Report a change in administrator or director of nursing

Learn how to report a change of administrator or director of nursing.

Division of Health Care Facility Licensure and Certification

The Details

What you need

When reporting a change of administrator or director of nursing under 105 CMR 150.002(D)(11), a facility must:

We no longer accept paper reports from nursing homes on these change notices.

How to report

Reporting Resignations of an Administrator or Director of Nursing

Report the following for these required HCFRS fields:

  1. “Enter a Patient or Resident” - Indicate “No”
  2. “Incident Date” - Indicate the effective date of the resignation
  3. “Incident Type” - Indicate “Change in Administrator/DON”
  4. “Incident Narrative” - Indicate the name and license number of the individual who resigned, and the date that they resigned

Reporting Dismissals of an Administrator or Director of Nursing

Report the following for these required HCFRS fields:

  1. “Enter a Patient or Resident” - Indicate “No”
  2. “Incident Date” - Indicate the effective date of the dismissal
  3. “Incident Type” - Indicate “Change in Administrator/DON”
  4. “Incident Narrative” - Indicate the name and license number of the individual dismissed, the date that they were dismissed, and the reason or reasons for dismissal

Reporting a New Administrator or Director of Nursing

Report the following for these required HCFRS fields, and attach a completed New Administrator/DON Worksheet

  1. “Enter a Patient or Resident” - Indicate “No”
  2. “Incident Date” - Indicate the start date
  3. “Incident Type” - Indicate “Change in Administrator/DON”
  4. “Incident Narrative” - Indicate the name and license number of the new administrator or director of nursing, and the date that he or she started or will start in that position
  5. Complete, scan, and attach a New Administrator/DON Worksheet

More info

To ensure new facility administrators and directors of nursing obtain access to critical information available from the Department, a New Administrator/DON Worksheet must be completed and attached to the report submitted when the Department is notified of a replacement. The consistent use of this form will ensure access to the following key resources:

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