Anybody know about a company called PharmaCare Services?

[Secret_Informant]

I applied to an accepted an offer as a PRN Pharmacist at a Rehabilitation Hospital in Florida. I spoke with the Director a Pharmacy and they promised me verbally hours on Friday to start, then remote order entry on the weekends as time goes on. The work schedule is not in writing yet as the employer still has the background check on the drug screen to evaluate, which I feel will not be a problem. The goal of the position was to use premixed bags for IVs (including vancomycin and metronidazole), and to minimize the cost of the pharmacy by providing the medications that are on the hospital formulary (unless the patient brings a brand-name from home and they must take it for medical reasons). The starting pay is $60 per hour with two dollars per hour additional for on-call hours. The pay is not bad, but I have a lot of concerns that I do not feel comfortable sharing with my employer due to fear of retaliation.

Some additional information about the site as follows. The site finished construction at the end of October and it’s relatively new. New staff, new facility, and not very many reviews. The IV room is non-functional and the Director may remove it to cut costs next year. The Director also promised accommodations as well, but they are not in writing. The EHR system they use is called Cerner, which is through a company called OracleHealth. Because of the contract, I am an employee of PharmaCare Services and not the rehabilitation hospital itself. Employees can only apply for a position if PharmaCare Services provides written consent to an employee. It sounds very sketchy, but a job is a job. The company is based in Blanco, Texas, so that may speak volumes as to a poor culture. However, the worksite was wonderful, and I could see myself being at the facility as a full-time employee. Because of the contract I signed, I may not be able to be full-time, unless PharmaCare Services allows it in writing.

Before any judgments are made as to whether or not signing this contract was dumb, accepting this position was the only way to gain hospital experience without a pharmacy residency as all of the others require one year of long-term care, a Pharmacy practice residency, or three years in an acute care setting. Some require a residency on top of experience and others require a PGY2 as well. I am already trained in IV sterile compounding and earned a certification for it, yet I am not experienced via a job as a pharmacist. As a technician, I was. Keep in mind this is Florida, and employers are very picky about what they want. Florida is also an “at will” state and you cannot strike against employers. Texas employment laws, I heard, are much worse.

I have worked in multiple retail jobs in Florida with little success and many of them have had a poor culture, including CVSHealth (which people are calling CVSHellth and for obvious reasons), Walgreens, an independent pharmacy, and a staffing agency which had an 18 month restrictive covenant agreement for every assignment I had. The relationship with the staffing agency was terminated due to stunted career growth.

My first job was remote and performing comprehensive medication reviews, which I enjoyed, as is my current gig job. Roles like that seem to be nonexistent as only companies like Humana and Centene have roles like this. CVS and Walgreens only have remote order entry, which will pay the bills but not give me the skills needed for increasing my expertise. I am already pursuing a CDCES certification and a BCMTMS certification, which will help but may not be enough to earn full-time.

PharmaCare Services has 1.9 out of five stars on GlassDoor due to poor work life balance, and management issues. The same company was reviewed on indeed at 3.1 out of five stars. However, no reviews were on the facility I accepted the offer for.

My questions are as follows.

1. Should I see this as an opportunity to improve work culture or should I treat this as a job: get in, get out, keep my mouth shut, and seek additional training elsewhere and use the experience as a springboard towards another hospital? I cannot take another retail store; it’s too much.

2. I am also considering other states if this position does not plan out, including: Wisconsin, North Carolina, Washington, and Colorado. Should I focus on those MPJE exams while pursuing this job and not tell my employer about it?

3. What recommendations for states other than Florida should I pursue that have clinical pharmacist roles, not retail chains providing clinical services? Many employers do not perceive retail as clinical and the experience: it’s tough to justify even after two years practice experience.

4. For those who worked with Cerner before, what experiences am I in for? Could the facility switch from Cerner to EPIC without notice? If so, how would I prepare for that?

5. For those who worked with PharmaCare Services before, how do you suggest I watch my back and protect my license?

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[RXDOC1986]

I applied to an accepted an offer as a PRN Pharmacist at a Rehabilitation Hospital in Florida. I spoke with the Director a Pharmacy and they promised me verbally hours on Friday to start, then remote order entry on the weekends as time goes on. The work schedule is not in writing yet as the employer still has the background check on the drug screen to evaluate, which I feel will not be a problem. The goal of the position was to use premixed bags for IVs (including vancomycin and metronidazole), and to minimize the cost of the pharmacy by providing the medications that are on the hospital formulary (unless the patient brings a brand-name from home and they must take it for medical reasons). The starting pay is $60 per hour with two dollars per hour additional for on-call hours. The pay is not bad, but I have a lot of concerns that I do not feel comfortable sharing with my employer due to fear of retaliation.

