This article is sponsored by PharMerica. The long-term care industry has witnessed unprecedented change in recent years, and the pace of new developments shows no signs of slowing down. Skilled Nursing News sat down with Jennifer Yowler, President of PharMerica, to discuss how the long-term care pharmacy provider is helping facilities survive and thrive in today’s environment.
Skilled Nursing News: What career experiences do you most draw from in your role today?
Jennifer Yowler: I have been in this industry for over 20 years and, despite that, there have been times in my career when I faced situations that I didn’t have immediate answers to. However, I discovered that these challenges were actually valuable growth opportunities because I had to delve deep into unfamiliar territory and find solutions to tasks that were new and, in some cases, even intimidating.
By teaching me to embrace change and push past my comfort zone, these experiences have been particularly important when I have been asked to take on a new role. Knowing that I have a track record of thriving in the face of uncertainty gives me the confidence to step up and that’s enabled me to further both my personal and professional growth. My role at PharMerica is a perfect example of that. While I was hired as the CFO, within three years, I became President, and I’m fortunate to be able to lead a company that not only serves millions of patients who are some of the most complex and high-need individuals in the country.
Skilled Nursing News: Inflation and rising operational costs are causing some facilities to shutter or close wings. How is PharMerica is helping clients to lower or contain pharmacy spend?
Cost containment is a vital aspect of ensuring a skilled nursing facility’s financial health and, consequently, the well-being of its patients. While many focus solely on reducing the initial medication costs and negotiating lower prices, our approach goes beyond contractual considerations. Our goal is to explore lower-cost alternatives that maintain equal efficacy, optimize medication usage in terms of dosage and duration, and design specific interventions based on our clients’ referral sources’ prescribing trends.
Dealing with medications involves numerous variables and choices, making a one-size-fits-all approach impractical. That’s why we take a personalized approach, collaborating closely with our clients to tailor cost-containment strategies that prioritize both quality and affordability. By analyzing their history and physicians’ prescribing patterns, we develop customized solutions based on their unique circumstances and other relevant factors. Additionally, PharMerica’s local teams work closely with skilled nursing facilities, providing valuable insights and support for their cost containment goals on the ground.
Our ultimate aim is to drive positive outcomes and empower facilities to succeed. By achieving these goals, we know we’ve fulfilled our mission.
Skilled Nursing News: As staffing challenges and turnover persist, how is PharMerica enhancing its support and improving efficiencies to free up teams and facility resources?
In the face of persistent staffing shortages, PharMerica’s consultant pharmacists step in to provide tailored clinical support for each facility. Our approach involves comprehending opportunities to streamline processes and alleviate the burden on nursing staff. A prime example of this is our focus on med pass efficiency. Our consultants take a holistic view and implement small yet impactful improvements. For instance, if nurses need to crush a pill, we explore the possibility of finding a liquid equivalent. Moreover, during monthly visits, we identify areas of polypharmacy and opportunities for deprescribing, which can reduce the pill burden during med pass.
Considering the challenges posed by high turnover rates in many facilities, we go beyond clinical support and extend training and education on pharmacy-related topics to enhance staff capabilities and efficiency right from the start. Our onboarding program for new employees expedites their familiarization with pharmacy processes, allowing them to save time on tasks like medication ordering and administration. Our consultant pharmacists work collaboratively with each facility to identify knowledge or skills gaps among new hires and offer comprehensive support, ranging from in-services to practical resources such as tip handouts and a library covering topics like PRN administration, time-sensitive medication administration, side effects, and error reporting.
With evolving surveyor focus, how do PharMerica’s local clinical consultants help ensure optimal care and compliance and minimize financial penalties?
Amidst ever-changing rules, requirements, and regulatory scrutiny, our consultant pharmacists continually seek ways to help facilities enhance health outcomes while avoiding fines. To strategically prepare for surveys, we provide oversight in pharmacy F755 through F760 regulatory requirements, offering compliance recommendations, survey preparation and support, and developing action plans.
