Trilogy Health Services Nursing Homes: Chain Profile, Ownership, and CMS Record

Who Is Trilogy Health Services?

Trilogy Health Services, LLC is a for-profit operator of skilled nursing and senior living facilities in the Midwest. By number of CMS-affiliated skilled nursing facilities, it is the sixth-largest nursing home chain in the United States.^[3]

The company was founded in 1997 by Randall Bufford and is headquartered in Louisville, Kentucky. Bufford moved to chairman in 2019, and Leigh Ann Barney became president and chief executive officer.^[5] Trilogy is known for a "campus" model that combines skilled nursing with assisted living and memory care on a single site.^[4]

What Kind of Chain Is Trilogy Health Services?

Trilogy operates skilled nursing facilities (SNFs) together with assisted living and memory care at many of its locations. Skilled nursing facilities care for patients who need 24-hour nursing care, often after a hospital stay, and are rated on the federal CMS five-star scale; assisted living and memory care are licensed at the state level and are not rated on that scale. As a result, the company's own count of total "communities" or "campuses" can differ from the number of CMS-certified nursing homes affiliated with the chain.^[4]

Who Owns Trilogy Health Services?

Trilogy operates as a for-profit company. Its affiliated real estate is held through Trilogy REIT Holdings, which American Healthcare REIT, Inc. (NYSE: AHR) — a publicly traded real estate investment trust — became the sole owner of in September 2024.^[6] Because federal ownership records are updated over time, some CMS records may still list prior investors in the chain.^[6] As with most large operators, the corporate, management, and real estate entities behind any individual facility are worth confirming when a resident is harmed.

How Big Is the Trilogy Health Services Nursing Home Chain?

Trilogy by the Numbers

Federal CMS data describes the following:

Facility, state, and bed counts are from the CMS Nursing Home Chain Performance Measures dataset (most recent 2026 release).^[3]

• The most recent federal CMS chain-level data affiliates 127 nursing homes across Indiana, Kentucky, Michigan, Ohio, and Wisconsin with the chain (CMS chain ID 524) — ranking it #6 of the 611 chains CMS tracks by number of facilities.^[3]
• The affiliated homes hold about 8,453 certified beds; the chain's facilities tend to be smaller on average than those of some other large operators.^[3]

Trilogy Health Services CMS Ratings and Staffing Data

The figures below are reported by CMS for the chain in the most recent CMS Nursing Home Chain Performance Measures release (127 facilities). CMS five-star ratings are relative, point-in-time measures calculated against other facilities nationally; they do not guarantee the quality of care any individual resident receives, and serious harm can occur at a facility regardless of its rating.

• The chain-average overall star rating was about 4.2 of 5 (the national chain average is 3.0). The chain-level component averages CMS publishes were 3.5 for health inspections, 3.3 for staffing, and 4.8 on the quality measure rating, which is largely self-reported.^[3]
• CMS data reports 2 of 127 facilities (1.6%) with a one-star ("much below average") overall rating (national rate 20.5%) and 0 facilities carrying a CMS abuse icon (national rate 9.7%).^[3]
• Average total nurse staffing was about 3.9 hours per resident per day (the same as the national average), and reported nursing-staff turnover was about 41.2% (national 45.8%).^[3]
• CMS records show 31 fines totaling about $517,692 and 2 Medicare payment denials across the chain in the most recent three-year window.^[3][2]

Trilogy Health Services Nursing Home Facilities

The table below is the complete roster of the Trilogy-affiliated nursing facilities (CMS chain ID 524) in the federal CMS Provider Information dataset (May 2026 release), which listed 124 facilities. It shows each facility's name, city and state, street address, and phone number, along with any current CMS quality flag. The chain-level totals cited above reflect the most recent CMS Nursing Home Chain Performance Measures release, which affiliates 127 facilities with the chain; this per-facility roster is the May 2026 provider-level snapshot and will be refreshed when CMS posts the corresponding provider-level file. The facility list changes as the company opens, acquires, and divests properties.^[1]

The "CMS Flag" column marks homes that CMS has identified as a Special Focus Facility, a Special Focus Facility Candidate, behind on inspections ("Delayed inspection"), or carrying an abuse icon.^[1]

