Relief Is Due for the Pharmacies That Kept Residents Alive When Senior Communities Bore the Brunt of COVID-19
By Alan Rosenbloom
You may not know long-term care pharmacies, but for the nearly 2 million Americans in nursing homes and senior living communities across the country, LTC pharmacies – and the nurses and consultant pharmacists they employ – can be the difference between life and death. Never has this been more apparent than during the past year, as the coronavirus swept through LTC communities like a tornado.
LTC pharmacies serve LTC facility residents who rely on about a dozen prescription drugs every day to manage multiple complex and chronic conditions. LTC pharmacies deliver these drugs daily and provide a variety of patient care services essential to resident health and quality of life. And now, vaccination against COVID-19 takes a prominent place among the essential clinical services these organizations provide.
Yet LTC pharmacies remain conspicuously absent from the list of providers who received assistance from the U.S. Department of Health and Human Services’ Provider Relief Fund. In the CARES Act, Congress took historic steps to offer much-needed financial relief to health care providers who have seen higher costs and lower revenues due to COVID-19. Shockingly, very few LTC pharmacies have received any assistance.
This must change, and quickly.
For more than a year, LTC pharmacies have provided uninterrupted care and access to prescription medications to people living in LTC facilities, among the most vulnerable Americans before the pandemic and ground zero for COIVD-19 infections and deaths. This has come at a significant cost, and LTC pharmacies now need a lifeboat to keep afloat, save their own employees and protect the health and wellbeing of the residents they serve.
Over the course of the past year, LTC pharmacies suffered significant revenue losses hovering at 11 percent nationally. And these essential service providers are still operating with costs 10 percent above pre-pandemic levels due to the need for personal protective equipment, social distancing requirements and compliance with new patient infection protocols.
As trusted providers for this patient population, LTC pharmacies are also administering COVID-19 vaccines. Member organizations of the Senior Care Pharmacy Coalition alone have provided hundreds of thousands of vaccines this year as part of the successful effort to protect people at highest risk of death. However, federal reimbursements do not account for the higher costs of vaccine administration in LTC settings, leaving 40 percent of the costs not covered – and forcing LTC pharmacies to absorb the burden of costs that worsen pandemic-related revenue declines.
The impact on LTC pharmacies mirrors the impact on nursing homes and assisted living facilities. In 2020, HHS allocated more than $12 billion in much-deserved assistance to these LTC facilities. By contrast, and despite substantial bipartisan support, HHS provided almost no relief to LTC pharmacies, with most applications for relief flatly denied. Secretary Becerra must prioritize LTC pharmacies in the next distribution from the Provider Relief Fund, particularly as many providers who received relief last year seek additional relief this year.
SCPC estimates that proportionate relief for LTC pharmacies would likely cost no more than $370 million. This would be money well-spent; LTC pharmacy services are the backbone of care for the most vulnerable members of society. If LTC facilities do not get medication management right for their residents, the results can be dire – unnecessary trips to the hospital, deteriorating health and even death. For anyone who has ever watched an aging relative struggle to manage dozens of pill bottles as health deteriorates and cognitive impairment advances, the value of LTC pharmacy patient care and services becomes obvious. “Care” must be exactly that – tending to vulnerable citizens’ health needs with attention, commitment and empathy.
We cannot wait any longer. LTC pharmacies need assistance from the Provider Relief Fund right now to continue meeting the unprecedented and ongoing impact of the pandemic and to ensure that LTC facility residents receive the best care available. HHS must ensure LTC pharmacies, and the residents they serve, get the help they desperately need and deserve. While many worthy providers received much needed funding last year and deserve the additional relief they seek, we cannot ignore the LTC pharmacies that remain on the front lines.
You can view the original on Morning Consult here.
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