This chapter establishes standards for the imposition of disciplinary sanctions, monetary penalties, and civil fines for violations of the Maryland Physical Therapy Act. In this chapter, the following terms have the meanings indicated. Terms Defined. “Act” means the Maryland Physical Therapy Act, Health Occupations Article, Title 13, Annotated Code of Maryland. “Board” means the State Board of Physical Therapy Examiners. “Civil fine” means a fine assessed by the Board against an individual for practicing physical therapy or limited physical therapy without a license. “License” means a license issued by the Board to practice physical therapy or limited physical therapy. “Licensee” means a physical therapist or physical therapist assistant who is licensed by the Board to practice physical therapy or limited physical therapy. “Penalty” means monetary penalty. “Sanction” means a disciplinary action reprimanding, restricting, suspending, or revoking a license. Imposition of a Penalty after a Hearing. If the Board finds that there are grounds under Health Occupations Article, §13-316, Annotated Code of Maryland, to reprimand a licensee or suspend or revoke a license, the Board may impose a penalty as set forth in this chapter: Instead, of, or in addition to, reprimanding the licensee or suspending the license; or In addition to revoking the license. Subject to the provisions of this chapter, the Board may impose the following sanctions and, if appropriate, penalties for violations of the Act and its regulations according to the minimum and maximum sanctions and penalties set forth in the following categories: If a licensee is found in violation of more than one category enumerated in this regulation, the category or categories containing the highest maximum sanction and penalty shall control. Notwithstanding the guidelines set forth in this regulation, in order to resolve a pending disciplinary action, the Board and licensee may agree to a surrender of license or a consent order with terms, sanction, and penalty agreed to by the Board and the licensee. A departure from the guidelines set forth in this regulation, on its own, is not grounds for any hearing or appeal of a Board action. The Board may not consider a petition for reinstatement of a license that has been revoked until at least 3 years have passed from the date of revocation. Depending on the facts and circumstances of each case, and to the extent that the facts and circumstances apply, the Board may consider, but not be limited to, the mitigating and aggravating factors outlined in §§B and C of this regulation in determining whether the sanction in a particular case should fall outside the range of sanctions established by the guidelines. Mitigating Factors. The Board may consider the following mitigating factors: The licensee’s lack of a prior disciplinary record; The licensee self-reported the violation to the Board; The licensee’s full and voluntary admission of misconduct to the Board and cooperation during Board proceedings; The licensee implemented remedial measures to correct or mitigate harm arising from the misconduct; The licensee made timely good-faith effort to make restitution or to rectify the consequences of the misconduct; Evidence of rehabilitation or rehabilitative potential; Absence of premeditation to commit the misconduct; Absence of potential harm to the public or adverse impact; and The licensee’s conduct was an isolated incident and not likely to recur. Aggravating Factors. The Board may consider the following aggravating factors: The licensee has a 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 for financial gain; The vulnerability of the patient or patients; The licensee attempted to hide error or misconduct from patients or others; Previous attempts at rehabilitation of the licensee were unsuccessful; and The licensee committed the violation under the guise of treatment. The existence of one or more of these factors does not impose on the Board or an Administrative Law Judge any requirement to articulate its reasoning for not exercising its discretion to impose a sanction outside of the range of sanctions set forth in this chapter. Nothing in this regulation requires the Board or an Administrative Law Judge to make findings of fact with respect to any of these factors. Practicing on an Expired License. The Board may assess a civil fine against a physical therapist or physical therapist assistant who practices physical therapy or limited physical therapy on an expired license in the amount of $100 per day of practice past the expiration date of the license. Practicing Without a License. The Board may assess a civil fine of no less than $5,000 and no more than $50,000 against an individual who practices physical therapy or limited physical therapy without a license. Factors in determining the amount of a fine include, but are not limited to, the following: The extent to which the individual derived any financial benefit from the unauthorized practice; The willfulness of the unauthorized practice; Actual or potential public harm caused by the unauthorized practice; and The length of time in which the individual engaged in the unauthorized practice. Unless the Board specifies otherwise, a licensee shall pay to the Board a penalty imposed under this chapter as of the date the Board's order is issued. Filing an appeal under State Government Article, §10-222, Annotated Code of Maryland, or Health Occupations Article, §13-318, Annotated Code of Maryland, does not automatically stay payment of a penalty imposed by the Board pursuant to this chapter. If a licensee fails to pay, in whole or in part, a penalty imposed by the Board pursuant to this chapter, the Board may not restore, reinstate, or renew a license until the penalty has been paid in full. In its discretion, the Board may refer all cases of delinquent payment to the Central Collection Unit of the Department of Budget and Management to institute and maintain proceedings to ensure prompt payment. Deposit of Monies. The Board shall pay all monies collected pursuant to this chapter, except for civil fines collected under Regulation .06 of this chapter, into the State's General Fund. The Board shall pay all civil fines collected under Regulation .06 of this chapter into the State Board of Physical Therapy Examiners Fund, in accordance with Health Occupations Article, §13-407(b)(2), Annotated Code of Maryland. Health Occupations Article, §1-606, Annotated Code of Maryland Effective date: May 15, 2000 (27:9 Md. R. 858) Regulation .04C amended effective April 16, 2001 (28:7 Md. R. 690); April 6, 2009 (36:7 Md. R. 525) Regulations .01—.06 under chapter, Monetary Penalties repealed and new Regulations .01—.07 under chapter Disciplinary Sanctions, Monetary Penalties, and Civil Fines adopted effective January 23, 2012 (39:1 Md. R. 18)