TL;DR
A Skilled Nursing News report describes how Signature HealthCARE and Trilogy Health Services are expanding staff training and monitoring for nursing home residents with complex medical and behavioral needs. The operators cited wound-care certifications, infection tracking, medication reviews and regular quality meetings; the report does not provide comparative outcomes or independent evidence that these approaches have improved results.
Signature HealthCARE and Trilogy Health Services are using expanded staff training, clinical certifications and monitoring systems to manage nursing home residents with complex medical and behavioral needs, according to a Skilled Nursing News report published in October 2026. The approaches cover wound care, infection prevention, medication use and other clinical indicators, as operators seek to standardize care and identify problems for review.
Trilogy, based in Louisville, Kentucky, compiles weekly information on unplanned hospitalizations, antipsychotic use, infections and abnormal or critical laboratory results. Its medical director reviews the reports, and trends can be brought to monthly Quality Assurance and Performance Improvement (QAPI) meetings for further examination, Senior Vice President and Chief Nursing Officer Rhonda Dempsey told the publication. The company also uses dashboards to monitor wound-care activity across its facilities.
Trilogy has added a wound-care certified nurse at each campus and uses a standardized formulary of approved dressings and other treatments, Dempsey said. Signature sends two nurses from each facility for wound-care certification training. Chief Nursing Officer Barbara Revelette said the company certified 150 nurses over the prior two years and used $1 million in grant funding to support training. She also described a partnership with a wound-care company that helps conduct skin checks and enter information for root-cause analysis.
The operators described additional steps for preventing infections and addressing behavioral or medication concerns. Signature uses onboarding instruction and observed “return demonstrations” to teach infection-prevention tasks, Revelette said. Trilogy monitors infection rates against company targets and investigates when a facility is off target, Dempsey said. Its QAPI work has also included medication reviews in assisted living, including checking diagnoses and educating clinicians about antipsychotic prescribing, she said.
Training Responds to Higher Care Needs
The programs described in the report show how nursing home operators are organizing care as residents arrive with multiple health conditions, greater medical needs and behavioral challenges. More complex treatment, including IV medication administration, can require additional nursing time and staff expertise, Revelette said. She also noted that higher payment rates for some services do not remove the associated costs.
For residents and families, the practical stakes include whether facilities have staff trained for the care being delivered and whether clinical problems are recognized and reviewed. Standardized procedures and recurring reviews may help leaders spot patterns across facilities, but the report describes operators’ processes rather than establishing that the programs have produced better outcomes.
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How Operators Review Care Patterns
The report places these initiatives against a backdrop of rising resident acuity and multiple comorbidities, alongside behavioral needs that can complicate daily care. Revelette said some behavioral-health instruction takes place during onboarding, helping staff recognize when behavior may affect care. The report does not quantify how common these conditions are across nursing homes.
QAPI meetings provide Trilogy a forum to examine patterns found in weekly reviews and develop focused projects, Dempsey said. The report also describes a voluntary Joint Commission accreditation effort for Trilogy’s assisted-living properties, involving on-site surveys and interviews with staff and patients. That effort is distinct from federal nursing home ratings, which do not apply to assisted-living properties in the same way.
“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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Outcomes and Costs Remain Unreported
The report does not provide comparative outcome data showing whether the described programs reduced infections, hospitalizations, wounds or unnecessary medication use. It also does not state how the operators’ results compare with other providers or how consistently each program is applied at every facility.
The total costs of training, staffing and monitoring were not detailed. Revelette said IV medication services can bring higher payment rates as well as higher costs, but the report does not give figures. It also does not specify the duration, eligibility requirements or future availability of the grant funding used for Signature’s wound-care certification program.
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Facilities Continue Quality Reviews
According to the report, Trilogy will continue its weekly clinical reviews and monthly QAPI discussions, using identified trends to select areas for closer examination. Its infection-monitoring program calls for a focused review when a facility misses a company target. Signature’s described approach includes continued staff training, wound-care certification and review of information gathered through its wound-care partnership.
The next meaningful measure of these efforts would be data showing changes in clinical outcomes, staffing demands and costs over time. The report does not give a timeline for such results or identify a forthcoming evaluation.
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Key Questions
What did the report say nursing homes are doing?
It described staff training, clinical certifications, standardized procedures and dashboards used by Signature HealthCARE and Trilogy Health Services to monitor care needs and identify issues for review.
What does Trilogy review each week?
Trilogy compiles information on unplanned hospitalizations, antipsychotic use, infections and abnormal or critical lab results. Its medical director reviews the material, and trends can be discussed at monthly QAPI meetings.
How is wound-care training being supported?
Trilogy has added a certified wound-care nurse at each campus. Signature reported training two nurses from each facility and certifying 150 nurses over two years, with $1 million in grant funding supporting the effort.
Do the programs show improved resident outcomes?
The report describes the programs but does not provide comparative data or outcome measurements demonstrating that they improved resident health results.
What remains unknown about the programs?
The report does not detail total program costs, how consistently each practice is used across facilities, or how outcomes compare with those at other operators.
Source: rss
