October 2025

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

Edited by Malcolm Fraser MD, CMD

Flu Vaccine Update

Well, at last, we have (relative) clarity regarding flu and COVID vaccinations for the upcoming season.


Last year’s flu outbreak was one of the worst in many years, as shown in the following CDC graph.

Even though we expect this year’s flu season to be relatively mild, it remains very important that as many of our nursing home staff and residents as possible receive their flu vaccinations.

For those 65 years and older, it’s especially important to use the “high-octane” type of vaccine. Below is a list of the preferred options for this population:

1. High-Dose Flu Vaccine (Fluzone High-Dose Quadrivalent)

• Contains four times the antigen of a standard flu shot

• Designed to produce a stronger immune response

• Shown to reduce flu-related illness and hospitalizations in older adults


2. Adjuvanted Flu Vaccine (Fluad Quadrivalent)

• Contains an adjuvant (MF59) to boost the body’s immune response

• Especially useful for those with weaker immune systems


3. Recombinant Flu Vaccine (Flublok Quadrivalent)

• Produced without eggs (safe for egg-allergic individuals)

• Contains a higher dose of antigen than standard vaccines

• Proven effective in older adults


The “grey area” involves which vaccine type to use for individuals under 65 who are immunocompromised. Your Red Rock pharmacist will guide you in choosing the most appropriate vaccine for your ALF/NH patients and residents.

Shixian Wang

Director of Operations

Employee of the Month – October

We’re excited to recognize Shane as our Employee of the Month for October!


Shane joined Red Rock Pharmacy in 2023 and is a valued member of our Springville Branch, where he serves as the Lead Technician. Since joining the team, Shane has been a steady and positive presence, known for his dedication and teamwork.


When asked what he loves most about his work, Shane shared that it’s the people and the strong relationships that make his job so rewarding. Over time, he’s developed greater patience and understanding—skills that have enhanced both his personal and professional growth.


What keeps Shane motivated each day is the hard work and dedication of his coworkers. Seeing his team go above and beyond to provide the best care for patients inspires him to do the same. Shane’s commitment to excellence and his appreciation for his team truly embody the Red Rock spirit.

Survey Update

In late September we asked ChatGPT for a Survey update and the following was the answer.

Changes to Nursing Home “Care Compare” / Five-Star Ratings (QSO-25-20-NH)

• Starting July 2025, CMS will use only the two most recent standard surveys to calculate the Health Inspection portion of the star rating instead of the three most recent. AHCA/NCAL+2polaris-group.com+2

• Complaint surveys and infection control inspections will still be considered over a three-year lookback period. AHCA/NCAL+1

• As of July 30, 2025, performance data for nursing home chains (owner/operators of multiple facilities) will be posted on Nursing Home Care Compare; this includes average ratings for chains in inspection, staffing, quality measure, etc. AHCA/NCAL

• The Long-Stay Antipsychotic measure is being updated: starting Oct 29, 2025, claims/encounter data (Medicare & Medicaid) will be incorporated in addition to MDS data. This aims to more accurately capture use of antipsychotics. AHCA/NCAL+1

• Removal of the COVID State-By-State Breakdown

https://projects.propublica.org/nursing-homes/summary Updated H=July 2025. Accessed 9/24/2025

Colorado HCA Conference Recap


In mid-September, Red Rock Marketer Brian Martin and Regional Director of Marketing Dave Rimlinger had the pleasure of representing Red Rock Pharmacy at the CHCA Conference held at the Loveland Conference Center.


It was a fantastic opportunity to reconnect with our current partners and build new relationships across the senior care community. The event was very well attended, and it was inspiring to see so many dedicated professionals from the healthcare sector come together.


Our booth—presented in partnership with our sister company, Canyon Home Care & Hospice—featured a lively western theme. Attendees enjoyed visiting our “watering hole” for Cow Tales and other fun snacks while learning more about how we support facilities and residents.


To add to the excitement, we hosted a raffle for a flat-top griddle! Congratulations again to our lucky winner—you know who you are!


Overall, the event was a great success and showcased the strong collaboration and team spirit that define Red Rock Pharmacy. We’re grateful to everyone who stopped by and look forward to continuing the conversations started at CHCA.

Physical frailty contributes to the development of dementia


A new study published in the journal Neurology shows that physical frailty contributes to the development of dementia.


Physical frailty is defined as having three or more of the following five symptoms:

• Often feeling tired
• Little or no physical activity
• Slow walking speed
• Low grip strength
• Unintentional weight loss


The study examined 489,573 UK Biobank participants without dementia at enrollment between 2006 and 2010, who were then followed for 14 years. During that period, 8,900 participants developed dementia. A total of 4.6% of those with frailty developed dementia, compared to 1.3% without frailty. Overall, the risk of dementia was 182% higher among those with frailty. The full study was published in Neurology.


Editor’s Note: Does this study help expand the indications for Part B therapies? 
Time will tell.

The Power of Socialization in Managing Depression Among Older Adults

A new study published in the Journal of the American Medical Association reinforces that increased social participation is associated with a lower risk of depressive symptoms among older adults.


The study followed more than 42,000 participants aged 65 and older and found that those who socialized regularly were significantly less likely to develop depression.


What does this mean for nursing homes?

Efforts to promote socialization among residents with depression should be documented as appropriate non-pharmacological interventions.

Death Rate from High Blood Pressure–Related Kidney Disease Rapidly Increasing

The death rate from high blood pressure–related kidney disease has increased by 48% over the past 25 years, according to preliminary research presented at the American Heart Association’s Hypertension Scientific Sessions 2025.

These findings highlight the urgent need for improved screening and management of high blood pressure to reduce the risk of hypertensive kidney disease—particularly in communities at higher risk.

The study analyzed 25 years of data from the CDC WONDER database, reviewing all U.S. death certificates listing hypertensive renal disease as a cause of death between 1999 and 2023. Researchers found a 22% higher mortality rate among individuals with renal failure.

Regional differences were also observed, with the mortality rate in the Western U.S. at 4.59 per 100,000, and Washington, D.C. reporting the highest rate at 7.6 per 100,000.

What can we do in Assisted Living (AL) and Nursing Homes (NHs)?

Ensure that renal function—best measured with a Renal Panel blood test—is checked at least yearly in all patients or residents with hypertension.

Your Red Rock Pharmacist can provide additional guidance and recommendations for specific patients or residents.

Clopidogrel (Plavix) Found More Effective Than Aspirin for Preventing Heart Attacks and Stroke

Researchers at the recent European Society of Cardiology Congress reported that the blood thinner clopidogrel may be more effective than aspirin as a routine medication for preventing heart attacks and strokes in people with heart conditions.


The study, published in The Lancet on August 31, pooled data from 29,000 patients with coronary artery disease who had participated in seven previous randomized trials. Those taking clopidogrel had a 14% lower risk of major cardiovascular or cerebrovascular events compared with those taking aspirin, after an average follow-up of 5.5 years.


These findings are consistent with results from a similar study published in June. While there were initial concerns about ulcers and bleeding complications with clopidogrel, this study found no significant difference in bleeding risk compared to aspirin.


Researchers concluded that clopidogrel should be considered the preferred long-term antiplatelet therapy for patients with established coronary artery disease. Clopidogrel is the generic form of the commonly prescribed medication Plavix.


Editor’s Note: Many older adults cannot take aspirin due to an increased risk of gastrointestinal bleeding. Additional studies are needed to determine whether Plavix (clopidogrel) would be a valuable alternative for this population.