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Tuff Memorial Home
Nursing Home & Skilled Nursing · Hills, MN
CMS overall rating Info CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
Exterior view of Tuff Memorial Home facility entrance Entrance sign for Tuff Village assisted living facility Exterior view of Tuff Memorial Home with trees and flag Outdoor space with seating and gazebo at the facility Exterior view of Tuff Memorial Home with sign and flag Exterior view of Tuff Memorial Home with flower pots Exterior view of Tuff Memorial Home with garden space Entrance of Sunview Apartments with a door and signage Exterior view of a facility entrance with a vending machine Outdoor gazebo area with seating at the facility Interior view of a multi-purpose room with chairs arranged Common area with seating and television Cozy resident room with personal touches Bright dining room with tables and plants Interior reception area with wooden counter and decor Bright interior lounge area with chairs and artwork Common area with dining tables and chairs in bright space Bright common area with seating and windows Outdoor patio area with seating and greenery Interior of a cozy common area with seating. Interior view of a therapy room with equipment Interior view of a multi-purpose room with chairs and musical instruments Common area with seating and decorative elements

Tuff Memorial Home

Nursing Home & Skilled Nursing · Hills, MN
CMS overall rating Info CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
301 County Road 6, Hills, MN 56138 View map Calculator: See prices in your area
Tuff Memorial Home accepts Medicare, Medicaid, and private pay.
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Tuff Memorial Home accepts Medicare, Medicaid, and private pay.

Overview of Tuff Memorial Home

Tuff Memorial Home is a 48-bed nursing home in Hills, Minnesota, a small rural town near the South Dakota state line. The surrounding area is car-dependent, with a Walk Score of 8, which is standard for a community this rural and this size. Rehabilitation services, respite care, and 24-hour staffing are on-site. Medicare, Medicaid, and private pay are all accepted, while the minimum admission age is 50.

At 78% occupancy and an average length of stay of 285 days, the resident population here leans longer-term. The facility handles both extended care and rehabilitation admissions, though the stay-length average suggests the majority of residents are not short-term rehab cases. Total nursing hours are 4 hours and 47 minutes per resident per day; registered nurses account for 43 of those minutes.

Meals are adapted to individual needs, with regular, liberalized, and modified diet options available. Housekeeping and utilities are included, and the facility has a chapel with Sunday morning services.

Two structural details stand out: first, the facility maintains both an Active Resident Council and an Active Family Council, which means there are organized, ongoing forums for raising concerns about care, policies, and daily life. Those aren’t universal in small rural nursing homes. Second, the dietary program specifically accommodates modified diets, which matters for residents with swallowing difficulties or other clinical dietary needs.

At 48 beds in a rural Minnesota town with Medicare, Medicaid, and private pay accepted, Tuff Memorial Home is a small, community-based nursing home that covers the essentials of long-term and rehabilitative care for the region it serves.

Facility Direct Line (701) 780-6000
Facility Direct Line (701) 780-6000

Quality ratings

Measured by Centers for Medicare & Medicaid Services (CMS)

Overall rating Info 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.
▲ 84.1% Above SD avg. ▲ 84.1% Above SD avg.SD average: 2.7Click the badge to see the full State ranking.Click here to see the full State ranking.
Health Inspection Info 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.
▲ 84.8% Above SD avg. ▲ 84.8% Above SD avg.SD average: 2.7Click the badge to see the full State ranking.Click here to see the full State ranking.
Staffing Info 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.
▲ 50.8% Above SD avg. ▲ 50.8% Above SD avg.SD average: 3.3Click the badge to see the full State ranking.Click here to see the full State ranking.
Quality Measures Info 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.
▲ 46.7% Above SD avg. ▲ 46.7% Above SD avg.SD average: 2.7Click the badge to see the full State ranking.Click here to see the full State ranking.

Staffing hours Info 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.

Hours per resident per day vs South Dakota averages

Rank #29 / 66Nurse hours — State benchmarkedThis home is ranked 29th out of 66 homes we track in Minnesota for nurse hours. Shows adjusted nurse hours per resident per day benchmarked to the Minnesota average, with a ranking across 66 Minnesota facilities. More hours mean more direct care. The national average is about 3.5 hrs; below 3.0 is a red flag.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Minnesota that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.

