Attendees of a session on operating a long-term-care (LTC) pharmacy received tips on key metrics, technology advancements, and meeting customer needs, during the National Community Pharmacists Association (NCPA) 2019 Annual Convention in San Diego, California on Saturday, October 26, 2019.

During the session, “The Long-Term Care Pharmacy of the Future, Today,” presenter Paul Shelton, president of PharmComplete Consulting, urged pharmacists to embrace change to improve their LTC business.

“If we don’t change, we are either going to get run over or bypassed,” he said.

Shelton recommended getting buy-in from the team, starting with the bottom up, such as a junior technician or cashier, and getting ideas from that employee.
“Make sure everyone understands the change is mission critical,” he said

It is also important to get feedback from those who work at the LTC, including administrators, floor nurses, and even janitors.

“Who better to tell us what to do than our customers? Learn what they need, but more importantly, learn what they want,” Shelton said.

He suggested getting feedback from the LTC at least once a quarter and asking questions, such as: what are the top 3 challenges you see in your business today?
What are the top 3 opportunities that you see today? How do you retain talent?

In terms of metrics, Shelton has compiled 9 key ones from a team of consultants and determined where an average pharmacy should ideally be performing. These are:
  • Average revenue per patient per month: $525 to $650
  • Overall margin/Overall COG%: 70% (66% to 71%)
  • Turns per year: >12
  • Patients per Billing tech: 850
  • Rxs per filling tech: 5000
  • Rxs per data entry/account management tech: 8500
  • Rxs per pharmacist for PV1: 7000
  • Rx’s per pharmacist for PV2: 13000
  • % of revenue for delivery cost (either outsourced or inhouse) <4.8%
Shelton recommended using the Lean Six Sigma Process Improvement program, integration and data, business intelligence, and fulfillment automation.

“There’s an automation product on the market that does what you do,” he said.

In addition, Shelton said pharmacies should not be afraid to partner with other entities, such as industry advocates, suppliers, or other pharmacies, and outsource when necessary.

“You all have industry resources that want to help you,” he said.


Shelton P. The Long-Term Care Pharmacy of the Future, Today. Presented at: National Community Pharmacists Association (NCPA) 2019 Annual Convention; San Diego, California; October 26, 2019.