64B10-14.004. Disciplinary Guidelines; Range of Penalties; Aggravating and Mitigating Circumstances

(1) The Board sets forth below a range of disciplinary guidelines from which disciplinary penalties will be imposed upon practitioners guilty of violating chapters 456 and 468, part II, F.S. The purpose of the disciplinary guidelines is to give notice to licensees of the range of penalties which will normally be imposed upon violations of particular provisions of chapters 456 and 468, F.S. The disciplinary guidelines are based upon a single count violation of each provision listed. Multiple counts of violations of the same provision of chapters 456 and 468, F.S., Part II., or the rules promulgated thereto, or other unrelated violations contained in the same administrative complaint will be grounds for enhancement of penalties. All penalties at the upper range of the sanctions set forth in the guidelines, i.e., suspension, revocation, etc., include lesser penalties, i.e., fine, reprimand, or probation which may be included in the final penalty at the Board’s discretion. For the purposes of this rule, the descriptions of the violations are abbreviated and the full statute or rule cited should be consulted to determine the prohibited conduct.

(2) The following disciplinary guidelines shall be followed by the Board in imposing disciplinary penalties upon licensees for violation of the below mentioned statutes and rules:

Violation

Minimum

Maximum

(a) Violation of Section 468.1745(1)(a), (b), (c) or (e), 468.1755(1)(a), F.S., unlicensed practice by an applicant for licensure.

First Offense:	Reprimand and $500 fine.	Probation and $500 fine.
Second Offense:	Probation and $1,000 fine.	Denial/revocation.

(b) Giving false or forged evidence to obtain a license.

(Sections 468.1745(1)(d), and 468.1755(1)(a), F.S.)

First Offense:	Probation and $500 fine.	Denial/revocation and $500 fine.
Second Offense:	6 months suspension followed by probation and $1,000 fine.	Denial/revocation.

(c) Knowingly employ unlicensed persons.

(Sections 456.072(1)(j), 468.1745(1)(f), and 468.1755(1)(a), F.S.)

First Offense:	Reprimand and $500 fine.	Probation and $500 fine.
Second Offense:	Probation and $500 fine.	6 month suspension followed by probation and $1,000 fine.
Third Offense:	6 months suspension followed by probation and $1,000 fine.	Revocation.

(d) Knowingly conceal violations of this act.

(Sections 468.1745(1)(g), and 468.1755(1)(a), F.S.)

First Offense:	$500 fine.	$1,000 fine.
Second Offense:	$1,000 fine.	Probation and $1,000 fine.
Third Offense:	Probation and $1,000 fine.	1 year suspension followed by probation and $1,000 fine.

(e) Attempting to procure license by bribery, fraudulent misrepresentation or error of the Department or Board. However, if the offense is for fraud, the fine is increased to $10,000 per count or offense.

(Sections 456.072(1)(h), and 468.1755(1)(b), F.S.)

First Offense:	Probation and $500 fine.	Denial/revocation.
Second Offense:	6 months suspension followed by probation and $1,000 fine.	Denial/revocation.

(f) Nursing Home Administrator License Disciplined by another jurisdiction.

(Sections 456.072(1)(f), and 468.1755(1)(c), F.S.)

Same penalty as imposed by other jurisdiction, if consistent with Florida law and these guidelines for similar cases.

(g) Criminal conviction relating to practice or ability to practice nursing home administration.

(Sections 456.072(1)(c), and 468.1755(1)(d), F.S.)

First Offense:	Reprimand and $1,000 fine.	1 year suspension, followed by probation and $1,000 fine.
Second Offense:	1 year suspension followed by probation and $1,000 fine.	Denial/revocation.

(h) Knowingly making or filing false report.

(Sections 456.072(1)(l), and 468.1755(1)(e), F.S.)

First Offense:	Reprimand and $1,000 fine.	1 year suspension, followed by probation and $1,000 fine.
Second Offense:	1 year suspension followed by probation and $1,000 fine.	Denial/revocation.

(i) Authorizing the discharge or transfer of a resident for a Reason other than those provided in section 400.022 and 400.0255, F.S.

(Section 468.1755(1)(f), F.S.)

First Offense:	Reprimand.	Reprimand and $1,000 fine.
Second Offense:	Probation $1,000 fine.	1 month suspension.

(j) Fraudulent, false, deceptive or misleading advertising. However, if the offense is for fraud, the fine is increased to $10,000 per count or offense.

(Section 468.1755(1)(g), F.S.)

