The Ohio Board of Pharmacy on Tuesday imposed stiff sanctions on a CVS pharmacy in Canton over short staffing in 2021 that the board concluded had endangered patient safety. The penalties could be the first of many against the company because the pharmacy board has yet to adjudicate violations its inspectors have alleged against 14 other CVS stores.
The board fined the company $250,000.
As part of its three-year probation period, the store “must ensure that sufficient personnel are scheduled at all times in order to minimise fatigue, distraction, or other conditions that interfere with a chemist’s ability to practice with the requisite judgement, skill, competence, and public safety.” Staffing levels shall not be exclusively dependent on prescription volume; rather, in establishing the need for staff, CVS #2063 shall consider any other pharmacy practice required by pharmacy professionals during working hours.”
The pharmacy board also directed the CVS shop to develop a procedure via which employees can seek extra staff in writing and communicate such requests with the board. It also prevented CVS from retaliating against pharmacy workers who reported harmful situations.
Importantly, the court compels the retailer to supply prescriptions within three days, excluding those that are automatically supplied. Those must be ready within five days.
Violating the restrictions would result in additional fines, “up to and including revocation of the pharmacy’s licence,” board member Mindy Ferris stated after stating the requirements.
When asked for comment, a CVS spokesman emphasised that the firm had made modifications to the Canton pharmacy since inspectors discovered problems there.
“We are aware of the Ohio Board of Pharmacy’s decision regarding our Fulton Drive NW pharmacy (in Canton) and will continue to collaborate with the Board,” the spokesperson, Amy Thibault, stated in an email. “The claims relate to BOP inspections in 2021, at the height of the COVID-19 outbreak, and we’ve made significant progress to improve circumstances there in the years since, including establishing a strong pharmacy team that continues to offer high-quality care to patients. We are committed to ensuring that our pharmacies have adequate staffing and resources.
The punishments mark the conclusion of a hearing procedure that began in November.
On September 13, 2021, a pharmacy board inspector visited the Canton store and found a staff member who was so busy that they didn’t see her for 20 minutes. Some prescriptions were taking weeks to fill, and when an inspector called back on October 29, 2021, he had to wait on hold for 20 minutes. The person was then informed that “the pharmacy was over a month behind filling prescriptions,” according to the inspection report.
To deal with high staff turnover and other issues, the business closed its inside counter and instructed customers to use the drive-through queue to receive their medicine. Even so, several customers were unable to get through the queue before the store was forced to close at 9 p.m.
Haille Stanick, a former pharmacy worker, recalled how angry customers confronted her in the parking lot during a November hearing.
“I was cornered at my car by about three or four patients, all very angry, asking me what was going on with their medications,” Stanick said, adding that she understood their rage but also felt frightened. “One gentleman was trying to get antibiotics for his son, and he was very, very upset.”
Inspectors discovered broken phones, malfunctioning refrigerators, and a lack of safeguards over dangerous drugs at the pharmacy.
During the hearings on the Canton store findings, CVS lawyers blamed the difficulties on the coronavirus outbreak. It increased the burden by needing personnel to deliver immunisations and other care, while also discouraging many employees from coming to work for fear of contracting the sickness.
However, the board, which is nearly entirely made up of chemists, did not appear to accept that argument.
“We hope that this decision will send a strong message to Ohio pharmacies that they have an obligation to serve their patients by ensuring appropriate staffing levels,” said Steven W. Schierholt, executive director of the Pharmacy Board, in a statement. “The Board will continue to inspect and hold those accountable for working conditions that endanger patients and pharmacy staff.”
While CVS claimed that the pandemic was to blame for the problems in Canton, board inspectors discovered major issues at other CVS locations in Ohio months before the worst hit, as early as last September.
They visited store No. 10246 in Toledo eight times between March 2020 and June 2022. They discovered a pharmacy that was regularly unclean and disorganised, had expired or contaminated pharmaceuticals on its shelves, experienced lengthy delays filling scripts, created labels without adequate directions, and at least one case of giving a patient the incorrect drug.
When asked, employees told inspectors that “supervisors/district managers do not respond to staff calls for help,” according to the inspection report.
The board will hold hearings on the infractions in March.
CVS is a vertically integrated firm that owns doctors’ offices, offers insurance, and operates the largest pharmacy chain. It is also the largest pharmacy benefit manager, and as such, it determines how much to pay retail competitors and its own stores for pharmaceuticals dispensed.
CVS claims to maintain firewalls between its various business areas, but some competitors suspected it of pushing down reimbursements in the years preceding the epidemic and then purchasing smaller pharmacies. It then merged those prescriptions into current CVS operations.
The corporation is currently in the midst of closing 900 of its own stores, and testimony in the Ohio hearings over the Canton store revealed that the company added little staff to handle the additional work.
David Burke, a former state legislator and executive director of the Ohio Pharmacists Association, believes the pharmacy board’s punishments on Tuesday should serve as a reminder to CVS to clean up its act.
“Based on the facts and in the name of safety, the Board of Pharmacy delivered its first punitive action in nearly a dozen cases against CVS,” Burke wrote in a note to the editor. “The message was clear: Putting patients at risk while demeaning the practice of pharmacy is not a tolerated business model in Ohio.”