New Survey Reveals Imminent Long-Term Care Crisis: 80% of America’s Nursing Home Residents Face Loss of Access to Essential Prescription Drugs Pharmacy Services in 2026

DATE: December 30, 2025

Without an immediate long-term care pharmacy fix, more than 1.6 million vulnerable seniors risk losing access to critical medication management

Washington, D.C. (December 30, 2025) — A devastating long-term care crisis is unfolding in America’s nursing homes. New survey data released today by the American Society of Consultant Pharmacists (ASCP) and the Senior Care Pharmacy Coalition (SCPC) reveals that Medicare Part D drug pricing policies in the Inflation Reduction Act may force LTC pharmacy closures and widespread service cuts that could directly impact more than 80% of vulnerable long-term care residents nationwide.

The numbers are stark:

84% of respondents will reduce services or stop serving facilities or regions entirely. This will disproportionately impact seniors and older adults in rural areas. In some cases, lack of access to LTC pharmacy services could lead to closure of care facilities.

The survey respondents represent almost 20% of the estimated 1,400 closed-door LTC pharmacies serving patients in LTC facilities. They serve more than 800,000 patients or about 40% of all the patients in LTC facilities across the country. Nearly 300,000 live in rural communities. 

78% of respondents will lay off essential LTC pharmacy staff. These layoffs have already started.

“We are witnessing the collapse of America’s long-term care pharmacy infrastructure in real time, led by small, independent LTC pharmacies throughout the country,” said Alan Rosenbloom, President/CEO of SCPC. “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.”

The immediate threat is clear: Historically, Medicare Part D Plans (Plans) have reimbursed LTC pharmacies more for brand name drugs to offset inadequate reimbursement for generic drugs and significant under payment for legally required LTC pharmacy services. Under the Part D pricing program that takes effect January 1, LTC pharmacies will receive much lower reimbursement for brand name drugs subject to negotiated prices. LTC pharmacies rely on Part D reimbursement for economic viability – 75% of LTC pharmacy revenues are from Part D – and drugs subject to negotiated prices in 2026 are heavily prescribed to LTC patients. 

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

The solution exists: The Preserving Patient Access to Long-Term Care Pharmacies Act (H.R. 5031 and S. 3159) would establish a temporary supply fee for medications subject to negotiated Medicare prices dispensed by LTC pharmacies. This targeted fix ensures LTC pharmacies continue providing the specialized services required by federal law that keep vulnerable seniors safe and out of the hospital.

Congress and the Trump administration must act immediately. Every day of inaction brings more pharmacy closures, more layoffs, and puts more seniors at risk. The question facing policymakers is simple: Will they allow a well-intentioned drug pricing program to inadvertently destroy the pharmacy infrastructure that serves two million of America’s most vulnerable older adults?

The time for warnings has passed. The crisis is here.

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About the Senior Care Pharmacy Coalition: The Senior Care Pharmacy Coalition (SCPC) is the only national organization exclusively representing the interests of LTC pharmacies. Its members serve one million patients in nursing homes, assisted living facilities, and other long-term care settings. Visit seniorcarepharmacies.org to learn more. 

About the American Society of Consultant Pharmacists: 

ASCP is the only international professional society devoted to optimal medication management and improved health outcomes for older adults. Our thousands of pharmacist members manage drug therapies and support the quality of life of geriatric patients and others living in a wide variety of care settings, including: sub-acute and long-term care facilities (LTCFs), skilled nursing facilities (SNFs), assisted living facilities, psychiatric hospitals, hospice programs, correctional facilities, and home and community-based care. Visit www.ascp.com to learn more.