For many senior living providers, relinquishing pharmacy services to a third party is one of the easier make-buy decisions they face. And it’s becoming a market differentiator among seniors looking for reliable, competent and service-minded companies to manage one of their most important medical issues.
Senior living communities choose to partner with a company to manage pharmacy services for many reasons. One is the growing problem of polypharmacy. Another is the increase in adverse medication events and the negative publicity it brings.
This is why medication management is a growing concern among families of community residents.
Jennifer Hardesty, Pharm.D., FASCP, chief clinical officer and corporate compliance officer for Remedi SeniorCare, says it’s a topic that arises during virtually every conversation between a community’s sales and marketing representative and the prospective resident. Of course, licensing and fee structure can determine what kinds of medication management a community can provide, she warns.
“Assistance with medication management and administration can be one of the top reasons prompting a move into a senior living community,” she says. “A senior or their family may no longer be able to self-manage their medication regimen. The stress of prescriber communication and delivery to worrying about the administering and monitoring of the medications can adversely impact the quality of family relationships.”
Few marketed services scream safety more than medication management. “Advertising smart medication management systems promotes the wellbeing of the residents and their families,” says Patricia Howell, RN BSN, WCC, CFCS, clinical support manager for McKesson Medical-Surgical Extended Care. “These systems take the burden off family members having to manage the medications.”
Consider just the task of getting a list of a resident’s meds. Having a responsive medication management provider offers a great deal of peace of mind in the event of an emergency or an upcoming physician office visit, says Trisha Cole, COO of Medtelligent.
Accuracy is another buzzword.
“Simply having medication management services is part of the table stakes,” says Andy Brigant, vice president of pharmacy sales for PointClickCare. “Facilities that do not have medication management capabilities may risk being viewed as unable to grow with residents as their care needs progress. With constantly evolving, strict regulations governing medication administration and pharmacy dispensing compliance, it’s vital that providers create and maintain accurate records.”
Joe Kramer, vice president of sales and marketing for Geri-Care Pharmaceuticals Corp., believes “the first and best option to market to prospective residents or their gatekeepers is your facility’s low Medication Error Score. Numbers don’t lie, and once they see how diligent your facility is in ensuring residents take the correct medication at the right time, you have already earned their trust.”
Speaking of trust, having a geriatric pharmacy specialist on staff who is available to answer clinical questions goes far in instilling confidence, says Sarah Barker, Pharm.D., general manager of Montgomery Pharmacy for Turenne PharMedCo.
“When a resident makes the challenging decision to move into a senior living community, they and their family should have assurance that they are turning over the management of medications to a trusted team,” says Courtney Oland, president of Guardian Pharmacy of Maine. “Savvy operators choose their pharmacy partners carefully to meet this need.”
The trust also extends to operators themselves, who must have confidence in the clinical expertise of their pharmacy partner. Although not required by law in many non-skilled senior living settings, clinical oversight by a skilled senior care pharmacist can make the difference in the quality of life of residents and in turn, increase satisfaction with the community, Oland adds.
Another big issue is the high cost of drugs.
“Moving into a senior living community often changes the landscape of finances for the resident — they may go from owning a home to paying a monthly rent. Changing pharmacy providers can bring on uncertainty about ongoing medication costs,” says Libby McDonald, RN, senior vice president, account services, for Remedi SeniorCare.
For those residents coming from a hospital stay or departing home for any other reason, continuity is a topic near and dear to many families. Few things would imbue ease of mind among family members more than having a trusted pharmacy services provider that handles these changes for a living.
“The family wants to know that it will be a smooth transition behind the scenes, but most importantly, that their loved one won’t be without their medications,” McDonald says.
Medication errors are among the biggest gaffes during transitions, and the leading cause of trips back to the hospital.
Continuity is a major focus in provider-pharmacy services relationships, according to Chad Worz, Pharm.D., BCGP, CEO of the American Society of Consultant Pharmacists. “Operators are realizing that the cost of unmanaged patients is high: lower census, held beds while the patient is in the hospital, higher staff requirements in care and the ability to differentiate service level versus competitors are factors that more than justify the addition of a senior care pharmacist and specialized pharmacy.”
THE HOT BUTTONS?
This is the age of 24-hour everything, and that could not be more common, yet essential, than in the pharmacy services and senior living worlds.
“Five years ago, as a general rule, assisted living communities preferred partnering with smaller, local long-term care pharmacies because the relationship was strong and the needs of the residents were less from a medication perspective,” Cole says. “Now communities are seeing higher-acuity residents and have the need for around-the-clock services to attract and retain residents, so even though they still seem to prefer the smaller, local pharmacies, those pharmacies have not transitioned to supporting that.”
Packaging and delivery are another must-have. The greater the options and flexibility, the better.
ADVICE FROM THE EXPERTS
Here are some quick insights for those senior living providers considering or knee-deep in arrangements with pharmacy services companies:
Be as broad as possible with service offerings. Senior living residents prefer it, experts say. High on the list are electronic records technology and innovative dispensing methods — two “wonderful tools that help people manage their medications,” Worz says. Yet, although they improve staff efficiency and save money, they are only tools. “Good pharmacy service and a good consultant pharmacist go hand in hand and ultimately are not very expensive. Shorting one side of the management system or the other opens the door to more risk and higher cost for both the operator and the patient. Good utilization of both services ensures a healthier and less costly patient population.” Never miss the opportunity to tell residents they always have a choice, however.
Don’t oversell or overpromise. “An organization’s advertising needs to be honest and transparent about what they can offer, as well as any challenges related to medication management that they’re currently addressing. Otherwise, they may face legal challenges,” Brigant says.
Cole agrees. “My advice to communities marketing these kinds of services would be to stick to the facts and not overpromise,” she says.
Don’t dilute the clinical image of the partnership. “Most providers are attempting to provide a more homelike and social model of care,” Howell says. “This model of care isn’t always realistic when there are people who require more help with their medical needs, such as medication administration.
Finally, ensure the partnership is a good fit. “In deciding what type of medication service you are going to promote, operators also should consider, first, who will be administering the medications; and second, how often those medications would potentially be changing,” Hardesty says. “Choosing a medication management system that fits your community well can make medication procurement and administration a safer, quicker, more effective process for staff and residents.”
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