Joint Commission Merges Pharmacy Accreditation

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Joint Commission Merges Pharmacy Accreditation

Long-Term Care, Home Infusion Shifted To Home Care Program
In a move designed to provide a more cost-effective accreditation process for pharmacies, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) will consolidate pharmacy-based accreditation programs into its home care program. This change -- which begins January 1 -- will eliminate separate accreditation of long-term care pharmacies and ambulatory home infusion services.

JCAHO expects the transition to be smooth, with no loss in accreditation value or identity for long-term care pharmacies.

No More Multiple Fees
Darryl S. Rich, PharmD, JCAHO associate director of accreditation operations, said financial woes in the long-term care industry, in addition to pharmacies providing a wider range of patient care services for maximized reimbursement, led to this decision.

JCAHO statistics show that 48% of accredited long-term care pharmacies also provide home care or home infusion services, and many pharmacies provide services to multiple facilities and hospitals. This practice reality necessitated accreditation under multiple separate standards manuals as well as increased fees the pharmacies had to pay to JCAHO. Rampant complaints and confusion ensued, so JCAHO acted swiftly.

Although home care was chosen for JCAHO's administrative umbrella because it had the highest number of accredited pharmacies, all accreditation award letters will specify the exact services that the pharmacy is qualified to deliver. A new niche accreditation manual for pharmaceutical services will be developed to identify the standards applicable to all dispensing pharmacies as well as unique standards that apply to long-term care pharmacies, clinical/consultant pharmacist services, and ambulatory infusion services. Any pharmacy accredited within the last 3 years will go through the new process during the next cycle.

"Very little is changing in terms of accreditation awards, standards, or survey," Rich said. "Pharmacists will deal with one book, one contact person, and one fee instead of three."

A casualty of this decision is that the Advisory Committee on Long-Term Care Pharmacy, in which APhA participated, will be eliminated. Beginning next year, the Professional and Technical Advisory Committee for home care will provide advice on applicable standards affecting all pharmacies.

Reflective of the Times
In explaining the financial reasons for JCAHO's decision, Timothy L. Vordenbaumen, vice president of regulatory affairs for American Pharmaceutical Services, San Antonio, said this move is reflective of what is occurring throughout the long-term care industry.

"Hard times have set in. Long-term care pharmacy providers have suffered financially the same way as the nursing home industry has suffered," Vordenbaumen said. "It is all [JCAHO] can do. It will be awhile before long-term care pharmacy will be interested in accreditation again."

Vordenbaumen, who was APhA's representative to the advisory committee, added that he feels it is unfortunate that the accreditation is being combined, because long-term care pharmacy is a distinctly different practice.

"It is like home care only because of the volume of IV therapy, but otherwise it is very different. In my mind, long-term care pharmacy should be recognized as a type of practice setting," Vordenbaumen said.

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