TL;DR
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Nursing home operators Signature HealthCARE and Trilogy Health Services are expanding staff training and monitoring for complex care, including wounds, infections, IV medications and behavioral health. Their approaches include certifications, standardized practices, dashboards and regular reviews, according to executives quoted by Skilled Nursing News.
Signature HealthCARE and Trilogy Health Services are increasing staff training and using standardized clinical reviews to manage more complex care in nursing homes, according to a Skilled Nursing News report. The approaches cover wound care, infection prevention, behavioral health, antipsychotic use and IV medications, as operators respond to residents with higher acuity and multiple conditions.
At Trilogy, leaders review a weekly summary of unplanned hospitalizations, antipsychotic use, infections and abnormal or critical laboratory results. Medical directors examine the information, and patterns can lead to initiatives discussed at monthly Quality Assurance and Performance Improvement, or QAPI, meetings. Trilogy’s senior vice president and chief nursing officer, Rhonda Dempsey, told Skilled Nursing News that those discussions help teams identify trends and investigate root causes.
Trilogy has added a wound-care-certified nurse at each campus and uses a dashboard to track wound-care activity. Dempsey also described a standardized wound-care formulary: an approved list of dressings and treatments intended to support consistency across facilities. Signature, meanwhile, has sent two nurses from each facility through wound-care certification training using grant funding. Chief nursing officer Barbara Revelette said Signature certified 150 nurses in wound care over the preceding two years.
For infection prevention, Signature uses enhanced onboarding and “return demonstrations”: an instructor teaches and demonstrates a task, then watches the learner perform it. Trilogy monitors infection rates against company targets and reviews facilities when results fall outside the target. Revelette also said Signature nurses are administering and monitoring more IV medications, which adds staff time and requires appropriate staffing for complex processes. Payment rates may rise for such services, she said, but costs also increase.
Training for More Complex Care
The programs described by the operators show how nursing homes are responding to residents who may need more intensive clinical support alongside care for behavioral challenges and multiple health conditions. Staff competency and consistent procedures can affect whether facilities recognize problems, deliver treatments as intended and escalate concerns in a timely way.
The work also has operational costs. Certification, staff time, clinical monitoring and review of medication use all require resources. Revelette told Skilled Nursing News that higher payment rates for IV services do not remove the added costs of providing them. For residents and families, the practical issue is whether a facility has the trained staff and monitoring processes needed for the care it accepts.
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How Operators Review Care
The report describes QAPI meetings as one route from routine monitoring to targeted improvement work. Trilogy aggregates clinical events weekly, has its medical director review them, and brings emerging patterns to monthly meetings. The stated purpose is to identify what may have gone wrong and examine contributing causes, rather than relying only on individual incident reports.
Trilogy is also pursuing Joint Commission accreditation for its assisted-living properties, Dempsey said. As part of medication review work, staff and pharmacy partners examine medications on admission, consider whether diagnoses support their use and educate clinicians involved in resident care. Dempsey said the effort drew attention to psychotropic medication use and the risk of unnecessary prescriptions. The report also notes that accreditation is voluntary and includes on-site surveys and interviews with staff and patients.
“If you’re acquiring and spreading internally, we do a drill down. We set targets company wide, and then monitor what is happening.”
— Rhonda Dempsey, senior vice president and chief nursing officer at Trilogy Health Services
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What the Report Does Not Establish
The report describes programs and figures supplied by executives at two operators; it does not provide independently verified results showing whether the initiatives reduced infections, wounds, hospitalizations or unnecessary medication use. It also does not compare outcomes across facilities or operators, or quantify the full cost of the programs.
Details such as the specific infection-rate targets, the dashboard measures, the number of staff trained in infection prevention and the effects of the training on resident outcomes were not provided. The account does not establish whether these approaches are representative of nursing homes nationally. Results may vary by facility, staffing and resident needs.
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Further Outcomes and Reviews
The operators’ described processes point to continued monitoring: Trilogy reviews clinical events weekly and discusses trends through monthly QAPI meetings, while its infection program triggers a closer review when a facility misses a target. Signature’s account emphasizes ongoing certification, onboarding and infection-prevention demonstrations. The report does not give dates for future milestones or announce a new program launch.
Further information would be needed to judge how these efforts affect care, including outcome data over time, staffing levels and program costs. For now, the confirmed development is that the two operators say they are investing in training and structured monitoring to address increasingly complex resident care.
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Key Questions
What are the nursing home operators changing?
Signature HealthCARE and Trilogy Health Services describe expanded staff training and more structured monitoring for wound care, infection prevention, behavioral health, medication use and other complex care needs.
How does Trilogy monitor clinical issues?
Trilogy reviews weekly information on events including infections, unplanned hospitalizations, antipsychotic use and abnormal lab results. Medical directors review the summaries, and trends may be discussed at monthly QAPI meetings.
What wound-care training did Signature report?
Signature said it used grant funding to send two nurses from each facility through wound-care certification training. Revelette said the operator certified 150 nurses over the previous two years.
Has the report shown that the programs improve resident outcomes?
No outcome comparison was provided. The report describes operator programs and executive accounts, but does not quantify whether they reduced infections, wounds, hospitalizations or medication use.
Source: rss
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