For purposes of the following performance and service criteria, contracted Pharmacy Providers shall comply with the obligations thereunder.

1.             Comprehensive Inventory and Inventory Capacity – LTCPs must provide a comprehensive inventory of Plan formulary drugs commonly used in the long term care setting.  In addition, LTCPs must provide a secured area for physical storage of drugs, with necessary added security as required by federal and state law for controlled substances.  This is not to be interpreted that the pharmacy will have inventory or security measures outside of the normal business setting.

2.             Pharmacy Operations and Prescription Orders – LTCPs must provide services of a dispensing pharmacist to meet the requirements of pharmacy practice for dispensing prescription drugs to LTC residents, including but not limited to the performance of drug utilization review (DUR).  In addition, the LTCP pharmacist must conduct DUR to routinely screen for allergies and drug interactions, to identify potential adverse drug reactions, to identify inappropriate drug usage in the LTC population, and to promote cost effective therapy in the LTC setting.  The LTCP must also be equipped with pharmacy software and systems sufficient to meet the needs of prescription drug ordering and distribution to an LTC facility.  Further, the LTCP must provide written copies of LTCP’s pharmacy procedures manual and said manual must be available at each LTC facility nurses’ unit.  LTCPs are also required to provide ongoing in-service training to assure that LTC facility staff are proficient in the LTCP’s processes for ordering and receiving of medications.  LTCP must be responsible for return and/or disposal of unused medications following discontinuance, transfer, discharge, or death as permitted by State Boards of Pharmacy.  Controlled substances and out of date substances must be disposed of within State and Federal guidelines.

3.             Special Packaging – LTCPs must have the capacity to provide specific drugs in Unit of Use Packaging, Bingo Cards, Cassettes, Unit Dose or other special packaging commonly required by LTC facilities.  LTCPs must have access to, or arrangements with, a vendor to furnish supplies and equipment including but not limited to labels, auxiliary labels, and packing machines for furnishing drugs in such special packaging required by the LTC setting.

4.             IV Medications – LTCPs must have the capacity to provide IV medications to the LTC resident as ordered by a qualified medical professional.  LTCPs must have access to specialized facilities for the preparation of IV prescriptions (clean room).  Additionally, LTCPs must have access to or arrangements with a vendor to furnish special equipment and supplies as well as IV trained pharmacists and technicians as required to safely provide IV medications.

5.             Compounding/Alternative Forms of Drugs Composition – LTCPs must be capable of providing specialized drug delivery formulations as required for some LTC residents.  Specifically, residents unable to swallow or ingest medications through normal routes may require tablets split or crushed or provided in suspensions of gel forms, to facilitate effective drug delivery.

6.             Pharmacist On-call Service – LTCP must provide on-call, 24 hours a day, 7 days a week service with a qualified pharmacist available for handling calls after hours and to provide medication dispensing available for emergencies, holiday and after hours of normal operations.

7.             Delivery Service – LTCP must provide for delivery of medications to the LTC facility up to seven days each week (up to three times per day) and in-between regularly scheduled visits.  Emergency delivery service must be available 24 hours a day, 7 days a week.  Specific delivery arrangements will be determined through an agreement between the LTCP and the LTC facility.  LTCPs must provide safe and secure exchange systems for delivery of medication to the LTC facility.  In addition, LTCP must provide medication cassettes, or other standard delivery systems, that may be exchanged on a routine basis for automatic restocking. 

8.             Emergency Boxes – LTCPs must provide “emergency” supply of medications as required by the facility in compliance with State requirements.

9.             Emergency Log Books – LTCP must provide a system for logging and charging medication used from emergency/first dose stock.  Further, the pharmacy must maintain a comprehensive record of a resident’s medication order and drug administration.

10.           Miscellaneous Reports, Forms and Prescription Ordering Supplies – LTCP must provide reports, forms and prescription ordering supplies necessary for the delivery of quality pharmacy care in the LTC setting.  Such reports, forms and prescription ordering supplies may include, but not necessarily be limited to, provider order forms, monthly management reports to assist the LTC facility in managing orders, medication administration records, treatment administration records, interim order forms for new prescription orders, and boxes/folders for order storage and reconciliation in the facility.