<?xml version='1.0' encoding='utf-8'?>
<chapter num="07" heading="Certificate Holders—Code of Ethics" title_num="10" subtitle_num="39">
  <regulation prefix="Regulation" num=".01" heading="Definitions.">
    <paragraph num="A.">
      <text>In this chapter, the following terms have the meanings indicated.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Terms Defined.</text>
      <paragraph num="(1)">
        <text>Abandonment.</text>
        <paragraph num="(a)">
          <text>“Abandonment” means:</text>
          <paragraph num="(i)">
            <text>Termination by a certificate holder of a client assignment that was accepted by the certificate holder, without reasonable notification to the immediate supervisor to allow for the continuation of the client's care;</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Refusal by a certificate holder of an assignment, mandatory overtime, or both in the event of a natural disaster or a federal, State, county, or city declaration of an emergency; or</text>
          </paragraph>
          <paragraph num="(iii)">
            <text>Failure of a certificate holder to report for assigned duty or leaving a client unattended at the end of the assigned shift if the certificate holder is the sole provider of care for a private duty or hospice assignment and does not provide prior notification to the nursing supervisor, the cognitively capable adult client, or the client's designated representative.</text>
          </paragraph>
        </paragraph>
        <paragraph num="(b)">
          <text>“Abandonment” does not include the declining by a certificate holder of employer-stipulated mandatory overtime.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(2)">
        <text>“Accepting an assignment” means a certificate holder has arrived on duty and assumed responsibility for client care.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>“Board” means the Board of Nursing.</text>
      </paragraph>
      <paragraph num="(4)">
        <text>“Certificate holder” means an individual who is certified by the Board as a certified nursing assistant in any category, a certified dialysis technician, or a medication technician.</text>
      </paragraph>
      <paragraph num="(5)">
        <text>“Client” means a patient, resident, or recipient of care.</text>
      </paragraph>
      <paragraph num="(6)">
        <text>“Electronic devices” means, but is not limited to, any of the following:</text>
        <paragraph num="(a)">
          <text>Telephones with recording and picture-taking ability;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Digital cameras or any other device that can record pictures and data;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Facsimile machines, photocopiers, and scanners for copying; and</text>
        </paragraph>
        <paragraph num="(d)">
          <text>Recording devices.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(7)">
        <text>“Social media” means any form of electronic communication, including, but not limited to, communication by use of websites for social networking and blogging through which users create online communities to share information, ideas, personal messages, and other content such as videos.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".02" heading="Ethical Responsibilities.">
    <paragraph num="A.">
      <text>A certificate holder shall:</text>
      <paragraph num="(1)">
        <text>Respect the human dignity and uniqueness of a client and provide services unrestricted by consideration of social or economic status, religious affiliation, personal attributes, or the nature of health problems;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Safeguard a client's right to privacy by maintaining confidentiality of information;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Promptly report a breach of confidentiality or privacy;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Act to safeguard a client and the public if health care and safety are affected by the incompetent, unethical, or illegal practice of any individual;</text>
      </paragraph>
      <paragraph num="(5)">
        <text>Assume responsibility and accountability for the individual certificate holder's judgments and actions;</text>
      </paragraph>
      <paragraph num="(6)">
        <text>Maintain practice competence;</text>
      </paragraph>
      <paragraph num="(7)">
        <text>Inform the Board of unethical conduct by another certificate holder;</text>
      </paragraph>
      <paragraph num="(8)">
        <text>Demonstrate honesty and integrity in the performance of tasks, functions, and activities; and</text>
      </paragraph>
      <paragraph num="(9)">
        <text>Perform nursing tasks, functions, and activities based on a certificate holder's education and training, and at the direction of the supervising nurse.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>A certificate holder may not, when acting in the capacity or identity of a certificate holder:</text>
      <paragraph num="(1)">
        <text>Abandon a client or assignment after assuming care for the client or accepting the assignment;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Knowingly participate in or condone dishonesty, fraud, deceit, or misrepresentation;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Engage or participate in an action that violates or diminishes the civil or legal rights of a client;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Assume duties and responsibilities without adequate preparation or maintaining competency; or</text>
      </paragraph>
      <paragraph num="(5)">
        <text>Practice if unfit to perform procedures because of physical or mental impairment including, but not limited to, the effects of prescription drugs.</text>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>A certificate holder may not engage in the following behaviors that dishonor the practice, whether or not acting in the capacity or identity of a certificate holder, including, but not limited to:</text>
      <paragraph num="(1)">
        <text>Verbal abuse, including use of racial or ethnic slurs, directed toward a coworker, employer, Board staff member, client, or client’s family member;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Physically abusing, threatening, or intimidating a coworker, employer, Board staff member, client, or client’s family member;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Deceiving, defrauding, or stealing from a coworker, employer, client, or client's family member;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Diverting any medication or providing false or misleading information to an authorized prescriber or a pharmacist to obtain or attempt to obtain any medication;</text>
