Care facilities seek medical marijuana answers

Nevada’s nursing homes are wrestling to create policies covering medical marijuana use by patients.

The state’s new law does not address post-acute care facilities and advocates say many questions need to be answered in order to ensure that patients and medical personnel as well as the facilities are protected.

“We’re looking for the legislature to clarify,” says Daniel Mathis, president and CEO, Nevada Healthcare Association, the 40-year-old nonprofit representing assisted living and post-acute care facilities, referring to the Nevada Legislature convening next year. “If a resident patient is presented to a skilled nursing facility for housing, what is the compliance expectation around medical marijuana?”

Administration of medical marijuana, for example, is not clear cut. Physicians’ recommendations required for it are not the same as prescriptions and do not include dosages or designate time, forcing nurses and other medical personnel to take on responsibilities not associated with other drugs.

“Dosing needs to be addressed,” says Mathis. “It’s a lot of those details that everyone wants to get nailed down.”

The law now allows for an authorized caregiver to acquire and give medical marijuana, but only one caregiver can be designated per patient and only one patient per caregiver. In the case of a nursing home patient, that caregiver would likely be a child or some other relative of the patient, who might be required to administer it if some of the concerns of medical personnel are not addressed.

There is also the issue of how the medical marijuana is consumed, whether smoked or ingested.

“Facilities don’t want to take on responsibility for equipment or acquire it,” says Mathis.

NHA’s Mathis says other issues are not as problematic for the facilities.

“Safety and storage is not the issue. In a medical setting, we’re very used to keeping up with narcotics,” he says.

Patients, or their caregivers, will need to obtain medical marijuana at one of the state’s licensed dispensaries, but Mathis says nursing homes are also accustomed to providing transportation and assistance for patients to shop or go to outside medical appointments.

Facilities, however, can’t simply opt out of handling medical marijuana because the state’s existing patient rights laws guarantee patients the right to reasonable services.

The issue may seem unlikely to arise often, but most of the conditions under which medical marijuana are allowed, such as cancer and glaucoma, disproportionately afflict the elderly.

Many facilities are concerned about jeopardizing their federal funding because federal law on marijuana is currently at odds with state laws legalizing its use.

“The legislature could say that because they receive federal funding they can’t (allow) medical marijuana and then the controversy would be over,” says Mathis.