How can I convince my mom's nursing home to let us bring in her medications instead of going through their (much more costly) pharmacy?

It will be up to her doctor or those who have diagnosed her condition. My own brother entered with something saying he had miniscule cognitive changes and could leave on his own, take public transit, conduct business and etc. But the doctor automatically clicked the "needs help with meds" thing. Firstly he takes nothing but one ASA daily, and secondly is totally capable so we had to go to the admitting doctor to get that changed. It would otherwise have been another 400.00 a month whether one pill or a dozen. Speak with the doctor about level of dementia and about getting this changed and wishing you good luck.

At my mothers nursing home it was required that all prescription medication dispensed by their “Med Room” come to them in blister packs - each individual pill was in its own plastic bubble on a sheet of however many. They said it was to ensure the ethicacy(sp?)of the pills.

Most larger pharmacies will do that for patients in “institutional” settings but not for individual customers - regular folk.

My mothers suplimential insurance had a pharmacy branch that dealt exclusively with places like nursing homes and would fill the prescriptions into the approved blister packs when ordered by the Med Room. Because of this I was able to get around the homes requirement that their chosen pharmacy be used.

Still - all my mothers medication was required to be filled/refilled only by their staff. And - for this service we had to pay a monthly fee. It was cheaper than using their pharmacy so that what we did. I never touched or even saw the medications - they were delivered directly from the m pharmacy to the nursing homes Med Room.

One way or another, I figured the
nursing home was gonna get their profit from the pharmaceutical industry.

My dad is in AL - I get all his meds from the VA. No charge. The AL is fine with that - though it does require me to stay on top of supply - and to plan ahead.

Rules may be different in AL vs SNF.

The SNF I recently toured said most prescriptions are covered by their monthly fee - or by Medicaid.

This is NY.

You need to familiarize yourself with your State's Medicare, Tricare, and Medicaid regulations/guidelines and the nursing home's policy regarding “Medications Brought Into the Nursing Home” . 

http://file.cop.ufl.edu/ce/consultwb/2015Workbook/CHAPTER%2027.pdf
discusses Florida’s Law regarding “Medications Brought Into the Nursing Home”. You might want to review this document. I think that it can provide some suggestions as to how to “apply” for the “right” to bring medications into the nursing home from another pharmacy.

Good Luck.

If you look at the situation from the facilities viewpoint. They have many residents who need all sorts of different combinations of medications. It should be computerized. The doctor who visits residents prescribes as needed. That is then ordered to the pharmacy the facility uses. In many cases the resident is paying a co pay for these medications. Everything is in a chart and administered daily.

Now you come into the picture providing the medication you feel is right. Are you administering it at the times of day it is needed. What if you miss a day or a dose? How is the facility supposed to cope with any adverse effects if they do not know just what was administered?

In the 2nd AL facility my mother has been in I provide all her personal needs. I know I am saving alot from the previous AL facility which was charging regular drug store retail as opposed to me buying items at Target. I would not want the responsibility of having to deal with all her prescriptions as well as some over the counter products as needed.



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One of the reasons is because they need the medication in blister packs to make dosing and record keeping easier. So unless her online pharmacy will do that (most don’t) then they will use a preferred pharmacy. At my dad's NH there are two to choose from. I made that choice. You might ask if this is the reason and if so are there more than one to choose from

It’s a liability & management issue for NH skilled nursing facility.

On management, NH gets sealed individualized blister packs on most RXs in 90 day units designed to be stored in whatever medication management system this facility uses. Like stored in a larger glass front walk in closet which the med cart goes into or next to load up. The packs usually have an RFID sensor or old school barcode that get scanned & linked to their chart. The only RX outside this I ever saw was refrigerated drugs or specialty dermatology type of RX or a compounded RX or serious black box warning drugs - these came in smaller units & went into another secured entry box in the closet.

liability is about that with outside meds, they can’t verify that meds sent by mail or picked up at local pharmacy have not been tampered with and can go thru many hands till at the nurses station. At N
h my mom or mil were in, Family could not bring in vitamins or other otc - like Zyrtec - either.

if NH living is fairly new to you & your family, you may also find that at some point in time, all elders drugs and medical care will be completely under the direction of the MD who is the medical director of the NH with the DON ( director of nursing) as the day to day point person for decision making. So her old cardiologist or ophthalmologist RX or treatment plan or orders won’t necessarily be done till forever. Her care is now done by order from the NH MD or other NH staff. Her old docs can ask NH doc to put in an order or medication but it’s up to the NH physician to have it as a part of her care plan. Care plan meetings are held every 90 days, you should get a letter as to when it’s coming.

If this is a VA facility, the same thing happens & VA clinic & hospital systems should dovetail to her NH chart. VA ones seem to rotate the MD type medical directors or maybe have a PA acting as it.

Should your mom should go onto Medicaid to pay her room & board costs, (MediCARE does not pay R&B), there’s likely to be only 1 or 2 pharmacy groups that do all the Medicaid & Medicare scripts for your region. Ditto if the NH is part of a big chain, they are gonna have a preselected pharmacy for fulfillment. Rxs under contract & prices set & in a format that works for administration.

This may involve a liability issue in regard to the Nursing Home.

Under Federal Law a resident has a right to choose their own pharmacy and or doctor . The problem is that in order to exercise that right the family must follow the facilities rules for packaging the drugs. This usually requires that the drugs be unit dosed and that the pharmacy would agree to send medication ASAP in case of an emergency.

I would suggest you find out what the facilities packaging rules are then call around to local pharmacy to see who will do packaging to meet their guidelines. As I said most facilities require unit dosing, there are some private pharmacies who are willing to do this for families.

The other requirement I often see is that the pharmacy must ship the drugs directly to the facility. A family can not handle the medication it must come directly from the pharmacy.

We signed my mom up for a new Medicare Part D plan when she entered a nursing home, choosing a plan that covered medications from the nursing home's pharmacy. There is a special enrollment period allowing Medicare Part D subscribers to switch plans outside of the open enrollment period if they live in a nursing facility. It saved us a good deal of money and there was no need to lobby for providing her own medication. See https://www.medicare.gov/sign-up-change-plans/when-can-i-join-a-health-or-drug-plan/special-circumstances-special-enrollment-periods