Md. Code Regs. 10.47.04.08

Current through Register Vol. 51, No. 25, December 13, 2024

Section 10.47.04.08 - Denial, Probation, Intermediate Sanctions, Suspension, or Revocation

A. If an applicant or program fails to comply with the applicable State and federal laws, rules, or regulations, the Director may:

(1) Deny approval to the applicant; or

(2) Take disciplinary action, such as:

(a) Placing the program on probation;

(b) Suspending or revoking the certification of the program; or

(c) Imposing intermediate sanctions on the program.

B. For purposes of §A of this regulation, intermediate sanctions include:

(1) A directed plan of correction, if the program is directed to take a specific action by a certain date;

(2) A mandatory staffing pattern that is stricter than that required under the appropriate level of care required under COMAR 10.47.02, if the Administration defines for the program the level of individual supervision;

(3) Mandatory training, if the Administration identifies deficient areas in which training is needed;

(4) Patient relocation, if the Administration reserves the right to relocate a patient to another program in order to protect the health and safety of the patient;

(5) 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;

(6) Imposition of an intensive monitoring protocol by the Administration; or

(7) 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.

C. 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 governing body or the health officer and the administrator of the program.

D. In the written notice under §C of this regulation, the Director shall include:

(1) The statutory and regulatory authority upon which the proposed action is based;

(2) The facts supporting the alleged violation of law; and

(3) The applicant's or program's right to a hearing before final action under §F of this regulation.

E. Summary Suspension.

(1) 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 a certification if the Administration finds that the public health, safety, or welfare imperatively requires emergency action.

(2) 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:

(a) The proposed order for summary suspension which includes:

(i) The statutory and regulatory authority upon which the order is based;

(ii) The facts supporting the alleged violations of law;

(iii) The facts supporting the belief that there is an imminent danger to the health, safety, and welfare of individuals; and

(iv) The program's right to appeal the summary suspension, if executed by the Director; and

(b) A show cause notice providing an opportunity for the program to show cause as to why an order under §C(1) of this regulation should not be issued.

(3) The Director may suspend an approval without prior notice and the opportunity to be heard if:

(a) The Director determines that the health, welfare, and safety of the public imperatively requires immediate suspension;

(b) Notice of an opportunity to be heard before the action is not feasible; and

(c) The Administration provides the program with a post-deprivation hearing opportunity within 15 working days of the suspension.

(4) The Administration shall:

(a) Notify the individuals being served by the program and, if appropriate, their families or proponents, regarding the summary suspension; and

(b) Assist the individuals in finding alternative services if the approval is summarily suspended.

F. Procedures for Hearings.

(1) 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 §D of this regulation.

(2) Within 10 working days of receipt of the notice, the governing body 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:

(a) Director; and

(b) Administrative prosecutor.

(3) If the governing body or the health officer does not file a request for a hearing within 10 working days of receipt of the notification, the:

(a) Program waives its right to request a hearing; and

(b) Director may implement the proposed action.

(4) If a timely request for a hearing has been received, the Office of Administrative Hearings shall:

(a) Notify the Director, the governing body or health officer, and administrative prosecutor of the date, time, and location of the hearing; and

(b) 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.

(5) 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.

(6) A program may appeal any final decision from a contested case by following the provisions of Health-General Article, §2-207, Annotated Code of Maryland, and State Government Article, Title 10, Subtitle 2, Annotated Code of Maryland.

(7) In addition to disposing of a case by a hearing, the Director may dispose of a contested case by:

(a) Stipulation;

(b) Settlement;

(c) Consent order;

(d) Default;

(e) Withdrawal;

(f) Summary disposition; or

(g) Dismissal.

Md. Code Regs. 10.47.04.08

Regulation .08 amended as an emergency provision effective April 1, 2008 (35:9 Md. R. 894); amended permanently effective May 5, 2008 (35:9 Md. R. 898)