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Financial woes force Tuff Village assisted living to close

Lead Summary
Lori Sorenson

The Tuff Memorial Home Board last week made the difficult decision to close the failing Tuff Village assisted living facility in Hills.
“We’ve tried everything,” said board chair Greg Spath. “People have asked what they can do, but it comes down to staffing.”
In order to formally close the facility, the Village administration has applied to the state, and the process could take several weeks.
How did we get to this point?
Meanwhile, the Tuff Home Board is assessing how it got to this point when just three years ago the 18 assisted living residential units had a waiting list of 40 people.
Today there are just nine occupied units — not enough to cover the salaries of skilled staff required for assisted living licensure.
With tighter budgets, it’s been harder to compete with rising wages, resulting in more resignations, resulting in even greater difficulty operating the facility.
Four months ago, one of two Village care providers left and a nurse announced an end-of-August departure.
After four months of advertising the first open position, there have been no qualified applicants for that position or two other full-time positions that are now open.
Tuff administrator Eli Ripley has himself been filling shifts where needed … until Aug. 19, which he recently announced would be his last day.
Ripley declined to comment for the story, deferring to the board.
“It’s difficult,” Spath said. “I’ve been in a lot of interesting discussions in the past few months, and the biggest thing we keep coming back to is, ‘How do we protect our staff and our residents?’”
Facility needs to close, but how?
The income and expense sheet suggests the Village should cease operating, but Spath said it’s not a matter of just closing the doors.
For example, there are tenants with current leases, and eight dedicated Tuff Village employees (full and part-time) relying on income.
“We want to make sure we take care of the staff and residents,” said Spath, who’s been on the Tuff Board for 11 years.
He resigned from the board earlier this summer but returned to his post three days later after Ripley announced his resignation.
“I’ve been an educator all my life,” said Spath, who was the high school principal in Hills from 1973 to 1993. “As an administrator I have some experience with hiring and interviewing.”
Also, he leads the Tuff Board from the heart — both of his parents, his mother-in-law and an aunt were Tuff Home residents, and his children and grandchildren have worked there.
But he admits the problems facing Tuff Home Board seem bigger than he and the board are qualified to handle.
“We’re just a bunch of John Q Publics,” Spath said.
“We keep talking about what we can do to keep the staff at the Village and keep the Village open.”
Quelling rumors
A special Tuff Board meeting on Aug. 15 gathered input from five Tuff Home department heads, who shared that the nursing home staff is helping to cover shifts at the Tuff Village, some of them working long stretches without days off to provide services.
The board also heard about rumors that all three Tuff entities were closing — the nursing home, the assisted living and the three-plex apartments.
That, at least, isn’t the case. Only the Village is affected.
The three-plexes (three, three-unit apartment buildings) are full and the Tuff Memorial Nursing Home is operating on track with 38 residents. (Capacity is 48, but it’s not staffed for that many.)
But the Village, operating at only half capacity, is the one in trouble.
To bring in revenue, five of the assisted living units were recently opened to the public (some of them wind farm construction workers) without the assisted living care options.
While this rental income helps, it doesn’t address the heart of the problem: The Tuff Village carries an Assisted Living Home Care Providers License, which requires registered nurse supervision, 24-hour supervision of residents, three meals a day plus snacks, socialization programs and transportation.
All of which require paid staff, which the Village can’t afford due to low occupancy and due to the tight labor market.
Statewide problem
The Tuff Village isn’t alone in its struggles.
Almost 20 percent of assisted living providers — roughly 400 statewide — report that they may be forced to close or sell facilities due to “dire financial conditions.”
That’s according to a survey in April by the Long-Term Care Imperative, working in collaboration with LeadingAge Minnesota and Care Providers of Minnesota.
Altogether, nearly 30 percent of assisted living respondents said they reduced capacity to maintain financial solvency, while increasing wages by 10 to 15 percent in the past two years despite a lack of permanent funding.
In many cases, reserves were used to cover those and other cost increases.
More than 23,000 positions in Minnesota long term care positions are unfilled, and almost a third of assisted living providers reported that they were limiting census due to limited staffing.
Senior organizations pressed for legislative support for providers, first by adjusting the state Medicaid rates to support competitive wages, and it appeared a bipartisan bill was on its way to address staffing issues.
However, the session ended with no action on the matter, and care options for seniors continue to dwindle.
“I’m not very happy with our legislator in the House,” Spath said about Rep. Joe Schomacker, R-Luverne.
“When he was campaigning, he promised he’d work for our seniors, and so far, he’s done nothing.”
When asked what Schomacker should do, Spath said, “Work across the aisle and figure out how to solve these problems.”
How did we get to this point?
The Tuff Village Assisted Living center was built in 2001 with help from local donations, and until three years ago, it operated at capacity with waiting lists.
The apartments first opened with eight one-bedroom units and four two-bedroom units. Later, in response to demand, seven more units opened in the lower level, bringing the total number of apartments to 19.
Since then, one unit was converted to a conference room, bringing the capacity to 18 units.
A Hills Crescent story about the Nov. 17, 2001, dedication read, “Besides beautiful surroundings, Tuff Village offers residents Bible study, crafts, puzzles, card games, musical programs and outings, usually to Luverne, once a week for shopping.”
The assisted living apartments were attractive for those who no longer wanted to or were able to maintain their own homes, those needing support services and those who wanted companionship and fellowship for meals and daily activities.
In recent years, however, as more home care options have become available, the demand for assisted senior housing has steadily declined.
“People are living longer and choosing to stay in their homes longer,” Spath said.
“The Tuff Village used to be the farm system for the Tuff Home; people would live in assisted living until they moved into the nursing home. Now, some of the residents moving into assisted living are hardly settled in before they need nursing home care.”
Then Covid 19 exacerbated the trend. “We lost 10 residents in one month,” Spath said. “Seven were due to Covid.”
The pandemic brought into sharp focus exactly what options existed for seniors to age in their homes. In addition to expanded home care services, families stepped up.
“Kids are getting more involved with their parents’ care,” Spath said. “There is a tremendous change in what’s happening in the care of our elderly. … People are building homes with extra rooms for their parents.”

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