last updated: Jan 2026
Compare Nursing Home around Sioux Falls
The information below is reported by the South Dakota Department of Health, Office of Health Care Facilities Licensure.
Filter by care type
| Tuff Memorial Home |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence. | Sioux Falls | 48 | 78.0% | -2% | 4.78 | -22% | 0% | $44.4k | 13 | 3.3 | - | 37 | 8 | Alex Dysthe | $4.3M | $2.9M | 67% | 245548 | ||||
| Bethany Home Sioux Falls/Bethany Home-Brandon |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence. | Sioux Falls | 112 | 78.5% | -2% | 5.47 | -17% | +26% | $0 | 13 | 3.3 | 1 | 42 | 65 | Augustana Lutheran Church | $7.1M | $4.9M | 69.2% | 435096 | ||||
| Avantara Norton |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence. | Sioux Falls | 110 | 91.5% | +14% | 3.53 | +34% | -19% | $225.2k | 75 | 4.2 | 18 | 95 | 61 | Jeremy Klinkhammer | $16.6M | $7.4M | 44.4% | 435039 |
Financial Trends
Historical financial and operational data for Tuff Memorial Home based on CMS SNF Cost Reports.
Occupancy Rate
78.0%
↓ 1.2pp vs 2022
Net Income
$284.1K
↑ ~$301.7K vs 2022
Total Payroll
$2.9M
↑ ~$81.6K vs 2022
Profit Margin
7.1%
↑ 7.6pp vs 2022
Guides for Better Senior Living
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Understanding Senior Living Costs: Pricing Models, Discounts & Financial Assistance
Frequently Asked Questions about Tuff Memorial Home
Is Tuff Memorial Home in a walkable area?
Tuff Memorial Home has a walk score of 8. Car-dependent. Most errands require a car, with limited nearby walkable options.
What is the occupancy rate at Tuff Memorial Home?
Tuff Memorial Home's occupancy is 78.0%.
Are there photos of Tuff Memorial Home?
Yes — there are 25 photos of Tuff Memorial Home in the photo gallery on this page.
What is the phone number of Tuff Memorial Home?
(701) 780-6000 will put you in contact with the team at Tuff Memorial Home.
Is Tuff Memorial Home Medicare or Medicaid certified?
Yes — Tuff Memorial Home is a CMS-certified provider of Medicare and Medicaid.
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