Some additional information about the site as follows. The site finished construction at the end of October and it’s relatively new. New staff, new facility, and not very many reviews. The IV room is non-functional and the Director may remove it to cut costs next year. The Director also promised accommodations as well, but they are not in writing. The EHR system they use is called Cerner, which is through a company called OracleHealth. Because of the contract, I am an employee of PharmaCare Services and not the rehabilitation hospital itself. Employees can only apply for a position if PharmaCare Services provides written consent to an employee. It sounds very sketchy, but a job is a job. The company is based in Blanco, Texas, so that may speak volumes as to a poor culture. However, the worksite was wonderful, and I could see myself being at the facility as a full-time employee. Because of the contract I signed, I may not be able to be full-time, unless PharmaCare Services allows it in writing.

Before any judgments are made as to whether or not signing this contract was dumb, accepting this position was the only way to gain hospital experience without a pharmacy residency as all of the others require one year of long-term care, a Pharmacy practice residency, or three years in an acute care setting. Some require a residency on top of experience and others require a PGY2 as well. I am already trained in IV sterile compounding and earned a certification for it, yet I am not experienced via a job as a pharmacist. As a technician, I was. Keep in mind this is Florida, and employers are very picky about what they want. Florida is also an “at will” state and you cannot strike against employers. Texas employment laws, I heard, are much worse.

I have worked in multiple retail jobs in Florida with little success and many of them have had a poor culture, including CVSHealth (which people are calling CVSHellth and for obvious reasons), Walgreens, an independent pharmacy, and a staffing agency which had an 18 month restrictive covenant agreement for every assignment I had. The relationship with the staffing agency was terminated due to stunted career growth.

My first job was remote and performing comprehensive medication reviews, which I enjoyed, as is my current gig job. Roles like that seem to be nonexistent as only companies like Humana and Centene have roles like this. CVS and Walgreens only have remote order entry, which will pay the bills but not give me the skills needed for increasing my expertise. I am already pursuing a CDCES certification and a BCMTMS certification, which will help but may not be enough to earn full-time.

PharmaCare Services has 1.9 out of five stars on GlassDoor due to poor work life balance, and management issues. The same company was reviewed on indeed at 3.1 out of five stars. However, no reviews were on the facility I accepted the offer for.

My questions are as follows.

1. Should I see this as an opportunity to improve work culture or should I treat this as a job: get in, get out, keep my mouth shut, and seek additional training elsewhere and use the experience as a springboard towards another hospital? I cannot take another retail store; it’s too much.

2. I am also considering other states if this position does not plan out, including: Wisconsin, North Carolina, Washington, and Colorado. Should I focus on those MPJE exams while pursuing this job and not tell my employer about it?

3. What recommendations for states other than Florida should I pursue that have clinical pharmacist roles, not retail chains providing clinical services? Many employers do not perceive retail as clinical and the experience: it’s tough to justify even after two years practice experience.

4. For those who worked with Cerner before, what experiences am I in for? Could the facility switch from Cerner to EPIC without notice? If so, how would I prepare for that?

5. For those who worked with PharmaCare Services before, how do you suggest I watch my back and protect my license?

I am not familiar with Pharmacare, but I am pretty sure the Rehab hospital you are speaking of, is Encompass Rehab Hospital. There is some 140+ locations in North America and Mexico. I have been involved in one location, PRN, here for over 2 years. I was hired as PRN, and because of my extensive clinical experience. As the Director, and the staff pharmacist, were both straight out of Walmart! The same procedures are true, they do premixed or snap ABX, their non-existent kinetics involves waiting 2-3 days for a Vanc trough to result!!!! A simple INR takes 2 days! You have to start patients with questionable renal clearance with no SCr results for 2-3 days. They got some form of "exception" from the board, not to require a hood or clean room, where even retail locations are required to have an aseptic hood/clean room set-up. The on-call pay they offered me was $2/hr, not $2 + 60/hr!
When I get to train the other PRN staff, all from retail, I explain to them that "it's so cute, they consider themselves a hospital" As I have worked at MANY real hospitals, this isn't one!
They use a remote pharmacy services, Cardinal Health, for remote order entry on nights and weekends. They basically have bankers hours, 9-5, no nights or weekends.
As for Cerner, yes they use Cerner. I have extensive experience with both Cerner and Epic, in many different hospitals. There is not much chance of a Hospital System paying millions of $ for Cerner, and then jumping to Epic. As both systems are very comparable. This did happen to me once as my hospital group was bought out by a competing hospital group. Not a big deal, you definitely need to learn both systems, to succeed in the future.
This type of job isn't going to be much of a "springboard" into hospital pharmacy, if the hiring manager knows anything about the Rehab "hospital" operation.
I don't understand what you might be doing to risk your license at this place, or how to watch your back? If you could explain the shady practices.