Total nursing care Info This home is ranked 29th out of 66 homes we track in South Dakota for nurse hours. 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 55m

13% above state avg
Staff type
Hours / day / resident
vs state avg
Registered Nurse (RN) Info RNs hold the highest nursing license and can assess residents, interpret test results, and direct care plans. More RN hours per day often signals stronger clinical oversight and faster response to health changes.
55m
Avg State avg: 56m per day · National avg: 42m per day
LPN / LVN Info Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs) deliver routine hands-on care — medication administration, wound dressing, and monitoring vital signs. They work under RN supervision and make up a large share of daily bedside care.
19m
−42% State avg: 32m per day · National avg: 52m per day
Nurse Aide Info Certified Nurse Aides (CNAs) provide the most direct day-to-day assistance: bathing, dressing, feeding, and mobility. Nurse aide hours are typically the largest staffing category and directly affect residents' quality of life.
3h 41m
+25% State avg: 2h 56m per day · National avg: 2h 24m per day
Weekend Total Nursing Info 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.
4h 2m
+9% State avg: 3h 43m per day · National avg: 3h 31m per day
Physical Therapist Info Hours per resident per day provided by licensed Physical Therapists (PTs) or PT Assistants. PT services help residents recover mobility after injury or illness and are especially important for post-acute (short-stay) rehabilitation.
1m
−69% State avg: 3m per day · National avg: 4m per day
Weekend RN Info Registered nurse hours specifically on weekends. Facilities sometimes reduce RN presence on Saturdays and Sundays — a low weekend RN figure compared to weekday hours can indicate reduced clinical oversight when most administrative staff are absent.
25m
−22% State avg: 32m per day · National avg: 29m per day

3 of 6 metrics below state avg

Standout metric: Nurse Aide is +25% above South Dakota average

By The Numbers

Community insights.

Bed count Info A smaller, more intimate setting that may offer a quieter environment and closer staff-resident interactions. 48 Rank #67 / 95Bed count — State benchmarkedThis home is ranked 67th out of 95 homes we track in Minnesota for bed count. Shows this facility's certified or reported bed count compared to other Minnesota facilities. Larger communities may offer more amenities, programs, and on-site services for residents and families.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Minnesota that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.

Smaller home · May offer a more intimate, personalized care environment.

Walk Score Info Car-dependent. Most errands require a car, with limited nearby walkable options. Rank #97 / 104Walk Score — State benchmarkedThis home is ranked 97th out of 104 homes we track in Minnesota for walk score. Shows how walkable this facility's neighborhood is compared to the average walk score across Minnesota facilities. Higher scores benefit residents, families, and staff.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Minnesota that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
8 / 100
Occupancy rate Info Occupancy lower than 85% suggests more openings may be available. Rank #33 / 60Occupancy rate — State benchmarkedThis home is ranked 33rd out of 60 homes we track in Minnesota for occupancy. 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.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Minnesota that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
80.4% This home usually has availability
Similar to the South Dakota average: 84%
Residents per day (avg) Info The average number of residents living at this facility on a given day. CMS calculates this figure from the facility's Minimum Data Set (MDS) assessments and uses this value for other measures like Hours Per Resident Per Day (HPRD) and 5-Star Staffing rating.
39
Avg. Length of Stay Info Average number of days residents stay at this facility, based on CMS cost report data. Shorter stays often reflect post-acute or rehab care; longer stays reflect long-term care.
285 days

Safety & Compliance

Wheelchair Accessible

Payment & Insurance

2 services
Accept Medicaid
Accept Medicare

Therapy & Rehabilitation

2 services
Rehabilitation Services
Respite Care

Staffing & Medical

1 service
24-Hour Staffing

Additional Policies & Features

Minimum Age50
HousekeepingYes
Linen ServiceYes
Utilities IncludedYes

Amenities & Lifestyle

Religious ServicesSunday morning services in the chapel

Contact Tuff Memorial Home

CMS Health Inspection History

ALM Inspection Grade Unavailable

Not published

We don't have enough verified data to publish an inspection grade for this facility — a missing grade reflects what we've been able to verify, not the facility's quality.

ALM Inspection Grade unavailable: limited inspection data.
Inspections Since 2023 · 3 years of data

Includes all CMS health inspection records for this property, which could include management/ownership changes.

Total health inspections 3

South Dakota average 4.8

Last Health inspection on Aug 2025

Total health citations
6 Rank #11 / 66Health citations — State benchmarkedThis home is ranked 11th out of 66 homes we track in Minnesota for health citations. Shows this facility's total health deficiency citations benchmarked to the Minnesota State average, with a ranking across all 66 MN facilities. Lower citation counts earn a better rank.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Minnesota that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.

South Dakota average 16.9

Citations per inspection
2 Rank #20 / 66Citations per inspection — State benchmarkedThis home is ranked 20th out of 66 homes we track in Minnesota for citations per inspection. Shows average deficiency citations per CMS inspection for this facility versus the Minnesota mean across 66 facilities with citation data. Lower is better.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Minnesota that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.

South Dakota average 3.67

Health citations are formal notices following inspections when they fail to comply with safety and care standards.

5 of 6 citations resulted from standard inspections; and 1 of 6 resulted from complaint investigations.

