# Long term care pharmacy software built around the facility, not the walk in counter

> A long term care pharmacy is a closed door pharmacy serving residents of skilled nursing and assisted living facilities rather than walk in patients. It runs on cycle fills, unit dose packaging, emergency kits and a consultant pharmacist relationship. Federal rules shape it directly: 42 CFR 483.45 requires a monthly drug regimen review for every resident, and 42 CFR 423.154 requires brand solid oral doses to be dispensed in quantities of 14 days or less. Neurobird organises the work by facility.

- URL: https://neurobird.com/longterm/
- Product: Neurobird Long Term Care Pharmacy Operations Platform
- Niche: long term care pharmacy
- Buyer: long term care pharmacies
- Status: in development, open for early access
- Updated: 2026-08-21

## What Neurobird Long Term Care Pharmacy does

- Run cycle fill by facility and hall without losing STAT orders and new admissions in the same queue
- Capture monthly drug regimen review findings so irregularities reach the attending physician and the director of nursing
- Track controlled substance dispensing, partial fills and emergency kit access against the facility they serve
- Prove delivery with a signature tied to the resident, the drug and the cycle

## How it works

1. **Structure by facility and hall** Residents, cycles, delivery routes and emergency kits all live under the facility they belong to, so a STAT order never gets lost inside a cycle queue.
2. **Close the consultant loop** Monthly drug regimen review findings under 42 CFR 483.45 are recorded, routed to the attending physician and the director of nursing, and tracked to resolution.
3. **Keep the controlled record** Schedule II partial fills, emergency kit access and returns are logged against the facility and the resident, so an audit is a query rather than a search through a bound book.

## From the source material

> Financing IN GENERAL- Each eligible individual obtaining long-term care insurance coverage under this chapter shall be responsible for 100 percent of the premiums for such coverage.

Source: opm.gov, https://www.opm.gov/healthcare-insurance/long-term-care/reference-materials/

## Industry context

- **483.45** 42 CFR 483.45 requires long term care facilities to obtain pharmacist services and to have each resident's drug regimen reviewed at least monthly, with irregularities reported to the physician and facility leadership. (source: eCFR, 42 CFR 483.45, https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-B/section-483.45)
- **14 days** Under 42 CFR 423.154, Part D sponsors must require dispensing of brand name solid oral doses to long term care residents in quantities of 14 days or less to reduce waste. (source: eCFR, 42 CFR 423.154, https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-423/subpart-D/section-423.154)
- **483.60** 42 CFR 483.60 sets the food and nutrition requirements that sit alongside pharmacy services in the same federal participation rules, which is why survey findings often cross both. (source: eCFR, 42 CFR 483.60, https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-B/section-483.60)
- **15,300** Approximate number of nursing homes in the United States, each of which needs a pharmacy relationship, an emergency kit arrangement and a consultant pharmacist. (source: CDC National Center for Health Statistics, https://www.cdc.gov/nchs/fastats/nursing-home-care.htm)
- **2 registrants** Controlled substance handling in long term care involves both the pharmacy and the facility as separate parties under DEA rules, which is why kit access has to be documented on both sides. (source: DEA Diversion Control Division, https://www.deadiversion.usdoj.gov/)

## Pricing

- Single facility: $110 per facility, per month
- Closed door pharmacy: $260 per facility, per month
- Regional operator: $480 per facility, per month

## Questions

### What is a long term care pharmacy?

A long term care pharmacy is a closed door pharmacy that serves residents of skilled nursing facilities, assisted living and similar settings rather than walk in patients. It runs on cycle fills, unit dose or blister packaging, emergency kits held at the facility, and a consultant pharmacist relationship, and it is governed by both state pharmacy law and federal nursing home rules.

### What does 42 CFR 483.45 require?

It requires a long term care facility to provide routine and emergency drugs, employ or obtain the services of a licensed pharmacist, and have a licensed pharmacist review each resident's drug regimen at least once a month, reporting any irregularities to the attending physician and the medical director and director of nursing.

### What is short cycle dispensing?

Under 42 CFR 423.154, Part D sponsors must require network pharmacies serving long term care residents to dispense brand name solid oral doses in quantities of 14 days or less, in order to cut waste when a therapy changes or a resident is discharged. It changes the whole rhythm of the fill.

### How are controlled substances handled in a nursing home?

Under DEA rules a Schedule II prescription for a long term care facility resident may be partially filled, with the total quantity dispensed over an extended period. Emergency kits held at the facility have their own registration, access and accountability requirements, and every access has to be documented.

### Does this replace our pharmacy dispensing system?

No. Adjudication and label printing stay where they are. This is the operations layer: facility and hall structure, cycle scheduling, consultant review findings, controlled substance records and delivery proof.

## Sources

- [42 CFR 483.45, pharmacy services](https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-B/section-483.45)
- [42 CFR 423.154, dispensing in LTC facilities](https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-423/subpart-D/section-423.154)
- [DEA Diversion Control Division](https://www.deadiversion.usdoj.gov/)
- [CDC NCHS, nursing home care](https://www.cdc.gov/nchs/fastats/nursing-home-care.htm)

## Contact

- office@neurobird.com
- https://neurobird.com/