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Nursing home operators Signature HealthCARE and Trilogy Health Services say they are expanding staff training and monitoring programs as residents’ care needs grow more complex. Their approaches include wound-care certifications, infection tracking and reviews of medication use, lab results and hospital transfers; the report does not provide comparative outcome data.
Signature HealthCARE and Trilogy Health Services are expanding clinical training and monitoring across their nursing home operations as staff face residents with more complex medical and behavioral needs, according to a Skilled Nursing News report. The operators described programs covering wound care, infection prevention, IV medications, behavioral health and medication use, with dashboards and recurring reviews used to identify issues.
Trilogy reviews a weekly summary of unplanned hospitalizations, antipsychotic use, infections, abnormal lab 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 trends may be discussed at monthly Quality Assurance and Performance Improvement (QAPI) meetings. The report says those meetings can lead to projects examining possible root causes.
For wound care, Trilogy has added a wound-care-certified nurse at each campus, provided broader staff training and uses a dashboard to monitor services. Dempsey also described a standardized wound-care formulary: an approved list of dressings and treatments intended to support consistency across facilities, without requiring every campus to use products from one vendor.
Signature has sent two nurses from each facility for wound-care certification, 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. Signature also works with a wound-care company on skin checks and data entry for root-cause analysis. For infection prevention, Revelette described standardized practices, onboarding instruction and “return demonstrations,” in which a staff member performs a task while a trainer observes.
Training for More Complex Care
The programs address a practical challenge for nursing homes: care involving multiple conditions, behavioral needs and higher-acuity treatments can require more staff time and specialized skills. Revelette said IV medication administration and monitoring have increased at Signature facilities. She also cautioned that higher reimbursement associated with some services does not remove the related costs or staffing demands.
Regular reviews may help operators detect patterns that a single incident would not show, while standardized training can set common expectations across facilities. These are the operators’ stated aims; the report does not establish that the programs have reduced infections, hospitalizations, medication use or costs. Readers should distinguish the reported processes from evidence of their results.
wound care dressings for nursing homes
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How Operators Review Clinical Trends
The report describes QAPI meetings as a point where clinical patterns identified in routine reviews can be examined and turned into focused improvement work. Trilogy’s weekly summaries feed into medical-director review, with recurring trends potentially brought to monthly meetings. The company has also pursued voluntary Joint Commission accreditation for its assisted-living properties, Dempsey said.
Medication review is another part of that work. Dempsey said Trilogy staff and pharmacy partners examine medications at admission, including whether diagnoses support their use, and educate medical directors and physicians involved in assisted-living care. The report links this effort to attention to psychotropic medication use, but does not provide prescribing data or a measured change in use.
Revelette said Signature’s staff training also addresses behavioral health and crisis prevention, much of it during onboarding. The goal, she said, is to help staff recognize when behaviors may affect day-to-day resident care. The operators’ accounts reflect their own programs and should not be read as a measure of practice across the entire nursing home sector.
“We have a wound care formulary.”
— Rhonda Dempsey, senior vice president and chief nursing officer at Trilogy Health Services
Outcomes Still Need Measurement
The report does not provide before-and-after outcome figures showing whether these programs changed infection rates, wound outcomes, unplanned hospitalizations, antipsychotic use or staffing costs. It also does not specify the operators’ numerical targets, how consistently each program is applied, or how results compare between facilities.
Details about training schedules, certification renewal and the amount of grant funding available beyond Signature’s reported investment are not included. The operators’ descriptions establish that the programs and monitoring methods are being used, but their effectiveness cannot be determined from the information reported.
Ongoing Reviews and Facility Targets
Trilogy’s described process calls for continued weekly clinical summaries, medical-director review and monthly QAPI discussion when patterns emerge. Its infection monitoring program sets companywide targets and calls for a focused review when a facility misses them, Dempsey said. Signature’s account points to continued certification, onboarding and observed demonstrations as parts of its training approach.
The next evidence readers would need is outcome reporting tied to clear time periods and comparison points, including changes in infection rates, wound-care results, medication use and hospital transfers. The report does not give a date for such data or announce a new evaluation milestone.
Key Questions
What development does the report describe?
It describes training and clinical monitoring programs at Signature HealthCARE and Trilogy Health Services for nursing home residents with complex medical and behavioral needs.
What types of care are covered?
The programs discussed include wound care, infection prevention, IV medications, behavioral health and medication review. Trilogy also tracks clinical indicators such as hospital transfers and abnormal lab reports.
How are clinical problems reviewed?
Trilogy reviews a weekly summary of selected events and lab results, with its medical director examining the information. Trends may be brought to monthly QAPI meetings for further review and possible improvement projects.
Does the report show that these programs improved outcomes?
No. It describes the operators’ practices but provides no comparative outcome data showing whether the programs reduced infections, hospitalizations, wounds or medication use.
How many nurses did Signature certify in wound care?
Revelette said Signature certified 150 nurses over the two years before the report and sent two nurses from each facility for training, supported by $1 million in grant funding.
Source: rss
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