F0689

E

Unsecured Vapes and Illicit Substances in Resident Rooms

Blacksburg, Virginia Survey Completed on 02-24-2026

Penalty

No penalty information released

Summary

Facility staff failed to ensure that electronic cigarettes (vapes) and illicit substances were securely stored and controlled, contrary to the written smoking policy prohibiting smoking/vaping inside the facility and prohibiting residents from keeping smoking paraphernalia in their possession. The policy required all such items to be kept at the nurse’s station, in the med room, or another locked safe area. Despite this, multiple residents reported having vapes in their rooms and charging them independently, and staff interviews and documentation showed a pattern of noncompliance with the smoking policy and lack of secure storage of these items.

One resident with hemiplegia, generalized muscle weakness, chronic kidney disease, and intact cognition was care planned as an active smoker with a history of noncompliance and prior loss of smoking privileges. The care plan included an intervention to ensure smoking items were stored correctly per policy, but the resident reported that he vaped, kept his vape in his room, and charged it without staff assistance. The social worker reported having taken multiple marijuana and nicotine vapes from this resident’s room in the past, most recently a few months before the survey, with the items found in plain sight. The resident’s safe smoking assessment did not address vape use, and staff interviews showed that, although the activities department stated vapes were to be locked and only used at designated smoking times, they had only “heard” that residents had vapes and had not observed them.

Another resident with a history including cervical vertebrae dislocation, chronic pain syndrome, generalized muscle weakness, and intact cognition was care planned for a history of smoking with a goal not to smoke without supervision, but the safe smoking assessment listed the resident as a non-smoker. This resident stated he had a vape in a tote bag on his bed, that staff allowed him to vape while in bed, and that he charged the vape himself using his phone charger. A third resident, with diabetes, neuropathy, need for continuous supervision, and intact cognition, was care planned as a smoker with a history of noncompliance and documented vape use. A surveyor noted an odor resembling marijuana from this resident’s room after another resident entered and closed the door; the administrator also noted the odor, and later the resident admitted to having marijuana in his room and turned over a small baggie and a lighter. Multiple staff, including LPNs, CNAs, housekeepers, and a unit manager, reported smelling marijuana in or near this resident’s room over time, but the social worker, who stated she had received such reports and requested room searches, had not documented these conversations, and the clinical record contained no documentation of these reports or requests.

A fourth resident with Alzheimer’s disease, major depressive disorder, generalized arthritis, generalized muscle weakness, and intact cognition was documented in a physician progress note as reporting THC vape use for pain management. The resident’s care plan did not address smoking status, and the safe smoking assessment listed the resident as a non-smoker. This resident stated she did not smoke cigarettes but had a vape in her room and could charge it without staff assistance. Staff interviews indicated that CNA and housekeeping staff had noticed marijuana odors in the hallway and specifically from the vicinity of this resident’s room, but some staff did not report these odors because they were unsure of the source. The physician later stated he knew the resident used THC for pain control but had no knowledge that she was using it in the facility. Across these residents, the facility’s own policy requiring secure storage of vapes and smoking materials and prohibiting unauthorized controlled substances was not implemented, and staff reports and observations of marijuana odors and resident possession of vapes were not consistently documented or acted upon in a manner that ensured secure storage and prevention of misuse or hazards.