Breakdown of citation severity (last 3 years)
Critical health citations
0
100% better than South Dakota average

South Dakota average: 0.4

Serious health citations
0
100% better than South Dakota average

South Dakota average: 2.1

0 critical citations South Dakota average: 0.4
0 serious citations South Dakota average: 2.1
6 moderate citations South Dakota average: 14.4
0 minor citations South Dakota average: 0
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

Data sourced from CMS Health Deficiencies reports. Citation severity codes range from A (least serious) to L (most serious). Immediate Jeopardy (J-L) citations indicate situations where the facility's noncompliance has placed residents at risk of death or serious harm.

Staffing Data

Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.

Total staff 65
Employees 59
Contractors 6
Staff to resident ratio 1.63 : 1
16% fewer staff per resident than South Dakota average
South Dakota average ratio: 1.93 : 1 South Dakota average ratio: 1.93 : 1See full South Dakota ranking
Avg staff/day 22
Average shift 8.2 hours
6% better than South Dakota average
South Dakota average: 7.7 hours South Dakota average shift: 7.7 hoursSee full South Dakota ranking
Total staff hours (quarter) 16,552

Nursing staff breakdown

Q4 2025 · Oct 1 – Dec 31 More info This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Registered Nurse

Manages medical care and health needs.

RN Staff Info 7 total: 5 full-time employees and 2 contractors. 7
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 10.9 hours
Licensed Practical Nurse

Assists with medical care and medications.

LPN Staff Info All 3 LPN Staff are full-time employees. No contractors work on this role. 3
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 9.1 hours
Certified Nursing Assistant

Helps with daily care and mobility.

CNA Staff Info 39 total: 38 full-time employees and 1 contractor. 39
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 7.6 hours

Contractor staffing

Q4 2025 · Oct 1 – Dec 31 More info This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.

Total hours from contractors

3.7%

609 contractor hours this quarter

Registered Nurse: 2 Certified Nursing Assistant: 1 Medical Director: 1 Occupational Therapy Assistant: 1 Occupational Therapy Aide: 1

Staff by category

Q4 2025 · Oct 1 – Dec 31 More info This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Certified Nursing Assistant381398,36792100%7.6
Registered Nurse5271,4478795%10.9
Other Dietary Services Staff3031,0898896%6.8
Licensed Practical Nurse3031,0588188%9.1
Nurse Aide in Training2021,0007986%8.1
Medication Aide/Technician3039807885%12.2
Nurse Practitioner1016847177%9.6
Administrator1016227177%8.8
Dental Services Staff1014315762%7.6
Clinical Nurse Specialist1014234953%8.6
Dietitian1014045762%7.1
Occupational Therapy Assistant0113389%4.1
Occupational Therapy Aide011933%2.8
Medical Director01161820%0.4
39 Certified Nursing Assistant
% of Days 100%
7 Registered Nurse
% of Days 95%
3 Other Dietary Services Staff
% of Days 96%
3 Licensed Practical Nurse
% of Days 88%
View All Staffing Data in Sioux Falls

Penalties and fines

Includes penalties issued in 2023

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 #50 / 66Federal fines — State benchmarkedThis home is ranked 50th out of 66 homes we track in Minnesota for federal fines. Shows this facility's cumulative CMS federal fine dollars versus the Minnesota average among facilities with fines, and where it ranks among 66 facilities in the pool. Lower total dollars mean a better rank.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Minnesota that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
In line with South Dakota average

South Dakota average: $44K

Number of fines 12
498% more fines than South Dakota average

South Dakota average: 2.0

Payment Denials Info 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 average

South 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.

12 penalties in the past 3 years

Multiple penalties were reported in the last 3 years.

Civil Money Penalty Info Fines imposed for noncompliance, which can be assessed per day or per instance of violation. Nov 13, 2023
$5K
Civil Money Penalty Info Fines imposed for noncompliance, which can be assessed per day or per instance of violation. Nov 6, 2023
$5K
Civil Money Penalty Info Fines imposed for noncompliance, which can be assessed per day or per instance of violation. Oct 30, 2023
$5K
Civil Money Penalty Info Fines imposed for noncompliance, which can be assessed per day or per instance of violation. Oct 23, 2023
$5K

Last updated: Jan 2026

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 Info 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 average

South Dakota average: 11.1

Functional decline score Info A composite score based on activities of daily living decline, walking ability decline, and incontinence. 20.6
9% better than South Dakota average

South Dakota average: 22.6

Long-stay resident measures
Above average Info CMS star rating based on long-stay quality measure performance. 5 stars = significantly above average, 1 star = significantly below average.
Need for Help with Daily Activities Increased Info Percent of long-stay residents whose need for help with daily activities has increased 17.0%
11% better than South Dakota average

South Dakota average: 18.9%

Walking Ability Worsened Info Percent of long-stay residents whose ability to move independently worsened 12.0%
50% better than South Dakota average

