Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 43 - BOARD OF CHIROPRACTIC EXAMINERS › Chapter 10.43.15 - Sanctioning Guidelines › Section 10.43.15.06 - Disciplinary Guidelines

Current through Register Vol. 51, No. 14, July 12, 2024
The following guidelines shall be used by the Board as a
					 guide for sanctioning licensees in formal and informal actions and
					 proceedings:
A. Abuse - Physical and
				  Emotional.
Severity
Tier/Conduct
Sanction Range
Duration
Minimum
Maximum
Least to Greatest
(1) Unnecessary or disruptive behavior which may
							 include verbal comments, directed to a patient, resulting in minimal harm or a
							 risk of harm
Reprimand
Suspension for up to 5 years, and probation for up to 5
							 years, and conditions
Reprimand to suspension and probation for up to 5
							 years
(2) Physical abuse resulting in significant physical or
							 emotional injury
Suspension for 3 years, without stay for at least 30
							 days and probation for 3 years, and conditions
Revocation
Suspension for 3 years, without stay for at least 30
							 days, and probation for 3 years to revocation
B.
				  Criminal Convictions or Plea of Nolo Contendere.
Severity
Tier/Conduct
Sanction Range
Duration
Minimum
Maximum
Least to Greatest
(1) Convicted of or pleads guilty or nolo contendere to
							 a felony or to a crime involving moral turpitude
Suspension for 1 year and probation for 1 year, and
							 conditions
Revocation
Suspension for 1 year and probation for 1 year, to
							 revocation
(2) Convicted of or pleads guilty or nolo contendere to
							 a sexual offense
Suspension for 5 years, without stay for at least 60
							 days, and probation for 5 years, and conditions
Revocation
Suspension for 5 years, without stay for at least 60
							 days, and probation for 5 years, to revocation
C.
				  Disciplined by Another Licensing or Disciplinary Authority.
Severity
Tier/Conduct
Sanction Range
Duration
Minimum
Maximum
Least to Greatest
(1) Conduct resulting in no physical or psychological
							 harm
Reprimand
Reprimand and probation for up to 3 years, and
							 conditions
Reprimand to reprimand and probation for up to 3
							 years
(2) Conduct resulting in financial injury
Reprimand
Revocation
Reprimand to Revocation
(3) Conduct resulting in physical or psychological harm
							 or a risk of physical or psychological harm
Suspension for 3 years, without stay for at least 10
							 days, and probation for 3 years, and conditions
Revocation
Suspension for 3 years, at least 10 days without stay,
							 and probation for 3 years to revocation
(4) Misrepresentation or fraud
Suspension for 2 years, without stay for at least 5
							 days, and probation for 2 years, and conditions
Revocation
Suspension for 2 years, without stay for at least 5
							 days, and probation for 2 years to revocation
(5) Conduct not provided for in §C(1)-(4) of this
							 regulation
Reprimand
Revocation
Reprimand to Revocation
D.
				  Diversion of Controlled Substances or Prescription Drugs.
Severity
Tier/Conduct
Sanction Range
Duration
Minimum
Maximum
Least to Greatest
(1) Diversion without harm to self or others
Reprimand and conditions, and probation for 1 year
Suspension for up to 5 years, and probation for up to 5
							 years, and conditions
Reprimand and probation for 1 year to suspension for up
							 to 5 years and probation for up to 5 years
(2) Diversion creating risk of harm
Suspension for 3 years and probation for 3 years, and
							 conditions
Suspension for up to 5 years and probation for up to 5
							 years, and conditions
Suspension for 3 years and probation for 3 years to
							 suspension for up to 5 years and probation for up to 5 years
(3) Diversion with harm
Suspension for 5 years, without stay for at least 90
							 days, and probation for 5 years, and conditions
Revocation
Suspension for 5 years, without stay for at least 90
							 days, and probation for 5 years, to revocation
E.
