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<regulation prefix="Regulation" num=".05" citation="COMAR 10.58.09.05" title_num="10" subtitle_num="58" chapter_num="09" heading="Mitigating and Aggravating Factors.">
  <paragraph num="A.">
    <text>Depending on the facts and circumstances of each case, and to the extent that the facts and circumstances apply, the Board may consider mitigating and aggravating factors in determining whether the sanction in a particular case should fall outside the range of sanctions established by the guidelines.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Nothing in this regulation requires the Board or an Administrative Law Judge to make findings of fact with respect to any of these factors.</text>
  </paragraph>
  <paragraph num="C.">
    <text>A departure from the guidelines set forth in this chapter is not a ground for any hearing or appeal of a Board action.</text>
  </paragraph>
  <paragraph num="D.">
    <text>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.</text>
    <paragraph num="(1)">
      <text>The absence of a prior disciplinary record;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The offender self-reported the violation to the Board;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>The offender’s full and voluntary admissions of misconduct to the Board and cooperation during Board proceedings;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>The offender implemented remedial measures to correct or mitigate the harm arising from the misconduct;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>The offender made timely good-faith efforts to make restitution or to rectify the consequences of the misconduct;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>The offender has been rehabilitated or exhibits rehabilitative potential;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>The absence of premeditation to commit the misconduct;</text>
    </paragraph>
    <paragraph num="(8)">
      <text>The absence of potential harm to patients or the public or other adverse impact; or</text>
    </paragraph>
    <paragraph num="(9)">
      <text>The offender’s conduct was an isolated incident and is not likely to recur.</text>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>Mitigating factors may include, but are not limited to, the following:</text>
    <paragraph num="(1)">
      <text>The absence of a prior disciplinary record;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The offender self-reported the violation to the Board;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>The offender’s full and voluntary admissions of misconduct to the Board and cooperation during Board proceedings;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>The offender implemented remedial measures to correct or mitigate the harm arising from the misconduct;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>The offender made timely good-faith efforts to make restitution or to rectify the consequences of the misconduct;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>The offender has been rehabilitated or exhibits rehabilitative potential;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>The absence of premeditation to commit the misconduct;</text>
    </paragraph>
    <paragraph num="(8)">
      <text>The absence of potential harm to patients or the public or other adverse impact; or</text>
    </paragraph>
    <paragraph num="(9)">
      <text>The offender’s conduct was an isolated incident and is not likely to recur.</text>
    </paragraph>
  </paragraph>
  <paragraph num="F.">
    <text>Aggravating factors may include, but are not limited to, the following:</text>
    <paragraph num="(1)">
      <text>The offender has a previous criminal or administrative disciplinary history;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The violation was committed deliberately or with gross negligence or recklessness;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>The violation had the potential for, or caused, serious patient or public harm;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>The violation was part of a pattern of detrimental conduct;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>The offender was motivated to perform the violation for financial gain;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>The vulnerability of the clients;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>The offender lacked insight into the wrongfulness of the conduct;</text>
    </paragraph>
    <paragraph num="(8)">
      <text>The offender committed the violation under the guise of treatment;</text>
    </paragraph>
    <paragraph num="(9)">
      <text>The offender attempted to hide the error or misconduct from patients or others;</text>
    </paragraph>
    <paragraph num="(10)">
      <text>The offender did not cooperate with the investigation; or</text>
    </paragraph>
    <paragraph num="(11)">
      <text>Previous attempts at rehabilitation of the offender were unsuccessful.</text>
    </paragraph>
  </paragraph>
</regulation>