South Dakota average: 23.8%

Low Risk Residents with Bowel/Bladder Incontinence Info Percent of low risk long-stay residents who lose control of their bowels or bladder 32.9%
31% worse than South Dakota average

South Dakota average: 25.0%

Falls with Major Injury Info Percent of long-stay residents experiencing one or more falls with major injury 10.5%
182% worse than South Dakota average

South Dakota average: 3.7%

High Risk Residents with Pressure Ulcers Info Percent of long-stay high risk residents with pressure ulcers 2.5%
54% better than South Dakota average

South Dakota average: 5.4%

Urinary Tract Infection Info Percent of long-stay residents with a urinary tract infection 1.5%
45% better than South Dakota average

South Dakota average: 2.7%

Lost Too Much Weight Info Percent of long-stay residents who lose too much weight 5.8%
41% worse than South Dakota average

South Dakota average: 4.1%

Depressive Symptoms Info Percent of long-stay residents who have depressive symptoms 0.0%
100% better than South Dakota average

South Dakota average: 4.4%

Antipsychotic Use Info Percent of long-stay residents who received an antipsychotic medication 15.5%
10% better than South Dakota average

South Dakota average: 17.2%

Pneumococcal Vaccine Info Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine 100.0%
In line with South Dakota average

South Dakota average: 97.3%

Influenza Vaccine Info Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine 100.0%
In line with South Dakota average

South Dakota average: 96.0%

Short-stay resident measures
Pneumococcal Vaccine Info Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine 87.1%
In line with South Dakota average

South Dakota average: 88.9%

Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.

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

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.

Finances and operations

Based on CMS SNF Cost Report for fiscal year ending in 09/2023.

Nonprofit
Net patient revenue Info Net patient revenue — what the home actually collects for resident care, after contractual allowances, bad debt and discounts are subtracted from its gross charges (CMS cost report, Worksheet G-3). It covers resident care only; money the home earns from other sources is shown separately as "Other income."
$4.0M
Net patient income Info Net patient income: net patient revenue minus the home's total operating expenses. A positive figure means it earns more from resident care than it spends to deliver it; a negative figure means the opposite. It excludes non-operating "other income."
$15.3K
Nonprofit
Net patient revenue Info Net patient revenue — what the home actually collects for resident care, after contractual allowances, bad debt and discounts are subtracted from its gross charges (CMS cost report, Worksheet G-3). It covers resident care only; money the home earns from other sources is shown separately as "Other income."
$4.0M Rank #56 / 62Net patient revenue — State benchmarkedThis home is ranked 56th out of 62 homes we track in Minnesota. Shows this facility's net patient revenue compared to the Minnesota average, among facilities reporting a recent fiscal year. Higher revenue generally means more resources for staffing and capital — read alongside Payroll %.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Minnesota that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.
Net patient income Info Net patient income: net patient revenue minus the home's total operating expenses. A positive figure means it earns more from resident care than it spends to deliver it; a negative figure means the opposite. It excludes non-operating "other income."
$15.3K
Other income Info Money the home earns outside of resident care — such as investments, grants, rentals and other non-operating sources (CMS cost report, Worksheet G-3). It is tracked separately from net patient revenue: it is not part of that figure, and it is not included in net patient income.
$268.8K
Payroll costs Info Staff salaries plus wage-related costs — benefits such as payroll taxes, health insurance and retirement — from the home's own accounting records (CMS cost report, Worksheet A). Contract or agency labor is counted separately, under other operating costs. Rank #53 / 62Payroll costs — State benchmarkedThis home is ranked 53rd out of 62 homes we track in Minnesota. Shows total staff payroll — salaries plus wage-related benefits — benchmarked to the Minnesota average, among facilities reporting a recent fiscal year. Higher payroll relative to peers often signals better staffing and less reliance on contract labor.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Minnesota that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.
$2.7M 67.9% of net patient revenue Info Payroll as a share of revenue: staff salaries and wage-related benefits divided by net patient revenue. A higher figure means more of each revenue dollar goes to staff pay. Rank #20 / 62Payroll % of net patient revenue — State benchmarkedThis home is ranked 20th out of 62 homes we track in Minnesota. Shows payroll as a percentage of net patient revenue versus the Minnesota average, among facilities reporting a recent fiscal year. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings.Communities with the same value for a metric share the same rank. Rankings cover every community we track in Minnesota that reports data for that category. Communities without available data are excluded, so the pool size varies from metric to metric.
Other operating costs Info Everything it costs to run the home apart from payroll — food, utilities, supplies, maintenance, contract labor and administration. Calculated as total operating expense minus payroll (staff salaries and wage-related benefits).
$1.3M
Total costs Info The home's total operating expense for the year — all the costs of running it, salaries included (CMS cost report, Worksheet G-3).
$4.0M
How we calculate these figures

This home is owned by Alex Dysthe

Certified by the Centers for Medicare & Medicaid Services authority — CMS Certification Number: 245548

Show certification details

Who this home usually serves

TYPE OF STAY

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.

