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<regulation prefix="Regulation" num=".57" citation="COMAR 10.07.14.57" title_num="10" subtitle_num="07" chapter_num="14" heading="Sanctions.">
  <paragraph num="A.">
    <text>If the Secretary determines that an assisted living program has violated this chapter, the Secretary, in addition to the sanctions set forth in this chapter, may impose one or more of the following:</text>
    <paragraph num="(1)">
      <text>Restrict the number of residents the assisted living program may admit in accordance with Health-General Article, §19-328, Annotated Code of Maryland;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Require the assisted living program to reduce the number of residents in care;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Restrict the levels of care for which the assisted living program may provide services;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Require the assisted living program, and any of its staff, to receive remedial instruction in a specific area;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Require the assisted living program to use the services of and cover the costs of a management firm approved by the Department;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Require the assisted living program to use the services of and cover the costs of a consultant to provide expertise related to:</text>
      <paragraph num="(a)">
        <text>One or more licensure requirements;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Standards of care; or</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Discharge planning.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(7)">
      <text>Mandate staffing patterns which specify number of personnel, personnel qualifications, or both;</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Require the establishment of an escrow account in accordance with Health-General Article, §19-362, Annotated Code of Maryland;</text>
    </paragraph>
    <paragraph num="(9)">
      <text>Direct the assisted living program to correct the violations in a specific manner or within a specified time frame, or both;</text>
    </paragraph>
    <paragraph num="(10)">
      <text>Notify, or require the assisted living program to notify, the representative or family of any resident who is affected by the noncompliance;</text>
    </paragraph>
    <paragraph num="(11)">
      <text>Increase the frequency of monitoring visits during a specified period of time; or</text>
    </paragraph>
    <paragraph num="(12)">
      <text>Enter into an agreement with the assisted living program establishing certain conditions for continued operation, including time limits for compliance.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>If the Secretary determines that the assisted living program has violated a condition or requirement of an imposed sanction, the Secretary may suspend or revoke the license.</text>
  </paragraph>
  <paragraph num="C.">
    <text>Appeals.</text>
    <paragraph num="(1)">
      <text>An assisted living program aggrieved by the imposition of a sanction under §A(1), (2), or (3) or B of this regulation may appeal the Secretary’s action by filing a request for a hearing in accordance with Regulation .65 of this chapter.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>An assisted living program aggrieved by the imposition of a sanction under §A(8) of this regulation may appeal the Secretary’s action in accordance with Health-General Article, §§19-364 and 19-367, Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>This section does not, however, create an appeal for a decision made under Regulation .23A of this chapter.</text>
    </paragraph>
  </paragraph>
</regulation>