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Nursing home leaders at Signature HealthCARE and Trilogy Health Services say they are expanding staff training and using standardized practices and monitoring tools to respond to residents’ more complex clinical and behavioral needs. Their approaches include wound care certifications, infection tracking and reviews of medication use and hospitalizations; the report does not provide comparative outcome data.
Nursing home operators Signature HealthCARE and Trilogy Health Services are expanding specialized staff training and monitoring programs as residents arrive with higher acuity, multiple conditions and behavioral challenges, according to a report by Skilled Nursing News. The measures include wound care certifications, infection monitoring and regular reviews of hospitalizations and medication use.
Trilogy reviews weekly data on unplanned hospitalizations, antipsychotic use, infections, abnormal lab results and critical lab reports, Senior Vice President and Chief Nursing Officer Rhonda Dempsey told Skilled Nursing News. Its medical director reviews the information, and trends can be raised at monthly Quality Assurance and Performance Improvement, or QAPI, meetings. Those meetings can lead to projects that investigate possible causes and changes in care.
For wound care, Trilogy has added a wound-care-certified nurse at each campus and uses a dashboard to monitor services across facilities. Dempsey said the company also has a wound care formulary: a standardized list of approved dressings, bandages and topical treatments. Signature, meanwhile, funds wound care certification training for two nurses at each facility through grant funding. Chief Nursing Officer Barbara Revelette said Signature certified 150 nurses over two years and works with a wound care company on skin checks and data used for root-cause analysis.
Both operators described standardized infection prevention as another focus. Signature uses enhanced onboarding and return demonstrations, in which staff learn a task, watch it demonstrated and then perform it while an instructor observes. Trilogy tracks infection rates against company targets and conducts a focused review when a facility misses its target, Dempsey said. Signature also reports that nurses are administering and monitoring more IV medications, which adds work and requires appropriate staffing for complex processes.
Training for More Complex Care
The initiatives reflect the operational demands of caring for residents with more medical complexity and behavioral needs. Staff must be prepared to carry out specialized procedures, recognize changes in residents’ conditions and follow consistent infection prevention practices. For residents and families, the quality of that work can affect day-to-day care and whether problems are identified and addressed.
Monitoring systems can help clinical leaders spot patterns across facilities and focus reviews on sites that are outside established targets. But the report describes operators’ processes, not a measured comparison of outcomes. It does not establish that the programs have reduced infections, hospitalizations or medication use. Revelette also said that IV care can bring higher reimbursement under the Patient-Driven Payment Model, while adding costs and nursing time, making staffing and the cost of care part of the operational challenge.
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How Operators Review Care
The report describes two related layers of oversight: training at the facility level and data review across an operator’s facilities. At Signature, some behavioral health training takes place during onboarding, Revelette said, to help staff recognize when behaviors may affect residents’ daily care. At Trilogy, weekly clinical information feeds into medical director reviews and, when patterns emerge, monthly QAPI discussions.
Trilogy’s QAPI work has also included examining antipsychotic prescribing in assisted living. Dempsey said staff worked with pharmacy teams to review medications at admission, check whether diagnoses supported their use and educate clinicians involved in resident care. She also described Joint Commission accreditation for the company’s assisted living properties as a voluntary effort involving site surveys and interviews with staff and patients. These examples are specific to the operators quoted in the report, not evidence that every nursing home uses the same methods.
“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 Still Unreported
The report does not give before-and-after outcome figures showing whether these programs changed infection rates, hospital transfers, wound outcomes or antipsychotic prescribing. It also does not compare the two operators with other providers or describe how widely the practices are used across the nursing home sector.
Details about program costs, staffing levels, grant availability and the resources needed to maintain certifications are limited. The operators’ accounts explain their approaches, but independent evaluation would be needed to establish their effects. It is also unclear whether any particular training or monitoring method is responsible for a change in resident outcomes.
Ongoing Reviews and Staff Training
Trilogy’s described process calls for continued weekly clinical reviews, monthly QAPI discussions when trends emerge and targeted checks when infection performance falls outside company goals. Signature’s account points to continued certification, onboarding and infection prevention training, alongside monitoring of wound care and IV medication needs.
The next useful evidence would include reported results over defined time periods, such as changes in infection rates, hospitalizations or medication use, alongside information about staffing and program costs. The source report does not identify a scheduled results release or a specific upcoming policy decision.
Key Questions
What specialized programs are the nursing homes using?
The operators described wound care training, infection prevention, behavioral health support and reviews of medication use and hospitalizations. Signature also reported increased nursing work involving IV medications.
How does Trilogy monitor clinical trends?
Trilogy reviews weekly information including unplanned hospitalizations, antipsychotic use, infections and lab results. Its medical director reviews the data, and patterns may be discussed at monthly QAPI meetings, according to Dempsey.
What wound care training did the operators report?
Trilogy said it has a wound-care-certified nurse at each campus. Signature said it funded training for nurses at its facilities and certified 150 new nurses over two years.
Are the programs proven to improve resident outcomes?
The report describes the operators’ training and monitoring practices but does not provide comparative outcome data showing whether they reduced infections, hospitalizations or other measures.
Source: rss