New residents most often arrive under private pay (36% of admissions), and a typical private pay stay runs around 7 - 8 months.

Admissions
81 total

Coverage residents most often arrive under.

Medicare 31%
Private pay 36%
Medicaid 33%
Discharges
48 total

Coverage residents most often leave under.

Medicare 10%
Private pay 42%
Medicaid 48%

Admissions and discharges reflect care patterns over time — they are not used to rate this facility.

How we assess these insights

Places of interest near Tuff Memorial Home

Address 0.7 miles from city center Info Estimated distance in miles from Hills's city center to Tuff Memorial Home's address, calculated via Google Maps.

Calculate Travel Distance to Tuff Memorial Home

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Compare Nursing Homes around Sioux Falls

Info below is compiled from CMS reports & the SD Dept. of Health (DOH), senior community websites & trusted data sources such as Walk Score & BBB.

Communities are listed from highest-ranked to lowest-ranked based on our methodology.

The facility name. Click to view the full profile page on Assisted Living Magazine, including photos, services, and contact info.
CMS (Centers for Medicare & Medicaid Services, the federal agency that regulates nursing homes) Overall 5-star rating — a composite of Health Inspection, Staffing, and Quality Measures scores. 5 stars = top 10% nationally. 1 star = bottom 10%. The single most important number to start with when comparing facilities.
Care Types in This Table AL (Assisted Living): Housing with help for daily activities like bathing, dressing, and medication, without 24-hour skilled nursing. NH (Nursing Home): 24/7 skilled nursing care for residents with complex, ongoing medical needs. SNF (Skilled Nursing Facility): Round-the-clock nursing care, often for recovery after surgery, injury, or illness. MC (Memory Care): Secured, specialized care for people living with Alzheimer's or dementia. IL (Independent Living): Community living with dining, activities, and transportation for active seniors who need little personal care. HOS (Hospice Care): Comfort-focused care for those with a terminal illness, prioritizing quality of life over treatment.
Neighborhood or city area where the facility is located. Proximity to family, hospitals, and green space matters for both quality of life and ease of visitation. Consider drive time and transit access when evaluating location.
Licensed bed capacity. Larger facilities (300+ beds) often have more specialized programs but can feel institutional. Smaller homes (under 150 beds) tend to deliver more personalized care. Compare with Avg Res/Day to understand how full the facility typically runs.
Percentage of licensed beds filled on an average day. Color indicates financial health: green (90%+) = operationally strong, typically profitable. Amber (80–89%) = stable but leaving revenue on the table. Orange (70–79%) = financial strain likely, may struggle with fixed costs. Red (<70%) = significant distress, closure or ownership change risk increases sharply.
This facility's occupancy rate compared to the statewide average for similar facilities. A positive number means above-average demand. Facilities running 5%+ above the state average are typically the most sought-after in their market — a strong proxy for reputation.
CMS-adjusted total nurse hours per resident per day (RN + LPN + CNA combined). The national average is approximately 3.5 hrs. Higher is better — more direct care time per resident. Below 3.0 is a red flag. CMS weights RN hours more heavily because RNs handle complex clinical decisions that CNAs cannot.
CMS Health Inspection star rating (1–5 stars), based on the 3 most recent annual state surveys plus any complaint investigations. This is the hardest rating to manipulate — it reflects real surveyor findings on-site. 5 stars = fewest deficiencies found. 1 star = most. It carries the heaviest weight in the Overall CMS rating.
CMS Staffing star rating (1–5 stars), based on daily nurse staffing hours submitted to CMS via verified payroll data. Compares RN, LPN, and CNA coverage relative to resident acuity level. 5 stars = well above expected staffing. Weekend staffing is evaluated separately, as that's where many facilities quietly reduce coverage.
