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Do Nursing Homes Drug Test?

Nursing homes have a duty of care to their often very vulnerable residents. As well as making sure that they provide all necessary care to residents, nursing homes must ensure that staff members working with residents don’t pose a risk to patient safety and wellbeing.

Before beginning work at a nursing home, all job applicants have to pass a background check, and applicants for some roles will have to pass a drug test.

In this article we’ll answer your questions about:

  • Who, When, and How do nursing homes drug test?

Do Nursing Homes Drug Test Nurses?

Do Nursing Homes Drug Test

Yes, you will have to pass a drug test to work as a nurse at a nursing home. Initially, you’ll have to pass a drug test during the pre-employment background check process.

Then, depending on the policies in place at the nursing home you’re working at, you could have to undergo random drug tests, reasonable cause drug tests, and post-accident or incident drug tests.

Because the nursing staff is usually tested using a 10-panel drug screen, you should know that certain pain medications can give a positive result on the drug test.

If you test positive for illicit drugs, or for any pain medication that you don’t have a prescription for, you could lose your nursing license and face criminal charges.

Do Nursing Homes Drug Test All Employees?

Like any employer, a nursing home can drug test all employees. However, whether a nursing home chooses to test all employees will be down to each facility.

While nurses and certified nursing assistants have to undergo pre-employment drug testing before they can begin caring for patients at a nursing home, other staff may not need to be tested.

Drug testing for housekeeping staff, catering staff, maintenance staff, and administrative staff, who do not have a role in personal patient care could be carried out as part of a pre-employment background check. But ongoing testing of employees in these positions isn’t widespread in the nursing home sector.

That’s not to say that it doesn’t happen, just that it isn’t very common.

When you begin work at a nursing home, you’ll receive an employee handbook, which lists the policies you’ll have to follow as an employee. If further drug testing is going to be carried out, your employer must have a specific policy in place, and that policy must comply with state and federal laws on drug testing.

If there is no specific drug testing policy applicable to you, then you won’t have to be tested again unless you’re involved in an accident or incident at work.

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When Do Nursing Homes Carry Out Drug Tests?

When Do Nursing Homes Carry Out Drug Tests?

Nursing homes carry out initial drug tests during the hiring process. A drug test will form part of your background check and can only be carried out with your permission. And, you will, of course, need to give your permission if you want the job.

Drug tests and background checks are carried out once you receive and accept a conditional offer of employment.

Once you begin work at a nursing home, you may be subject to further drug testing depending on the policies in place at your particular nursing home.

These drug tests may be:

  • Conducted at random.
  • Carried out when there is reasonable suspicion of drug use.
  • Given if drugs go missing.
  • Required after an accident or incident.

Drug Testing On A Periodic Or Random Basis

Some nursing homes will choose to test employees on a periodic or random basis.

Periodic drug tests are usually carried out annually during a physical exam.

Random drug tests in some nursing homes are carried out each month, while in others, the testing is less frequent.

When random drug tests form part of the facility’s drug testing policy, employees are usually selected with an automated system to ensure that the selection process is fair.

Because the selection process is random, you could be chosen for a random drug test multiple times each year, or not at all.

Do Nursing Homes Drug Test Certified Nursing Assistants?

As a certified nursing assistant, you will usually have to pass a drug test as part of your pre-employment background check.

If your nursing home’s drug testing policy allows for random or periodic drug testing, and you use any of the drugs that are routinely tested for, the best course of action is to stop using drugs completely.

As a certified professional, you could lose your certification if you fail a drug test, which means you won’t be able to work at another nursing home facility unless you can convince your state board of nursing to reinstate your credentials.

Reapplying for certification is usually a very lengthy and expensive process with no guarantee of success.

Do They Drug Test Patients at Nursing Homes?

Nursing homes don’t require drug testing for residents on admission, but there are some circumstances where a drug test could be called for.

A drug test for a patient could be ordered if nursing staff suspect that the patient is using illegal substances or is misusing prescription drugs.

Drug misuse can cause behavior changes and lead to safety issues for the patient, staff, and other residents. And sometimes drug use can interfere with the patient’s treatment plan and make other medications less effective.

In these cases, a blood sample would be tested to find out exactly what substances the patient was using and the amounts involved.

See Also: How Do CNAs Get Drug Tested?

How Do Nursing Homes Drug Test?

Drug tests for nursing home staff will usually be saliva or urine tests. Nursing staff and certified nursing assistants will generally be asked to provide a urine sample for testing, while other non-caregiving staff may only need to submit to a saliva test.

The urine drug test for nursing staff will screen for the following substances using a 10-panel drug test.

  • Opiates – heroin, morphine, opium, codeine
  • Cocaine
  • Marijuana
  • Amphetamines – including methamphetamine, speed, and ecstasy
  • Phencyclidine (PCP)
  • Benzodiazepines – alprazolam, clonazepam, diazepam
  • Barbiturates – butalbital, phenobarbital, secobarbital
  • Methadone – opiate analgesic
  • Methaqualone – quaaludes
  • Propoxyphene – Darvocet

If your urine sample tests positive for any of the above substances, a confirmatory test will be carried out using gas chromatography analysis.

Other nursing home staff given a saliva test will be screened for these drugs:

  • Cocaine
  • Opiates
  • Marijuana
  • Amphetamines
  • Phencyclidine

Frequent Asked Questions (FAQs)

What Happens If You Fail A Nursing Drug Test?

What Happens If You Fail A Nursing Drug Test?

A failed drug test must be confirmed with a more thorough laboratory gas chromatography analysis. Nurses who receive a positive drug test result after the confirmatory analysis will lose their job.

Also, their employer has a responsibility to report the matter to the state board of nursing who will investigate, and may then suspend or revoke, a nurse’s license.

A nurse may face charges for practicing while impaired. If you’re a nurse who has failed a drug test, you should seek legal advice right away.

Do Nurses Do Drug Tests?

Yes, nurses have to take drug tests. Healthcare facilities will carry our pre-employment drug screens and they may also choose to conduct random drug testing.

You should also expect to be given a drug test anytime you are involved in an accident or incident at work.

Nurses can also be drug tested if drugs at the facility go missing, and if a patient or other staff member makes a complaint about suspected drug use.

What Is An In-House Drug Test?

In-house drug testing is drug testing carried out at a workplace instead of at a medical facility. In-house drug testing is usually carried out in one of two ways using either a saliva sample or a urine sample. This type of drug testing saves employers money and produces faster test results.

Staff must be trained to carry out drug tests and if proper procedures are not followed, an employee can dispute a positive result and take legal action against the employer. Positive tests must be sent to a laboratory for confirmation.

Are Home Drug Tests As Sensitive As Lab Tests?

Home drug tests are very sensitive and will detect any recent drug use. The difference between home drug tests and lab tests is in the quantity of the drug detected.

While a home drug test can tell you that drugs are present in the sample, only a lab test can tell you exactly how much of a substance is present.

Must Read: Can A Felon Be A Nurse?


As a member of staff at a nursing home involved in primary patient care or in an ancillary role, you are subject to drug testing in line with the policies in place at the facility you wish to work at.

Nurses and certified nursing assistants will need to pass a pre-employment drug test, but applicants for other roles may not need to take a drug test.

Once hired, you’ll find any ongoing drug testing requirements explained in your employee handbook. Ongoing testing may include random drug testing, reasonable cause drug testing, and post-incident drug testing.

Failing a drug test as a nursing professional can have serious long-term consequences beyond the loss of your current job. You could face revocation of your nursing license and possible criminal charges.

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