WOLF POINT, MT - Faith Lutheran Home has been operating without a licensed nursing home administrator since December 2024, creating regulatory violations that affect all residents at the 60-bed facility, according to a March 2025 inspection report.
Administrator Position Left Vacant Since December
The facility has operated without proper leadership since December 27, 2024, when the interim Director of Nursing Services departed after contract negotiations failed. The position has remained unfilled for over two months, despite federal regulations requiring nursing homes to maintain a full-time, state-licensed administrator at all times.
During interviews with inspectors, staff member A, currently serving as Director of Nursing, reported that she had applied for administrator licensing with the State of Montana but was still awaiting approval. She acknowledged that "the facility did not have a current administrator, and the facility had not advertised for the open administrator position."
The interim Chief Executive Officer confirmed that as of December 4, 2024, Faith Lutheran Home had not employed a Montana licensed Nursing Home Administrator. This regulatory gap occurred when the previous interim administrator's licensing and contract renewal plans fell through in late December.
Regulatory Requirements and Compliance Issues
Federal regulations mandate that nursing homes maintain a governing body legally responsible for establishing facility policies and appointing a properly licensed administrator. Montana state law requires nursing home administrators to hold current state licenses to ensure they meet education, training, and competency standards necessary for facility management.
The facility's own policy manual, last revised in June 2023, explicitly states that "the governing body appoints a licensed State administrator to be responsible for management of the facility." However, verification through Montana's Department of Labor and Industries showed no current temporary or permanent nursing home administrator license for the facility as of the inspection date.
Impact on Operations and Resident Care
Operating without a licensed administrator creates cascading effects throughout facility operations. Administrators are responsible for ensuring compliance with health and safety regulations, overseeing staff performance, managing budgets, and coordinating resident care services. Without proper administrative oversight, facilities risk compromising quality standards and regulatory compliance.
The violation affects all residents because administrators play critical roles in maintaining staffing levels, ensuring proper care protocols, coordinating with healthcare providers, and responding to emergency situations. They also serve as the primary point of contact for families, regulatory agencies, and medical professionals.
Federal regulations reference administrators in numerous facility requirements, including infection control programs, quality assurance activities, resident rights protections, and emergency preparedness plans. Without a licensed administrator, the facility cannot fully comply with these interconnected regulatory requirements.
Dual Role Complications
The situation became more complex when facility leadership considered having the Director of Nursing simultaneously serve as administrator. However, both positions require full-time commitment under federal regulations. During interviews, staff members indicated they were unwilling to work the extensive hours that would be required to fulfill both roles simultaneously.
This highlights a common challenge in rural healthcare facilities where finding qualified administrators can be difficult. The Director of Nursing position requires focused attention on clinical care coordination, staff supervision, and ensuring nursing standards compliance. Adding administrative responsibilities would create unrealistic workload expectations and potential conflicts between clinical and business priorities.
Industry Standards for Administrator Licensing
Nursing home administrators must complete specialized education programs, pass state licensing examinations, and maintain continuing education requirements. These standards exist because administrators must understand complex healthcare regulations, financial management, human resources, and resident care coordination.
The licensing process typically includes coursework in healthcare administration, supervised practical training, and demonstration of competency in areas such as resident care management, regulatory compliance, and facility operations. Montana, like other states, has specific requirements that must be met before issuing administrator licenses.
Additional Issues Identified
The inspection revealed that the facility had not provided documentation of recruitment efforts for the administrator position when requested by surveyors. The facility's Key Personnel Contact List dated March 10, 2025, did not include administrator contact information, further confirming the vacant position.
State licensing verification showed no current administrator credentials for the facility, creating ongoing compliance concerns that extend beyond the immediate staffing issue to broader regulatory obligations.
The violation carries a "minimal harm or potential for actual harm" classification but affects many residents due to the administrator's central role in facility operations and regulatory compliance.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Faith Lutheran Home from 2025-03-13 including all violations, facility responses, and corrective action plans.
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