Several months ago I was informed by one of our local skilled nursing facilities that they would be seeking a new provider pharmacy for the residents who resided there. Our long-term-care (LTC) pharmacy, Wrightway LTC Pharmacy (division of Wagner Pharmacy Co.), already serves a modest share of residents within this facility, by patient choice, however, not by choice of the facility nor those beyond who control decisions made there. I felt this would be a great opportunity to serve them on a greater level, and made sure the “need to know” individuals there knew that my team and I were ready to meet any needs their residents may have, day or night.

Servicing skilled nursing facilities is not an easy thing, as evidenced by the number of retail pharmacies outnumbering those LTCs 7 to 1 in Clinton. Twenty-four hour service is a prerequisite, and your pharmacy must be able to supply medications in whatever packaging form the facility requires. Additionally, although this isn’t a requirement, you simply won’t be competitive unless you are able to provide intravenous infusion services for their most critical patients, in as little as an hour turnaround. Yes, Wagner Pharmacy Co. can do that. As a small organization, it’s notable that we’ve positioned ourselves to meet all of those needs and in a fair and economical manner to boot. After all, nursing facilities are really in the same boat as we are in pharmacy and other areas of health care — asked to do more with less and less on the table to fuel it.

Late last month, I was notified that this facility was “informed” that a big box LTC pharmacy, whose nearest location is a full three hours away from Clinton, would be their primary provider pharmacy. I’m far beyond shock when I hear of these things, however, this was the first time the irony of the phrase “access to care” clicked with me. What exactly is access to care? Health care executives and legislators threw this term around loosely as the Affordable Care Act took shape and gained steam. What does “access to care” even include? To aid my search, I did what any upstanding millennial would do, and I Googled it. I found the two most consistent definitions revolved around “availability of personnel and supplies” and “(the patient’s) ability to pay for services.” Much to my chagrin, there was no reference to the temporal needs of the patient or the facility; time was completely left out as a variable that mattered. Perhaps ailing patients and the nursing staffs who have had no choice but to wait, days at times, for supply of needed medications weren’t asked for their opinion as to whether time was a factor in access to care?

Needless to say, that left me deep in thought. I know what matters to our local residents, my pharmacist and pharmacy technician colleagues know the same, and beyond us the physicians, nurse practitioners, physician’s assistants and nurses know what matters as well. They need access to care, and given the patient base served by skilled nursing facilities, they need it as soon as possible in many cases. My colleagues and I have been paged out of bed multiple times nightly to meet the needs of our local seniors; we do so without expectation of anything other than loyalty in return. My couriers make multiple daily runs to these nursing facilities, in response to nursing prompts for ASAP service or just common sense immediacy based on medication proxy. I might mention that the back-up pharmacy for this big box LTC pharmacy is yet another big box retail pharmacy for which I have the utmost respect on a retail level, however I don’t mind saying that they have no business serving a resident of a skilled nursing facility. It’s simply not in their realm of expertise.

Those driving decisions for Clinton’s most at-risk patient populations have often never been to Clinton. They don’t know these patients nor do they know those caring for them. We often hear from local nursing staffs that they would do anything to have us be their provider pharmacy, presumably due to our agility, reliability, and hopefully because of our sense of loyalty to the community. We, too, would love this opportunity, but we’re not even invited to the table.

Perhaps I am old fashioned, but I believe those who make the decisions for our community’s most vulnerable populations should be our own health care professionals and executives, not some board from afar without any ties to the community. We at Wrightway LTC Pharmacy and Wagner Pharmacy Co. stand ready to serve these patients and everyone. We stand ready until we’re unable to stand anymore, and with each sweeping decision by our local nursing facilities to outsource to outside and remote providers, that day may come sooner rather than later. Will our local nursing facilities miss us when we’re gone?

Tim Wright, PharmD, BCACP

President and CEO,

Wagner Pharmacy Co.