Administrator for Drug Use Faces No Charges From Licensing Board

A nursing home administrator in Iowa was let go last year after being found under the influence of drugs while working. She is also accused of unlawfully absconding with patient medications. Despite these allegations, however, the former administrator will not be facing any charges from the Iowa Board of Nursing Home Administrators that regulates her profession.

The Iowa Capital Dispatch reports that Cassandra M. Strube of Estherville was terminated from her position at Johnson County’s Atrium Village in November 2022. Strube has been employed as a nursing home administrator in the state for the last decade. During that time, she had no prior record of facing any public disciplinary action from the Iowa Board of Nursing Home Administrators.

The Incident That Led to Strube’s Termination

Officials from Atrium Village recently testified that Strube had been given a “guest room” to live in at the facility during her employment there. Atrium Village is fairly small, housing only a dozen or so residents. In addition to providing living quarters, it provides multiple other services to its residents, including physical therapy and hospice care.

The incident that led to Strube’s termination occurred on the night of November 29, 2022, when she was working. It was during this shift that she reportedly asked the on-duty charge nurse to let her borrow a set of master keys. Her guest room was locked and she needed to access it. This master set also contained keys to other areas at the facility, including a locked area where the facility’s emergency kit and other resident medications are stored. A short time later, Strube returned the master keys to the charge nurse.

The next day, another nurse coming into work discovered Strube in a disheveled and incoherent state. According to the nurse, Strube was outside of the building that morning without a coat or shoes. She appeared to be cold, was missing one sock and was also bleeding from her foot.

The nurse said that Strube indicated she had taken some drugs, triggering the nurse to call the paramedics. Another nurse searched Strube’s living quarters to determine what pills she might have swallowed. The nurse found Strube’s room in a bad state, noting that there were opened pill bottles and loose pills strewn on the floor. The nurse also noted the window had been left open, a plant was torn apart and various other items were thrown about the room.

During the investigation, the drugs found in Strube’s living quarters turned out to be taken from the facility’s emergency medical supply. The facility had an emergency board meeting and decided to notify the Johnson County Sheriff’s Department for further investigation into the incident.

Despite the evidence, Strube alleges that she was attacked by a stranger in the facility that night, during which she blacked out. The facility’s board did not buy that story and Strube was consequently fired.

Initially, Strube was approved to collect unemployment benefits. However, her eligibility was later rescinded by Administrative Law Judge Daniel Zeno. He determined that her actions disqualified her from receiving benefits and that she should also have to pay back the benefits she had already collected.

Is the Iowa Licensing Board Lax in its Duties?

Despite being found under the influence of drugs while on duty, Strube is not facing any charges from the board. She will also receive no disciplinary actions, other than the loss of her job.

The fact is, the board has a history of rarely assessing public disciplinary actions against Iowa administrators. Historically this has been true, even when serious circumstances seem to require some type of action should be taken.

Some examples where licensed administrators were directly involved and yet not disciplined include:

• Patient dumping
• Harassment of residents
• Incidents of abuse or neglect
• Retaliation against employees
• Falsifying nursing home records
• Actions or non-actions that led to resident deaths

Despite state investigators documenting these and other serious incidents, the board has only publicly disciplined licensed Iowa administrators on three occasions in over six years. When Michael Schueller of Epworth, currently the head of the board, was asked to give an explanation, he deferred to the board in charge of the Iowa Department of Health and Human Services.

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