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Carging to do Nursing Homes in MDS

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  • Carging to do Nursing Homes in MDS

    Does anyone know if any pharmacy has the temerity to charge nursing homes for dispensing into venalink, nomad etc?

    If so how much do they charge?
    Last edited by JonF; 20, August 2008, 11:38 AM. Reason: spelling error title

  • #2
    Re: Carging to do Nursing Homes in MDS

    We never charge, the script volume and the numerous acute scripts justify the extra work of blistering!!

    Comment


    • #3
      Re: Carging to do Nursing Homes in MDS

      ...and all the extra hassle of ordering Rx's, Nursing staff wanting things yesterday! I disagree that extra Rx volume and acutes is worth the extra hassle. Have always thought we're selling ourselves cheap not charging!

      by the way I know i made spelling error in title! Can't seem to be able to amend it!!

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      • #4
        Re: Carging to do Nursing Homes in MDS

        nursing homes are generally a LOT more hassle for what works out as a lower per-item profit unless you have a kind surgery giving you weekly scripts.

        I don't think it's technically illegal to charge a fee to a nursing home to provide services BUT since they changed our fee structures a few years back the DDA payment is supposed to help cover the cost of MDS so official types might get a bit shirty.
        In reality the fee doesn't cover much however and if it's a small home you'll be dispensing at a loss.
        “It's not worth doing something unless you were doing something that someone, somewhere, would much rather you weren't doing.”

        Terry Pratchett

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        • #5
          Re: Carging to do Nursing Homes in MDS

          A big chunk of our monthly items come from nursing homes. If we dicided to charge, a certain multiple up the road would be very happy to take them on and not charge.

          I have to agree with the head ache nursing homes cause like, and I agree with the statement nursing home staff want their meds yesterday and I have a daily pain in me chuddy's due to at least one of the homes phoning up and wanting meds that after noon.

          Can you see me point though? In the present climate an item is an item no matter how hard you have to work for it!! Goodness knows Ive had it rammed down me throat enough times by my area manager in the last couple of weeks! Category M category M category M category M

          I tell you what Id like to do to category effing M!!!!

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          • #6
            Re: Carging to do Nursing Homes in MDS

            Originally posted by Sir_Dispensalot View Post
            nursing homes are generally a LOT more hassle for what works out as a lower per-item profit unless you have a kind surgery giving you weekly scripts.

            I don't think it's technically illegal to charge a fee to a nursing home to provide services BUT since they changed our fee structures a few years back the DDA payment is supposed to help cover the cost of MDS so official types might get a bit shirty.
            In reality the fee doesn't cover much however and if it's a small home you'll be dispensing at a loss.
            The DDA payment doesn't cover nursing homes as residents, by definition, have help to take their meds so don't need MDS.
            The spirit of the time hath taught me speed- Wm Shakespeare- "King John"

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            • #7
              Re: Carging to do Nursing Homes in MDS

              DDA covers dispensing into MDS only when patients self medicate. In a nursing home qualified staff generally give out meds so this is not covered under DDA rules. The MDS is provided merely to make nursing staff's job easier. Have you ever seen MDS on a ward in a hospital?

              What gets me is that some homes have expected US to foot bill for drug cabinet to store all the MDS trays in that THEY have demanded!

              I totally agree that local multiples will hoover up homes if you start charging. We just need to act as one and things could change............excuse me i think i've just seen that flying pig again!!!

              Racer beat me too it!!

              Comment


              • #8
                Re: Carging to do Nursing Homes in MDS

                Originally posted by JonF View Post
                DDA covers dispensing into MDS only when patients self medicate. In a nursing home qualified staff generally give out meds so this is not covered under DDA rules. The MDS is provided merely to make nursing staff's job easier. Have you ever seen MDS on a ward in a hospital?

                What gets me is that some homes have expected US to foot bill for drug cabinet to store all the MDS trays in that THEY have demanded!

                I totally agree that local multiples will hoover up homes if you start charging. We just need to act as one and things could change............excuse me i think i've just seen that flying pig again!!!

                Racer beat me too it!!
                Policy should be that its weekly scripts or no MDS.
                Some homes have exacting requirements.
                Medicines listed in order of dosing of MAR, for example morning only listed first then night last. Then alphabetical within those criteria. And repacking everything when there is a dose change etc.
                They got very shirty when we refused the nursing home staff discount.
                We bring you all these scripts don't we?

                Truth is - think about the liability that you take on for patient care when you do an MDS. Does a few pence cover this?

                One pharmacy I know introduced charges. Only a few of the homes stayed on, the rest went with 'free' from B**ts. Result is not much change in income and a more manageable workload.
                47 BC : Julius Cesar : Veni Vidi Vici : I came, I saw I conquered.
                2018 AD : Modern Man : I shopped, I clicked, I collected.
                How times change.

