Trilogy Ceo Prioritizes ‘continuous Improvement,’ Staffing After Kingston Healthcare Deal

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Trilogy Health Services will focus on improving occupancy and tackling staffing challenges in 2026, while integrating recently acquired communities into its growing portfolio, according to CEO Leigh Ann Barney.

Following the acquisition of Kingston HealthCare’s 14 senior living properties in late 2025, Trilogy now boasts a portfolio of approximately 150 communities, with a focus on the full continuum of care and expertise in high-acuity clinical care.

“We’ve had a couple of really great years, so now it’s just about continuous improvement,” Barney told Senior Housing News.

In 2026, Trilogy will be “turning the dial up a little bit” on key metrics such as occupancy and margin, setting attainable expectations amid strong demand. Service standards and quality care remain the “bedrock” of what customers expect from Trilogy communities, Barney said.

But this year, Barney added that operators must be aware of how early Baby Boomer residents are shaping change, as the cohort is more tech-savvy and focused on wellness. Central to improving operating performance is reducing employee turnover and improving employee retention through workforce development, Barney said.

Trilogy’s development roots shine in tough conditions

Trilogy Health Services has a history of embarking on development projects, but due to ongoing tough conditions for new builds, the Louisville, Kentucky-based provider has focused on additions, such as independent living cottage units, on multiple campuses.

In 2024, Barney announced Trilogy’s plans to create “fourth generation” senior living communities designed around a “village concept” that clusters units around shared services and amenities to support aging in place. The model intentionally blends care levels across shared amenity spaces rather than segmenting areas of the continuum. Recent additions include cottage units and patio homes.

In the last two years, Trilogy Health Services has added approximately 30 patio homes to communities. Often, Trilogy acquires adjacent land near its communities to protect against unwanted development and to grow unimpeded. Demand for patio home projects remains elevated, Barney noted.

“This patio home product adds a new element for us that the consumer really likes. And I think what’s driving a lot of it is it’s an early entry point into a community,” Barney said.

This aligns well with more active, younger senior living residents considering a transition sooner rather than later. In some instances, these independent living settings are an ideal fit for couples who may need different levels of care, while still living on the same campus, Barney said.

Trilogy Health Services is also repositioning skilled nursing wings with more private settings to meet high-acuity demand, keeping “the asset relevant and marketable.” Bringing residents across the continuum together is more representative of life outside of a senior living community, and the fourth-generation model reflects that tenet, she said.

“This modern approach replaces rigid silos with an integrated setting where residents from all care levels—from independent living to skilled nursing—intertwine, dine, and socialize,” Barney added.

This new model is built on consumer input, with the company conducting focus groups and surveys to understand which design elements are most important, along with which amenities are most valuable to the next generation of senior living residents.

Kingston Healthcare integration continues

The acquisition of Kingston HealthCare helped expand Trilogy Health Services’ presence in the Midwest, including Fort Wayne, Indiana, a new market for the company. At the time, Barney said the acquisition was a cultural and operational fit, citing Kingston HealthCare’s experience in senior living and skilled nursing operations.

Fast-forward, Barney said the integration effort between the two companies has been “very positive,” noting that the acquisition helped Trilogy Health Services grow its market presence in the Midwest. Since the acquisition, leadership and frontline teams have focused on the employee experience.

Securing employee buy-in and support during the acquisition is vital, she noted, which in part led to the company’s slow approach to integration.

“We’re going slowly through system changes, and we wanted to spend at least a quarter talking to employees about our values and our background before embarking on any change that will be gradual and productive,” Barney said.

The future of senior living, solidifying staffing

Over the coming months, Barney estimated the integration effort could take approximately one year. In 2026, she sees Trilogy at a key “inflection point,” with new residents entering communities with new demands and expectations.

Alongside wellness offerings, new residents want access to educational programming, along with more information on brain and cardiac health. To improve occupancy, Barney sees a need for operators to focus on service standards and modernize operations to meet this incoming demand.

The biggest theme involving new residents is technology—and the adoption of technology by younger senior living residents. New residents demand a strong internet to support multiple devices, Barney said.

Rather than imposing a single monitoring platform, providers must develop versatile systems that can integrate with the various personal devices residents already use, such as smartwatches or rings. This flexible approach allows operators to honor individual preferences while capturing essential data needed to support resident wellness, Barney added.

“We can’t force them into one product,” Barney said. “While previous generations were generally willing to adapt to the existing offerings of a community, the incoming customer expects providers to cater specifically to their individual preferences.”

As residents’ acuity needs rise, the company’s track record in clinical care has become more important as residents seek to age in place in independent living settings as long as possible. For example, Trilogy will continue to monitor falls in assisted living and memory care. As demand for clinical care services increases, Barney sees a future where more operators embrace high-acuity services.

On staffing, Barney said the industry is rebounding, with new applicants again seeking senior living and health care roles after the exodus and burnout caused by the COVID-19 pandemic six years ago. Now, frontline caregiving roles are career-building jobs that won’t be easily replaced through technology or AI.

To improve the industry, Barney sees the need for providers to invest in career education, apprenticeships, wellness programs, and clear career paths.

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