ALJDEC decisions subject to certification as final

20A-1509074-NUR · State Board of Nursing · 2021-03-25

IN THE OFFICE OF ADMINISTRATIVE HEARINGS

IN THE MATTER OF REGISTERED

NURSE LICENSE NO. RN159336

ISSUED TO:

HEIDI DAWN HOLLINS,

aka HEIDI DAWN STEUBER,

RESPONDENT.

No. 20A-1509074-NUR

ADMINISTRATIVE LAW JUDGE DECISION

HEARING SESSIONS: December 9, 2020 and February 3, 2021.

APPEARANCES: Teresa M. Sanzio, Esq., for Appellant. Assistant Attorney General Elizabeth Campbell for Arizona State Board of Nursing.

ADMINISTRATIVE LAW JUDGE: Kay A. Abramsohn

_____________________________________________________________________

FINDINGS OF FACT

Heidi Dawn Hollins (“Respondent”) holds Board issued Registered Nurse

License Number RN159336 in the State of Arizona.

2. From February 2010 until October of 2015, Respondent worked as a registered nurse at Banner University Medical Center (“Banner University”) in Phoenix, Arizona.

3. On September 29, 2015, the Board received a self-report from Respondent stating that on September 29, 2015, while working at Banner University, she was asked to take a “for-cause” drug test. Respondent admitted to using recreational marijuana.

4. On or about November 2, 2015, the Board received a complaint from Banner University reporting that Respondent’s employment was terminated after a positive urine drug test (marijuana) and suspicion of narcotic diversion.

a. On October 13, 2015, after reviewing narcotic administration reports and concerns related to the administration of narcotics, Banner University requested a “for-cause” drug test.

b. Respondent’s test was positive for marijuana, hydrocodone, hydromorphone, and oxymorphone.

c. On October 13, 2015, Respondent had prescriptions for hydrocodone, hydromorphone, and oxymorphone.

d. Respondent admitted to recreational marijuana use.

e. Banner University terminated Respondent’s employment on October 23, 2015.

5. From February 2016 until November 2016, Respondent worked as a registered nurse at Honor Health John C. Lincoln (“Honor Health”) in Phoenix, Arizona. Prior to being hired, Respondent submitted to pre-employment drug the results of which were negative.

6. On November 14, 2016, the Board received a complaint from Honor Health reporting that Respondent’s employment had been terminated for suspected narcotic drug diversion.

a. On October 22, 2016, after review of narcotic administration reports and concerns related to the administration of narcotics, Honor Health requested a “for- cause” drug test.

b. Respondent’s test was positive for the opiates oxycodone, oxymorphone, hydromorphone, and morphine.

c. On October 22, 2016, Respondent had prescriptions for oxycodone, oxymorphone, and hydromorphone.

d. Respondent did not have a prescription for the morphine, which is a narcotic drug and a Schedule II Controlled Substance.

e. On November 4, 2016, Respondent resigned from Honor Health in lieu of termination.

7. During the investigation in this matter, on January 11, 2019, Respondent admitted to Board staff that she had received morphine from a family member in October 2016, and had taken the morphine in an attempt to control pain associated with a medical condition.

8. Respondent was working part-time as a registered nurse for Hospice at Home of Arizona. On October 14, 2019, Respondent was contacted to attend a death call for Patient RH at a group home in Mesa, Arizona.

9. At the group home, Respondent and a caregiver properly disposed of Patient RH’s opened medications. Respondent and the caregiver completed and signed a Drug Disposal Form listing those medications as destroyed.

10. In an atypical circumstance, there were two unopened bottles of Morphine for Patient RH.

11. Respondent removed the two unopened bottles of Morphine from the group home, ostensibly to return the unopened medication to the pharmacy. At that time, the two bottles were not accounted for on the Drug Disposal Form, as either being destroyed or for some other action being taken.

12. The group home policy required that all medications be destroyed.

13. After Respondent left the group home with the two bottles of Morphine, she was contacted by group home staff. According to group home staff, Respondent initially denied taking the Morphine; however, Respondent denied having denied the fact. That same evening, Respondent subsequently, electronically, submitted an altered Drug Disposal Form which now showed the two bottles of Morphine on the Drug Disposal Form. That same evening Respondent returned to the group home and destroyed both bottles of Morphine with a caregiver.

14. On October 15, 2019, Respondent submitted to a drug test which was negative for any unauthorized substances.

15. Hospice at Home terminated Respondent’s employment on November 1, 2019, for removing the Morphine from the group home and altering the Drug Disposal Form.

16. For purposes of Arizona Revised Statutes (“A.R.S.”) § 32-1601(26)(d), the conduct described in the Findings of Fact #2 - #7 constitutes conduct or practice that is or might be harmful to the health of a patient or the public pursuant to Arizona Administrative Code (“A.A.C.”) R4-19-403(18)(Obtaining, possessing, administering, or using any narcotic, controlled substance, or illegal drug in violation of any federal or state criminal law, or in violation of the policy of any health care facility, school, institution, or other work location at which the nurse practices). It is illegal to possess or use narcotic drugs without a prescription.

