General Application. This regulation shall be used by the Board as a guide for sanctioning licensees pursuant to its authority under Health Occupations Article, §§1A-205 and 1A-309, Annotated Code of Maryland, for violations of the Acupuncture Act and the Board's regulations. The Board is not required to make findings of fact with respect to any of the factors for determining the sanction indicated by the sanctioning guidelines. A departure from the sanctioning guidelines alone is not a ground for any hearing or appeal of a Board action. Notwithstanding these sanctioning guidelines, in order to resolve a disciplinary matter, the Board and the licensee or registered detoxification specialist may agree to surrender a license or registration or to a Consent Order with terms, conditions, and sanctions agreed upon. In a case where there are multiple and distinct violations, the Board may impose a sanction greater than the maximum indicated by the sanctioning guidelines for each individual violation. If probation is imposed, the Board may impose appropriate terms and conditions of probation, and, if a licensee or registration holder violates the terms or conditions of probation, the Board may take further disciplinary action against the individual. In the event a violation does not fall within the sanction range, the Board shall so indicate and use its best judgment to determine the appropriate sanction and shall consider, to the extent possible, the factors in the sanctioning guidelines. Range of Sanctions. Mitigating and Aggravating Factors. Depending on the facts and circumstances of each case, and to the extent that they apply, the Board may consider the following mitigating and aggravating factors in determining whether the sanction in a particular case should fall outside of the range of sanctions established by the guidelines. These factors may include, but are not limited to the following: Mitigating Factors: Absence of a prior disciplinary record; The licensee reported the violation to the Board; The licensee voluntarily admitted violation, provided full disclosure to the Board, and cooperated during Board proceedings; The licensee implemented remedial measures to correct or mitigate harm arising from the violation; The licensee made a timely good-faith effort to make restitution or otherwise rectify the consequences of the violation; Evidence of rehabilitation or potential for rehabilitation; Absence of premeditation to commit the violation; Absence of potential harm to or adverse impact on the public; Isolated incident and not likely to recur; and The licensee’s prior community service and present value to the community. Aggravating Factors: Previous criminal or administrative disciplinary history; The violation was committed deliberately or with gross negligence or recklessness; The violation had the potential for, or caused, serious patient harm; The violation was part of a pattern of detrimental conduct; The licensee was motivated to perform the violation by his or her financial gain; The vulnerability of the patient; The licensee attempted to conceal the violation, falsified or destroyed evidence, or presented false testimony or evidence; The licensee failed to cooperate with the Board’s investigation; and Previous attempts at rehabilitation were unsuccessful.