 

[sunnyandseventytwo]

I applied to an accepted an offer as a PRN Pharmacist at a Rehabilitation Hospital in Florida. I spoke with the Director a Pharmacy and they promised me verbally hours on Friday to start, then remote order entry on the weekends as time goes on. The work schedule is not in writing yet as the employer still has the background check on the drug screen to evaluate, which I feel will not be a problem. The goal of the position was to use premixed bags for IVs (including vancomycin and metronidazole), and to minimize the cost of the pharmacy by providing the medications that are on the hospital formulary (unless the patient brings a brand-name from home and they must take it for medical reasons). The starting pay is $60 per hour with two dollars per hour additional for on-call hours. The pay is not bad, but I have a lot of concerns that I do not feel comfortable sharing with my employer due to fear of retaliation.

Some additional information about the site as follows. The site finished construction at the end of October and it’s relatively new. New staff, new facility, and not very many reviews. The IV room is non-functional and the Director may remove it to cut costs next year. The Director also promised accommodations as well, but they are not in writing. The EHR system they use is called Cerner, which is through a company called OracleHealth. Because of the contract, I am an employee of PharmaCare Services and not the rehabilitation hospital itself. Employees can only apply for a position if PharmaCare Services provides written consent to an employee. It sounds very sketchy, but a job is a job. The company is based in Blanco, Texas, so that may speak volumes as to a poor culture. However, the worksite was wonderful, and I could see myself being at the facility as a full-time employee. Because of the contract I signed, I may not be able to be full-time, unless PharmaCare Services allows it in writing.

Before any judgments are made as to whether or not signing this contract was dumb, accepting this position was the only way to gain hospital experience without a pharmacy residency as all of the others require one year of long-term care, a Pharmacy practice residency, or three years in an acute care setting. Some require a residency on top of experience and others require a PGY2 as well. I am already trained in IV sterile compounding and earned a certification for it, yet I am not experienced via a job as a pharmacist. As a technician, I was. Keep in mind this is Florida, and employers are very picky about what they want. Florida is also an “at will” state and you cannot strike against employers. Texas employment laws, I heard, are much worse.

I have worked in multiple retail jobs in Florida with little success and many of them have had a poor culture, including CVSHealth (which people are calling CVSHellth and for obvious reasons), Walgreens, an independent pharmacy, and a staffing agency which had an 18 month restrictive covenant agreement for every assignment I had. The relationship with the staffing agency was terminated due to stunted career growth.

My first job was remote and performing comprehensive medication reviews, which I enjoyed, as is my current gig job. Roles like that seem to be nonexistent as only companies like Humana and Centene have roles like this. CVS and Walgreens only have remote order entry, which will pay the bills but not give me the skills needed for increasing my expertise. I am already pursuing a CDCES certification and a BCMTMS certification, which will help but may not be enough to earn full-time.

PharmaCare Services has 1.9 out of five stars on GlassDoor due to poor work life balance, and management issues. The same company was reviewed on indeed at 3.1 out of five stars. However, no reviews were on the facility I accepted the offer for.

My questions are as follows.

1. Should I see this as an opportunity to improve work culture or should I treat this as a job: get in, get out, keep my mouth shut, and seek additional training elsewhere and use the experience as a springboard towards another hospital? I cannot take another retail store; it’s too much.

2. I am also considering other states if this position does not plan out, including: Wisconsin, North Carolina, Washington, and Colorado. Should I focus on those MPJE exams while pursuing this job and not tell my employer about it?

3. What recommendations for states other than Florida should I pursue that have clinical pharmacist roles, not retail chains providing clinical services? Many employers do not perceive retail as clinical and the experience: it’s tough to justify even after two years practice experience.

4. For those who worked with Cerner before, what experiences am I in for? Could the facility switch from Cerner to EPIC without notice? If so, how would I prepare for that?

5. For those who worked with PharmaCare Services before, how do you suggest I watch my back and protect my license?

This is the longest post I've ever sort of read. Have you considered writing novellas instead of pharmacisting?

