Drug theft by health care workers has become so common that it accounts for nearly one-fifth of all abuse cases affecting elderly Minnesotans, the state Department of Health reported Monday.

In a sign of growing concern over the abuse of prescription drugs, state officials began a separate count of "drug diversion" incidents for the first time in their latest report on neglect and exploitation of vulnerable Minnesotans.

State investigators examined 192 allegations of drug theft during the 12 months ending in June 2014; they substantiated 27 cases perpetrated by 14 health care workers.

In some cases, nursing home staff replaced patients' oxycodone or Vicodin with over-the-counter pills; in others they forged documents to obtain medications.

"Drug diversion and prescription abuse is a growing area of concern nationally and in Minnesota," state Health Commissioner Dr. Ed Ehlinger said in a statement. "We want patients to be aware of the possibility of drug theft, we want workers to know it will not be tolerated, and we want providers to help prevent it by using best medicine management and tracking practices."

Overall, the agency substantiated 141 cases of abuse, neglect, or financial exploitation of vulnerable adults during the period.

In a 2014 incident disclosed Monday, a staff member removed a narcotic pain-relieving patch from a patient experiencing chronic pain, the Health Department report said. The employee at Cerenity Care Center in St. Paul lifted a bedsheet off a resident and removed a fentanyl patch from the resident's back and then left the facility. The staff member, who was not scheduled to work in the resident's room, was reported to police, the Health Department said.

About 70 percent of the substantiated cases of employees stealing medication from residents took place in nursing homes, the report said.

Added security measures

The findings shed new light on a long-standing problem in Minnesota nursing homes and hospitals.

From 2005 to 2011, Minnesota health care facilities reported about 250 cases of stolen or missing prescription drugs. A state-appointed task force of law enforcement and heath officials released the 2012 report following a spike in prescription drug abuse.

Since then, Minnesota hospitals have adopted elaborate procedures to track opioids and other painkillers. Some have added surveillance cameras, and many use locked drug cabinets and bar-code tracking of medications.

Nursing homes, too, are adopting new strategies.

Ecumen, one of the largest owners of long-term care homes, focuses on training and educating new employees on how to prevent drug diversion. Every shift, nurses are tasked with counting the narcotics and controlled substances.

Jennifer Severson, director of communications for Ecumen, said the company has not experienced a recent major drug diversion incident. A resident in pain at the Ecumen Lakeshore nursing home exposed a nurse's theft of hundreds of painkillers in 2012.

"It's really about deterrence and having good sound policies in place and practices," Severson said.

To prevent drug theft or diversion, the Health Department recommends:

• Reporting any concerns to a doctor or caregiver's employer.

• Knowing your medications and doses.

• Disposing of unused medications properly.

• Listening to family members complaining of pain when their medical log shows they received their medications.