Above average — CMS composite of the measures below.
The next survey window likely opens around April 2027
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Tuff Memorial Home during CMS and state inspections, most recent first.
The facility did not document measurable goals or action plans for its Restorative Program Performance Improvement Project (PIP). QAPI meeting minutes showed blank action plan tables and only included summaries of therapy days and non-participating residents, without any documented steps to address the issues. The administrator and SSD confirmed that no measurable goals or action plans were developed or recorded for the PIP.
The facility did not have consistent criteria for staff illness and return to work, allowed staff to assist multiple residents with meals without proper hand hygiene, and failed to ensure nebulizer equipment was cleaned according to manufacturer instructions. These deficiencies involved staff returning to work after illness without documented clearance, a nurse aide assisting several residents with the same gloves, and a resident's nebulizer equipment not being rinsed or air-dried after use.
Surveyors found a beauty salon ceiling vent with black, mold-like and rust substances, which had not been cleaned as scheduled. The maintenance director confirmed the vent was dirty and should have been addressed during routine checks, while a salon technician failed to report a resident's concern about the vent. Maintenance records for the required cleaning were missing.
A resident with a history of stroke and below-knee amputation was not accurately assessed in the MDS, as it failed to document the use of a left leg prosthetic. Despite the care plan addressing the need for prosthetic assistance, the MDS section GG did not reflect this, which was confirmed through observation and staff interviews. The oversight was acknowledged by a nurse and the DON, highlighting a lapse in the facility's assessment process.
A facility failed to implement an antibiotic stewardship program, resulting in a resident receiving long-term cephalexin without monitoring for effectiveness or appropriateness. The resident, diagnosed with chronic cystitis, had been on the antibiotic since admission, with no end date or specialist oversight documented. The facility's QAPI and infection reports did not track this use, and the infection preventionist did not follow up with the primary physician.
Lack of Measurable Goals and Action Plans for Restorative Program PIP
Penalty
Summary
The facility failed to provide evidence of measurable goals and documentation of analysis and evaluation of data for its Performance Improvement Projects (PIPs), specifically regarding the Restorative Program. Review of QAPI meeting minutes from multiple dates showed that while the Restorative Program was identified as a PIP, there were no measurable goals or action plans discussed or implemented. Meeting records included blank tables labeled for action plans, responsible persons, target dates, outcomes, and notes, but these sections remained unfilled. Summaries provided by the DON included only the number of days of Restorative therapy provided and lists of residents who did not attend therapy, without any documented action plan or measurable goals to address the identified issues. During an interview, the administrator and the social services designee acknowledged the lack of development and documentation of measurable goals and associated action plans for the Restorative Program PIP. The facility's own QAPI policy required quarterly meetings to evaluate and coordinate activities, including PIP projects, with actions to be monitored and documented. However, the documentation reviewed did not show that these requirements were met, and there was no evidence of oversight or a documented action plan for the identified PIP.
Failure to Implement Infection Control Practices for Staff Illness, Hand Hygiene, and Nebulizer Cleaning
Penalty
Summary
The facility failed to establish and implement clear criteria for employee illness and appropriate return to work, as evidenced by the review of illness forms and timecards for three sampled staff members. Employees returned to work following symptoms such as diarrhea, nausea, fever, and respiratory issues without documentation of symptom resolution or assessment of contagion risk. The infection preventionist and director of nursing both acknowledged the absence of a consistent process to determine when staff were safe to return, and logs lacked adequate surveillance and monitoring of employee illnesses. Staff did not perform appropriate hand hygiene while assisting residents with meals in the dining room. One nurse aide was observed assisting multiple residents with eating, using the same gloved hand without changing gloves or performing hand hygiene between residents or tasks. The aide also wiped a resident’s mouth with the resident’s clothing and continued to assist others without changing gloves. The infection preventionist confirmed that staff were expected to change gloves and use hand sanitizer between residents, but the last audit of dining room hand hygiene had been about a year prior. The facility also failed to follow manufacturer’s instructions for cleaning nebulizer administration sets. A resident receiving nebulized medications for COPD had equipment that was not rinsed or air-dried after each use, as required. Staff and the director of nursing were unaware of the need for cleaning after each use, and the facility’s policy did not include these instructions. The infection preventionist was aware of the correct procedure but was not monitoring compliance, and there was no evidence of staff training on this requirement.
