Key Takeaways
- Identify problems with the current pharmacy before comparing replacements.
- Evaluate delivery, after-hours support, eMAR integration, packaging, billing, and consultant pharmacist services.
- Consider the workload each provider creates for nursing and administrative staff, not just its quoted price.
- Require a transition plan covering resident data, active orders, insurance, technology, delivery schedules, and go-live support.
- LTCRFP recommends a structured RFP process so facilities can compare providers against consistent requirements.
Switching long-term care pharmacies involves more than comparing prices and service promises. Nursing homes and assisted living facilities need to identify what is not working with their current provider, determine what a replacement must improve, and make those expectations clear in the request for proposal (RFP).
Without a structured process, facilities may overlook problems that affect daily operations, including late deliveries, limited after-hours support, poor eMAR integration, billing issues, and time-consuming follow-up.
LTCRFP, which helps long-term care facilities manage pharmacy RFPs, recommends treating the process as an operational review before beginning the vendor search. This helps facilities compare providers on how well they address specific needs rather than relying on presentations or pricing alone.
Turn Current Problems Into RFP Requirements
Start by identifying the issues staff experience with the current pharmacy. If emergency medication access is unreliable, for example, ask providers about stat orders, after-hours delivery, backup medication availability, and escalation procedures.
Specific questions make proposals easier to compare than broad requests about customer service. Every pharmacy should explain how it would address the same operational concerns.
Evaluate Routine And Emergency Medication Delivery
Facilities should ask about standard delivery windows, order cut-off times, same-day and stat medications, weekend and holiday coverage, and what happens when a prescribed medication is unavailable.
They should also establish how staff can track delayed orders, who handles escalation, and what backup process supports urgent medication access.
A pharmacy that manages routine cycle fills well may still create problems if it struggles with emergency orders or late admissions.
Check After-Hours Pharmacist Support
Medication needs do not stop outside normal business hours. New prescriptions, hospital returns, and changing clinical needs can require assistance overnight or on weekends.
Before signing a contract, clarify:
- Is a pharmacist available after hours?
- Can urgent orders be processed overnight?
- Who answers medication questions?
- How are emergency deliveries arranged?
- What happens when the initial contact cannot resolve an issue?
Facilities need to understand exactly who is responsible when an urgent situation arises.
Confirm eMAR Integration
Poor integration with a facility’s electronic medication administration record (eMAR) can leave nurses re-entering orders, reconciling discrepancies, and calling the pharmacy to confirm changes.
Include the facility’s existing systems and integration requirements in the RFP. Ask whether the pharmacy can receive and transmit orders electronically, update medication profiles, support admissions and discharges, and communicate discontinued or modified orders promptly.
Also clarify who manages setup, how long implementation takes, what information moves between systems, and who troubleshoots problems after go-live. A provider’s ability to connect to an eMAR does not necessarily mean the integration will support the facility’s daily workflow.
Compare Packaging And Consultant Pharmacist Services
Medication packaging should fit the resident population and the facility’s medication administration routines. Compare options for unit-dose and multi-dose packaging, cycle fills, PRN medications, controlled substances, returns, and changes made during a cycle.
Consultant pharmacist support also deserves practical evaluation. Ask how often the pharmacist visits, how medication concerns are communicated, what reports are provided, and how recommendations are tracked. Facilities should also know who provides coverage when the regular consultant is unavailable.
Consider The Workload For Nursing And Administrative Staff
Pharmacy performance directly affects how much time staff spend following up on missing medications, checking order status, correcting profiles, resolving rejected claims, and manually entering information.
Ask each provider who handles prior authorizations, rejected claims, order clarifications, and unresolved delivery issues. Establish whether nurses can track orders and who takes responsibility for a problem until it is resolved.
A lower-priced proposal may not offer better value if the facility must absorb more administrative work to make the relationship function.
Billing should be assessed separately. Understand how the pharmacy handles insurance coordination, private-pay medications, rejected claims, prior authorizations, resident statements, facility charges, and billing disputes. Clear reports and accessible support can reduce confusion for staff, residents, and families.
Review Admissions And Hospital Returns
New admissions and hospital returns can put pharmacy operations under pressure, particularly when residents arrive with changed medication lists or incomplete insurance information.
Ask how providers receive new orders, perform medication reconciliation, supply first doses, and arrange urgent deliveries. These workflows help show whether a pharmacy can support the pace and changing needs of a senior living facility.
Require A Detailed Transition Plan
The pharmacy switch itself requires careful coordination. Resident profiles, active medication orders, insurance information, prescriber details, eMAR connections, packaging cycles, billing records, and delivery schedules may all need to be transferred or updated.
Before signing, ask the provider for a transition plan that identifies:
- Who is responsible for the switch on both sides
- What data and records need to move
- How resident profiles and active orders will be validated
- When eMAR testing and packaging setup will take place
- How emergency medications will be handled during the transition
- Who will be available on go-live day and during the first weeks
Facilities should also establish how missing medications, incorrect profiles, and technology issues will be resolved once the new pharmacy takes over.
Compare Total Cost, Not Just The Invoice
Pricing matters, but it should be considered alongside delivery reliability, after-hours support, technology, and the amount of work required from facility staff.
A lower quoted cost may be offset by extra nursing time spent resolving order problems or administrative hours devoted to billing and follow-up. A provider with a higher service cost may offer better overall value if it reduces that workload.
Facilities should evaluate the full operating relationship rather than making a decision based on the invoice alone.
Questions To Ask Before Selecting A Pharmacy
A structured RFP should ask every provider the same practical questions:
- What are your routine, same-day, and emergency delivery times?
- Is pharmacist support available after hours?
- How are stat medications handled?
- Which eMAR systems do you integrate with?
- How do you manage new admissions and hospital returns?
- What packaging and cycle-fill options do you offer?
- Who handles prior authorizations and rejected claims?
- What consultant pharmacist services are included?
- Who is the facility’s day-to-day contact?
- How are unresolved issues tracked?
- What billing support is available to residents and families?
- How will resident profiles and active orders be validated during the switch?
- What support is provided on go-live day and during the first 30 days?
Consistent questions allow facilities to compare proposals on equal terms and identify which provider best meets their requirements.
Make The Switch Solve The Problem
Changing long-term care pharmacy providers can improve service, but the new relationship should address the reasons the facility wanted to switch in the first place.
Start with the problems affecting nurses, administrators, residents, and families. Turn them into specific RFP requirements, compare providers against the same criteria, and give implementation planning and staff workload as much attention as pricing.
A successful transition should leave the facility with a pharmacy relationship that better supports daily operations and reduces medication-related workload.
LTCRFP
assist@ltcrfp.com
117 Rano Blvd
Suite 58
Vestal
NY
13850
United States
