Last week I was away from home all day on a local tour of one of the sights that school kids and out of town visitors usually see. After living here over 4 years I have just started to do some local sight-seeing. I haven’t felt free to make plans, but since dad is doing so much better this year, I am trying to do more.
Unfortunately, when I got home, there were two messages waiting on my telephone voice mail – both from Medco/Express Scripts about a medication ordered but not yet sent. It sounded unusual because they suggested that if dad had 3 pills or less we were to call and talk to customer service.
The next day when I went to see dad, I stopped at the medication station to see if dad had all the medications he was supposed to have. After keeping me waiting 15 minutes while she continued a telephone conversation, the medication aide finally spoke with me. She was defensive and a bit hostile.
It turned out that dad was totally out of his blood pressure medication again. He had received his last dose two days before. I was quite upset as you know this had happened last year with the very same medication.
I tried to determine why they did not call me when dad’s medications ran low. They told me it was not “their policy” to notify the family. The policy was to call MEDCO/Express Scripts again – which they said they did 5 times! They also are required to call the doctor when a resident is out of medications which they did first to reorder, and then to report two days in a row that he had no pills to take that day. Still, they did not call me.
I reminded the aide several times that we had agreed last year that I would be notified when dad was almost out of pills. She referred me to the nurse who was not available.
I went to speak to the director of the facility. She seemed surprised when I told her dad was out of his blood pressure medication. She said she needed some time to investigate and would get back to me. I mentioned that since this was the second time this had happened, I planned to notify the state health department. (I have not done that yet since I waited to see if dad ended up getting his pills and then we were into the holiday weekend).
I did get a swift oral response to the suggestion that I notify the state health department and felt this made them respond quicker than they otherwise would have (judging from the 5-day run-around I got last year!)
In the meantime I went home and telephoned Medco and spoke with customer service. The woman I spoke with was very nice and could see right away that they had messed up. She spoke with her supervisor and arranged to get five free pills to dad that day if his doctor called the pharmacy of my choice to order them.
I gave the name of the pharmacy. Then the woman told me there was an indication that another order had been obtained from a different pharmacy for 30 pills that same day at a charge of $45. She said I should cancel that $45 order to get dad his 5 free pills but would have to call the doctor for the prescription. I decided to wait until I spoke with the ALF because I wanted dad to get his pills as soon as possible and not jeopardize that by cancelling the order in process.
Later that day, the director phoned me on speaker phone with the nurse. It was a heated conversation as they sought to assure me that it was “not their fault” since Medco had failed to send the medications even after they called several times. I reminded them that I believed they were equally at fault since they had assured me last year that dad would not run out of medications again and he did. They again insisted I blame Medco.
I said: “I do blame Medco. But I also blame you.” Two wrongs do not make a right, and both the Assisted Living Facility and Medco were at fault so far as I could see. We discussed the order from their pharmacy that was to be delivered that afternoon and agreed that it was not possible to cancel it. I wanted them to go pick up the pills right away and they refused as it was not “their policy”. The pills would be delivered before the end of the day, they said. I was not convinced as it had taken 5 days last year for the same process.
The other thing that upset me was their lack of concern about dad missing his blood pressure medications for an uncertain number of days. They said they had notified the doctor each day and since the doctor was not concerned, neither were they. Now I am pretty sure they just send a fax to the doctor’s office and there is no way to know if she received the information or not.
Basically they said they have 46 residents and they have to stick to their own protocol with all of them and not get all concerned if one resident runs out of medications. I said I am paying them over $4000 per month to oversee dad’s health and I expect them to do exactly that! While they have 46 residents to oversee, I have just dad, and I will surely pay close attention to his needs.
After a brief discussion of how to make sure this does not happen again, we finally agreed on a process where they will notify me every time they reorder dad’s medications and I will follow-up by checking online and with them to be sure the pills come as expected. If they don’t, I will be the one to call Medco as apparently they are not very effective at that. They also agreed to pick up the $45 charge since it would normally cost dad less than $10 per month if he got it from Medco/Express-Scripts.
I still can’t believe they let dad run out of medications for the 2nd year in a row. I still intend to follow up with the state even though he now has his medications both from the local pharmacy and over the weekend, the Medco medications finally showed up.