First Offense:	Reprimand.	$500 fine.
Second Offense:	$500 fine.	$1,000 fine.
Third Offense:	Reprimand and $1,000 fine.	Probation and $1,000 fine.

(k) Fraud or deceit in the practice of nursing home administration. However, if the offense is for fraud, the fine is increased to $10,000 per count or offense.

(Section 468.1755(1)(h), F.S.)

First Offense:	Reprimand and $1,000 fine.	1 year suspension, followed by probation and $1,000 fine.
Second Offense:	1 year suspension followed by probation and $1,000 fine.	Revocation.

(l) Negligence or incompetence in the practice of nursing home administration.

(Section 468.1755(1)(h), F.S.)

First Offense:	Reprimand and $1,000 fine.	1 year suspension, followed by probation and $1,000 fine.
Second Offense:	1 year suspension followed by probation and $1,000 fine.	Revocation.

(m) Misconduct in the practice of nursing home administration including but not limited to: trust fund violations, Medicaid/insurance fraud, exploitation of a patient, and undue influence of a patient. However, if the offense is for fraud, the fine is increased to $10,000 per count or offense.

(Section 468.1755(1)(h), F.S.)

First Offense:	Reprimand and $1,000 fine.	1 year suspension, followed by probation and $1,000 fine.
Second Offense:	1 year suspension followed by probation and $1,000 fine.	Revocation.

(n) Violation of previous disciplinary order or subpoena issued by the Board or Department.

(Sections 456.072(1)(q), and 468.1755(1)(i), F.S.)

First Offense:	$1,000 fine.	6 months suspension, followed by probation and $1,000 fine.
Second Offense:	6 months suspension followed by probation and $1,000 fine.	Revocation.

(o) Practice on a revoked license.

(Section 468.1755(1)(j), F.S.)

First Offense:	$500 fine.	$1,000 fine.
Second Offense:	$500 and denial of future applications.	$1,000 fine and denial of future applications.

(p) Practice on a suspended license.

(Section 468.1755(1)(j), F.S.)

First Offense:	$1,000 fine.	6 months suspension followed by probation and $1,000 fine.
Second Offense:	6 months suspension followed by probation and $1,000 fine.	Revocation.

(q) Practice on an inactive license.

(Section 468.1755(1)(j), F.S.)

First Offense:	$1,000 fine.	6 months suspension, followed by probation and $1,000 fine.
Second Offense:	6 months suspension followed by probation and $1,000 fine.	Revocation.

(r) Practice on a delinquent license.

(Section 468.1755(1)(j), F.S.)

First Offense:	$1,000 fine.	6 months suspension, followed by probation and $1,000 fine.
Second Offense:	6 months suspension followed by probation and $1,000 fine.	Revocation.

(s) Repeatedly acting inconsistently with health, safety and welfare of patients.

(Section 468.1755(1)(k), F.S.)

First Offense:	Reprimand and $1,000 fine.	1 year suspension, followed by probation and $1,000 fine.
Second Offense:	1 year suspension followed by probation and $1,000 fine.	Revocation.

(t) Inability to practice with skill and safety due to mental or physical impairment.

(Section 468.1755(1)(l), F.S.)

First Offense:	Probation.	Suspension until the licensee can demonstrate to the Board that he/she is able to practice with reasonable skill and safety and $500 fine.
Second Offense:	Probation and $1,000 fine.	Suspension until the licensee can demonstrate to the Board that he/she is able to practice with reasonable skill and safety and $1,000 fine.
Third Offense:	Suspension until licensee can demonstrate to the Board that he/she is able to practice with reasonable skill and safety and $1,000 fine.	Revocation.

(u) Willful or repeated violation of laws and rules governing nursing homes.

(Section 468.1755(1)(m), F.S.)

First Offense:	Reprimand and $1,000 fine.	1 year suspension, followed by probation and $1,000 fine.
Second Offense:	1 year suspension followed by probation and $1,000 fine.	Revocation.

(v) Payment for solicitation or procurement of nursing home usage.

(Section 468.1755(1)(n), F.S.)

First Offense:	Reprimand and $1,000 fine.	1 year suspension followed by probation and $1,000 fine.
Second Offense:	1 year suspension followed by probation and $1,000 fine.	Revocation.

(w) Willfully permitting unauthorized disclosure of patient information.

(Section 468.1755(1)(o), F.S.)

First Offense:	Reprimand and $1,000 fine.	1 year suspension, followed by probation and $1,000 fine.
Second Offense:	1 year suspension, followed by probation and $1,000 fine.	Revocation.

