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Tuesday, December 29, 2015

MDH report highlights senior care drug diversions

Drug diversions in health care facilities accounted for about 20 percent of the 141 substantiated allegations of abuse, neglect, or financial exploitation of vulnerable adults between July 2013 and June 2014, according to a new MDH report.

MDH investigators substantiated that 14 health care workers diverted drugs from 27 vulnerable adults in the one-year period ending June 2014. MDH received a total of 192 drug diversion allegations involving thefts from individuals and facilities during this time. Allegations are considered substantiated when a majority of the evidence supports a finding of fault.

"Drug diversion and prescription abuse is a growing area of concern nationally and in Minnesota," said Minnesota Health Commissioner Dr. Health Ed Ehlinger. "We want patients to be aware of the possibility of drug theft, we want workers to know it will not be tolerated, and we want providers to help prevent it by using best medicine management and tracking practices."

This is the first year MDH has collected these data as part of its report on the maltreatment of vulnerable adults (PDF). In previous vulnerable adult reports, MDH included drug diversion cases in the financial-exploitation category but did not break them out separately. MDH investigates allegations of drug thefts from individuals under Minnesota's Vulnerable Adults Act, whereas MDH investigates thefts from facilities under different regulations.

About 70 percent of the substantiated cases of a worker taking medications from a vulnerable adult occurred in nursing homes. The rest occurred in assisted living facilities or care provided in homes.  In all of the cases, MDH investigators found the individual workers at fault for the diversions, rather than the facilities. After finding evidence of a drug diversion, facilities typically notified the police and terminated the employee. Some facilities also took steps to prevent future events, such as daily narcotic counts, narcotic counts between shifts, training nurses to identify the signs of drug diversion, changing locks on medication storage boxes, and requiring two staff members to sign off on medication flow sheets. 

A joint MDH and Minnesota Department of Human Services (DHS) work group charged with improving care for vulnerable adults has selected control and storage of medications as a key focus area. At the direction of the Governor and the Legislature, DHS has also formed an expert work group to address the wide availability of prescription opioids and provide recommendations that will guide Minnesota's response to the crisis of opioid overuse and abuse.

The Maltreatment of Vulnerable Adults Update includes mistreatment allegations of vulnerable adults occurring in facilities licensed by MDH including nursing homes, hospitals, boarding care homes, supervised living facilities, assisted living providers, home care providers, hospice providers, and free standing outpatient surgical centers. The full report is available at the MDH Health Regulation Division website at Maltreatment of Vulnerable Adults Update (PDF).

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