Source: Centers for Medicare & Medicaid Services, Provider Data Catalog, Nursing Home "Provider Information" dataset (NH_ProviderInfo_May2026.csv), filtered to Trilogy Health Services, chain ID 524. Inclusion on this list reflects CMS chain-affiliation data and does not by itself indicate that any particular facility committed wrongdoing.^[1]

Special Focus Facilities and SFF Candidates in Trilogy Health Services

The Special Focus Facility (SFF) program is run by CMS to identify nursing homes with a history of serious quality problems; a "Special Focus Facility Candidate" is a home with a history of serious quality issues that has not yet been formally placed in the program.^[7]

According to the most recent CMS Nursing Home Chain Performance Measures release, the Trilogy chain had 0 Special Focus Facilities and 0 SFF candidates, and the CMS May 2026 provider-level data showed 0 facilities carrying an abuse icon.^[3][1] These designations are reassessed by CMS monthly and can change.

Trilogy Facilities With Delayed Inspections (May 2026)

The CMS May 2026 provider-level data flagged these Trilogy facilities as not having received a standard health inspection in more than two years:^[1]

• Village Green Rehabilitation and Healthcare Center — Greenville, OH
• Gateway Springs Health Campus — Hamilton, OH
• Liberty Station Health Campus — Liberty Twp, OH

Trilogy Health Services Fines, Lawsuits, and Regulatory Record

The items below are drawn from federal CMS enforcement data and the sources reviewed for this page.

Federal Civil Money Penalties and Payment Denials

CMS enforcement records show that, across the chain, CMS imposed 31 fines totaling about $517,692 and 2 Medicare payment denials in the most recent three-year window reflected in the data. These are regulatory penalties recorded by CMS and reflect the chain's inspection and compliance history.^[2][3]

Federal Fraud Settlements

The government records and reporting reviewed for this page do not reflect a major federal False Claims Act settlement against Trilogy Health Services. This statement is limited to the sources cited here and is not a representation that no litigation exists; court and agency records should be checked for current matters.^[2]

How Michael Hill Trial Law Investigates Claims Against Trilogy Health Services

Michael Hill Trial Law focuses exclusively on nursing home abuse and neglect. The firm has handled more than 1,000 cases against nursing home operators and has recovered hundreds of millions of dollars for clients, including a $26 million verdict in Ohio.^[8]

A facility's overall CMS rating reflects national comparisons and past inspections; it does not determine whether a particular resident was harmed. When we investigate a claim against a Trilogy facility, we compare the home's CMS staffing and inspection history against what happened to the resident, obtain the facility's care records and any available documentation, and work to identify which operating subsidiary, landlord, and management entity were responsible for the resident's care. The kinds of injuries and claims our firm investigates include:

• Bedsores and pressure injuries
• Falls and fractures
• Malnutrition and dehydration
• Infections and sepsis
• Medication errors
• Elopement (wandering away from a facility)
• Understaffing and neglect
• Physical or sexual assault
• Wrongful death

We are investigating claims against facilities operated by Trilogy Health Services. If your loved one was injured or died in a Trilogy nursing home, the public record on this page may be relevant to your situation. Our firm serves families nationwide.

Frequently Asked Questions About Trilogy Health Services

Who owns Trilogy Health Services?

Trilogy Health Services is a skilled nursing and senior living operator founded in 1997 by Randall Bufford and headquartered in Louisville, Kentucky; Leigh Ann Barney is its chief executive. Its real estate holding company, Trilogy REIT Holdings, became wholly owned by American Healthcare REIT, Inc. (NYSE: AHR) in September 2024; some CMS ownership records may still list prior investors.

How many nursing homes does Trilogy Health Services operate?

The most recent CMS chain-level data affiliates about 127 nursing homes with the chain across Indiana, Kentucky, Michigan, Ohio, and Wisconsin, ranking it the sixth-largest nursing home chain in the United States by number of facilities — #6 of the 611 chains CMS tracks. Trilogy operates a “campus” model that combines skilled nursing with assisted living and memory care on a single site.

Is Trilogy Health Services for-profit or nonprofit?

