Company overview

Guardian Pharmacy Services operates local pharmacies serving residents of U.S. long-term care facilities. Most revenue comes from residents of assisted living and behavioral health facilities; skilled nursing residents account for most of the rest. Its pharmacies fill physicians’ prescriptions, package medicines by resident and administration time, and deliver them to facilities. Medication tracking and caregiver training help facility staff manage residents’ medicines.

The facilities provide access to residents, but they are not always the payer. Most revenue comes through Medicare Part D prescription drug plans, under reimbursement agreements negotiated with those plans. Medicaid, commercial insurers and healthcare providers also pay Guardian. For residents whose skilled nursing stay is covered by Medicare Part A, the nursing facility pays Guardian under its contract rather than Guardian receiving payment directly from Medicare.

The business depends on residents choosing its pharmacies and on reimbursement terms. Preferred-provider agreements with assisted living and behavioral health facilities do not automatically secure residents’ business, and state freedom-of-choice rules can prevent facilities from requiring residents to use Guardian. Its pharmacies must maintain state licenses and meet government program requirements, including the service standards needed to participate in Medicare Part D’s long-term care pharmacy networks.