Long-Term Care Pharmacy Crisis Could Affect 80% of Nursing Home Residents

DATE: December 30, 2025

By Amy Stulick | Skilled Nursing News

An imminent long-term care pharmacy crisis could affect more than 80% of nursing home residents by 2026, with about 84% of pharmacies planning to reduce services or stop serving certain facilities or regions.

About 78% of long-term care pharmacies expect to lay off staff as well, with layoffs already underway, according to a survey conducted by the American Society of Consultant Pharmacists (ASCP) and Senior Care Pharmacy Coalition (SCPC).

The survey respondents represent nearly 20% of closed-door long-term care pharmacies nationwide, serving about 800,000 patients, 300,000 of whom are in rural areas, according to a release issued Tuesday by the ASCP and SCPC. The impact of pharmacy changes are expected to be most severe in rural areas.

Pharmacy companies have been forced to make such drastic moves as reimbursement for brand name drugs is expected to sharply decrease due to changes in Part D drug pricing under the Inflation Reduction Act.

The changes undermine the financial viability of long-term care pharmacies, which rely on Part D for 75% of their revenue, the associations stated.

“We are witnessing the collapse of America’s long-term care pharmacy infrastructure in real time, led by small, independent [long-term care] pharmacies throughout the country,” Alan Rosenbloom, president and CEO of SCPC, said in a statement.

The associations point to a legislative solution – the Preserving Patient Access to Long-Term Care Pharmacies Act – which would create a stopgap in the face of reimbursement decreases. A temporary supply fee would be charged to stabilize long-term pharmacy reimbursement, if those drugs are subject to negotiated Medicare prices.

The associations urged Congress and the Trump administration to act quickly, warning that a lack of intervention would leave millions of older adults without access to critical medications.

“Rural America will be hit hardest,” said Chad Worz, CEO of ASCP. “Nearly half of the [long-term care] pharmacies surveyed serve rural communities — areas already struggling with health care access. When these pharmacies reduce services or can no longer survive serving rural nursing homes, where will those homes and their patients turn?”

The association explained that long-term care pharmacies provide legally required, specialized medication management services that can’t be replaced by standard retail pharmacies. Closures of long-term care pharmacies could leave nursing homes without access to essential pharmacy services and in turn lead to nursing home closures and increased hospitalizations.

“These aren’t projections—these are decisions LTC pharmacies are making right now because small and mid-size LTC pharmacies cannot survive under the current reimbursement structure. When these pharmacies close, there is no one to replace them,” said Rosenbloom.

While Rosenbloom drew particular attention to the plight of small and mid-size pharmacies, an industry giant – Omnicare – is dealing with its own significant challenges.

Omnicare, a subsidiary of CVS Health (NYSE: CVS), entered into Chapter 11 bankruptcy proceedings in September 2025. The move was in part a response to a $135 million verdict against Omnicare in a False Claims Act case. Omnicare intends also to use the Chapter 11 process to “address other financial challenges facing the broader long-term care pharmacy industry,” and is considering options such as restructuring or a sale, the company’s bankruptcy press release stated.

Read the full article on Skilled Nursing News here