Failure to Investigate Resident’s Positive Drug Screen for Marijuana
Penalty
Summary
Surveyors identified a deficiency related to the facility’s failure to investigate and monitor the use of illegal substances after a resident tested positive for marijuana. The resident was admitted with diagnoses including paraplegia and multiple sclerosis, and had a BIMS score of 15, indicating intact cognition. A nurse’s note documented that the resident was acting impaired after returning from smoking, and a physician ordered a urinalysis with drug screen via straight catheter. Laboratory results from that testing showed the resident was positive for cannabis. Despite the positive drug screen and the facility’s corporate policy defining illegal substances and requiring an investigation to identify who brought the substance into the facility and whether a patient used or had access to it, no investigation was conducted. In an interview, the resident stated she occasionally used non-prescribed marijuana and had smoked it in the designated smoking area without staff awareness. During a subsequent interview and record review, the DON confirmed that no search of the resident’s room or investigation for illegal substances had been performed, and acknowledged that, per policy, an investigation should have occurred after the positive drug test.
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