Seniors’ homes in Minnesota are surrounded by employees stealing painkillers

Eric Lane made a humble request to the nursing home who was looking after his mother while she was dying of Alzheimer’s disease in the spring of 2019. He asked that she be allowed to die peacefully and without any undue pain.

However, Lynn’s confidence was shattered when he learned that someone working the night shift had stolen several doses of morphine and his mother’s anti-anxiety medication. He said no one could identify the perpetrator or care enough to investigate. Influenced by this revelation, Lynn moved his 65-year-old mother outside the facility the next morning to his family’s home near St Cloud, where she died four days later.

“I couldn’t stand the thought of my mother dying in this way—alone and in pain,” said Lynn, a plumber. “What little she had–her sense of peace–was taken away from her.”

Amid the escalating epidemic of opioid abuse, the homes of seniors in Minnesota are becoming attractive targets for addicts and drug dealers. New research shows that nursing homes and living facilities across the state often fail to protect seniors from theft of addictive painkillers — thousands of pills are stolen each year by people tasked with caring for vulnerable populations. The consequences are dire: many elderly people have suffered needlessly for long periods without knowing the cause of their misery.

In the past eight years, more than 11,300 drugs, mostly narcotic pain medications, have been stolen from at least 368 residents of nursing homes and living sites across Minnesota, according to a soon-to-be-published study. In some cases, oversight is so poor that thefts go undetected for months, resulting in dozens or more casualties in one location. On average, thefts occurred over 56 days with more than 30 doses stolen per resident, according to an analysis of 107 documented drug diversion reports investigated by the Minnesota Department of Health.

The researchers found that the perpetrators, about half of whom were nurses, sometimes used ingenious tactics. They came out of their rooms with potent drugs tucked into their pockets, waist belts, bras and stockings. Sometimes replace them with an over-the-counter medication such as aspirin. They diluted the liquid medicines in syringes and throat lozenges – and kept a portion of the medicines for themselves. The researchers found that they had carefully concealed their traces by re-sealing perforated drug packages, forging employee signatures on drug number, and stuffing pill packages into shredders.

The researchers found that some workers even took the stolen drugs during their shifts, compromising patient care.

“The situation is out of control,” said Elon Caspi, a gerontologist and professor at the University of Connecticut, who led the research project with researchers at Purdue University.

Although the problem of opioid thefts is not new, it has been exacerbated by the opioid epidemic and government workforce crisis that has hampered efforts to tackle thefts. The state’s long-term care groups say a backlog of investigations is preventing them from identifying culprits quickly enough. It could take anywhere from six months to a year for the Minnesota Board of Nursing to complete an investigation after a theft was reported. Meanwhile, a nurse can jump from one big house to another, stealing medicines everywhere without the providers knowing that they are a danger to patients.

And thieves are also getting bolder, long-term care managers say, taking advantage of their access to painkillers by stealing hundreds of pills for months at a time. In the case of 2018, a nurse at an assisted living facility in Grand Rapids stole more than 1,900 tablets over a two-year period by routinely placing them in an “excess storage area” in her office. When medication shortages at the facility, the nurse makes excuses for not being able to reach them. In all, 13 residents went without pain medication, according to a state investigation.

“Our concern is that it’s not just addicts stealing themselves,” said Patti Cullen, president and CEO of Care Providers of Minnesota, an industry group. “We are seeing cases where the amount of drugs stolen far exceeds what one person can use.”

But the public may find it difficult to learn about these crimes and where they occurred. This is because completed government investigations of drug thefts in long-term care homes are grouped under the broad category of “financial abuse,” along with thefts of personal items such as jewelry. Even in cases where stolen drugs are found, the term “robbery” does not appear often in government abuse reports. Instead, regulators refer to it as “drug diversion” — a term that some patient care advocates argue underestimates crimes.

“We need to stop purging this cruelty by calling it drug diversion and calling it what it is — the criminal theft of pain medications,” said Kristen Sundberg, CEO of Elder Voice Family Advocates.

Drug thefts have been known for years as a workplace hazard in seniors’ homes, and have spawned a range of safety protocols. Each dose of the controlled substance taken must be documented, and the number of drugs in each work shift is done to detect inconsistencies. Medicines at risk of theft should be stored in double-locked containers accessible only to authorized personnel, according to Long-Term Care Groups.

Recognizing the need for more changes, the Department of Health and state long-term care industry groups met in 2019 and developed a long list of recommended preventative measures, including strong hiring practices and prompt reporting of suspected thieves to professional licensing boards.

However, law enforcement officials say investigating such thefts presents unique challenges, due to the large volume of drugs taken and the number of rotating staff with access to them. In one case this spring, more than 240 narcotic pills were lost to three residents over several months from Sanctuary, a help-dwelling home in West St. Paul. A government report said state health investigators were unable to identify the culprit due to poor record keeping at the facility and a lack of procedural oversight.

A Sanctuary spokeswoman said the facility has re-educated employees about drug administration and changed its procedures to require two employees to sign all drugs. She said that after an internal investigation, the facility fired an outside nurse believed to be responsible for the theft.

“The biggest problem is that a lot of people have access to these drugs at any time,” said Brian Sturgeon, the West St. Paul Police Department chief and former drug investigator. Inventory doesn’t help [of drugs] It’s often not done correctly – if it’s done at all.”

Once drug thefts are discovered, family members are often left feeling guilt and remorse for not seeing the warning signs.

Louis Gildia, a research nurse at the University of Minnesota, said she had no reason to suspect a nurse had stolen painkillers from her mother-in-law at a home they helped live in Wizzata. Then a grooming aide Gildia hired one day discovered that some of the pills in her dispenser had a slightly lighter color than the prescribed anesthetic. Fearing this, Gildia placed a small camera inside a teddy bear next to her mother’s bed. Video footage showed a nurse stealing drugs while her mother-in-law was in the bathroom, she said.

“The most worrisome part was not knowing how long I had been upset and in pain,” Gildea said.

Carrie Showside said her 88-year-old mother is still traumatized by what she suffered three years ago.

A home health nurse has been discovered stealing drugs from her mother, Lavon Burchim, who had severe rheumatoid arthritis, and replacing them with allergy pills. This transformation caused a disturbing deterioration in her mother’s health that family members thought she might be dying. She slept most of the day and then woke up in agony – sometimes crying and begging for painkillers. No one suspected the home nurse until Burchim’s husband took her to a pain clinic, and blood tests showed no opioids in her system, Shaw said.

The nurse, La Vang, who was assigned to care for Borsheim pleaded guilty in May 2019 to theft of prescription opioids and was sentenced to 18 months in prison.

“It was a nightmare,” Shaw said. My mother kept saying, ‘The pain is unbearable, but no one could understand why.’

Now, Burchim is afraid to be alone in her room in an assisted living house in Maple Grove. She spends most of her days in the lobby of the building, playing dominoes and sharing stories, only venturing back to her bedroom for bedtime. “When someone invades your private space and almost kills you, it’s just-” said Xu, searching for the right words. “This is a memory that will never go away.”

The following findings were based on a review of 107 investigation reports conducted by the state health department that established drug thefts in the homes of seniors in Minnesota between 2013 and 2021.

The number of drugs stolen: 11328

death toll: 368

Average number of doses stolen per resident: 30

The average time the thefts took place: 56 days

Percentage of medicines stolen from living facilities: 85%

Percentage of medicines stolen from nursing homes: 15th%

Sources: Elon Caspi, University of Connecticut. Wei-Lin Xue, School of Nursing, Purdue University; Pi-Ju (Marianne) Liu, School of Nursing, Purdue University

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