LINDSAY DYMOWSKI CONSTANTINO, PRESIDENT & COFOUNDER OF CENTENNIAL PHARMACY SERVICES
QUESTION & ANSWER
FALL 2025 I RETAIL/COMMUNITY • SPECIALTY • LTC
24
LONG-TERM
Q. What exactly is “long-term care at home” and
how is it different from traditional retail or
LTC pharmacy models?
Long-term care pharmacy at home refers to the services and
supports that a pharmacy provides specific patients residing in
their own homes that is equal to or greater than the level of care
that they would receive if they were residing in a long-term care
facility. Unlike traditional retail models that focus on point-of-sale
transactions, LTC at home pharmacies provide comprehensive
medication management including adherence packaging, 24/7/365
availability, cyclical medication reviews, delivery coordination, and
care coordination with other community providers and caregivers.
In traditional LTC pharmacy, pharmacies are providing medications
to facilities; LTC at home is rooted in the community, serving patients
who may never enter a facility but still require high-touch, ongoing
clinical support.
Q. Who qualifies for long-term care at home
pharmacy services? Is it only for patients receiving
home health?
Not at all. While patients receiving home health services may qualify,
the LTC at home model is designed for any individual who requires
a skilled level of care, regardless of whether they are enrolled in a
formal home care program. This includes patients with chronic
conditions, cognitive impairment, mobility limitations, polypharmacy,
or frequent hospitalizations. Eligible populations may range from
medically complex children to adults living in private residences.
In fact, many patients receiving Medicaid home and community-
based services or those who are dually eligible for Medicare and
Medicaid often meet the criteria, even if they are not actively
receiving in-home nursing support. It’s important to note that
there is a formal qualification process. Pharmacies are responsible
for identifying, qualifying, and continually re-qualifying patients to
ensure they meet the criteria for LTC-level pharmacy services. This
must be clearly documented and maintained at the pharmacy to
support compliance, payer expectations, and patient safety.
Q. What services must a pharmacy provide to be
considered compliant with LTC at home?
First and foremost, any pharmacy operating under their LTC NPI must
meet the CMS requirements for LTC-level of pharmacy care. The CMS
requirements include comprehensive inventory, adherence packaging
requirements, pharmacist on call service, IV and compounding access,
medication delivery, and emergency medication supplies.
In addition to meeting CMS requirements, pharmacies must
recognize that LTC at home patients are often living independently
or supported by non-clinical caregivers. This reality demands that the
pharmacy elevate its role, delivering a level of care equivalent to what
the patient would receive in a facility setting. That means stepping
beyond dispensing and into true medication management. Pharmacies
must provide comprehensive care coordination, including medication
synchronization, up-to-date clinical documentation and qualification
forms, and most importantly, perform a complete Medication
Dispensing Review (a combination of medication reconciliation
and drug utilization review) every time medications are dispensed.
By doing so, the pharmacy ensures patients are not only receiving the
right medications but are also being actively monitored and clinically
managed in the home. This model moves beyond simple delivery and
becomes a robust, patient-centered system of care, supporting both
safety and better health outcomes.
Q. Why is LTC at home becoming more important in
today’s healthcare landscape?
A shift towards aging in place, combined with rising facility costs and a
sever shortage of LTC beds, has created a growing demand for LTC-
level services delivered at home. By 2030 — five short years — nearly
one in five Americans will be 65 or older. Meanwhile, more than 70%
of individuals who need long-term care reside in the community,
not in institutions. The LTC pharmacy at home model fills a critical
gap by offering continuity or care, improving medication adherence,
and reducing hospitalizations … all while also supporting caregivers,
community providers, and reducing health care costs.
LONG-TERM
PHARMACY