Mom's new ALF wants to charge $400 a month to use a different pharmacy than theirs. How is this legal?

I'm confused about this:

'her current facility's pharmacy - a different one to the new facility "

Is she in the new facility now?

Wherever she is, you should check the admission papers to see if the facility has the right to choose the pharmacy, which I suspect it does. It may get some kind of discount, then kick up the price for direct pay by the patient's family.

If you or someone else has agreed to this authority under the admission papers, you could try to address the issue and concern with the admissions staff.

She will be going to the new facility at the end of this month. I have tried to negotiate with the new facility about this but they will not negotiate. Their "reason" is that their nurses will have to verify every bubble pack coming from the local pharmacy. I call bs money grab. Otherwise everything seems very good about the new facility and I realize there always seems to be something and I have to pick my battles. I have found that many facilities do this and it just seems so wrong to me. I was hoping I might either have some legal ground to decline the fee or could start something about it. I do plan on contacting AARP and legal aid.

The last person handling the meds is the one responsible for dispensing. I am positive this is a legal issue. Drop your pharmacy and go with their approved provider.

Here in NY, the state requires the facility to control ALL medications. For example, last flu season the residents were getting their own aspirin and cough syrup and the nurses were having an absolute nightmare with medication interactions. There are good and valid reasons why all medication, even aspirin, or vitamins, are kept controlled, must have an MD written order and are tracked. We had to constantly check mom's medicine cabinet and remove things she should not have.

I am sorry that your mom's insurance does not pay better on her meds which much be some very high powered stuff with no generics. Maybe she needs a better supplemental insurance to pay better for her meds or look into Medicare Part D which does have a do-nut hole in it which I don't know if that has been fixed.

I think the facility has a threefold reason for wanting to control the pharmacy procurements: (a) there probably is a sole source supplier contract with it (b) it wants to ensure that the meds are of the caliber it wants, i.e., hopefully not from an emerging market country with little if any quality control and (c) it may already have vetted this pharmacy and doesn't want to deal with another one.

I wouldn't waste too much time with AARP; I haven't found it to be very helpful in addressing issues. Legal aid can offer advice, but you might want to consider contacting the nursing home/care ombudsperson for your area. There are some legal firms that specialize in nursing home intervention, but you'll pay probably at least $250 to $300 an hour.

The only other leverage I can think of would be to find an alternative nursing home and advise that if you can't negotiate something on the med issue that you'll take your mother there (assuming they have openings). You know the old saying: Money talks. If they know they'll lose a client, they might be more flexible.

But frankly, the nurses or someone SHOULD BE verifying every bubble pack as to dosage and strength. I would think that goes without saying.

SMacArthur, imagine if every residents in a nursing home wanted to use their own pharmacy.... it would be nightmare.

The $14 a day sounds reasonable so that your Mom can use her own pharmacy. Pills are usually handed out twice a day.

As for it being illegal.... would you say the same about a hospital that uses it's own pharmacy for patient meds? One cannot bring in meds from the outside.

I wouldn't start off on the wrong foot with the new facility. Look at the fine print of the contract. I don't see it as a money grab since insurance will be paying for most of it anyhow. I think it mainly makes it easier for them to manage.

This might be a bit late but better late than never. I'm a pharmacy owner certified consultant / doctor of pharmacy in the state of Florida. Any patient in any assisted living can choose any pharmacy they would like. Also any independent pharmacy should be able to package these medications for the patient. Some of the pharmacy owners don't even charge for these packagings. Also as a new pharmacy owner I have a new system that provides Medicare plans price comparison tool. Meaning I could tell the patient based on their medication profile which plan offers the lowest copay and the lowest premium. I had to learn all those different technology tools on my own to be able to compete with big chain pharmacies. :) Good luck!

Mom does have part D. She is in the do-nut hole now and has been since August. That is why her meds are so much. No copay now, she has to pay a percentage. Thanks for your reply though.