Trilogy Health Services operates as a for-profit company. Its affiliated real estate is owned by American Healthcare REIT, Inc., a publicly traded real estate investment trust.

How is Trilogy Health Services rated by Medicare?

According to the most recent CMS chain data, the chain's average overall star rating is about 4.2 of 5 (the national average is 3.0), with chain-average ratings of 3.5 for health inspections, 3.3 for staffing, and 4.8 on quality measures. CMS data reports 2 of 127 facilities (1.6%) with a one-star overall rating and 0 facilities carrying an abuse icon, with 0 Special Focus Facilities or candidates. CMS star ratings are relative, point-in-time measures and do not guarantee the care any individual resident receives.

Has Trilogy Health Services been fined or sanctioned?

CMS enforcement records show 31 federal fines totaling about $517,692 and 2 Medicare payment denials across the chain in the most recent three-year window. The sources reviewed for this page do not reflect a major federal False Claims Act settlement against Trilogy Health Services.

What should I do if a loved one was harmed at a Trilogy facility?

Michael Hill Trial Law investigates abuse and neglect claims against nursing home operators nationwide, including facilities affiliated with Trilogy Health Services. A facility's overall rating does not determine whether a particular resident was harmed. You can contact the firm for a confidential review of your situation.

Sources

1. Centers for Medicare & Medicaid Services, Provider Data Catalog, Nursing Home "Provider Information" dataset (NH_ProviderInfo_May2026.csv), filtered to Trilogy Health Services, chain ID 524 (facility counts, addresses, phone numbers, bed counts, ownership type, star ratings, abuse icons, Special Focus status, delayed inspections). https://data.cms.gov/provider-data/dataset/4pq5-n9py
2. Centers for Medicare & Medicaid Services, Provider Data Catalog, Nursing Home "Penalties" file (May 2026 release) (fine amounts and payment denials). https://data.cms.gov/provider-data/
3. Centers for Medicare & Medicaid Services, Provider Data Catalog / data.gov, "Nursing Home Chain Performance Measures" (Affiliated Entity Performance Measures) dataset, most recent 2026 release, filtered to Trilogy Health Services (CMS chain ID 524): affiliated-facility count, states, bed count, chain-average star ratings, one-star share, abuse-icon share, Special Focus Facilities and candidates, fines, payment denials, staffing hours, and turnover. https://data.cms.gov/provider-data/ ; dataset listing: https://catalog.data.gov/dataset/nursing-home-chain-performance-measures
4. Trilogy Health Services, corporate profile (campus model combining skilled nursing, assisted living, and memory care). https://www.trilogyhs.com/
5. Senior Housing News, "Bufford to Step Down as Trilogy CEO, Barney Tapped as Successor" (June 30, 2019) (founded 1997 by Randall Bufford; headquartered in Louisville, Kentucky; Leigh Ann Barney named president and CEO). https://seniorhousingnews.com/2019/06/30/bufford-to-step-down-as-trilogy-ceo-barney-tapped-as-successor/
6. American Healthcare REIT, Inc., "American Healthcare REIT Acquires Remaining Minority Membership Interest in Trilogy REIT Holdings; Becomes Sole Owner of Trilogy REIT Holdings" (September 2024). https://ir.americanhealthcarereit.com/news/news-details/2024/American-Healthcare-REIT-Acquires-Remaining-Minority-Membership-Interest-in-Trilogy-REIT-Holdings-Becomes-Sole-Owner-of-Trilogy-REIT-Holdings/default.aspx
7. Centers for Medicare & Medicaid Services, "Special Focus Facility (SFF) Program" overview and monthly candidate/participant lists. https://www.cms.gov/medicare/health-safety-standards/certification-compliance/special-focus-facility
8. Michael Hill Trial Law. https://protectseniors.com/

This page is for general informational purposes and is not legal advice. It is attorney advertising. Ratings, fines, and Special Focus data are from federal CMS records and reflect inspection findings and regulatory penalties, not court judgments; CMS star ratings are relative, point-in-time measures and do not guarantee the care any individual resident receives. Facility data and corporate ownership change over time; verify current details before relying on them. Last reviewed: October 26, 2026.