CMS Quality Measures star rating (1–5 stars), based on 15 clinical outcome metrics including fall rates, pressure ulcers, antipsychotic drug use, and hospital readmissions. Captures actual resident health outcomes, not just compliance. High QM combined with low Health Inspection scores can indicate a facility with strong care but weak documentation practices.
Registered Nurse hours per resident/day compared to the statewide average. RNs are the highest-skilled nursing staff — they assess residents, manage medications, and respond to emergencies. A value of +50% means RN coverage is 50% above the state norm. Negative values are a concern for residents with complex or acute medical needs.
Total nursing staff hours (RN + LPN + CNA combined) per resident/day vs. the statewide average. A broader measure than RN vs State — it captures the entire care team. A facility can have high total staffing but low RN hours, meaning more aides and fewer nurses. Read both columns together for the full picture.
Total dollar amount of federal monetary fines (civil money penalties) issued by CMS in the past 3 years. Fines are only levied for serious violations — typically actual harm to residents, repeated uncorrected deficiencies, or systemic non-compliance. Even a single fine is noteworthy. Multiple fines strongly suggest a pattern, not isolated incidents.
Total health deficiency citations from the most recent standard inspection cycle. Minor citations (scope A–C) are common and often administrative in nature. Higher counts aren't always disqualifying, but should be read alongside Severe Citations to understand actual harm levels. Under 10 is strong for a large facility; 30+ warrants a closer look.
Average deficiency citations per CMS inspection (survey) in the reporting window — total citations divided by the number of inspections. Lower is better; compare alongside total Citations and Severe Citations for context.
Citations at CMS scope/severity level G or higher — G–I means actual harm occurred; J–L means residents were placed in immediate jeopardy. (D–F is potential for harm only). Examples include unaddressed falls, medication errors causing injury, neglect, or abuse.
Average number of residents in the building on any given day, derived from annual census data. Reflects true operating scale — a 400-bed facility running 200 residents/day operates very differently from one at 390. Higher resident counts generally mean more funded staffing hours.
Better Business Bureau rating (A+ to F). Reflects complaint history, business transparency, and how family disputes were resolved. A+ means no significant unresolved complaints. A blank (—) means the facility isn't BBB-accredited, which is common for healthcare providers and not necessarily a negative signal.
Walk Score® (0–100). Measures walkability of the surrounding area. 90–100 = Walker's Paradise. 70–89 = Very Walkable. 50–69 = Somewhat Walkable. Below 50 = Car-Dependent. Higher scores benefit family visitors, resident outings, and staff commuting.
The licensed owner or operator of record filed with CMS — the individual or organization legally accountable for the facility. Searching the operator name across other facilities can reveal chain or multi-site ownership, which matters: chain-operated homes tend to have more variable quality outcomes than independently run facilities.
What the home actually collects for resident care, after contractual allowances, bad debt and discounts — not gross billings. Taken from the latest complete annual cost report, so it is comparable across homes reporting the same period. Revenue alone doesn't indicate care quality, but it funds staffing and capital reinvestment. Pair with Payroll %. Figures are from each facility's most recent complete fiscal year — hover a value for the exact year; a * marks homes that report an older period than most facilities.
