<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".04" citation="COMAR 10.65.09.04" title_num="10" subtitle_num="65" chapter_num="09" heading="Aggravating and Mitigating Factors.">
  <paragraph num="A.">
    <text>Sanctions in a particular case may fall outside the range of the sanctioning guidelines established by the Board.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Depending on the facts and circumstances of each case, and to the extent that the facts and circumstances apply, the Board may consider the following aggravating and mitigating factors in determining whether the sanction in a particular case should fall outside the range of the sanctioning guidelines:</text>
    <paragraph num="(1)">
      <text>Aggravating Factors:</text>
      <paragraph num="(a)">
        <text>Previous criminal or administrative discipline history;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Whether the offense was committed deliberately or with gross negligence or recklessness;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Whether the offense has the potential for, or caused, serious patient harm;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Whether the offense was part of a pattern of detrimental conduct;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Whether the respondent pursued the respondent’s financial gain over the patient’s welfare;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Whether the patient was especially vulnerable;</text>
      </paragraph>
      <paragraph num="(g)">
        <text>Whether the respondent attempted to hide error or misconduct from patients or others;</text>
      </paragraph>
      <paragraph num="(h)">
        <text>Whether the respondent:</text>
        <paragraph num="(i)">
          <text>Concealed, falsified, or destroyed evidence; or</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Presented false testimony or evidence;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(i)">
        <text>Whether the respondent willfully and without legal justification failed to cooperate with a lawful investigation conducted by the Board; and</text>
      </paragraph>
      <paragraph num="(j)">
        <text>Whether previous attempts to rehabilitate the respondent were unsuccessful; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Mitigating Factors:</text>
      <paragraph num="(a)">
        <text>Absence of a prior disciplinary record;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The passage of time since any prior offenses;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Whether the respondent self-reported to the Board;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Cooperation with the Board’s investigation;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Full disclosure to the Board;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Implementation of remedial measures to correct or mitigate harm arising from the misconduct;</text>
      </paragraph>
      <paragraph num="(g)">
        <text>Timely good-faith efforts to make restitution or to rectify consequences of misconduct;</text>
      </paragraph>
      <paragraph num="(h)">
        <text>Evidence of rehabilitation or rehabilitative potential;</text>
      </paragraph>
      <paragraph num="(i)">
        <text>Absence of premeditation to commit the offense;</text>
      </paragraph>
      <paragraph num="(j)">
        <text>Absence of potential harm to the public;</text>
      </paragraph>
      <paragraph num="(k)">
        <text>Absence of adverse impact;</text>
      </paragraph>
      <paragraph num="(l)">
        <text>Whether the offense was an isolated incident and not likely to recur;</text>
      </paragraph>
      <paragraph num="(m)">
        <text>How and when the respondent has been involved in community service and the value of the community service to the community; and</text>
      </paragraph>
      <paragraph num="(n)">
        <text>Voluntary admissions of misconduct.</text>
      </paragraph>
    </paragraph>
  </paragraph>
</regulation>