# COMAR Title 10 — Maryland Department of Health

## Subtitle 27 — Board of Nursing

### Chapter 18 — Monetary Penalties

**Authority:** Health Occupations Article, §§8-316, 8-6C-20, and 8–6D–10, Annotated Code of Maryland

**Administrative History:** Effective date: April 10, 1995 (22:7 Md. R. 536)

**Administrative History:** Regulation .01 amended effective July 2, 2018 (45:13 Md. R. 667)

**Administrative History:** Regulation .02B amended effective July 2, 2018 (45:13 Md. R. 667)

**Administrative History:** Regulation .03A amended effective July 2, 2018 (45:13 Md. R. 667)

**Administrative History:** Regulation .04A, H amended effective July 2, 2018 (45:13 Md. R. 667)

#### Regulation .01 Scope.

*COMAR 10.27.18.01*

This chapter establishes standards for the imposition of monetary penalties not exceeding $5,000 against a registered nurse, licensed practical nurse, direct-entry midwife, licensed certified midwife, or advanced practice registered nurse if the Board finds that there are grounds to take action under Health Occupations Article, §8-316, Annotated Code of Maryland.

#### Regulation .02 Definitions.

*COMAR 10.27.18.02*

A. In this chapter, the following terms have the meanings indicated.

B. Terms Defined.

  (1) “Board” means the Board of Nursing.

  (2) “Licensee” means, unless the context requires otherwise, a:

    (a) Registered nurse, a licensed practical nurse, or an advanced practice registered nurse as defined in Health Occupations Article, §8-101, Annotated Code of Maryland;

    (b) A licensed direct-entry midwife as defined in Health Occupations Article, §8-6C-01, Annotated Code of Maryland; and

    (c) A licensed certified midwife as defined in Health Occupations Article, §8-6D-01, Annotated Code of Maryland.

  (3) “Penalty” means monetary fine.

#### Regulation .03 Imposition of Penalty Generally.

*COMAR 10.27.18.03*

A. The Board may impose a penalty against a licensee if the Board finds that there are grounds to take action against the licensee pursuant to Health Occupations Article, §8-316, Annotated Code of Maryland.

B. The penalty in §A of this regulation may be imposed instead of or in addition to suspending or revoking the license, reprimanding the licensee, or placing the licensee on probation.

#### Regulation .04 Imposition of Penalties on Licensees.

*COMAR 10.27.18.04*

A. A penalty of not less than $100 or more than $1,000 may be imposed by the Board on a licensee if found guilty of any of the following:

  (1) Filing a false report or record of an individual under the licensee's care;

  (2) Giving any false or misleading information about a material matter in an employment application;

  (3) Failing to file or record any health record that is required by law;

  (4) Obstructing the filing or recording of any health record as required by law;

  (5) Inducing another individual to fail to file or record any health record as required by law;

  (6) Violating any provision of Health Occupations Article, §8-316, Annotated Code of Maryland;

  (7) Submitting a false statement to collect a fee;

  (8) Being professionally, physically, or mentally incompetent;

  (9) Providing professional services while:

    (a) Under the influence of alcohol, or

    (b) Using any narcotic or controlled dangerous substance, as defined in Criminal Law Article, Annotated Code of Maryland, or other drug that is in excess of therapeutic amounts or without valid medical indication;

  (10) Knowingly failing to report suspected child abuse in violation of Family Law Article, §5-704, Annotated Code of Maryland;

  (11) Refusing, withholding, denying, or discriminating against an individual with regard to the provision of professional services for which the licensee is licensed and qualified to render care because the individual is HIV positive;

  (12) Except in an emergency life-threatening situation where it is not feasible or practicable, failing to comply with the guidelines on universal precautions which are incorporated by reference in COMAR 10.06.01.02B(13);

  (13) Being in independent practice and failing to display the notice required under Health Occupations Article, §8-506, Annotated Code of Maryland;

  (14) Failing to begin to fulfill a public service requirement within 1 year of when the assignment is to begin that was a condition of the applicant or licensee receiving State or federal loans or scholarships for the applicant's or licensee's nursing education; or

  (15) Being expelled from the Safe Practice Program established pursuant to Health Occupations Article, §8-208, Annotated Code of Maryland, for failure to comply with the conditions of the program.

B. Violation of Probation. A penalty of $100 per violation may be imposed by the Board on a licensee who fails to comply with the conditions of probation.

C. A penalty of not less than $1,000 or more than $5,000 may be imposed by the Board on a licensee found guilty of any of the following:

  (1) Fraudulently or deceptively obtaining or attempting to obtain a license for the applicant or for another;

  (2) Fraudulently or deceptively using a license;

  (3) Being disciplined by a licensing or disciplinary authority of any other state or country or convicted or disciplined by a court of any state or country for an act that would be grounds for disciplinary action under the Board's disciplinary statutes;

  (4) Being convicted of or pleading guilty or nolo contendere to a felony or to a crime involving moral turpitude whether or not any appeal or other proceeding is pending to have the conviction or plea set aside.

D. The Board may impose a penalty of not less than $500 or more than $5,000 upon a licensee found guilty of knowingly doing any act that has been determined by the Board, in the Board's regulations, to exceed the scope of practice authorized to the individual under this title when the violation is:

  (1) Determined to be willful or actual harm results, or both, the penalty may range from $500 to $5,000;

  (2) Determined to be willful and there is potential harm to the public, the penalty may range from $500 to $2,000;

  (3) Determined to be negligent or actual harm results, or both, the penalty may range from $500 to $5,000;

  (4) Determined to be negligent and there is potential harm to the public, the penalty may range from $500 to $2,000; and

  (5) A repeat offense, the penalty may be double the amount for the category of offense described in this section, not to exceed $5,000.

E. A penalty of up to $1,000 per violation may be imposed by the Board on a licensee who knowingly abuses a patient without causing patient harm.

F. A penalty of up to $5,000 per violation may be imposed by the Board on a licensee who knowingly abuses a patient and causes patient harm.

G. Fines other than those stated above may be imposed at the discretion of the Board.

H. Failure to Renew.

  (1) The Board may impose the following penalties on a licensee for failure to renew licensure:

    (a) Not less than $150 per month for practicing on a non-renewed license for a period of up to 1 year; or

    (b) Amount to be determined by the Board for practicing nursing with a license that was non-renewed for a period of more than 1 year.

  (2) A penalty of up to $5,000 may be imposed by the Board on a director of nursing found guilty of employing nurses with lapsed licenses on two or more occasions within 1 year.

#### Regulation .05 Payment of Monetary Penalties.

*COMAR 10.27.18.05*

A. The licensee shall pay all fines by cashier's check or money order made payable to the Board and delivered personally or by certified mail to the Board within 60 days of the date of the order.

B. The Board shall pay all monies collected by the Board pursuant to these regulations into the general fund of the State.