Administrator accused of on-the-job drug use faces no licensing-board charges

An Iowa nursing home administrator fired last year after being accused of stealing patient medications and being under the influence of drugs at work is facing no charges from the licensing board that oversees her profession.

State records indicate Cassandra M. Strube of Estherville, a state-licensed nursing home administrator, was fired last November from Johnson County’s Atrium Village care facility for the willful destruction of the employer’s property, the unauthorized removal of the employer’s property, and the misuse of drugs.

Strube has been a state-licensed nursing home administrator since 2012 and has no record of any public discipline by the Iowa Board of Nursing Home Administrators, which regulates the profession.

In the past six years, the board has publicly sanctioned an Iowa administrator on only three occasions – despite the state’s own investigators documenting numerous incidents in which licensed administrators were reported to be directly involved in resident deaths, patient dumping, harassment, abuse, neglect, retaliation against employees and the falsification of records.

The head of the nine-member board, Michael Schueller of Epworth, on Tuesday referred all questions on the board’s activities to the state employees who provide administrative support for the board at the Iowa Department of Health and Human Services.

Asked why the board has taken disciplinary action in so few cases, Schueller said, “I guess I don’t know how to answer that question, we just take the cases as they go – but really it’s best if you call the state office because we’re just supposed to direct everything to them.”

According to state records, Atrium Village is a small facility, located in the town of Hills, that provides hospice care, physical therapy and other services to about a dozen residents. Last November, Strube was working as Atrium Village’s administrator and was also living there in what the facility calls a “guest room.”

According to testimony from Atrium Village officials at a recent state unemployment hearing, Strube was working the night of Nov. 29, 2022, when she obtained from the on-duty charge nurse a set of keys to access her guest room, which was locked. The set included a master key that could unlock the area where the facility stores the emergency medication kit, which includes drugs for resident use. Strube returned the keys to the nurse a short time later.

The next day, according to unemployment case testimony, a nurse arrived for work and allegedly found Strube walking about outside, saying she was locked out of the building. At the time, Strube was allegedly incoherent, appeared to be cold, had no coat or shoes, was missing one sock and her foot was bleeding. After Strube indicated she had taken some kind of medication, paramedics were summoned and a nurse went to Strube’s room to gather the administrator’s medications.

The nurse allegedly found the room in a disheveled state, with many loose pills on the floor, according to the Atrium officials’ testimony. The nurse also reported finding an open box that contained pills and observed bottles of pills on the windowsill. After collecting the pill bottles and giving them to paramedics, the nurse went to Strube’s office to find her emergency-contact information.

In the office, she found a sock on the floor and saw the window was left open. In addition, the phones were knocked off the hook, a plant had been torn apart, and various items were thrown about on the desk and scattered on the floor, according to the unemployment case testimony. After being notified of the situation, the facility’s board of directors called an emergency meeting and contacted the Johnson County Sheriff’s Department because of the pills found in Strube’s room. After a sheriff’s deputy asked the staff to check the emergency medication supply, a nurse allegedly confirmed there were drugs missing, according to the testimony.

Board members then examined Strube’s room and allegedly found more than 100 loose pills scattered about, along with opened packaging that matched those of the missing medications, according to testimony. Strube was contacted and allegedly stated that a stranger had attacked her in the facility and she had blacked out. The board, indicating it did not believe the explanation, fired Strube.

Iowa Workforce Development initially awarded Strube unemployment benefits, finding that she was fired for reasons that didn’t disqualify her from collecting benefits.

Atrium Village appealed that ruling and the matter went before Administrative Law Judge Daniel Zeno, who recently reversed the previous decision. Zeno ruled that Strube was fired for job-related misconduct and was not entitled to benefits. Strube should repay the $3,997 in benefits already collected, Zeno ruled.

The Iowa Department of Inspections and Appeals’ last published report of an inspection at Atrium Hills is dated August 2022, three months before the incident involving Strube. There’s no public record of any criminal charges in the case.

Kristine Tomasch, the current administrator at Atrium Village, said the incident was reported to DIA last year, and to the Iowa Board of Nursing Home Administrators and the state’s Medicaid Fraud Control Unit. She said Atrium Village has no other comment on the matter.

Strube could not be reached for comment. In the past, she has worked at the Anamosa Care Center, Trinity Senior Living Communities, Ruthven Community Care Center and other facilities.

A spokesman for the Johnson County Sheriff’s Department said they were called to the facility on Nov. 30 in response to a report of an assault. He said he couldn’t release any other information on the matter without jeopardizing an investigation that is still ongoing.