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Nursing home operators Signature HealthCARE and Trilogy Health Services are expanding staff training and monitoring for residents with complex clinical and behavioral needs. Their reported approaches include certified wound-care nurses, infection tracking, medication reviews and regular analysis of clinical events; the report does not provide outcome data showing how effective the programs have been.
Nursing home operators Signature HealthCARE and Trilogy Health Services are expanding staff training and clinical monitoring to address residents’ more complex medical and behavioral needs, according to a report published by Skilled Nursing News. The approaches include wound-care certification, infection surveillance, medication reviews and dashboards that help clinical leaders examine trends across facilities.
At Trilogy, clinical leaders review weekly reports covering unplanned hospitalizations, antipsychotic use, infections, abnormal laboratory results and critical lab reports. The medical director reviews the information, and trends identified across the weekly summaries may be taken to monthly Quality Assurance and Performance Improvement, or QAPI, meetings for further analysis. The report says those discussions can lead to focused projects intended to identify root causes and improve practice.
Trilogy has also added a wound-care-certified nurse at each campus and uses a dashboard to track wound-care activity across its operations. Senior Vice President and Chief Nursing Officer Rhonda Dempsey said the company uses a wound-care formulary: an approved list of dressings and treatments intended to support consistent practice. The report does not say that every resident receives the same product or that the formulary relies on a single supplier.
Signature HealthCARE has funded wound-care certification for nurses and said it certified 150 nurses over the past two years. Chief Nursing Officer Barbara Revelette said the operator sends two nurses from each facility through training, supported by $1 million in grant funding. The company also works with a wound-care partner on skin checks and data collection for root-cause analysis, according to the report.
Both operators described infection-prevention training and monitoring. Signature uses enhanced onboarding and return demonstrations, in which staff learn a task, watch it demonstrated and then perform it under observation. Trilogy tracks infection rates against company targets and conducts a focused review when a facility falls short, Dempsey said. The report also describes behavioral-health training and medication reviews, as well as the growing nursing workload associated with administering and monitoring IV medications.
Training Meets More Complex Care
The programs reflect the operational demands of caring for residents who may have multiple conditions, higher acuity and behavioral challenges. Wound treatment, infection prevention and IV medication administration require staff with appropriate skills and consistent procedures. Operators told Skilled Nursing News that training and clinical review are ways to identify problems and support care across facilities.
These efforts also carry costs. Revelette said IV services can bring higher payment rates under the Patient-Driven Payment Model, but they also require more nursing time and staffing. Certification, data systems and monitoring add further demands. For residents and families, the practical concern is whether facilities can match staff capacity and expertise to the care residents need; the report describes operator practices but does not establish their effects on resident outcomes.
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How Operators Review Care
The report places these programs within Quality Assurance and Performance Improvement, a process nursing home staff use to review care and identify areas for improvement. Trilogy’s weekly clinical summaries feed into monthly QAPI discussions when leaders see a pattern. Its projects can include work beyond nursing homes: Dempsey said the company set a goal for its assisted-living properties to seek Joint Commission accreditation, a voluntary process that includes on-site surveys and interviews.
Medication use is another focus. Dempsey said Trilogy’s QAPI work includes coordinating with pharmacy staff to review medications at admission, check whether diagnoses support their use and educate clinicians involved in assisted-living residents’ care. The report links this work to efforts to reduce unnecessary antipsychotic use, but provides no measured reduction or comparison over time.
For infection prevention, Signature described standard procedures and training for infection preventionists, while Trilogy said it tracks facility performance against targets. Wound-care dashboards and standardized formularies are intended to make activity and practice more visible across campuses. These are operator descriptions reported by Skilled Nursing News, not an independent evaluation of program performance.
“I think it’s good that you have consistency on great products and consistency that is the same in each campus; that doesn’t mean that you’re using all one product from one vendor.”
— Rhonda Dempsey, senior vice president and chief nursing officer at Trilogy Health Services
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Outcomes and Costs Remain Unreported
The report does not provide comparative outcome data showing whether these programs have reduced infections, wounds, hospitalizations or inappropriate medication use. It also does not report the full costs of training and monitoring, how consistently each practice is applied at every facility, or how staffing levels compare with the growing clinical workload. Statements about program goals and practices come from the operators cited in the report; their impact on residents remains unquantified in the material provided.
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Monitoring Continues Across Facilities
The operators’ described next steps are ongoing reviews: Trilogy’s weekly clinical summaries and infection targets, monthly QAPI discussions when trends emerge, and Signature’s continued staff training and wound-care data collection. These processes are intended to identify issues and guide facility-level follow-up. The report does not announce a new deadline, external assessment of the programs or a forthcoming results release, so whether the operators will publish outcome measures is unclear.
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Key Questions
What are nursing homes changing?
Signature HealthCARE and Trilogy Health Services described expanded staff training and monitoring for wound care, infection prevention, medication use and complex clinical needs. Their approaches include certifications, dashboards, clinical reviews and standardized procedures.
How does Trilogy review clinical trends?
Trilogy compiles weekly information on events including hospitalizations, infections, medication use and laboratory results. Its medical director reviews the summaries, and trends may be discussed at monthly QAPI meetings.
How many nurses did Signature certify in wound care?
Signature HealthCARE’s chief nursing officer said the company certified 150 new nurses over two years and used $1 million in grant funding to support wound-care training.
Do the programs show improved resident outcomes?
The report describes operator practices but does not provide outcome data demonstrating whether the programs reduced infections, wounds, hospitalizations or unnecessary medication use.
Source: rss
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