Long-term care facilities (LTCFs) provide a range of services, including medical and personal care, to adults who are unable to live independently. These types of facilities include, but are not limited to, skilled nursing facilities, nursing homes, assisted living facilities, and other congregate living settings where most people receiving care/supervision are older than 65 years of age. The communal nature of LTCFs and the population served (generally older adults, often with underlying medical conditions) put facility residents at increased risk of SARS-CoV-2 infection and severe illness from COVID-19.
The Pharmacy Partnership for Long-Term Care (LTC) Program is facilitating on-site vaccination of residents and staff at more than 63,000 enrolled LTCFs, with pharmacy partners conducting three on-site vaccination clinics for every enrolled facility. The vaccination clinics have now successfully concluded in skilled nursing facilities (SNFs) and in a majority of assisted living facilities enrolled in the program. However, ensuring steady access to vaccine is necessary after the program ends in early-April, because new residents are being admitted to these facilities daily, and new staff and residents who may have initially been hesitant may now wish to be vaccinated.
In mid-March, the federal government started providing a direct allocation of COVID-19 vaccine to long-term care (LTC) pharmacies participating in the Federal Retail Pharmacy Program through three group purchasing organizations across the country — Managed Health Care Associates, Inc. (MHA), GeriMed, and Innovatix. Overall, weekly allocations to the Federal Retail Pharmacy Program continue to increase as more vaccine supply becomes available, and the three group purchasing organizations now receive a proportion of vaccine through the program to distribute to their member long-term care pharmacies.
Ways for Long-term Care Facilities to Continue Receiving COVID-19 Vaccine
LTCF administrators and clinical leadership should consider the following options when making COVID-19 vaccination plans for their facilities.
- LTCF staff should contact their facility’s current LTC pharmacy to check if they are enrolled to provide COVID-19 vaccine through the state or territory.
- LTC pharmacies that are not enrolled to provide COVID-19 vaccine with the state or territory, or through the Federal Retail Pharmacy Program (see next section), can visit their state immunization program website to explore options for becoming a COVID-19 vaccination provider.
*An LTC pharmacy is a specialized pharmacyexternal icon that is designed specifically to support people living in an LTC community.
Some LTC pharmacies enrolled as providers in the CDC COVID-19 Vaccination Program, either through the Federal Retail Pharmacy Program or through the state or territorial immunization program, may not have enough staff to administer vaccines on site at the facility.
Generally, LTCF staff should not administer vaccine on behalf of the pharmacy unless one of the following are true:
- The LTCF is also enrolled as a provider in the CDC COVID-19 Vaccination Program with the state or territorial immunization program.
OR
- The LTC pharmacy is enrolled as a provider in the Federal Retail Pharmacy Program AND the LTC pharmacy contracts with the LTCF or LTCF staff to administer COVID-19 vaccines, as is permitted in the CDC COVID-19 Vaccination Provider Agreement signed by all participating LTC pharmacies. LTC pharmacies enrolled in the CDC COVID-19 Vaccination Program through their state or territorial immunization program may do the same.
LTC pharmacies should consult with their own counsel to determine whether such a contract complies with applicable state or territorial laws and to ensure they are meeting all the requirements of the CDC COVID-19 Vaccination Program Provider Agreement.
- The federal government has launched the Federal Retail Pharmacy Program, a collaboration between the federal government, states and territories, and 21 national pharmacy partners and independent pharmacy networks representing over 40,000 pharmacies nationwide, including LTC pharmacy locations.
- LTC pharmacy partners participating in the Federal Retail Pharmacy Program are receiving limited vaccine allocations from the federal government to distribute to their LTC pharmacy locations.
- Facilities may coordinate directly with participating LTC pharmacies to get access to vaccines and plan vaccination clinics.
*An LTC pharmacy is a specialized pharmacyexternal icon that is designed specifically to support people living in an LTC community.
Some LTC pharmacies enrolled as providers in the CDC COVID-19 Vaccination Program, either through the Federal Retail Pharmacy Program or through the state or territorial immunization program, may not have enough staff to administer vaccines on site at the facility.
Generally, LTCF staff should not administer vaccine on behalf of the pharmacy unless one of the following are true:
- The LTCF is also enrolled as a provider in the CDC COVID-19 Vaccination Program with the state or territorial immunization program.
OR
- The LTC pharmacy is enrolled as a provider in the Federal Retail Pharmacy Program AND the LTC pharmacy contracts with the LTCF or LTCF staff to administer COVID-19 vaccines, as is permitted in the CDC COVID-19 Vaccination Provider Agreement signed by all participating LTC pharmacies. LTC pharmacies enrolled in the CDC COVID-19 Vaccination Program through their state or territorial immunization program may do the same.
LTC pharmacies should consult with their own counsel to determine whether such a contract complies with applicable state or territorial laws and to ensure they are meeting all the requirements of the CDC COVID-19 Vaccination Program Provider Agreement.
LTCFs becoming COVID-19 vaccination providers would be responsible for vaccine ordering, storage, handling, and administration. Facilities would also be responsible for reporting supply and vaccine administration information to their state. The COVID-19 vaccination provider enrollment process differs by state and may not be an option for every facility. Facilities should contact their state immunization program for more information.
Next Steps for Long-Term Care Facilities
- Initiate a discussion with your existing LTC pharmacy to better understand your options. If the pharmacy is set up to receive COVID-19 vaccine through the federal government or through your state, the pharmacy can administer vaccine to your residents and staff.
- Find an alternate pharmacy if your existing LTC pharmacy is not a federal or state COVID-19 vaccination partner. View the list of long-term care (LTC) pharmacies enrolledpdf icon with the federal government to provide COVID-19 vaccine. You can also contact your state health department to find additional providers in your area.
- Lastly, some states may enroll LTCFs as COVID-19 vaccination providers and allow them to order COVID-19 vaccine directly for administration to their residents and staff. The COVID-19 vaccination provider enrollment process differs by state and may not be an option for every facility. Facilities should work directly with their state immunization program if this option is desired.