				  Failure to Renew a License When the Licensee Has Continued to Practice.
Severity
Tier/Conduct
Sanction Range
Duration
Minimum
Maximum
Least to Greatest
(1) Failure to renew a license and practicing for up to
							 1 year
Reprimand
Revocation
Reprimand to suspension for 2 years, and probation for
							 to 2 years
(2) Failure to renew a license and practicing for 1
							 year or longer
Suspension for 2 years, and probation for 2 years, and
							 conditions
Revocation
Suspension for 2 years, and probation for 2 years, to
							 revocation
F.
				  Noncompliance with Board Orders.
Severity
Tier/Conduct
Sanction Range
Duration
Minimum
Maximum
Least to Greatest
(1) Failure to comply with a Board order
Suspension for 3 years, without stay for at least 10
							 days, and probation for 3 years, and conditions
Revocation
Suspension for 3 years, without stay for at least 10
							 days, probation for 3 years, to revocation
(2) Failure to comply with a Board order with
							 additional unprofessional conduct
Suspension for 3 years, without stay for at least 30
							 days, and probation for 3 years, and conditions
Revocation
Suspension for 3 years, without stay for at least 30
							 days, and probation for 3 years, to revocation
(3) Failure to comply with a Board order with serious
							 physical injury or death of a patient, or the risk of significant physical
							 injury or death
Suspension for 5 years, without stay for at least 1
							 year, and probation for 5 years, and conditions
Revocation
Suspension for 5 years, without stay for at least 1
							 year, and probation for 5 years, to revocation
G.
				  Incompetent Practice Or Misconduct.
Severity
Tier/Conduct
Sanction Range
Duration
Minimum
Maximum
Least to Greatest
(1) Practice below acceptable standards with a low risk
							 of patient harm
Reprimand and conditions
Suspension for 1 year, and probation for 1 year, and
							 conditions
Reprimand to suspension for 1 year, and probation for 1
							 year
(2) Practice below acceptable standards with patient
							 harm or risk of patient harm
Suspension for 3 years, without stay for at least 30
							 days, and probation, and conditions
Revocation
Suspension for 3 years, without stay for at least 30
							 days, and probation, to revocation
(3) Practice below acceptable standards with serious
							 physical injury or death of a patient, or a risk of significant physical injury
							 or death
Suspension for 3 years, without stay for at least 90
							 days, and probation for 3 years, and conditions
Revocation
Suspension for 3 years, without stay for at least 90
							 days, and probation for 3 years, to revocation
H.
				  Sexual Misconduct.
Severity
Tier/Conduct
Sanction Range
Duration
Minimum
Maximum
Least to Greatest
(1) Unsolicited conduct of a sexual nature excluding
							 physical contact that serves no diagnostic or treatment purpose
Reprimand and conditions
Revocation
Reprimand to suspension for 1 year, and probation for 1
							 year
(2) A personal relationship that violates professional
							 ethics
Suspension for 1 year, and probation for 1 year, and
							 conditions
Suspension for up to 5 years, probation for up to 5
							 years, and conditions
Suspension for 1 year, and probation for 1 year, to
							 suspension for up to 5 years, and probation for up to 5 years
(3) Physical contact of a sexual nature that does not
							 include force, intimidation, the use of drugs, or alcohol, and that serves no
							 diagnostic or treatment purpose
Suspension for 2 years, without stay for at least 90
							 days, and probation for 2 years, and conditions
Revocation
Suspension for 2 years, without stay for at least 90
							 days, and probation for 2 years, to suspension for up to 7 years, without stay
							 for at least 90 days, and probation for up to 7 years
(4) Sexual conduct involving, but not limited to, force
							 intimidation, the use of drugs, or alcohol, or multiple victims
Suspension for 5 years, without stay for at least 1
							 year, and probation for 5 years, and conditions
Revocation
Suspension for 5 years, without stay for at least 1
							 year, and probation for 5 years to revocation
I.
