Final answer:
If a grandfathered pharmacy does not renew their permit for a year, they would likely lose their grandfathered status and have to comply with current regulations as a new entity upon renewal.
Step-by-step explanation:
If a pharmacy that was grandfathered in does not renew their permit for one year, the most likely outcome is d) Loss of grandfathered status. The term 'grandfathered in' usually refers to an entity being exempt from new rules and regulations because they were already in operation before these rules were established. If a grandfathered pharmacy allows its permit to lapse, it could be treated as a new entity under current laws if and when they decide to renew. This means that automatic renewal is highly unlikely, fines, and warnings are possible, but the renewal process would be in accordance with current regulations, and they may have to meet all the modern requirements despite their previous status. Moreover, forced closure is probable only in the event of operating without a valid permit, which doesn't correlate directly with the grandfathered status itself, but any time a permit is required for legal operation.