Extreme weather, man-made threats and other emergencies can cause long term care facilities to lose power, shelter in place or even evacuate, posing potentially serious health consequences for the elderly and disabled. To minimize the impact of these crises on operations, the Centers for Medicare and Medicaid Services released a final rule, Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers, in 2016, with a compliance effective date of November 15, 2017. And some states impose additional requirements for facility emergency plans.
Under these directives, in order to ensure the health and safety of residents before, during and after a crisis, facilities must establish policies and procedures to address a range of issues enterprise-wide, including meeting the needs of those residents who require prescription medications. Since continuous availability of life-and-death medications starting immediately after and for days following an extended emergency is crucial to this vulnerable population, ensuring dependable prescription delivery services is critical to mitigate risk.
A facility’s robust emergency preparedness plan should include standard operating procedures for ensuring vital supplies of medication when a disaster strikes to mitigate risk. Central components of a center’s planning should include:
Many of these preparatory actions can be undertaken by center staff directly. However, depending on the nature of the emergency, a facility may be impacted for an extended period of time. In those instances, a center should work closely with its long term care pharmacy partner. These pharmacies should have their own preparedness plans for maintaining access throughout a disaster that include steps such as filling prescriptions in advance, modifying delivery schedules, and developing procedures for deliveries when an area’s infrastructure has been affected.
To help facilities prepare for disasters, PharMerica has protocols that outline the company’s actions when emergencies occur at the pharmacy or the long term care facility, including:
In addition, PharMerica also employs event-specific procedures for foreseeable events such as snowstorms, severe flooding, and hurricanes. For example, when a potential hurricane is predicted in a service area, PharMerica will undertake several actions, including:
PharMerica clients operate facilities all over the country and experience a range of events that can drastically impact their operations. PharMerica’s disaster protocols are designed to ensure resident access to medications at all times, and are routinely tested by crises, including two recent headline-making natural disaster events.
Hurricane Harvey: Three days before the category four hurricane swept through southeast Texas and southern Louisiana, forcing thousands of residents to be evacuated from nursing and assisted living communities in Texas, PharMerica initiated its disaster planning to ensure continuous medication availability to the 61 facilities it services in the greater Houston-Beaumont area. For the emergency, it:
Worked with facilities and third party payers to order seven days’ worth of medications ahead of time
Once the disaster struck and a state of emergency was declared, PharMerica took additional steps to ensure resident access to medications. Specifically:
California Mudslides: During the deadly mudslides impacting parts of California in early 2018, roads were blocked and impassable, and power lines were down. But to keep life-and-death medicines in the hands of residents who were cut off from PharMerica’s normal supply route, the company moved from highways to the water.
While the Pacific Coast Highway was closed, PharMerica utilized a daily ferry boat service to make its deliveries. One of the company’s technicians met the boat each day, then delivered the medications and supplies to nursing facilities in the area. On the weekends, PharMerica serviced its centers by Amtrak train.