<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".05" citation="COMAR 10.47.05.05" title_num="10" subtitle_num="47" chapter_num="05" heading="Denial, Probation, Intermediate Sanctions, Suspension, or Revocation.">
  <paragraph num="A.">
    <text>If an applicant or Program fails to comply with the applicable State and federal laws, rules, or regulations, the Director may:</text>
    <paragraph num="(1)">
      <text>Deny approval to the applicant; or</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Take disciplinary action, such as:</text>
      <paragraph num="(a)">
        <text>Placing the program on probation;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Suspending or revoking the certification of the program; or</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Imposing intermediate sanctions on the program.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>For purposes of §A of this regulation, intermediate sanctions include:</text>
    <paragraph num="(1)">
      <text>A directed plan of correction, if the program is directed to take a specific action by a certain date;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>A mandatory staffing pattern that is stricter than that required under the appropriate level of care in these regulations, if the Administration defines for the program the level of individual supervision;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Mandatory training, if the Administration identifies deficient areas in which training is needed;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Expansion ban, if the Administration retains the authority to prohibit the program from obtaining additional sites, admitting individuals, or providing additional services at the site;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Imposition of an intensive monitoring protocol by the Administration; or</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Imposition of a temporary site monitor, if the Administration maintains an ongoing physical presence for the purpose of providing assistance and evaluating the extent of the program's corrective actions.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>If the Director proposes to deny approval to an applicant or to take disciplinary action against a program, the Director shall give written notice to the health officer or executive director of the program.</text>
  </paragraph>
  <paragraph num="D.">
    <text>In the written notice under §C of this regulation, the Director shall include:</text>
    <paragraph num="(1)">
      <text>The statutory and regulatory authority upon which the proposed action is based;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The facts supporting the alleged violation of law; and</text>
    </paragraph>
    <paragraph num="(3)">
      <text>The applicant's or program's right to a hearing before final action under §F of this regulation.</text>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>Summary Suspension.</text>
    <paragraph num="(1)">
      <text>Under the State Government Article, §10-226(c)(2), Annotated Code of Maryland, and if appropriate, after a predeprivation hearing, the Director may summarily order the suspension of the approval if the Administration finds that the public health, safety, or welfare imperatively requires emergency action.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The Director shall notify the program in writing of the suspension, findings, and reasons that support the findings, and, if appropriate, the opportunity for a predeprivation hearing. The notice shall include:</text>
      <paragraph num="(a)">
        <text>The proposed order for summary suspension which includes:</text>
        <paragraph num="(i)">
          <text>The statutory and regulatory authority upon which the order is based;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>The facts supporting the alleged violations of law;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>The facts supporting the belief that there is an imminent danger to the health, safety, and welfare of individuals; and</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>The program's right to appeal the summary suspension, if executed by the Director; and</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>A show cause notice providing an opportunity for the program to show cause as to why the order may not be issued if the public health, safety, and welfare permits.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>The Director may suspend approval without prior notice and the opportunity to be heard if:</text>
      <paragraph num="(a)">
        <text>The Director determines that the health, welfare, and safety of the public imperatively requires immediate suspension;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Notice of an opportunity to be heard before the action is not feasible; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>The Administration provides the program with a post-deprivation hearing opportunity within 15 working days of the suspension.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="F.">
    <text>Procedures for Hearings.</text>
    <paragraph num="(1)">
      <text>If the Director proposes to deny an approval or take disciplinary action against a program, the Director shall give the program written notice according to §C of this regulation.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Within 10 working days of receipt of the notice, the executive director or health officer may file a written request for a hearing with the Office of Administrative Hearings and send copies of the request to the:</text>
      <paragraph num="(a)">
        <text>Director; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Administrative prosecutor.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>If the executive director or health officer does not file a request for a hearing within 10 working days of receipt of the notification, the:</text>
      <paragraph num="(a)">
        <text>Program waives its right to request a hearing; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Director may implement the proposed action.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>If a timely request for a hearing has been received, the Office of Administrative Hearings shall:</text>
      <paragraph num="(a)">
        <text>Notify the Director, the executive director or health officer, and administrative prosecutor of the date, time, and location of the hearing; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>In accordance with COMAR 28.02.01, hold a hearing and, unless the final decision is delegated to the Office of Administrative Hearings, render a proposed decision to the Director.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(5)">
      <text>After giving the parties the opportunity to file exceptions under the provisions of State Government Article, §10-216, Annotated Code of Maryland, the Director shall issue a final decision and send notice to the governing body or the health officer.</text>
    </paragraph>
    <paragraph num="(6)">
      <text>A program may appeal any final decision from a contested case by following the provisions of Health-General Article, §2-207, and State Government Article, Title 10, Subtitle 2, Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(7)">
      <text>In addition to disposing of a case by a hearing, the Director may dispose of a contested case by:</text>
      <paragraph num="(a)">
        <text>Stipulation;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Settlement;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Consent order;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Default;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Withdrawal;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Summary disposition; or</text>
      </paragraph>
      <paragraph num="(g)">
        <text>Dismissal.</text>
      </paragraph>
    </paragraph>
  </paragraph>
</regulation>