Senior Care Pharmacies
In skilled nursing centers, senior living residences, and other emerging non-institutional health settings across America, medically compromised seniors and patients facing rehabilitation and/or extended custodial care significantly benefit from the specialized services and clinical oversight only independent long-term care (LTC) pharmacies, and the consulting pharmacists they employ, can provide.
FIRST PHARMACIST REVIEW
After receiving a patient order from the care facility, patient data is entered for fulfillment and billing purposes, and necessary data is provided to the Pharmacy Benefit Manager (PBM)/Prescription Drug Plan (PDP) to determine reimbursement eligibility, and amount.
Prior to dispensing, the pharmacist specializing in geriatric care reviews the order, confirms the accuracy of prescription entry based on the doctor’s orders, critically assesses the possibility for interactions with other current drug orders, and evaluates the appropriateness of every specific medication given each patient’s overall health care needs and degree of impairment.
SECOND PHARMACIST REVIEW & DELIVERY
After dispensing in packaging designed to enhance compliance and ease administration for the nurse, the medication is rechecked by the pharmacist, who confirms the correct medication is dispensed to avoid errors.
The packaged medication is delivered to the facility promptly on a 24/7 basis, and controlled substances are tracked and managed as mandated by DEA regulations. Medication delivery is the third largest cost for independent LTC pharmacies, and is driven by the significant labor required to sort, pack, prepare and deliver the orders, insurance, vehicle and fuel needs.
CONSULTATIVE SERVICES, RECORDS MAINTENANCE & COLLECTIONS
LTC pharmacies review each patient’s medication regimen on a monthly and quarterly basis, and whenever there is a significant change in a patient’s condition — working jointly with patients, family members, doctors, and staff to optimize care, contain costs and minimize unnecessary or duplicative drug regimens.
On a monthly basis, the LTC pharmacy provides the facility a complete set of administration records used to properly document the medications and treatments provided to each patient. Appropriate payer sources are billed, funds are collected and tabulated, and patient billing issues are resolved. Multiple payers are involved, including state Medicaid, Medicare Part D and Medicare Part A. Private pay and co-pays are also billed and collected post consumption.
ONGOING TRAINING & EDUCATION
LTC pharmacies provide ongoing training to facility staff regarding antipsychotics, diabetes management, antibiotics, infusion therapy administration, narcotic documentation (and rules), Med Pass observations, psychotropic medications, blood-borne pathogens, depression, fall prevention and more.
The net result is fewer mistakes in medication administration, an increased level of caregiver knowledge and competency, and an overall improved standard of patient care.
Among the many duties performed by LTC pharmacies are:
- Comprehensive medication regimen review (MRR) which assures proper drug selection and decreased adverse drug events
- Present in-services to the facility staff on pharmacy related topics, and participate as a key part of each patient’s care management team
- Ongoing caregiver education to optimize on-site care
- Provide IV medications and infusion therapy services compliant with USP 797 requirements
- Maintain and sustain comprehensive inventory
- Manage patient reimbursement issues with Pharmacy Benefit Managers (PBMs), PDPs and other payers
- Provide facility with Medication Administration Records (MAR)
- Integrate with facility clinical software systems including e-MAR and e-prescribed programs to facilitate seamless information flow between healthcare providers
- Pharmacy operations and prescription order processing
- Compounding/Alternative forms of drug composition
- Special packaging to meet federal compliance standards, including Food and Drug Administration (FDA) requirements
- Pharmacist On-call service (24/7) and ability to deliver medications expeditiously upon receiving prescription order
- Delivery service (24/7)
- Emergency medications stored on-site at facility (24/7)
- Maintain reports, forms and prescription ordering tools