Staff salaries plus wage-related benefits from the latest complete annual cost report. Contract and agency labour is counted separately, under other operating costs, so a home leaning on agency staff can show a low figure here. Payroll is the cost most directly tied to care quality — compare with Payroll % for full context. Figures are from each facility's most recent complete fiscal year — hover a value for the exact year; a * marks homes that report an older period than most facilities.
Payroll as a share of NET PATIENT REVENUE (not gross revenue). Both figures come from the same cost-report year. A higher figure means more of each revenue dollar goes to staff pay. Read with the Staffing star rating to judge whether spend translates into coverage — and note that homes whose patient revenue covers only part of their operation can read implausibly high. The Minnesota average is: 70.4% Figures are from each facility's most recent complete fiscal year — hover a value for the exact year; a * marks homes that report an older period than most facilities.
CMS Certification Number: the unique federal identifier for this skilled nursing provider.
Bethany Home Sioux Falls/Bethany Home-Brandon ★ ★ ★ ★ ★
NH
AL
IL
MC
SNF
Sioux Falls
112
Facility 112
SD AVG 71
Rank #5 / 70
--
5.61
Facility 5.61
SD AVG 4.34
Rank #4 / 65
 ★ ★ ★ ★ ☆ ★ ★ ★ ★ ★ ★ ★ ★ ☆ ☆ -15%+29%
$0
Facility $0
SD AVG $38.5k
Rank #1 / 67
12
Facility 12
SD AVG 14.8
Rank #27 / 65
3.0
Facility 3.0
SD AVG 3.3
Rank #35 / 65
-42-
65
Facility 65
SD AVG 43
Rank #14 / 73
Augustana Lutheran Church
$5.9MFiscal year ending 06/2024
Facility $5.9MFiscal year ending 06/2024
SD AVG $7.1M
Rank #30 / 58
$4.1MFiscal year ending 06/2024
Facility $4.1MFiscal year ending 06/2024
SD AVG $4.2M
Rank #21 / 58
68.6%Fiscal year ending 06/2024
Facility 68.6%Fiscal year ending 06/2024
SD AVG 58.6%
Rank #8 / 58
435096
Tuff Memorial Home ★ ★ ★ ★ ★
NH
SNF
Hills48 80.4% +3%4.92 ★ ★ ★ ★ ★ ★ ★ ★ ★ ★ ★ ★ ★ ★ ☆ -24%+3%$44.4k62.0-39- 8 Alex Dysthe$4.0MFiscal year ending 09/2023$2.7MFiscal year ending 09/202367.9%Fiscal year ending 09/2023245548
Good Samaritan Society Sioux Falls Center ★ ★ ☆ ☆ ☆
NH
SNF
Sioux Falls
98
Facility 98
SD AVG 71
Rank #14 / 70
81.7%
Facility 81.7%
SD AVG 84%
Rank #26 / 33
-3%
4.09
Facility 4.09
SD AVG 4.34
Rank #23 / 65
 ★ ★ ☆ ☆ ☆ ★ ★ ★ ★ ☆ ★ ★ ☆ ☆ ☆ +21%-6%
$11.3k
Facility $11.3k
SD AVG $38.5k
Rank #26 / 67
18
Facility 18
SD AVG 14.8
Rank #29 / 65
3.6
Facility 3.6
SD AVG 3.3
Rank #52 / 65
380-
19
Facility 19
SD AVG 43
Rank #58 / 73
Luke Wanous
$8.1MFiscal year ending 09/2023
Facility $8.1MFiscal year ending 09/2023
SD AVG $7.1M
Rank #15 / 58
$4.5MFiscal year ending 09/2023
Facility $4.5MFiscal year ending 09/2023
SD AVG $4.2M
Rank #15 / 58
56%Fiscal year ending 09/2023
Facility 56%Fiscal year ending 09/2023
SD AVG 58.6%
Rank #27 / 58
435046
Good Samaritan Society Sioux Falls Village ★ ☆ ☆ ☆ ☆
NH
AL
IL
MC
Sioux Falls
177
Facility 177
SD AVG 71
Rank #2 / 70
91.0%
Facility 91.0%
SD AVG 84%
Rank #14 / 33
+8%
4.26
Facility 4.26
SD AVG 4.34
Rank #17 / 65
 ★ ☆ ☆ ☆ ☆ ★ ★ ★ ★ ☆ ★ ★ ★ ☆ ☆ +5%-2%
$72.8k
Facility $72.8k
SD AVG $38.5k
Rank #56 / 67
43
Facility 43
SD AVG 14.8
Rank #63 / 65
6.1
Facility 6.1
SD AVG 3.3
Rank #62 / 65
5161-
2
Facility 2
SD AVG 43
Rank #73 / 73
Dana Bachmeier
$19.5MFiscal year ending 09/2023
Facility $19.5MFiscal year ending 09/2023
SD AVG $7.1M
Rank #4 / 58
$10.5MFiscal year ending 09/2023
Facility $10.5MFiscal year ending 09/2023
SD AVG $4.2M
Rank #4 / 58
54.1%Fiscal year ending 09/2023
Facility 54.1%Fiscal year ending 09/2023
SD AVG 58.6%
Rank #39 / 58
435045
Avantara Norton -
NH
HOS
SNF
Sioux Falls
110
Facility 110
SD AVG 71
Rank #6 / 70
88.9%
Facility 88.9%
SD AVG 84%
Rank #18 / 33
+6%
3.53
Facility 3.53
SD AVG 4.34
Rank #41 / 65
---+53%-19%
$153.6k
Facility $153.6k
SD AVG $38.5k
Rank #63 / 67
75
Facility 75
SD AVG 14.8
Rank #64 / 65
4.0
Facility 4.0
SD AVG 3.3
Rank #47 / 65
1998-
61
Facility 61
SD AVG 43
Rank #19 / 73
Jeremy Klinkhammer
$10.3MFiscal year ending 12/2023
Facility $10.3MFiscal year ending 12/2023
SD AVG $7.1M
Rank #7 / 58
$4.4MFiscal year ending 12/2023
Facility $4.4MFiscal year ending 12/2023
SD AVG $4.2M
Rank #19 / 58
42.4%Fiscal year ending 12/2023
Facility 42.4%Fiscal year ending 12/2023
SD AVG 58.6%
Rank #57 / 58
435039

