Nurses who fail pre employment and employment drug test

Columnist · May 11, 2018

I think, at least in my state, that it is still reportable. If the nurse tested positive and did not have supportive documentation (script ect.). then the hospital would have an obligation to initiate report.

JustBeachyNurse, LPN · May 11, 2018

HIPAA does not apply as medical insurance is not involved.

Healthcare facilities are mandated reporters to the BoN as matter of public safety.

JustANormalGirl · May 11, 2018

Strange that it's one of the few jobs we report a failed test to the state. No other jobs can legally tell anyone they failed a drug test or why they were fired. You can only say if you'd hire them or not again.

Also, labs are only obligated to report a pass or fail drug test. So what do you report to the state? That the test said they failed but I'm not sure for what?? Then the state has to take my complaint and depending on what's going on it may take them awhile to address the person. Then said person receives more time to get clean and denies they used any drugs. And this applies to pre employment as well? Because if they're not associated with us or working/employed I don't see the point in reporting them. They don't work for me, won't make money, or interact with patients thankfully, and will fail the other drug test for another company and still not work within the field and interact with the patients.

allnurses Guide · May 12, 2018

JustANormalGirl said:
Strange that it's one of the few jobs we report a failed test to the state. No other jobs can legally tell anyone they failed a drug test or why they were fired. You can only say if you'd hire them or not again.
Also, labs are only obligated to report a pass or fail drug test. So what do you report to the state? That the test said they failed but I'm not sure for what?? Then the state has to take my complaint and depending on what's going on it may take them awhile to address the person. Then said person receives more time to get clean and denies they used any drugs. And this applies to pre employment as well? Because if they're not associated with us or working/employed I don't see the point in reporting them. They don't work for me, won't make money, or interact with patients thankfully, and will fail the other drug test for another company and still not work within the field and interact with the patients.

In California Labs report the full result and the person being tested signs a consent for the result to be reported in full to the hospital.

Hipaa only applies to patients in the hospital not employees.

Hppy

psu_213, BSN, RN · May 12, 2018

JustANormalGirl said:
No other jobs can legally tell anyone they failed a drug test or why they were fired.
Then the state has to take my complaint and depending on what's going on it may take them awhile to address the person.

There is no other job in America that is allowed to report a failed drug test to a regulatory agency/licensing board? Maybe you're right, but I'm wondering if you could pass on some references that support this claim.

What complaint are you making? Or is someone filing a complaint against you? Sorry, just a bit confused.

wondern, ASN · May 12, 2018

Not doctors or pilots even? Hmmmm. Teachers?

JustBeachyNurse, LPN · May 12, 2018

You're wrong. Positive drug tests for pilots, drivers of buses, trains, trucks all reportable. Do you think a physician positive for cocaine or opiates is not reportable? It's not a criminal report (unless diversion or dustribution is suspected) but a public safety issue

inthecosmos, BSN, MSN, RN, APRN · May 12, 2018

If you think you'll fail, don't show up. If you fail and have no evidence to say "I'm not a user," then you should be reported.

broughden · May 12, 2018

JustANormalGirl said:
Hey everyone, I hope we are all doing great! I have a simple question that was being discussed and argued about in my hospital. I am in Mesa, Arizona; and have been a nurse for over 15 years and have never heard this come up before. Anyways, other nurses and doctors were saying that the hospital cannot report a failed pre employment drug test to the state boards because A) They are not an employee. B) They are protected by HIPPA. C) The labratory can only give a pass or fail result to the employer not specifics even if it is a prescribed narcotic by a doctor because again HIPPA and D) It is not stated in the hospital policy that a failed pre employment drug test can be reported to the BON. Any opinions on this? I would hope we could report them, but due to all of those circumstances I think it only applies to current employees being reported. Thank you all!

Sorry but the nurses and doctors in your facility dont adequately understand HIPAA then.

1. Any testing facility and employer are BOTH going to obtain a signed HIPAA waiver by anyone being given a pre-employment drug screening, so that the information can be shared between the testing lab and the employer.

2. As long as the test is being conducted in connection with employment and by a third party lab, the results are part of your employment record and not your health care record and as such are not protected by HIPAA.

(If tests are being run in-house by a lab in the hospital, then yes the results can be considered a health record and protected by HIPAA, but they can still be reported to the BON. But this is why many employers use 3rd party testing labs.)

3. State BON's and state laws typically have in place law, which states that a licensee has a legal duty to report another licensee for illegal drug usage so that the BON may investigate.

4. Even as an actual patient (RN involved in accident and brought to ER) if their tox screen shows an illegal substance in their blood, the results cannot be reported to their employer, but they can be reported by the ER to their state BON.

http://www.paed.uscourts.gov/documents/opinions/99d0038p.pdf

Horseshoe, BSN, RN · May 17, 2018

I agree that this is not a HIPAA issue.

Also, please note that it is HIPAA, not HIPPA.

Double-Helix, BSN, RN · May 25, 2018

broughden said:
Sorry but the nurses and doctors in your facility dont adequately understand HIPAA then.
1. Any testing facility and employer are BOTH going to obtain a signed HIPAA waiver by anyone being given a pre-employment drug screening, so that the information can be shared between the testing lab and the employer.
2. As long as the test is being conducted in connection with employment and by a third party lab, the results are part of your employment record and not your health care record and as such are not protected by HIPAA.
(If tests are being run in-house by a lab in the hospital, then yes the results can be considered a health record and protected by HIPAA, but they can still be reported to the BON. But this is why many employers use 3rd party testing labs.)
http://www.paed.uscourts.gov/documents/opinions/99d0038p.pdf

This is rather confusing to me. The lab and the employer will obtain a HIPAA waiver for results that are not protected by HIPAA? Then why is the waiver required?