                If you find you have read something that has upset or offended you an anyway please unread it at once.

                Comment


                • #9
                  Re: Carging to do Nursing Homes in MDS

                  When I took over as a marketing manager in the 60s at an old fashioned company, found many items sold at a loss 'for good will'. However, often found that that customer only bought the loss leaders, our competitors got the more profitable business. I asked the IT dept for a list of prods and customers by profit and started deliberately shedding the losers.

                  A bad habit of British industry is to chase volume rather than value. Classic example being the m/c and car industries.
                  johnep

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                  • #10
                    Re: Carging to do Nursing Homes in MDS

                    Johnep is correct. I used to do three nursing homes, lost one to Boots when they started giving the owner big discounts on everything inlcuding perfume for his mistress, the second when they fell out with the local GPs and ended up with a dispensing practice.
                    The third went to Boots when the home changed hands and then rapidly wanted to return to us. They wouldn't agree to my conditions (they were astonished I didn't snap their arm off at the offer of the business) and they've ended up with Lloyds although we still do their acute scripts. This is all over a 20+ year period.
                    Nowadays we have no Nursing Homes and I don't want any. Let some poor multiple manager/locum have the hassle.
                    The spirit of the time hath taught me speed- Wm Shakespeare- "King John"

                    Comment


                    • #11
                      Re: Carging to do Nursing Homes in MDS

                      The original rush to pander to nursing homes as a way of increasing script nbrs was because of purchase profits made on meds. I also saw some some bad practices such as reusing unused meds returned.

                      Nursing homes just rubbed their hands with glee as they were able to sack qualified staff and employ low cost 'carers' to give out the meds in trays. This is also what social services do, in old days would have been a district nurse, now a low cost carer.
                      johnep

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                      • #12
                        Re: Carging to do Nursing Homes in MDS

                        Originally posted by Pharmanaut View Post

                        One pharmacy I know introduced charges. Only a few of the homes stayed on, the rest went with 'free' from B**ts. Result is not much change in income and a more manageable workload.
                        Any idea on the fee they charged?

                        Originally posted by Mr Pharm S
                        Can you see me point though? In the present climate an item is an item no matter how hard you have to work for it!! Goodness knows Ive had it rammed down me throat enough times by my area manager in the last couple of weeks! Category M category M category M category M
                        Tell your area manager more profit would be added to the bottom line if his company charged nursing homes for suppplying MDS!! Would certainley ease the pain of Cat. M!!

                        Comment


                        • #13
                          Re: Carging to do Nursing Homes in MDS

                          Originally posted by Racer View Post
                          Let some poor multiple manager/locum have the hassle.
                          Oh dear..didn't think there were any of these arrogant old shopkeepers left..not much business either, by the sound of it..Hope you eventually get a good price for all your "hard work".
                          Don't Stop Believing

                          http://youtube.com/watch?v=rnT7nYbCSvM

                          Comment


                          • #14
                            Re: Carging to do Nursing Homes in MDS

                            Originally posted by Racer View Post
                            Johnep is correct. I used to do three nursing homes, lost one to Boots when they started giving the owner big discounts on everything inlcuding perfume for his mistress, the second when they fell out with the local GPs and ended up with a dispensing practice.
                            The third went to Boots when the home changed hands and then rapidly wanted to return to us. They wouldn't agree to my conditions (they were astonished I didn't snap their arm off at the offer of the business) and they've ended up with Lloyds although we still do their acute scripts. This is all over a 20+ year period.
                            Nowadays we have no Nursing Homes and I don't want any. Let some poor multiple manager/locum have the hassle.
                            More anecdotal evidence.
                            The more you give for free now; the more is expected of you for the same amount.
                            Instead look where the money is and the professional satisfaction.
                            B*gger the articles on 'how pharmacists can help do xyz'.
                            47 BC : Julius Cesar : Veni Vidi Vici : I came, I saw I conquered.
                            2018 AD : Modern Man : I shopped, I clicked, I collected.
                            How times change.

                            If you find you have read something that has upset or offended you an anyway please unread it at once.

                            Comment


                            • #15
                              Re: Carging to do Nursing Homes in MDS

                              I used to advise a firm of Care Home operators, with quite a few homes. There was one Home where the local pharmacist charged for MDS; all the others got everything free from conventional independents, multiples or a specialist care home pharmacy.

                              There's really no intrinsically good reason why MDS should be used in Homes; however it's a lot easier to audit the process if they are. Really shouldn't use them for "prn" medication, but I've seen it done quite often.

                              From my experience (and I've had quite a lot, as supplier, inspector and advisor) I think servicing Homes requires a lot more than MDS and the service should be paid for, either by the Homes themselves, or, in part at any rate, by the PCT, since a proper Medicine Management service would improve safety, promote better prescribing and reduce waste.

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