Drugs Prescribed for Residents in Iowa Senior-Living Facility Diverted by Medication Aide

A certified medication aide (CMA) in a senior-living facility is facing three felony charges after an investigation revealed she diverted controlled medications for her personal use that were prescribed for the residents.

The investigation conducted by Iowa’s Medicaid Fraud Control Unit found that between April 12, 2019, and February 12, 2020, the medication aide worked at the senior-living facility. She is alleged to have diverted medications, including hydrocodone that was intended for the residents, and then falsely documented in the controlled medication log to conceal her theft.

On February 12, 2020, after she diverted a resident’s newly prescribed 60-pill order for Tramadol (a pain relieving medication), it was discovered that the pills were missing. When she was confronted about the missing medication, she admitted to taking it and retrieved the pills from her car minus 10 of the pills. 

Shortly after her arrest and booking, she was released on bond from the county jail. A preliminary hearing is set for November 20.

Compliance Perspective

Failure to prevent drug diversion by staff who cover up their theft by falsifying medication log books might indicate that staff responsible for verifying and reconciling the facility’s medication log from one shift to another may not be adequately attentive to the protocols designed to identify drug diversion. This may result in resident abuse and neglect due to their not receiving prescribed medications. Diversion could result in medication errors when doses are missed or other medications are substituted for the prescribed medications. This diversion activity could place residents in jeopardy of harm and be considered provision of substandard quality of care.

Discussion Points:

  • Review policies and procedures for the securing and administration of controlled medications to prevent diversions that put residents at risk for abuse and neglect.
  • Train staff regarding reconciliation protocols to ensure that any suspicious entries are reported and investigated.
  • Periodically audit to ensure that residents with orders for controlled medications are receiving them at the level and frequency prescribed. Auditing may also involve interviewing residents who complain that they are in pain to ensure that their medications are not being diverted.

DRUG DIVERSION – WHAT EVERY NURSING FACILITY NEEDS TO KNOW