Emergency Preparedness in Long Term Care Pharmacy

November 10, 2020

Steps to Preserving Medication Access

Extreme weather, man-made threats and other emergencies can cause long-term care facilities to lose power, shelter in place or even evacuate. In advance of Hurricane Florence, for instance, South Carolina Governor Henry McMaster called for a mandatory evacuation of nursing homes, a response likely the result of previous storms like Hurricane Irma that caused power outages resulting in the deaths of more than ten nursing home residents in Florida.

Federal Requirements

In 2017, there were 260 disasters that required American Red Cross intervention. From hurricanes and flooding to wildfires and tornadoes, unpredictable crises pose potentially serious health consequences for the elderly and disabled, who are often medically fragile. To minimize the impact of these disasters on operations and residents, 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. The rule requires facilities to develop a comprehensive program to meet the health, safety and security needs of staff and residents. And some states impose additional requirements for facility emergency plans.

Under these directives, in order to protect 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, a dependable prescription supply is critical.

Emergency Preparedness Plan Components

To prepare, 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, to be reviewed annually, should include:

  • Stock a 5 to 14-day supply of medications for all residents
  • Secure expanded or extra emergency drug kits and maintain them in strategic points throughout the facility, ensuring security safeguards for kits with controlled substances
  • Maintain a profile of each resident that includes the names of their medication(s), dosage, and frequency
  • Develop a process to collect and transport at least a three-day supply of medications in case of evacuation, with a plan to keep medications cool, if necessary
  • Design a plan for assembling medications for inclusion in a go pack or resident survival kit
  • Ensure maintenance of residents’ regular medication schedules with medication reminders

The Role of Pharmacy

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 or securing alternate transportation, and identifying back-up locations when an area’s infrastructure has been affected.

Interruptions to the normal supply of medications can result in adverse events, hospitalizations, or even resident death. To learn how best to address medication needs during a crisis, and how your long-term care pharmacy provider can help, contact PharMerica at [email protected] or 855-637-1755.