Do Not Return (DNR) Management

AdminSupervisor

The Do Not Return (DNR) system in HCSS Events Platform allows authorized users to flag caregivers who should not be assigned to future events. A DNR flag is a serious designation that prevents a caregiver from appearing in candidate pools and blocks assignment creation. This guide covers how to flag caregivers, manage DNR records, and understand how DNR status interacts with BlueSky CRM imports.

What Is a DNR Flag?

A DNR flag marks a caregiver as ineligible for future event assignments. Common reasons for applying a DNR include:

• Performance issues -- Caregiver did not meet clinical standards.
• Behavioral concerns -- Unprofessional conduct, policy violations, or interpersonal conflicts.
• Attendance problems -- No-call/no-show, repeated tardiness, or early departure.
• Facility request -- The client facility has requested the caregiver not return.
• Compliance failure -- Failed drug screen, expired credentials, or other compliance issues.
• Other -- Any other reason documented by the flagging user.

caution

A DNR flag has significant consequences for the caregiver. Ensure you have proper authorization and documentation before applying this designation.

Flagging a Caregiver as DNR

🔒Requires permission: Caregivers.DNR

From the Caregiver Detail Page

1. Navigate to the caregiver's detail page (see Caregiver Details).
2. Click the Flag DNR button in the header area.
3. The DNR dialog opens. Complete the following fields:

Field	Required	Description
Reason Category	Yes	Select from: Performance, Behavioral, Attendance, Facility Request, Compliance, Other.
Detailed Reason	Yes	Free-text explanation of why the DNR is being applied. Minimum 20 characters.
Facility Scope	No	If the DNR applies only to a specific facility, select it here. Leave blank for a system-wide DNR.
Supporting Documentation	No	Upload supporting files (incident reports, emails, facility letters). Max 10 MB per file.
Effective Date	Yes	The date from which the DNR takes effect. Defaults to today.
Review Date	No	Optional future date to review whether the DNR should be maintained or lifted.

4. Review the information and click Confirm DNR.
5. The caregiver's status changes to DNR immediately.

From the Caregiver List (Bulk DNR)

Admin

1. Navigate to the Caregivers list page.
2. Select one or more caregivers using the checkboxes.
3. Click the Bulk Actions dropdown and select Flag as DNR.
4. Complete the DNR dialog. The same reason and category will apply to all selected caregivers.
5. Click Confirm DNR.

note

Bulk DNR operations require the Admin role. Supervisors can only flag individual caregivers.

Viewing DNR Caregivers

To view all caregivers with a DNR flag:

1. Navigate to Caregivers in the left sidebar.
2. Set the Status filter to DNR.
3. The list shows all DNR-flagged caregivers, sorted by the date the DNR was applied (most recent first).

DNR Details

Click a DNR caregiver's name to view their detail page. The header displays a prominent DNR badge. The Personal Info tab includes a DNR Information section with:

Field	Description
Reason Category	The category selected when the DNR was applied.
Detailed Reason	The explanation provided by the flagging user.
Facility Scope	"All Facilities" or the specific facility name.
Flagged By	The user who applied the DNR flag.
Flagged Date	The date and time the DNR was applied.
Review Date	The scheduled review date, if set.
Supporting Documents	Links to uploaded documentation.

Removing a DNR Flag

🔒Requires permission: Caregivers.DNR

A DNR flag can be removed if circumstances change:

1. Navigate to the DNR caregiver's detail page.
2. In the DNR Information section, click Remove DNR.
3. The Remove DNR dialog opens. Complete the following fields:

Field	Required	Description
Removal Reason	Yes	Explanation of why the DNR is being lifted.
Approved By	Yes	Name of the authorizing manager or administrator.
Restore to Status	Yes	Select whether to restore the caregiver to Active or Inactive status.

4. Click Confirm Removal.
5. The caregiver's status changes to the selected status.

info

Removing a DNR does not delete the historical record. The DNR history is preserved in the caregiver's audit log for compliance and reference purposes.

DNR and BlueSky CRM Imports

The DNR status in the platform interacts with BlueSky CRM imports in the following ways:

During Event Imports

When caregivers are imported from BlueSky CRM for a new event:

1. The import process checks each caregiver against the the platform DNR list.
2. System-wide DNR: The caregiver is excluded from the import entirely. They will not appear in the event's candidate pool.
3. Facility-scoped DNR: The caregiver is excluded only if the event is at the flagged facility. They can still be imported for events at other facilities.

DNR Visibility in Import Reports

After an import, the import summary report includes a DNR Exclusions section that lists:

• Caregiver name and BlueSky ID.
• DNR reason category.
• Whether the exclusion was system-wide or facility-specific.

This report helps administrators verify that DNR rules are being applied correctly.

Synchronization with BlueSky CRM

DNR status in the platform is not synchronized back to BlueSky CRM. The two systems maintain separate records:

System	DNR Scope
BlueSky CRM	Manages caregiver eligibility at the CRM level. A BlueSky deactivation sets the caregiver to Inactive in the platform.
the platform	Manages event-specific DNR flags. An the platform DNR does not affect the caregiver's BlueSky status.

tip

If a caregiver should be permanently barred from all HCSS events, coordinate with the BlueSky CRM team to deactivate their profile in addition to applying the the platform DNR flag.

DNR Audit Trail

All DNR-related actions are logged in the system audit trail:

Action	Logged Details
DNR Applied	User, date/time, reason category, detailed reason, facility scope.
DNR Removed	User, date/time, removal reason, approved by, restored status.
DNR Import Exclusion	Event name, caregiver, exclusion type (system-wide or facility-specific).

To view the audit trail:

1. Navigate to the caregiver's detail page.
2. Click the Audit Log link in the page footer.
3. Filter by action type "DNR" to see all DNR-related entries.

Best Practices

1. Document thoroughly -- Always provide a detailed reason and attach supporting documentation when applying a DNR. Vague entries make future reviews difficult.
2. Use facility-scoped DNR when appropriate -- If the issue was specific to one facility (e.g., a personality conflict with facility staff), a facility-scoped DNR is more appropriate than a system-wide flag.
3. Set review dates -- For DNRs related to correctable issues (e.g., an expired credential), set a review date so the flag can be reassessed.
4. Coordinate with BlueSky -- For serious issues, ensure the caregiver's BlueSky CRM record is also updated to prevent gaps in enforcement.
5. Review DNR list regularly -- Periodically review the DNR list to remove outdated flags and ensure accuracy.