Failure to Maintain Salon Vent in Sanitary Condition
Penalty
Summary
A deficiency was identified when surveyors observed one of thirteen ceiling vents, specifically in the facility's beauty salon, to have black spotted substances resembling mold and rust both inside and outside the vent. The maintenance director confirmed that the black substance was removable and attributed its buildup to the room's high humidity and heat during the summer. Despite a routine cleaning schedule of every two months for vents, the maintenance log showed the last cleaning was completed in early July, with no record for August. The maintenance director acknowledged that the vent should have been addressed during monthly checks and agreed it appeared dirty and unkempt. Further investigation revealed that the salon technician was made aware of the vent's condition by a resident, but did not report the concern to administration and was unaware of the vent's state prior to the resident's comment. Review of the facility's Preventative Maintenance Program policy indicated that the maintenance director was responsible for ensuring a safe, functional, and sanitary environment, including developing and maintaining a calendar for all maintenance tasks. However, the requested cleaning record for the salon fan for August was not provided during the survey period.
Inaccurate MDS Assessment for Resident with Prosthetic
Penalty
Summary
The facility failed to ensure that a resident's status was accurately identified in the Minimum Data Set (MDS) assessment. The resident, who had a history of a transient ischemic attack, below-knee amputation of the left leg, anxiety, and depression, was cognitively intact and required substantial assistance with activities of daily living, including mobility and transfers. However, the MDS assessment did not reflect the resident's use of a left leg prosthetic, which was a significant oversight given the resident's condition and care needs. The resident's care plan acknowledged a self-care performance deficit related to the left leg amputation and included interventions for staff to assist with the prosthetic. Despite this, the MDS section GG failed to document the prosthetic, which was confirmed through observation and interviews. The resident had a prosthetic and a stump shrinker sleeve, which were observed next to his recliner. A registered nurse admitted to not coding the prosthetic accurately on the MDS, and the director of nursing expected accurate coding, indicating a lapse in the facility's assessment process.
Failure to Monitor Long-term Antibiotic Use
Penalty
Summary
The facility failed to develop an antibiotic stewardship program that included protocols and a system to monitor antibiotic use, leading to inappropriate long-term antibiotic therapy for a resident. The resident, who had intact cognition and was independent in activities of daily living, was diagnosed with chronic cystitis without hematuria and had been taking cephalexin 250 mg daily since admission in January 2024. The care plan for the resident included monitoring for adverse reactions but did not address monitoring for effectiveness or the appropriateness of long-term antibiotic use. There was no documentation of alternative prevention methods or specialist oversight. The facility's Quality Assurance and Performance Improvement (QAPI) minutes and infection surveillance reports did not include the resident's chronic antibiotic use. The infection preventionist acknowledged the lack of an end date for the antibiotic order and the absence of monitoring for effectiveness or consultation with a physician or specialist. The facility's antibiotic stewardship policy required prescriptions to specify dose, duration, and indication, and for staff to monitor responses and consult with physicians, which was not followed in this case.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Hills
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Bethany Home - Brandon | 10.3 mi | ★★★★★ | 15 | 0 |
| Good Samaritan Society - Mary Jane Brown | 11 mi | ★★★★★ | 8 | 0 |
| Lyon Specialty Care | 11.4 mi | ★★★★★ | 3 | 0 |
| Mn Veterans Home - Luverne | 12.1 mi | ★★★★★ | 5 | 0 |
| Palisade Healthcare Center | 15 mi | ★★★★★ | 5 | 1 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.