      </paragraph>
      <paragraph num="(5)">
        <text>Knowingly employing another individual to practice or engage in or attempt to practice or engage in an occupation or profession licensed under this title if the employee is not licensed to do so under Health Occupations Article, Title 8, Annotated Code of Maryland;</text>
      </paragraph>
      <paragraph num="(6)">
        <text>Obtaining or copying any part of a client's health record;</text>
      </paragraph>
      <paragraph num="(7)">
        <text>Using, possessing, supplying, administering, or attempting to use, possess, supply, or administer prescription drugs or controlled dangerous substances without valid medical indication;</text>
      </paragraph>
      <paragraph num="(8)">
        <text>Reporting for employment under the influence of alcohol or a controlled dangerous substance or submitting a pre-employment sample that is positive for alcohol or a controlled dangerous substance without having provided evidence of valid prescriptions for all controlled dangerous substances in the sample;</text>
      </paragraph>
      <paragraph num="(9)">
        <text>Reporting for employment under the influence of an illicit drug or submitting a pre-employment sample that is positive for an illicit drug;</text>
      </paragraph>
      <paragraph num="(10)">
        <text>Using the power, influence, or knowledge obtained during the certificate holder’s relationship with the client for the certificate holder’s personal gratification or benefit;</text>
      </paragraph>
      <paragraph num="(11)">
        <text>Performing acts beyond the scope of practice for which the individual is certified, unless acting in accordance with COMAR 10.27.11;</text>
      </paragraph>
      <paragraph num="(12)">
        <text>Engaging in unprofessional or immoral conduct;</text>
      </paragraph>
      <paragraph num="(13)">
        <text>Misrepresenting or concealing a material fact in obtaining a certificate, renewing a certificate, or reinstating a certificate;</text>
      </paragraph>
      <paragraph num="(14)">
        <text>Committing an act of moral turpitude, dishonesty, or corruption when the act directly or indirectly affects the health, welfare, or safety of the citizens of this State, and, if the act constitutes a crime, conviction thereof in a criminal proceeding is not a condition precedent to disciplinary action; or</text>
      </paragraph>
      <paragraph num="(15)">
        <text>Arranging or permitting another certificate holder or unlicensed person to replace the certificate holder or utilize the certificate holder's certificate to provide care to a client.</text>
      </paragraph>
    </paragraph>
    <paragraph num="D.">
      <text>A certificate holder may not engage in sexual misconduct including, but not limited to:</text>
      <paragraph num="(1)">
        <text>Sexual behavior with a client during the performance of a procedure or service for the client, regardless of the setting in which the service is rendered;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Sexual behavior with a client under any pretext of therapeutic intent or benefit;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Solicitation of a sexual relationship, whether consensual or nonconsensual, with a client;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Sexual advances toward, or requesting sexual favors from, a coworker, student, employer, client, or client’s family member;</text>
      </paragraph>
      <paragraph num="(5)">
        <text>Discussion of sexual matters while caring for a client;</text>
      </paragraph>
      <paragraph num="(6)">
        <text>Taking photographs of a client for a sexual purpose or personal gratification;</text>
      </paragraph>
      <paragraph num="(7)">
        <text>Sexual harassment of a coworker, student, employer, client, or client's family member;</text>
      </paragraph>
      <paragraph num="(8)">
        <text>Sexual contact with an incompetent or unconscious client;</text>
      </paragraph>
      <paragraph num="(9)">
        <text>Intentionally exposing any of the certificate holder's sexual body parts; and</text>
      </paragraph>
      <paragraph num="(10)">
        <text>Intentionally exposing any of the client's sexual body parts for a nontherapeutic purpose.</text>
      </paragraph>
    </paragraph>
    <paragraph num="E.">
      <text>Electronic devices, including but not limited to telephones, may not be used to record medical records and take pictures or videos of clients without written client authorization.</text>
    </paragraph>
    <paragraph num="F.">
      <text>A certificate holder:</text>
      <paragraph num="(1)">
        <text>May not make use of electronic devices and social media to transmit or place any client information online; and</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Shall adhere to the following principles for the use of social media:</text>
        <paragraph num="(a)">
          <text>Every certificate holder has an obligation to understand the nature, benefits, and consequences of the use of electronic devices and participating in social media networking;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Certificate holders are bound to observe ethically prescribed client-certificate holder boundaries online as in any other setting;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Client information shall be maintained in separate encrypted and secure files on personal computers and online;</text>
        </paragraph>
        <paragraph num="(d)">
          <text>A certificate holder has an obligation to report any content that could harm a client’s privacy rights; and</text>
        </paragraph>
        <paragraph num="(e)">
          <text>The standards of professionalism are the same when using electronic devices and social media as in any other circumstance.</text>
        </paragraph>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".03" heading="Penalties.">
    <text>Violation of this chapter may result in the Board taking disciplinary action against a certificate holder pursuant to Health Occupations Article, §8-6A-10, Annotated Code of Maryland.</text>
  </regulation>
  <annotations>
    <annotation type="Authority">Health Occupations Article, §§8-205 and 8-6A-01, Annotated Code of Maryland</annotation>
    <annotation type="History" subtype="Administrative History">Effective date: April 7, 2008 (35:7 Md. R. 749)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .01B amended effective December 11, 2014 (41:24 Md. R. 1428); August 4, 2025 (52:15 Md. R. 812)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .02 amended effective December 11, 2014 (41:24 Md. R. 1428)</annotation>
  </annotations>
</chapter>