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Nursing home operators Signature HealthCARE and Trilogy Health Services are expanding staff training and standardizing programs for wound care, infection prevention, behavioral health and other complex needs. Their approaches include certifications, weekly clinical reviews and dashboards, though the report does not provide comparative outcome data.
Signature HealthCARE and Trilogy Health Services are expanding staff training and tracking clinical care more systematically as nursing home residents present with greater acuity, multiple conditions and behavioral challenges, according to an October report by Skilled Nursing News. Their programs cover areas including wound care, infection prevention, medication use and behavioral health, with monitoring intended to identify problems and guide improvements.
Trilogy compiles weekly information on unplanned hospitalizations, antipsychotic use, infections, abnormal laboratory results and critical lab reports, said Rhonda Dempsey, the company’s senior vice president and chief nursing officer. Its medical director reviews the information, and recurring patterns are discussed at monthly Quality Assurance and Performance Improvement (QAPI) meetings, where teams may launch projects to investigate root causes.
For wound care, Trilogy has added a wound-care-certified nurse at every campus and uses a dashboard to monitor services across facilities. Dempsey also described a standardized wound-care formulary: an approved list of dressings and treatments intended to support consistent practice. She said consistency does not require using products from a single vendor.
Signature has sent two nurses from each facility through wound-care training, using $1 million in grant funding, according to chief nursing officer Barbara Revelette. She said the operator certified 150 nurses over the past two years and also works with a wound-care company on skin checks and data collection. For infection prevention, Signature uses onboarding instruction and observed “return demonstrations,” in which staff learn a task, demonstrate it and then perform it while a trainer watches. Trilogy tracks infection rates against company targets and investigates when a facility falls short.
Training Meets More Complex Care
The initiatives reflect a practical challenge for nursing homes: residents with more complex clinical needs may require additional staff time, specialized skills and closer monitoring. Revelette said Signature nurses are administering and monitoring more IV medications, which increases the nursing work involved. She also cautioned that higher payment rates for some services do not remove the associated costs, making staffing and care quality important considerations for operators.
Standardized procedures and regular reviews can give clinical leaders a way to spot variation between facilities and direct further investigation. The examples in the report show how operators are organizing that work, but they do not establish that any one training or monitoring approach has improved resident outcomes. The report provides no outcome comparison or measured effect for the initiatives described.
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How Operators Review Care
The operators’ approaches combine staff education with routine clinical oversight. At Trilogy, weekly information feeds into medical director review and monthly QAPI discussions. Those meetings can lead to focused projects; one cited example was a company commitment to pursue Joint Commission accreditation for its assisted living properties, a voluntary process that includes onsite surveys and interviews with staff and residents.
Dempsey said the accreditation work drew attention to psychotropic medication use in assisted living. Trilogy staff worked with pharmacy teams to review medications at admission, check diagnoses and educate clinicians involved in resident care, with the stated aim of reducing unnecessary antipsychotic use. Separately, Revelette said Signature provides behavioral-health and crisis-prevention training, much of it during onboarding, to help staff recognize when behaviors may affect day-to-day care. These are operator-reported practices, not findings from an independent evaluation.
“We set targets company wide, and then monitor what is happening.”
— Rhonda Dempsey, senior vice president and chief nursing officer at Trilogy Health Services
Outcomes and Costs Remain Unreported
The report does not provide data showing whether the programs have reduced infections, hospital transfers, wound complications or antipsychotic use, nor does it compare results across facilities. It also does not quantify the staffing costs, training expenses or financial returns tied to the programs. The number of Signature nurses certified is reported by the company, but the report does not give the total nursing workforce or the share of facilities and shifts covered by those certifications. The operators’ descriptions establish what they say they are doing, not whether the methods produce the same results across organizations.
Further Monitoring and QAPI Reviews
Based on the practices described, Trilogy’s weekly reviews and monthly QAPI meetings will continue to serve as points for identifying patterns and selecting areas for follow-up. Its infection monitoring can trigger a facility-level review when targets are missed. Signature’s training and wound-care data collection provide another mechanism for reviewing practice, according to Revelette.
The report does not give dates for upcoming evaluations or publish a new set of clinical results. Readers looking for evidence of impact will need subsequent reporting that includes outcome measures, time periods and comparison baselines, alongside information on how staffing and costs change as the programs expand.
Key Questions
What is the development described in the report?
Signature HealthCARE and Trilogy Health Services are using specialized training and monitoring programs to address more complex care needs in nursing homes, according to Skilled Nursing News.
Which areas of care do the programs cover?
The report describes work involving wound care, infection prevention, behavioral health, antipsychotic use and IV medications, among other clinical needs.
How does Trilogy review clinical issues?
Trilogy compiles weekly information on events including infections, unplanned hospitalizations and medication use for medical director review. Trends may be taken to monthly QAPI meetings for further investigation.
What results have the programs produced?
The report does not provide comparative outcome data or quantified changes in infections, hospital transfers, wound outcomes or antipsychotic use. The practices and training figures are reported by the operators.
Source: rss