17. For purposes of A.R.S. § 32-1601(26)(d), the conduct described in the Findings of Fact #8- #15 constitutes conduct or practice that is or might be harmful to the health of a patient or the public pursuant to A.A.C. R4-19-403(7)(Failing to maintain a patient record that accurately reflects the nursing assessment, care, treatment, and other nursing services provided to the patient).

18. For purposes of A.R.S. § 32-1601(26)(d), the conduct described in the Findings of Fact #8 - #15 constitutes conduct or practice that is or might be harmful to the health of a patient or the public pursuant to A.A.C. R4-19-403(8)(b)(Falsifying or making a materially incorrect, inconsistent, or unintelligible entry in any record pertaining to obtaining, possessing, or administering any controlled substance as defined in the federal Uniform Controlled Substances Act, 21 U.S.C. 801 et seq., or Arizona’s Uniform Controlled Substances Act, A.R.S. Title 36, Chapter 27).

19. For purposes of A.R.S. § 32-1601(26)(d), the conduct described in the Findings of Fact #8 - #15 constitutes conduct or practice that is or might be harmful to the health of a patient or the public pursuant to A.A.C. R4-19-403(16)(Removing, without authorization, a narcotic, drug, controlled substance, supply, equipment, or medical record from any health care facility, school, institution, or other work place location).

20. For purposes of A.R.S. § 32-1601(26)(d), the conduct described in the Findings of Fact #8 - #15 constitutes conduct or practice that is or might be harmful to the health of a patient or the public pursuant to A.A.C. R4-19-403(31)(Practicing in any other manner that gives the Board reasonable cause to believe the health of patient or the public may be harmed.)

CONCLUSIONS OF LAW

1. The Arizona State Board of Nursing (“Board”) has the authority to regulate and control the practice of nursing in the State of Arizona, pursuant to A.R.S. §§ 32-1606, 32-1663, 32-1664, 41-1092.11(B). The Board also has the authority to impose disciplinary sanctions against the holders of nursing licenses for violations of the Nurse Practice Act, A.R.S. §§ 32-1601 to -1669 and Arizona Administrative Code (“A.A.C.”) Rules 4-19-101 to -815.

2. The Board bears the burden of proof and must establish cause to discipline Respondent’s registered nurse license by a preponderance of the evidence. See A.R.S. § 41-1092.07(G)(2); A.A.C. R2-19-119(A) and (B)(1); see also Vazanno v. Superior Court, 74 Ariz. 369, 372, 249 P.2d 837 (1952).

3. “A preponderance of the evidence is such proof as convinces the trier of fact that the contention is more probably true than not.” Morris K. Udall, Arizona Law of Evidence § 5 (1960). A preponderance of the evidence is “evidence which is of greater weight or more convincing than evidence which is offered in opposition to it; that is, evidence which as a whole shows that the fact sought to be proved is more probable than not.” Black’s Law Dictionary 1120 (8th ed. 2004).

4. Respondent’s conduct and the circumstances described in the Findings of Fact constitute unprofessional conduct pursuant to A.R.S. § 32-1601(26)(d) (any conduct or practice that is or might be harmful or dangerous to the health of a patient or the public). Such conduct and circumstances are grounds for disciplinary action pursuant to A.R.S. § 32-1663 and § 32-1664.

5. Respondent’s conduct and the circumstances described in the Findings of Fact constitute unprofessional conduct pursuant to A.R.S. § 32-1601(26)(g) (Willfully or repeatedly violating a provision of this chapter or a rule adopted pursuant to this chapter). Such conduct and circumstances are grounds for disciplinary action pursuant to A.R.S. § 32-1663 and § 32-1664.

6. Respondent’s conduct and the circumstances described in Findings of Fact constitute unprofessional conduct pursuant to A.R.S. § 321601(22)(j) (Violating a Board statute or rule). Such conduct and circumstances are grounds for disciplinary action pursuant to A.R.S. § 32-1663 and § 32-1664.

7. Accordingly, the Board established that Respondent engaged in unprofessional conduct as defined by A.R.S. § 32-1601(26)(d), (g), and (j); and A.A.C. R4-19-403(7), (8)(b), (16), and (31). Thus, the Board established cause to impose a disciplinary sanction against Respondent’s license under A.R.S. § 32-1663(D) and A.R.S. § 32-1664(O).

RECOMMENDED ORDER

Based on the foregoing, the Administrative Law Judge recommends that the Board place Respondent Heidi Dawn Hollins, aka Heidi Dawn Steuber, Registered Nurse License Number RN159336, on a 12-month probation to include drug testing and specified employer supervision with submission of specified employer monitoring and reports.

In the event of certification of the Administrative Law Judge Decision by the Director of the Office of Administrative Hearings, the effective date of the Order will be five days from the date of that certification.

Done this day, March 25, 2021.

/s/ Kay A. Abramsohn

Administrative Law Judge

Transmitted electronically to:

Joey Ridenour, RN, MN, Executive Director

State Board of Nursing