Nursing homes charge pharmacies 'bed fees'; Long-term-care facilities get per-patient c... - 0 views
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Nursing homes charge pharmacies 'bed fees'; Long-term-care facilities get per-patient cash in exchange for contracts to dispense drugs Toronto Star Mon Oct 17 2016 Page: A1 Section: News Byline: Moira Welsh Toronto Star For the lucrative rights to dispense publicly funded drugs to Ontario nursing homes, pharmacies must pay the homes millions of dollars in secret per-resident "bed fees," a Star investigation reveals. Seniors advocates, presented with the Star's findings, say this practice raises serious accountability questions. "What is happening with that money? We have to know. There is no transparency," said Jane Meadus, a lawyer with the Advocacy Centre for the Elderly. "It's the dirty little secret of the industry that homes are requiring pharmacies to pay in order to get a contract." The 77,000 seniors in Ontario nursing homes are a captive market. Pharmacies compete for a share of an annual $370-million pool of public and resident money to supply and dispense drugs to 630 homes - medicines for ill residents, blood-thinners, antidepressants and a host of other drugs.
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It's big business and a small number of pharmacies have a monopoly at individual homes. To secure these dispensing rights, pharmacies are typically asked by nursing homes to pay between $10 and $70 per resident per month, the Star found. Not all homes demand the payments. A conservative estimate by the Star, based on information from sources and documents, puts the total amount paid by pharmacies to secure nursing home contracts in Ontario at more than $20 million a year. Neither the nursing homes nor the pharmacies would provide the Star with the amount of money that pharmacies pay nursing homes to get the contracts, or a detailed breakdown of how the money is spent. The pharmacies and nursing homes provided general comments on how the money is spent - on training, "nurse leadership sessions" and conferences - but little specific information. Meadus said that, in her opinion, these are "kickbacks" that are detrimental to the system in Ontario that cares for seniors. "Now we have companies getting contracts based on what they can pay instead of what services they provide," she said. The high cost of providing and dispensing drugs to seniors in nursing homes is mostly paid by the taxpayer-funded Ontario Drug Benefit Plan, along with a "co-payment" of $2 paid by the resident for each drug dispensed in the first week of every month. A recent Star investigation found that pharmacies charge more to dispense drugs in nursing homes than to seniors in the community, but provide less service - the drugs are couriered to the homes in blister packs and there is no daily on-site pharmacist to provide counselling on side-effects. Pharmacy executives have countered that argument, telling the Star they put significant resources into high-tech systems that provide quality control.
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Industry sources say the terms "bed fees" or "resident fees" are used casually to describe the way the payments are structured: higher total fees when there are more residents in the home. Speaking on the record, executives at both nursing homes and pharmacies prefer to use terms such as "patient program funding" or "rebates." Neither the nursing homes nor pharmacies would disclose how much money changes hands, saying it is proprietary information. Sources in the industry provided the Star with information on practices and payments related to the bed fees and provided estimates of between $10 and $70 per resident per month. When the Star asked nursing homes about the practice of charging fees to pharmacies, executives at the homes said money collected is used in the homes. Extendicare, a chain of 34 homes, uses the pharmacy payments for "training and education of staff, technology applications or other similarities," president and CEO Tim Lukenda said in a written statement.
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