depending on what rip youre using.. if you opt out of CMYKcm then you'll need to reprofile all your media.
Yes you can run the machine on CMYK only. I have for years.. matches my screen print decal work better that way and cuts ink cost by 25%.
The variable dot that the epson heads produce is voltage specific, varying voltage to the head makes three sizes of ink dot, big, medium, and tiny. When electronics go bad on a head, its often this circuit first. The head wont properly jet at low voltages needed for vardot printing. This makes a blurry mess on the DT1 service test section as thats the vardot action on the head. (while this can mean a dying head - Ive seen this with fresh from the box heads as well tho, which is why the head ranking is important, it defines that voltage set.)
So just switch your rip's dot selection to bypass it for now.. In onyx use standard modes instead of any VarDot modes. In Roland or wasatch colorRip select the "standard dark" or "standard dry" mode.
Print resolution is part of this now - you'll need to print at not less than 360x720. ideally 720x720. and likely 8 pass. the lack of variable dot in lower resolutions will show.
When you change from Vardot to standard dot you'll disable the variable dot function and make a bigger ink dot (more peppering), but you'll still use CMYKcm and shouldnt need a major reprofile. Id just add that as a new media. you still need to clean those heads, and i'd suggest getting a new head in there asap as most manufacturers ICC profiles are built on that technology.