 

[Secret_Informant]

This is the longest post I've ever sort of read. Have you considered writing novellas instead of pharmacisting?

I prefer to be thorough in my posts. To answer your question, though, no. A novella will not change pharmacy.

 

[Secret_Informant]

I am not familiar with Pharmacare, but I am pretty sure the Rehab hospital you are speaking of, is Encompass Rehab Hospital. There is some 140+ locations in North America and Mexico. I have been involved in one location, PRN, here for over 2 years. I was hired as PRN, and because of my extensive clinical experience. As the Director, and the staff pharmacist, were both straight out of Walmart! The same procedures are true, they do premixed or snap ABX, their non-existent kinetics involves waiting 2-3 days for a Vanc trough to result!!!! A simple INR takes 2 days! You have to start patients with questionable renal clearance with no SCr results for 2-3 days. They got some form of "exception" from the board, not to require a hood or clean room, where even retail locations are required to have an aseptic hood/clean room set-up. The on-call pay they offered me was $2/hr, not $2 + 60/hr!
When I get to train the other PRN staff, all from retail, I explain to them that "it's so cute, they consider themselves a hospital" As I have worked at MANY real hospitals, this isn't one!
They use a remote pharmacy services, Cardinal Health, for remote order entry on nights and weekends. They basically have bankers hours, 9-5, no nights or weekends.
As for Cerner, yes they use Cerner. I have extensive experience with both Cerner and Epic, in many different hospitals. There is not much chance of a Hospital System paying millions of $ for Cerner, and then jumping to Epic. As both systems are very comparable. This did happen to me once as my hospital group was bought out by a competing hospital group. Not a big deal, you definitely need to learn both systems, to succeed in the future.
This type of job isn't going to be much of a "springboard" into hospital pharmacy, if the hiring manager knows anything about the Rehab "hospital" operation.
I don't understand what you might be doing to risk your license at this place, or how to watch your back? If you could explain the shady practices.

The rehab hospital I am speaking of is called ClearSky Health. The company I am speaking of celebrates their patients upon discharge, and every staff member seems extremely nice on the surface. I believe they use Cardinal Health as their system but I am not quite sure, as I have not gotten into the training yet. However, I’m concerned the culture might change on a moments notice. Considering any email sent is considered public record by Florida law, communications may be monitored through PharmaCare Services or by the staff itching to fire you if you make the wrong decision or react the wrong way. Florida is an “at-will” state and you can be ditched for anything no matter how frivolous the reason. I’m wondering if this communication could be monitored as well. On a related note, the background check seems to be taking longer than I expected: I expected less than one week that everything would be done. It may take three weeks due to Thanksgiving coming up next week.

Please clarify the following statement for me, which you quoted in your last post:

“When I get to train the other PRN staff, all from retail, I explain to them that "it's so cute, they consider themselves a hospital" As I have worked at MANY real hospitals, this isn't one!”

Believe it or not, rehabilitation hospital locations are considered rotation sites in pharmacy practice residency programs, including those programs that are ASHP accredited. One of the directors from ClearSky Health worked in a variety of hospital systems before moving on to Texas, albeit without a pharmacy residency. Best part: they never worked at Walmart and they are not residency trained either.

Considering rehab patients need a medication list, both upon admission and upon discharge and transition of care is extremely important in any hospital setting, I’m curious as to what evidence you are basing the term “cute” on, considering the evidence I’m hearing is expert opinion? Considering you have extensive experience, can you clarify your interpretation of what you consider a “real hospital?” Acute care hospital with an ER, a full unit ICU, and 600 beds perhaps? No reasonable person would be able to take that kind of environment head-on without extensive training; even a pharmacy practice or pharmacy specialty residency wouldn’t be enough to handle all of the cases presented. Sometimes transitioning through a rehabilitation hospital provides the necessary experience you would not get with a residency. That chronic stress work environment is also not suitable for all healthcare providers, which is why doctors run their own practices after leaving hospitals and group practices. They want more autonomy in how they care for patients. How do I know? I shadowed five of them in my lifetime, one of which is a very good friend of mine.

