When must the signed agreement between the Administrator and DON be filed with the Department?

The signed agreement between the Administrator and the Director of Nursing (DON) must be filed with the Department during the application for an initial license. This process ensures that the Department has all necessary documentation to verify that there is a formal understanding and agreement regarding the roles and responsibilities of both the Administrator and the DON in the operation of a healthcare facility.

This requirement serves essential regulatory purposes: it confirms that both positions have been filled appropriately and that there is a clear framework for accountability in delivering care. By filing this agreement during the initial licensing process, the Department can ensure that proper governance structures are in place from the outset, setting a foundation for compliance with ongoing operational standards. This proactive measure helps to maintain the safety and quality of care provided within the facility.

The other options suggest scenarios that do not align with the regulatory requirements set by COMAR, as the focus is on the initial licensing stage, not on circumstances such as audits or staff changes.