Medical Marijuana Raises Tough Questions for Nursing Homes
By NUSHIN RASHIDIAN AND ALYSON MARTIN
Every night before bed, Norma Winkler, 82, opens a small jar of cannabis oil and measures out a quarter-teaspoon to mix with homemade applesauce. Soon after she eats it, she drifts off to sleep.
Ms. Winkler, who lives in Rhode Island, where medical marijuana is legal, has endured chronic back pain since a car accident fractured her skull and spine at age 15. Operations haven’t helped, and other medicines don’t touch the pain that can keep her up through the night.
“It’s really been a lifesaver for me,” Ms. Winkler said of her cannabis oil. “I used to walk into the walls sometimes. I was so tired because I didn’t sleep.”
Today, she’s healthy enough to remain independent in her home and to operate the jewelry factory she owns. But she worries about what will happen if she needs institutional care. Would a long-term care facility allow her to use this particular medicine?
“I wouldn’t go if they didn’t allow me to take it,” Ms. Winkler said.
When states began embracing medical marijuana, few anticipated this inevitable scenario: patients using it would grow older, and many would need to enter assisted living and nursing homes. The prospect has just begun to raise difficult questions for administrators and state regulators.
Any patient using medical marijuana breaks federal law. Marijuana is listed as a Schedule 1 drug, which means the federal government considers it to have no medicinal value. Despite this, physicians in 14 states and the District of Columbia are allowed to recommend it. Legalization of medical marijuana is under consideration in eight additional states this year.
Though firm numbers are difficult to come by, experts say elderly patients like Ms. Winkler increasingly use medical marijuana to ease their pain. But many care facilities in which they reside, or will reside, receive federal funding through Medicare and indirectly through Medicaid.
Many facility administrators wonder how they can comply with federal law and preserve their reimbursements and at the same time permit residents to medicate with marijuana. At an American Health Care Association conference in early October, Fred Miles, a Colorado lawyer who represents health care providers, gave a presentation called “Medical Marijuana — Are Nursing Homes Going to Pot?”
The issue is badly in need of federal clarification, he said.
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