COLUMBUS, Ohio (AP) — The state’s efforts to reduce prescription painkiller theft in nursing homes has met with a cool reception from Ohio’s nursing home industry, which says a letter sent by Attorney General Mike DeWine to facilities contains incomplete and a “potentially misleading description” of their legal obligations for reporting wrongdoing.

The Ohio Health Care Association also takes issue with DeWine’s allegation that prescription drug theft constitutes abuse or neglect of patients, saying that’s a blanket conclusion not backed up by evidence.

“Indeed, we are not aware of any evidence that contradicts our general understanding that in the limited instances of drug diversion in Ohio long-term care facilities, in most cases the residents do not miss any medications,” the association said in its response to DeWine’s office late last month, which was obtained by The Associated Press through a public records request.

The letter DeWine sent to all nursing homes in the state reminded them of their obligations under law to report suspected illegal activity and lets them know of assistance available from the state to prosecute prescription drug theft.

The health care association says the letter suggests DeWine’s office should receive such reports, when in fact nursing homes report issues to the state Department of Health.

Nursing homes are worried about the perception that residents are being abused by the theft of drugs, said Peter Van Runkle, executive director of the health care association.

“Creating that perception that people in skilled nursing facilities are being abused or neglected because there may be cases of drug diversion — those two don’t necessarily add up,” Van Runkle said.

The association says it’s committed to caring for patients, preventing drug thefts and following reporting requirements.

DeWine’s office says the letter was a reminder of the importance of reporting drug thefts, and it disagrees that there was anything misleading about the notice.

The state also says that reports from nursing homes about drug thefts have fallen sharply in recent years, with 18 reports in 2009 and 26 in 2010, but only seven last year and just six so far this year.

“Our biggest issue or concern, quite honestly, is that it’s not getting reported at all,” said Keesha Mitchell, section chief of DeWine’s health care fraud unit.

Until the state investigates, “You don’t know if a patient is being abused or not,” she said.

Van Runkle said he’s not aware of instances of drug thefts going unreported.

Some thefts — including operations caught on camera by an attorney general’s investigation — show employees stealing prescriptions from a room where medicines are stored.

But other cases have involved employees attempting to remove patients’ pain patches or water down drugs they’re receiving. In those cases, the patient does suffer, Mitchell said.

That was the allegation against an employee of a central Ohio nursing home in 2010, after resident Timothy Tyler said an aide repeatedly came into his room and removed his patches.

Eventually, he fought her after she tried to take it again.

“She got the patch off of me, and she says, ‘Well, I’ll take it down to the nurse’s station,'” Tyler, 73, of Canal Winchester in suburban Columbus, said at a news conference last month.

“I said, ‘No, we’ll both take it down to the nurse’s station,'” he said.

Tyler says the nursing home was upset when his son called police and a sheriff’s deputy came to investigate.

The home, Winchester Place Nursing and Rehabilitation Center, also in Canal Winchester, says the incident was an isolated one, police and the state Health Department were contacted and the employee was dismissed immediately.

“We support the Attorney General’s initiative and appreciate his efforts to help stop pharmaceutical drug theft,” executive director Chris Hudson said in a statement.

The employee pleaded guilty to one count of robbery in 2012 and was sentenced to 26 days in jail and three years of post-release supervision, according to the attorney general’s office.

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