Rural Hospitals Cope with Local Pharmacy Closures

The ongoing closure of Shopko’s pharmacy and merchandise stores is affecting rural hospitals and the communities they serve.

Shopko opened its first store in Green Bay, Wisconsin, in 1962 and at one time reported operating 363 stores in 24 states. But the company filed for bankruptcy in January and announced in March that all stores would close by this summer.

The shuttering of the Wayne, Nebraska, Shopko was a surprise to the store’s staff, said Kimberly R. Lueders, Pharmacy Director for Providence Medical Center, a critical access hospital in Wayne.

“They found out on a Friday afternoon that Saturday at 2:00 would be the end of it. They would be closed,” she said.

Shopko’s closure also appeared to surprise ThedaCare, a seven-hospital system in Wisconsin. ThedaCare announced January 15 that Shopko was closing the store in Darboy that housed one of the health system’s urgent care clinics; the last day for patient visits was January 24.

On February 6, ThedaCare announced that Shopko-operated retail pharmacies at two of the health system’s medical centers had ceased operations that day.

The closing of the Shopko in Abbotsford, Wisconsin, left that town with no pharmacy for the first time in more than a century, according report in a local newspaper, the Tribune-Phonograph.

Codee Peterson, Inpatient Pharmacist at Aspirus Medford Hospital, about 15 miles north of Abbotsford, said prescription files for the former Shopko customers were sold to a pharmacy located about 25 miles from the shuttered store.

She said there have been delays getting those prescriptions transferred elsewhere for patients who don’t want to use the new pharmacy.

“They’re having trouble with transfers ... because that other pharmacy is getting so bogged down with the new prescriptions,” Peterson said. She said her colleagues have told her it takes up to an hour to have prescriptions routed from the new pharmacy to Aspirus Medford’s small retail pharmacy.

Peterson said other area pharmacies have gone out of business in recent years, but Shopko’s exit has been the most disruptive.

But Lueders said the Wayne, Nebraska, Shopko closure marked a new opportunity for Providence Medical Center, which decided to open its own community pharmacy and to staff it with the former Shopko team.

The medical center announced February 26 that two pharmacists and three certified pharmacy technicians from the old Shopko store had been hired to run the new pharmacy.

Lueders said her chief executive officer (CEO) approached her when he learned the Shopko was closing, and he asked how quickly the medical center could open a community pharmacy.

“Our CEO had been thinking about it for a while. But we didn’t want to compete with the other businesses in town,” she said. Shopko’s exit left Wayne with just one community pharmacy, a locally owned U-Save Pharmacy.

“We decided ... we can support two pharmacies in town. So this would be an opportunity to not only help out the job situation ... but also to extend our service line as a rural healthcare provider in the area,” Lueders said.

She said the retail pharmacy will be open 9:00 a.m. to 6:00 p.m. Monday through Friday and 9:00 a.m. to 2:00 p.m. Saturdays — the same as the Shopko hours.

Shopko transferred its prescription files to the U-Save Pharmacy, which announced that it would begin filling Shopko patients’ prescriptions starting January 14.

Lueders said opening the new community pharmacy has been challenging, mostly because of the short notice and the time required to complete the project.

Among other things, she said, Providence Medical Center had to obtain approval from its board of directors to establish the new pharmacy. The medical center also had to remodel the building that would house the pharmacy, contract with a designer, install shelving and fixtures, and set up telephone services.

In mid-March, Lueders was waiting for pharmacy to be assigned a Drug Enforcement Administration (DEA) number — a process she said was delayed by the recent federal government shutdown.

“That DEA number ... is kind of the lynchpin for all of our contracting and everything else,” she said.

She said the downtime has been used to train the new pharmacy staff.

“They’ll be operating as a department of the hospital,” she said. “So there’s lots of things we have to do.”

Lueders praised the new staff members’ enthusiasm. She said one of the pharmacy technicians, on her own initiative, is pursuing certification in sterile compounding, which wasn’t required for her retail position.

“Now that she’s part of the hospital she thought that that would be great, and she just wants to do whatever she can to help,” Lueders said.

She said the Shopko team, before the store closed, was filling about 300 prescriptions per day.

In addition to handling prescriptions for former Shopko customers, Lueders said the new pharmacy may fill prescriptions for the hospital’s hospice service and for some employees who are covered under the medical center’s health plan.

[This news story appears in the August 1, 2019, issue of AJHP.]