Pharmacists are yearning to expand on their success helping skilled nursing facilities during the pandemic, a top executive said Monday. 

Pharmacists began vaccinating patients to lighten the load during the pandemic. Some 8,000,000 inoculations in SNFs later, the the medication handlers are touting their efficacy and raising the possibility of doing even more to help the sector struggling mightily with staffing shortages, said Chad Worz, PharmD, executive director and CEO of the American Society of Consultant Pharmacists. 

Chad Worz, PharmD

In order for pharmacists to take advantage of the trust they built, the vaccination flexibilities of the public health emergency have to become permanent, Worz told McKnight’s Long-Term Care News on Monday. The previous week, he made a similar case at his group’s annual meeting in San Antonio. 

“This allows the pharmacy to acquire, prepare, deliver and the pharmacist to assess, administer, monitor and report adult vaccines back to the state immunization information systems,” Worz explained. “This drives up the number vaccinated and improves our surveillance of infections and our preventative strategies.

“In addition, broader adoption of collaborative practice agreements allowing ‘incident to’ billing under general supervision for pharmacist’s assessment and management services (is needed), especially now with the need for better access to COVID therapeutics.”

Worz said Innovative pharmacists and nursing homes could expand those responsibilities further, particularly if supported by the Centers for Medicare & Medicaid Services in terms of reimbursement through Medicare Part B. Medication assessment and monitoring, particularly for psychoactive medications, could be a service that supports staff and improves quality, he added.

Pharmacists to the rescue

Pharmacist-led vaccinations in community settings have been happening for some time, Worz said, but COVID brought a dual challenge: vaccinating millions of people in a very short time frame, and at a time when staffing issues were at their worst. 

“Nursing homes needed someone to step in,” he recounted.  “Couple that with the relative apathy we have approached seasonal influenza within skilled nursing homes with pre-pandemic annual rates in the 50s and 60% range. There wasn’t an emphasis on vaccines, the reimbursement was complex, and oftentimes nursing homes provided them at a loss.”

Enter pharmacies and pharmacists who were authorized to be Medicare Part B mass vaccinators and quickly granted permission to create links to state immunization information systems. They also were empowered to cross state lines to vaccinate, Worz noted. Those systems provided the platform for the dramatic success that followed.

Pharmacists are involved with SNFs in more ways than vaccinations, Worz added. They perform new-admissions medication reviews, help manage psychoactive medications, ensure proper pharmacy procedures are maintained, evaluate medication pass process and work to ensure medication use is safe, effective and efficient for nursing homes. 

Many pharmacists also have taken steps to collaborate with physicians and nurse practitioners to provide advanced services, such as anticoagulation management, chronic disease management, and the ability to initiate countermeasures to infectious outbreaks like the flu and now COVID, he said. The rise of flu season and the changes in Advisory Committee on Immunization Practices recommendations for vaccines have kept the industry busy in SNFs, as well, Worz added.

“Pharmacy has again swiftly moved into action, and looking into the future, flu, likely COVID, pneumonia and RSV vaccines are going to be common, routine vaccines for older adults,” he observed.