Another proactive measure we take to prevent regulatory action is through our medication stewardship programs. We offer customizable stewardship programs for antibiotics, opioids, and psychotropics, employing a step-wise approach to ensure appropriate use of these high-impact drug classes, promoting resident mental, physical, and psychosocial well-being. Simultaneously, these programs enhance compliance with CMS regulations governing these drug classes, and notably, our antibiotic stewardship program empowers facilities to meet explicit CMS requirements. We are proud to share that 100% of facilities that implemented our antibiotic stewardship program have remained citation-free for F881.
PharMerica has grown significantly in the past few years, yet has doubled down on its local presence. How does this approach benefit clients?
In today’s long-term care pharmacy, we understand that filling orders is just the beginning. To effectively help facilities manage outcomes, spending, and risk, we’ve aligned our service and support to be hands-on. For each client, this means providing one-on-one implementation support, a dedicated Account Management team, and clinical consultants who conduct monthly medication reviews, QAPI sessions, training, and more.
Being physically closer to our clients allows our relationship to flourish. Our local presence enables our teams to easily visit facilities, becoming integrated into the community and culture. This closeness enhances our service, fostering a sense of ownership and a deeper understanding, allowing us to be true partners. We go beyond merely delivering medications; we engage with staff, meet with leadership, and assess processes. By leveraging our boots-on-the-ground approach, we gain a comprehensive view of the facility, enabling us to make recommendations that align with our shared commitment.
DONs and other nurse leaders are pulled in a million different directions, including taking shifts, and it’s leading to burnout. How can PharMerica ease the burden on these individuals, who are at the heart of the long-term care team?
Last year, PharMerica responded to the ongoing workforce challenges by introducing a nurse advancement program, dedicated to supporting DONs and other nurse leaders with the necessary resources and education. This program’s content is carefully crafted based on direct feedback from the field. We conduct regular surveys on our social platforms, perform market research, and gather insights from ongoing customer feedback surveys. Additionally, we seek real-time data and information from our partners’ members and boards of directors to understand their pain points, top challenges, and concerns.
With the invaluable information we collect, PharMerica’s team collaborates with partners to create easily accessible content, primarily housed on our website. This content includes webinars, documentation of best practices, handouts, and worksheets offering timely tips and solutions. We also feature video and podcast interviews with industry leaders who bring innovation to the field.
We recognize the importance of supporting nurses and nurse leaders in such a rapidly evolving sector. Through this program, we aim to let them know that they have a voice with us and that we are dedicated to supporting them every step of the way.
In a couple of words, finish this sentence: “In the skilled nursing industry, 2023 has been defined by…?”
Jennifer Yowler:
… unprecedented challenge and opportunity.
As in recent years, we’ve seen facilities continue to be challenged by hiring headaches, staffing shortages, and turnover, and these issues could become even more problematic if and when minimum staffing requirements are implemented. Changing payment structures are putting additional increased pressure on facilities amid profit margins that are still razor thin. And new competitors in the space threaten smaller operators and could cause facilities to shutter wings or close entirely if they can’t scale.
Yet despite these developments, 2023 has also been a time of great opportunity. We’ve seen our clients expand into new markets like SNF-at-home and grow their portfolios. Higher acuity means facilities must be more creative in terms of what they offer in order to take care of these more clinically complex individuals – and this can help them attract nursing staff that are looking for alternatives to hospital settings. And the explosion of our country’s senior population is driving demand for services that will outstrip supply; there is simply not going to be enough bed space for all those who will need it. This, too, will drive innovation in our sector and technology that can supplant the roles of today’s workforce.
Editor’s Note: This article has been edited for length and clarity.
PharMerica is a leading provider of institutional, community- and home-based pharmacy services. To learn more, visit www.pharmerica.com.
The Voices Series is a sponsored content program featuring leading executives discussing trends, topics and more shaping their industry in a question-and-answer format. For more information on Voices, please contact [email protected].