State licensing officials have sanctioned pharmacies in nine of Iowa’s Walgreens stores for a variety of alleged violations, including lack of narcotics, lack of qualified personnel and issues that caused some Iowans to lose access to their medications.
Two of the nine stores were sanctioned for their recruiting practices earlier this year.
The store with the most severe penalties is the Walgreens Pharmacy at 1251 Fourth St. SW in Mason City. The Iowa Board of Pharmacy charged the store with six separate regulatory violations: practicing in a manner that is harmful to the public; failure to employ sufficiently qualified personnel; failure to ensure that the ongoing inventory of all Schedule II controlled substances is accurate and consistent with actual on-hand inventory; not transferring prescriptions to another pharmacy at the request of a patient; failure to comply with regulations regarding a change in the status of the responsible pharmacist; and failure to create and maintain complete and accurate records.
According to the board, the Mason City pharmacy was inspected in December 2021 following a complaint received by the board. During the inspection, the management’s compliance officer found insufficient staff and a high staff turnover in the store.
The compliance officer also noted that after three different Schedule II controlled substances were counted, the results for all three showed discrepancies between the written, ongoing inventory and the actual on-hand inventory of those drugs.
In addition, the store’s permanent pharmacist in charge had left that position in March 2021, but the board received no notification from the temporary responsible who was appointed, and the board only received an application for the appointment of a new permanent pharmacist in charge at the end of December of that year.
Also, during the week of January 17, 2022, the Mason City store was intermittently closed during regular business hours due to lack of pharmacist coverage. Once the pharmacy was able to find coverage and reopen to the public, staff pharmacists were unable to transfer their prescriptions elsewhere if patients requested it. As a result, some patients were unable to access their medications.
The board has issued the Mason City store’s license with 18 months’ probation and imposed a $20,000 civil fine, although payment of $10,000 of that fine will be suspended, subject to compliance with other terms imposed by the management have been established.
In addition, if the store’s pharmacy is unable to operate during normal business hours due to a lack of sufficient staff, it must provide timely notice to patients and prescribers of the closure, both through signage and a recorded message with a telephone number that patients can transfer to another pharmacy of their choice, so that the other pharmacy can call directly and request the transfer of prescriptions.
West Des Moines store fined $4,500
In addition to the charges against the Mason City store, the board also has the Walgreens store on Grand Ave. Sued 1999 in West Des Moines for violating state rules that require pharmacies to employ and appoint a professionally competent, legally qualified pharmacist; rules relating to changes in the status of the responsible pharmacist; and rules requiring pharmacies to conduct an accurate inventory of all controlled substances immediately upon termination of a responsible pharmacist.
In particular, the board stated that the store’s responsible pharmacist had left the position on September 7, 2021 and that the store had been without a temporary or permanent responsible pharmacist for seven weeks, until October 28, 2021.
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In addition, the store has reportedly not filed an application with the board until November 9, 2021 to identify the new regular pharmacist. That application was reportedly incomplete and the store subsequently failed to respond promptly to requests from the board for additional information. administration claimed.
The store was also accused of failing to complete an inventory of controlled substances until November 4, 2021, nearly two months after the previous pharmacist in charge was fired.
The store denied the allegations, but agreed to a settlement that involves a $4,500 civil fine.
Other stores risk $10,000 fines
At its August meeting, the board of directors also imposed sanctions on seven other Iowa Walgreens stores, most of which faced identical charges and penalties.
The seven stores are located at 15601 Hickman Road in Clive; 12753 University Avenue at Clive; 901 N Ankeny Blvd. in Ankeny; 3140 SE 14th St in Des Moines; 2545 E. Euclid Ave. in Des Moines; 4555 Fleur Drive in Des Moines; and 111 W. Ridgeway Ave. in Waterloo.
The store at 3140 SE 14th St. in Des Moines faced a series of charges that were different from the other six. That store was the target of a complaint alleging no patient counseling had been provided to a patient who had been given a new prednisone prescription. The store’s security video footage confirmed there was no escort. The store was inspected in September 2021. At that time, the store’s supply of hydrocodone was short of 247 tablets, at which point a board compliance officer requested a full audit of all Schedule II controlled substances.
That audit identified a shortage of 44 tablets of oxycodone and a shortage of 60 capsules of dexmethylphenidate.
The six remaining Walgreens stores were each charged with failing to account for controlled substances and records, and for failing to create and maintain complete and accurate records of all controlled substances on hand. According to the board, each of the six pharmacies reported controlled substance losses to the board in November 2020, which Walgreens attributed to employee theft. The available documents made public by the board do not reveal the full extent of the theft.
The board asked Walgreen Co. later to conduct an audit of all controlled substances in the six stores, from June 2019 to June 2021. The audit reports for each of the pharmacies showed “a large number of drugs that were found to be losing or having surpluses,” it claimed board, and Walgreen Co. was unable to definitively determine what led to the loss of so many controlled substances.
According to the board of directors, the audit found that many of the stock quantities that do not contain controlled substances “must have been entered inaccurately at the time of the annual inventory”, although it is not clear from the board’s records what that means in relation to to actual losses versus inaccurately reported losses.
The license of each of the six pharmacies, as well as the license of the Des Moines store on Southeast 14th Street, is subject to a one-year probation period, and each store has been fined $20,000, though only $10,000 of that has to be paid. subject to compliance with other governance requirements, with the remaining $10,000 in fines deemed “remained.”
In addition, all resident pharmacists and technicians working in the seven stores must complete two hours of additional inventory management training and commit to implementing a new inventory management system by the end of October.
Also, any discrepancies between actual and projected controlled substance counts will result in a $500 civil fine, and delays in implementing the inventory control system will result in fines of $1,500, with both drawn from the $10,000 deferral fines. .
In March, two of the sanctioned Walgreens stores were among three to be sanctioned by the Iowa Board of Pharmacy for hiring-related violations.
The Walgreens store at 12753 University Ave., Clive, was fined $1,500 last spring for operating for 12 days without a designated pharmacist, and the store at 3140 SE 14th St. in Des Moines was fined $750 for hiring two pharmacy assistant trainees who are not registered with the board.
In addition, the store at 3030 University Ave. in Des Moines fined $1,500 for hiring a person to assist a pharmacist with technical work in October 2021, although the employee would not become a registered pharmacy technician until the following month.