Rank badges are statewide: each nursing home is ranked against every SD nursing home we track that reports that metric, not just the 5 on this page. See how we rank facilities

Nursing Home Explorer

Financial Assistance for
Nursing Home in South Dakota

Tuff Memorial Home is located in Hills, South Dakota.
Here are the financial assistance programs available to residents in South Dakota.

Get Financial aid guidance

Home and Community Based Services Waiver

SD Medicaid HCBS Waiver

Age 65+ or disabled
General South Dakota resident, Medicaid-eligible, nursing home-level care need.
Income Limits (2025) ~$2,829/month 300% FBR, individual
Asset Limits $2,000 (individual), $3,000 (couple).
SD

Sparse population aids rural access; limited providers.

Benefits
Personal care (5-7 hours/day) Respite (240 hours/year) Adult day care (~$60/day) Home aides

South Dakota Elderly Services Program

SD ESP

Age 60+
General South Dakota resident, at risk of decline.
Income Limits ~$1,732/month individual, varies
Asset Limits $5,000 individual
SD

Limited funding; rural focus.

Benefits
In-home care (2-4 hours/week) Respite (up to 5 days/year) Transportation (~5 trips/month)

Medicare Savings Program (MSP)

South Dakota Medicare Savings Program

Age 65+ or disabled
General SD resident, Medicare Part A/B.
Income Limits (2025) ~$2,510/month (QMB), ~$3,380/month (SLMB), ~$3,598/month (QI)—individual.
Asset Limits $9,430 (individual), $14,130 (couple).
SD

Three tiers; includes Extra Help for Part D; no waitlist.

Benefits
Covers Part B premiums ($174.70/month) Deductibles ($240/year) Copays (~20%)

Low-Income Home Energy Assistance Program (LIEAP)

South Dakota LIEAP

Age 60+ prioritized
General SD resident, low-income household.
Income Limits (2025) ~$3,970/month individual, 185% FPL
Asset Limits Not assessed; income-focused.
SD

Covers gas, electric, propane; weatherization add-on available.

Benefits
Heating/cooling aid ($300-$1,000/season) Emergency aid ($500 max)

Family Caregiver Support Program (FCSP)

South Dakota Family Caregiver Support Program

Age —
General Caregivers of 60+ needing care or 55+ caregivers of others; SD resident; functional needs (2+ ADLs).
Income Limits (2025) No strict cap; prioritizes low-income ~$24,980/year
Asset Limits Not assessed; need-based.
SD

Rural emphasis; includes grandparent caregivers.

Benefits
Respite (4-6 hours/week or 5 days/year) Adult day care ($60/day) Training Supplies (~$500/year)

VA Aid and Attendance (A&A) and Housebound Benefits

South Dakota VA Aid and Attendance/Housebound

Age 65+ or disabled veteran/spouse
General SD resident, wartime service, need for ADL help (A&A) or homebound.
Income Limits (2025) Net income < ~$1,984/month (veteran with dependent, A&A); pension offsets income.
Asset Limits ~$155,356 net worth limit
SD

Supports rural veterans; high demand near Sioux Falls VA.

Benefits
Cash (~$1,433-$2,642/month veteran, ~$951-$1,318 spouse) for care costs (e.g., in-home, assisted living)

Property Tax Reduction Program

South Dakota Property Tax Reduction from Municipal Taxes

Age 65+ (or disabled) by Jan 1
General SD resident entire prior year, homeowner/renter.
Income Limits (2025) ~$20,192/year (single), ~$24,679/year (multiple-member household).
Asset Limits Not assessed; income-focused.
SD

Refunds up to $575; ~10,000 seniors benefit annually.

Benefits
Tax refund (~$250-$575/year based on income)

Senior Farmers’ Market Nutrition Program (SFMNP)

South Dakota SFMNP

Age 60+
General SD resident, low-income.
Income Limits (2025) ~$2,322/month individual, 185% FPL
Asset Limits Not assessed.
SD

Vouchers (~$50/season); serves ~5,000 annually via 6 AAAs.

Benefits
Vouchers (~$50/season) for fresh produce at approved markets

Freeze on Assessments for Dwellings of Disabled and Senior Citizens

South Dakota Property Tax Freeze

Age 65+ (or disabled)
General SD resident 200+ days prior year, homeowner.
Income Limits (2025) ~$35,000/year (single), ~$45,000/year (multiple-member household).
Asset Limits Property value < $250,000 (single), $300,000 (multiple).
SD

Saves ~$300-$600/year avg.; applies to primary residence.

Benefits
Assessment freeze (~$300-$600/year savings)

Older Americans Act (OAA) Services

South Dakota OAA Services

Age 60+
General SD resident (or spouse of any age); no income/asset limits.
Income Limits (2025) None; donations encouraged for some services.
Asset Limits Not assessed.
SD

6 AAAs; rural focus due to sparse population.

Benefits
Meals (home-delivered or congregate, ~$5-$7/meal value) Transportation Homemaker services (~4 hours/week) Respite (~5 days/year) Legal aid

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 80.4%.

Are pets allowed at Tuff Memorial Home?

No, Tuff Memorial Home has a no-pet policy.

Does Tuff Memorial Home operate as a for-profit or non-profit?

Tuff Memorial Home is registered as a non-profit.

What is the overall rating for Tuff Memorial Home?

Tuff Memorial Home received a 5-star overall rating from the CMS (Centers for Medicare and Medicaid Services). This score combines results from staffing levels, quality measures, and health inspections.

How many beds does Tuff Memorial Home have?

Tuff Memorial Home has 48 beds.

Are there photos of Tuff Memorial Home?

Yes — there are 23 photos of Tuff Memorial Home in the photo gallery on this page.

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