The Tampa, FL Veterans Administration hospital lost their pharmacists recently due to burnout and are all complaining about low staff since management is leaving positions vacant. This implies that only residency trained or extensively clinically trained pharmacists comprise their staff (five years experience or more). The link to the article is below if you care to read it, but that article is a discussion for another thread:

Pharmacists at Tampa veterans hospital complain of understaffing and burnout

Pharmacists in government employees union warn that patient safety is being compromised by management leaving positions vacant.

www.tampabay.com

As far as learning EPIC, how do you suggest I learn the program without working for a hospital that uses it or by asking a university that uses the same program for training? There is a program through Chapters Health System through RxProstaff that teaches acute care hospital work for two weeks. The problem is it costs $2500 or more and there is no guarantee of a job upon completion. You learn hospital workflow in addition to obtaining a sterile compounding IV certification through the Texas Board of Pharmacy, which I have. The unfortunate part is that this program does not have a payment plan; they want their money upfront. The person I called over the course of two days still did not send me a payment plan via email. The program includes EPIC training as well as Cerner, in addition to antibiotic dosing and pharmacokinetics for vancomycin and aminoglycosides, basically second and third professional year pharmacy school review.

 

[RXDOC1986]

The rehab hospital I am speaking of is called ClearSky Health. The company I am speaking of celebrates their patients upon discharge, and every staff member seems extremely nice on the surface. I believe they use Cardinal Health as their system but I am not quite sure, as I have not gotten into the training yet. However, I’m concerned the culture might change on a moments notice. Considering any email sent is considered public record by Florida law, communications may be monitored through PharmaCare Services or by the staff itching to fire you if you make the wrong decision or react the wrong way. Florida is an “at-will” state and you can be ditched for anything no matter how frivolous the reason. I’m wondering if this communication could be monitored as well. On a related note, the background check seems to be taking longer than I expected: I expected less than one week that everything would be done. It may take three weeks due to Thanksgiving coming up next week.

Please clarify the following statement for me, which you quoted in your last post:

“When I get to train the other PRN staff, all from retail, I explain to them that "it's so cute, they consider themselves a hospital" As I have worked at MANY real hospitals, this isn't one!”

Believe it or not, rehabilitation hospital locations are considered rotation sites in pharmacy practice residency programs, including those programs that are ASHP accredited. One of the directors from ClearSky Health worked in a variety of hospital systems before moving on to Texas, albeit without a pharmacy residency. Best part: they never worked at Walmart and they are not residency trained either.

Considering rehab patients need a medication list, both upon admission and upon discharge and transition of care is extremely important in any hospital setting, I’m curious as to what evidence you are basing the term “cute” on, considering the evidence I’m hearing is expert opinion? Considering you have extensive experience, can you clarify your interpretation of what you consider a “real hospital?” Acute care hospital with an ER, a full unit ICU, and 600 beds perhaps? No reasonable person would be able to take that kind of environment head-on without extensive training; even a pharmacy practice or pharmacy specialty residency wouldn’t be enough to handle all of the cases presented. Sometimes transitioning through a rehabilitation hospital provides the necessary experience you would not get with a residency. That chronic stress work environment is also not suitable for all healthcare providers, which is why doctors run their own practices after leaving hospitals and group practices. They want more autonomy in how they care for patients. How do I know? I shadowed five of them in my lifetime, one of which is a very good friend of mine.

The Tampa, FL Veterans Administration hospital lost their pharmacists recently due to burnout and are all complaining about low staff since management is leaving positions vacant. This implies that only residency trained or extensively clinically trained pharmacists comprise their staff (five years experience or more). The link to the article is below if you care to read it, but that article is a discussion for another thread:

Pharmacists at Tampa veterans hospital complain of understaffing and burnout

Pharmacists in government employees union warn that patient safety is being compromised by management leaving positions vacant.

www.tampabay.com

As far as learning EPIC, how do you suggest I learn the program without working for a hospital that uses it or by asking a university that uses the same program for training? There is a program through Chapters Health System through RxProstaff that teaches acute care hospital work for two weeks. The problem is it costs $2500 or more and there is no guarantee of a job upon completion. You learn hospital workflow in addition to obtaining a sterile compounding IV certification through the Texas Board of Pharmacy, which I have. The unfortunate part is that this program does not have a payment plan; they want their money upfront. The person I called over the course of two days still did not send me a payment plan via email. The program includes EPIC training as well as Cerner, in addition to antibiotic dosing and pharmacokinetics for vancomycin and aminoglycosides, basically second and third professional year pharmacy school review.

IF, you have ever worked in a rehab hospital, and then in a real hospital, you would know the MANY differences.
No need to get snarky, my young friend! Just telling you how it is, do with it what you please. I really don't need to present any evidence, it's not a trial!
Advice on this board is worth exactly what you pay for it, ZERO!