NURSING HOMES AND PHARMACY – How it works
In British Columbia all nursing home facilities have one licensed pharmacy contracted to provide pharmacy services to their residents.
Kerrisdale Pharmacy is the licensed pharmacy for Blenheim Lodge providing pharmacy services which include:
PHARMACARE COVERAGE DETAILS
When a person takes residence in a long-term care facility, their Fair PharmaCare medication coverage is replaced with a different medication coverage called PharmaCare Plan B.
Plan B coverage applies to the same formulary of medications as were eligible under the Fair PharmaCare program. Unlike the Fair PharmaCare plan (which applied when living in the community), Plan B is not associated with a yearly deductible that resets annually.
Therefore, residents in long-term care facilities will receive immediate coverage for all medications that are PharmaCare benefits.
All medications dispensed fall into one of 3 categories:
NON-BENEFIT MEDICATIONS (not covered)
The following is a list of medication classes (with examples) that are not covered by PharmaCare (non-benefit medications) and are the financial responsibility of the resident:
(Please note that the above list represents the most commonly prescribed medications and is not a complete list).
All medications that have been reviewed by PharmaCare and determined to be non-benefit in status are not covered by PharmaCare and are the financial responsibility of the resident.
Newly released medications from drug manufacturers that have not yet been reviewed by PharmaCare are given non-benefit status and are not covered by PharmaCare and are the financial responsibility of the resident.
SPECIAL AUTHORITY COVERAGE
Some prescription medications that are normally classified as non-benefit drugs by PharmaCare may be eligible for Special Authority coverage.
The Special Authority coverage can only be applied for by the patient’s physician or specialist.
In order to be granted the Special Authority coverage, the patient must meet the criteria listed for each medication. If the resident does not meet the criteria indicated by PharmaCare, coverage will not be granted. For a complete list of coverage, please refer to the website: www.health.gov.bc.ca/pharmacare/sa/criteria/genericbrandtable.html
All medications sent by the pharmacy to the facility for the resident are initiated and authorized by the resident’s physician or specialist.
All re-ordering of liquid medications, topical medications, inhaled medications, and PRN medications is done by the nursing staff when supplies are low. The pharmacy will send the re-orders of these medications when the request from the nurse is received.
PAYMENT FOR NON-BENEFIT ITEMS (not covered by PharmaCare)
The pharmacy will charge the costs of all medications not covered or not fully covered by PharmaCare to the resident’s pharmacy charge account. Any front store or home health care product ordered and sent to the resident will also be charged to the resident’s pharmacy charge account.
A Statement of Account will be sent by the pharmacy to the facility or to the resident/person responsible for the financial affairs of the resident each month. Payment is to be made to the pharmacy each month.
It is the responsibility of the resident or person in charge of the financial affairs of the resident to pay the pharmacy charges each month.
If a resident’s pharmacy charge account falls greater than 60 days without payment, the pharmacy reserves the right, as supported by the B.C. College of Pharmacists, to withhold dispensing of non-benefit or partially covered medications until payment of the resident’s pharmacy charge account is cleared.