SCPC Calls for Expanded Provider Relief Following HHS Announcement

DATE: September 9, 2020

Private-Pay Assisted Living Facilities May Now Apply for CARES Funding, but Essential “Behind the Scenes” Long-Term Care Pharmacies Are Still Left in Limbo

Washington, DC –  The Senior Care Pharmacy Coalition (SCPC) is encouraged by the recent announcement from the U.S. Department of Health and Human Services (HHS) that private-pay-only assisted living facilities (ALFs) qualify for financial relief in response to the COVID-19 pandemic and that HHS will open a new application process beginning September 13. Despite this progress, LTC pharmacies have yet to receive the substantial relief necessary to care for LTC patients during COVID-19, an issue of particular concern as vaccines become available. The continuing confusion regarding LTC pharmacy eligibility for adequate relief risks leaving seniors behind at a time when both uninterrupted access to essential prescription drugs and related patient care services and safe and timely access to COVID-19 vaccines depend on a robust LTC pharmacy sector.

“While we are grateful for HHS’ continuing attention to possible relief, LTC pharmacies need more comprehensive relief – NOW.  Uninterrupted access to prescription drugs and related patient care services plus smooth distribution of COVID-19 vaccines to patients and staff in LTC facilities– demand no less,” said SCPC President and CEO Alan Rosenbloom.

Under the Coronavirus Aid, Relief, and Economic Security (CARES) Act, Congress appropriated $175 billion for the Public Health and Social Service Emergency Fund (the Provider Relief Fund). Private-pay-only ALFs now join many other providers, from hospitals to physicians to nursing homes, in qualifying for assistance equal to 2% of annual revenues. Thus far, relief distributed by this fund has included at least $7.9 billion in economic relief for nursing homes, an additional $5 billion to nursing homes specifically for COVID-19 testing and infection control,  $15 billion for Medicaid providers (a portion of which has gone to LTC facilities), and an unspecified amount for private-pay-only ALFs. By contrast, the LTC pharmacies indispensable to patient/resident quality of life, care, health and safety, remain in limbo with undue constraints that are driving relief well below the 2% of annual revenues goal that HHS has met for other providers.

“The limited assistance that LTC facilities have received to date is much needed and well deserved, but also starkly highlights one glaring oversight among providers eligible for relief: the LTC pharmacies that provide prescription drugs, patient care and other specialized services to these residents and patients, who average 12-13 prescription medications every day,” said Rosenbloom. “SCPC calls for immediate action to remedy this situation by assuring that the LTC pharmacies, crucial to the lives and health of patients and residents in all LTC facilities, receive fair and proportionate relief as well.”

The typical LTC pharmacy may dispense thousands of prescriptions every day, often throughout an entire state– all while providing crucial patient care services and other medication management and consulting services. Similar to LTC facilities, LTC pharmacies have been hit hard by the pandemic, with revenues for Medicare patients down more than 20% and 15-20% for long-term living patients/residents. Meanwhile, costs have increased 10% or more.

Nonetheless,  substantial confusion remains on eligibility relief for LTC pharmacies, with some LTC pharmacies receiving relief at 2% of revenues, some receiving far less, some asked to modify their applications and others with applications still under consideration. Last Thursday, HHS stated in updated FAQs that it “is still reviewing potential exceptions to the [prescription sales limitation] as related to providers who provide unreported health care services as a part of the furnishings of pharmaceuticals.” According to Rosenbloom, “this change reflects an understanding of the plight LTC pharmacies face; it is high time to translate understanding into action.”

It is especially noteworthy that Operation Warp Speed, the Administration’s initiative to get COVID-19 vaccines to Americans as quickly as possible, expects to rely on LTC pharmacies to shoulder the enormous task of ensuring patients, residents and staff in LTC facilities get COVID-19 vaccines as soon as they become available. 

“We cannot leave LTC pharmacies behind if we want to maintain the best possible care for our vulnerable seniors amidst this pandemic. The September 13 application deadline for LTC pharmacies is less than a week away.  With the scope of relief still unresolved after four months, immediate action is essential to avoid a dire outcome – – and to assure that LTC pharmacies have the resources they need to get COVID-19 vaccines to those who most need them,” Rosenbloom concluded.

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The Senior Care Pharmacy Coalition (SCPC) is the only national organization exclusively representing the interests of LTC pharmacies. Its members operate in all 50 states and serve 850,000 patients daily in skilled nursing and assisted living facilities across the country. Visit seniorcarepharmacies.org to learn more.