				  Substance Abuse.
Severity
Tier/Conduct
Sanction Range
Duration
Minimum
Maximum
Least to Greatest
(1) Misuse of drugs or alcohol without harm to
							 others
Suspension for 2 years and probation for 2 years, and
							 conditions
Suspension for up to 5 years, and probation for up to 5
							 years, and conditions
Suspension for 2 years and probation for 2 years, to
							 suspension for up to 5 years and probation for up to 5 years
(2) Misuse of drugs or alcohol with patient harm or a
							 risk of patient harm
Suspension for 5 years, without stay for at least 90
							 days, probation for 5 years, and conditions
Revocation
Suspension for 5 years, without stay for at least 90
							 days, and probation for 5 years to revocation
J.
				  Unauthorized Practice.
Severity
Tier/Conduct
Sanction Range
Duration
Minimum
Maximum
Least to Greatest
(1) Licensee knowingly allows an unauthorized
							 individual to practice outside their scope of practice without patient harm or
							 minimal patient harm
Reprimand and conditions
Suspension for 2 years, and probation for 2 years, and,
							 conditions
Reprimand to suspension for 2 years, and probation for
							 2 years
(2) Licensee knowingly allows an unauthorized
							 individual to practice outside their scope of practice with greater than
							 minimal patient harm
Suspension for 5 years, without stay for at least 30
							 days, and probation for 5 years, and conditions
Revocation
Suspension for 5 years, without stay for at least 30
							 days, and probation for 5 years to revocation
(3) An unauthorized individual practices outside their
							 scope of practice without patient harm or minimal patient harm
Reprimand
Suspension for 2 years, and probation for 2 years, and,
							 conditions
Reprimand to suspension for 2 years, and probation for
							 2 years
(4) An unauthorized individual practices outside their
							 scope of practice with greater than minimal patient harm
Suspension for 5 years, without stay for at least 30
							 days, and probation, and conditions
Revocation
Suspension for 5 years, without stay for at least 30
							 days, and probation, to revocation
K.
				  Unethical Conduct.
Severity
Tier/Conduct
Sanction Range
Duration
Minimum
Maximum
Least to Greatest
(1) Unethical Conduct resulting in no physical or
							 psychological harm
Reprimand and conditions
Suspension for up to 2 years, and probation for up to 2
							 years, and conditions
Reprimand to suspension for up to 2 years, and
							 probation for up to 2 years
(2) Unethical conduct resulting in financial
							 injury
Suspension for 3 years, and probation for 3 years, and
							 conditions
Revocation
Suspension for 3 years, and probation for 3 years, to
							 revocation
(3) Unethical conduct resulting in physical or
							 psychological harm or a risk of physical or psychological harm
Suspension for 3 years, and probation for 3 years, and
							 conditions
Revocation
Suspension for 3 years, and probation for 3 years, to
							 revocation
(4) Unethically, and without legal justification, fails
							 to cooperate with a lawful investigation conducted by the Board
Suspension for 5 years, without stay for at least 30
							 days, and probation, for 5 years, and conditions
Revocation
Suspension for 5 years, without stay for at least 30
							 days, and probation for 5 years, to revocation
(5) Unethical conduct resulting from misrepresentation
							 or fraud
Suspension for 5 years, and probation for 5 years, and
							 conditions
Revocation
Suspension for 5 years, and probation for 5 years, to
							 revocation
(6) Threatens, forces, intimidates, or influences a
							 person to change or withhold evidence before the Board or the Office of
							 Administrative Hearings.
Suspension for 5 years, without stay for at least 90
							 days, and probation for 5 years, and conditions
Revocation
Suspension for 5 years, without stay for at least 90
							 days, and probation for 5 years, to revocation
(7) Unethical Conduct resulting from any violation not
							 provided for in §K(1)-(6) of this regulation
Reprimand
Revocation
Reprimand to revocation