A Montana nurse who admitted to stealing opiates while working at multiple healthcare facilities was sentenced to one year and one day in prison, to be followed by one year of supervised release. The government alleged in court documents that the defendant diverted opiates in 2021 while working at multiple healthcare facilities. In June 2021, a hospital manager discovered that the defendant, for at least the previous three months, routinely obtained oxycodone from the hospital’s pharmacy but did not administer that drug to the intended patients. A total of 392 oxycodone pills were unaccounted for. When confronted by management, the defendant denied diverting drugs, claimed she always administered them to patients, and that “nobody scans things.” Other employees discredited her assertion and indicated it would be “extremely rare” for someone to not record the administration of a drug to a patient. The hospital terminated her employment.
The defendant began working at a nursing home 11 days later. The nursing home subsequently discovered diversions of hydrocodone, and that the defendant had worked shifts at the facility within the days of the diversions.
Another diversion occurred in October 2021 at a different nursing home, where the defendant worked as a traveling nurse. Dozens of hydrocodone and oxycodone tables were unaccounted for and patient log sheets had been manipulated and destroyed in violation of recordkeeping policies. Because of the diversion, a patient had to go without oxycodone for several days until a new supply arrived. Management then announced a drug screening, and most nurses provided urine samples, which were all negative for the diverted drugs. The defendant did not submit to the drug test and did not return to work at that facility.
A subsequent diversion occurred in November 2021 at yet another nursing home. That facility experienced a significant drug diversion while the defendant was working there as a nurse. The director then requested urine samples from the staff. All complied and tested negative except for the defendant, who refused and left the facility. Her employer then contacted her and instructed her to provide a sample. She returned to the facility several hours later and requested a specific bathroom for the drug test. When she provided the sample, it was cold, and yielded an inconclusive result.
When interviewed by a DEA agent, the defendant denied diverting drugs and blamed the medication discrepancies on the poor recordkeeping practices at the facilities.
Issue:
Failure to prevent diversion of residents’ prescribed controlled medications by staff who sell or take the drugs for their personal use may be considered abuse, neglect, misappropriation, and fraud, in violation of state and federal regulations. Staff who divert medications have developed a number of ways to conceal diversion. Facilities should implement a proactive diversion-prevention program which identifies the types of medications most likely to be taken, signs that diversion has taken place, and signs of impairment.
Discussion Points:
- Review your policies and procedures on preventing, identifying, and responding to drug diversion. Update as needed.
- Train appropriate staff on actions that can be taken to prevent, identify, and respond to any suspicion of drug diversion. Provide education on the impact of drug diversion on residents as a form of abuse and neglect, staff responsibility to report concerns immediately, and the consequences of theft of controlled substances. Document that the trainings occurred, and place the signed document in each employee’s education file.
- Periodically audit to ensure that all controlled substances are accounted for each shift, and that proper documentation of controlled substances has occurred. Your consultant pharmacist can be included in this effort.
