April 2026

Any comments/suggestions please email the editor at editor@redrockrx.com

Edited by Malcolm Fraser MD, CMD

Vaccination Rates in Senior Care: 
What the Latest Study Shows

A study published last month in the Journal of the American Medical Directors Association compared vaccination rates between nursing homes and assisted living facilities.


The study evaluated the presence of vaccination programs for seven vaccine-preventable illnesses: influenza, COVID-19, respiratory syncytial virus (RSV), pneumococcal disease, hepatitis B, shingles, and tetanus, diphtheria, and pertussis (Tdap). In general, vaccination rates were higher in nursing homes than in assisted living facilities—no surprise there.


The study also examined less commonly used vaccines and found the following:

The full study can be found here: Click Here


At Red Rock Pharmacy, we are committed to supporting vaccination programs for all of our customers—regardless of location. We are dedicated to helping assisted living facilities increase their vaccination rates and promote aging in place.


If you would like more information about the support Red Rock Pharmacy can provide for your vaccine programs, please contact your Red Rock pharmacist.

Shixian Wang

Director of Operations

SURVEY UPDATE


“Doctor - I am a Nursing Home State Surveyor and would like to talk with you privately about a resident at this Nursing Home.”

How should you proceed?

Find the answer at the end of the newsletter.

Spring Medication Review: Aligning Cost, Care, and Rehab Outcomes in LTC 

Spring is a natural time to clean things up, and in long-term care, the medication cart is a great place to start.


Residents often return from the hospital with expanded medication lists that made sense during an acute stay but may not align with current goals in a skilled or rehab setting. Over time, these additions can quietly drive up costs, increase side effects, and even slow progress.


This is where a focused medication review can make a real impact. So, what trends should you pay attention to?


• Duplicate therapies started during transitions of care
• High-cost medications without a clear short-term benefit
• Sedating agents that impact participation in therapy
• Appetite-suppressing medications that work against recovery
  

Not every medication added during a hospital stay needs to follow the resident through their entire skilled stay.


Medication regimens directly influence outcomes. Over-sedation, dizziness, or poor appetite can delay rehab progress, increase fall risk, and extend length of stay. At the same time, unnecessary or misaligned therapies contribute to avoidable pharmacy spend.


A cleaner, more intentional med list supports both better care and better operational performance. Here’s where a pharmacist can help:

• Review post-admission medication lists for appropriateness
• Identify opportunities for therapeutic interchange
• Recommend adjustments to days’ supply to reduce waste
• Flag high-cost medications that may not align with current goals of care


These conversations are most effective when they are collaborative and centered on the resident’s immediate priorities, such as stabilization, participation in therapy, and safe discharge.


Instead of asking, “Was this medication appropriate in the hospital?” ask, “Is this medication helping this resident today?” That shift creates space for better decisions and more meaningful conversations around the most appropriate medications.


Red Rock can help you evaluate medications in relation to rehab goals through a collaborative effort with facility staff.


Dave Rimlinger,

Director of Marketing

OIG Updates Nursing Home Schizophrenia Antipsychotic Audit


In March 2026, the Office of the Inspector General updated the Schizophrenia Antipsychotic Audit. The full 36-page audit can be found here: Click Here


Highlights:

1. Nursing homes administered antipsychotic drugs to residents with dementia to manage behavior for the benefit of staff, despite the FDA’s warning that these drugs may increase the risk of death.
2. Even though antipsychotic drugs pose risks to residents’ health, nursing homes did not take the required steps to help protect residents receiving these medications.
3. Medical directors failed to prevent the inappropriate use of antipsychotic drugs.
4. Nursing home pharmacists failed to identify medical concerns and did not recommend dose reductions.
5. Inadequate nursing home policies and procedures undermined safeguards meant to protect residents.
   

OIG Recommendations for CMS:

1. Further develop resources for nursing homes and increase transparency to reduce inappropriate use of antipsychotic drugs and improve dementia care.
2. Take steps to ensure that nursing home medical directors fulfill their role in reducing inappropriate antipsychotic use.
3. Take steps to ensure that nursing home pharmacists fulfill their role in reducing inappropriate antipsychotic use.
4. Assist nursing homes in improving policies and procedures related to antipsychotic drug use.

GLP-1 Medications Show Potential Beyond Weight Loss and Diabetes


Evidence continues to mount suggesting that GLP-1 medications may help people reduce cigarette use, alcohol intake, and opioid use.


A study conducted in St. Louis, MO, and recently published in the British Medical Journal found that GLP-1 medications such as semaglutide and tirzepatide may help individuals cut back on smoking, drinking, and opioid use.


Use of GLP-1 receptor agonists was consistently associated with reduced risk of developing various substance use disorders (SUDs), suggesting a broad preventive effect across multiple substance types. Their use was also associated with reduced risk of adverse clinical outcomes in individuals with pre-existing SUDs.


These observational findings suggest a potential role for GLP-1 receptor agonists in both the prevention and treatment of substance use disorders, warranting further evaluation.


It is important to emphasize that GLP-1 medications are not currently indicated for the treatment of substance use disorders. However, if a resident is taking a GLP-1 for an FDA-approved indication, improvement in substance use behaviors may be an additional benefit.


Full study: Click Here

Did You Know?


Compared with older adults without diabetes:


• Those with Type 1 diabetes have nearly a threefold higher risk of developing all-cause dementia over a 2.4-year follow-up period.
  
• Those with Type 2 diabetes have approximately a twofold higher risk.
  

Source: Click Here

Answer from Survey Question Above: 

This situation recently occurred to the editor at a nursing home where he serves as Medical Director.


There is nothing in the federal regulations that empowers state surveyors to require private conversations with staff during a survey. This has been confirmed in writing by the Colorado Department of Health.


It is my preference to have a witness present—such as the Executive Director or Director of Nursing—during conversations with state surveyors to ensure that communication is clear and accurately represented.