(x) Discrimination to staff or patients.

(Section 468.1755(1)(p), F.S.)

First Offense:	Reprimand and $1,000 fine.	1 year suspension followed by probation and $1,000 fine.
Second Offense:	1 year suspension followed by probation and $1,000 fine.	Revocation.

(y) Failure to implement quality Assurance program.

(Section 468.1755(1)(q), F.S.)

First Offense:	Reprimand.	Reprimand.
Second Offense:	Probation and $1,000 fine.	1 month suspension.

(z) Violating any provision of this chapter or Chapter 456, F.S., or any rules adopted pursuant thereto.

(Section 468.1755(1)(r), F.S.)

First Offense:	For any offense not specifically listed herein, based upon the severity of the offense and the potential for patient harm, from a reprimand to revocation or denial; and an administrative fine from $500 to $5,000.
Second Offense:	For any offense not specifically listed herein, based upon the severity of the offense and the potential for patient harm. From probation to revocation or denial and an administrative fine from $500 to $5,000.

(aa) Making misleading, deceptive, or fraudulent representations in or related to the practice of the licensee’s profession. However, if the offense is for fraud, the fine is increased to $10,000 per count or offense.

(Section 456.072(1)(a), F.S.)

First Offense:	Reprimand and $1,000 fine.	1 year suspension followed by probation and $1,000 fine.
Second Offense:	1 year suspension followed by probation and $1,000 fine.	Revocation.

(bb) Intentionally violating any rule adopted by the Board or the Department, as appropriate.

(Section 456.072(1)(b), F.S.)

First Offense:	$1,000 fine.	6 months suspension followed by probation and $1,000 fine.
Second Offense:	6 months suspension followed by probation and $1,000 fine.	Revocation.

(cc) Failing to comply with the educational course requirements for human immunodeficiency virus, acquired immune deficiency syndrome.

(Section 456.072(1)(e), F.S.)

First Offense:	$750 fine.	$1,000 fine.
Second Offense:	Probation and $750 fine.	Probation and $1,000 fine.
Third Offense:	Probation and $1,000 fine.	6 months suspension followed by probation and $1,000 fine.

(dd) Having been found liable in a civil proceeding for knowingly filing a false report or complaint with the Department against another licensee.

(Section 456.072(1)(g), F.S.)

First Offense:	Reprimand and $1,000 fine.	1 year suspension, followed by probation and $1,000 fine.
Second Offense:	1 year suspension followed by probation and $1,000 fine.	Denial/revocation.

(ee) Failing to report to the Department any person who the licensee knows is in violation of chapter 456, F.S., the chapter regulating the alleged violator, or the rules of the Department or the Board.

(Section 456.072(1)(i), F.S.)

First Offense:	Reprimand.	$500 fine.
Second Offense:	$500 fine.	$750 fine.
Third Offense:	$1,000 fine.	probation and $1,000 fine.

(ff) Aiding, assisting, procuring, or advising any unlicensed person or entity to practice a profession contrary to chapter 456, F.S., the chapter regulating the profession, or the rules of the Department or the Board.

(Section 456.072(1)(j), F.S.)

First Offense:	Reprimand and $500 fine.	Probation and $500 fine.
Second Offense:	Probation and $500 fine.	6 months suspension followed by probation and $1,000 fine.
Third Offense:	6 months suspension followed by probation and $1,000 fine.	Revocation.

(gg) Failing to perform any statutory or legal obligation placed upon the licensee.

(Section 456.072(1)(k), F.S.)

First Offense:	Reprimand and $1,000 fine.	1 year suspension, followed by probation and $1,000 fine.
Second Offense:	1 year suspension followed by probation and $1,000 fine.	Denial/revocation.

(hh) Making deceptive, untrue, or fraudulent representations in or related to the practice of a profession or employing a trick or scheme in or related to the practice of a profession. However, if the offense is for fraud, the fine is increased to $10,000 per count or offense.

(Section 456.072(1)(m), F.S.)

First Offense:	Reprimand and $1,000 fine.	1 year suspension, followed by probation and $1,000 fine
Second Offense:	1 year suspension followed by probation and $1,000 fine	revocation

(ii) Practicing or offering to practice beyond the scope permitted by law or accepting and performing professional responsibilities the licensee knows, or has reason to know, the licensee is not competent to perform.

(Section 456.072(1)(o), F.S.)

First Offense:	Reprimand and $500 fine.	probation and $500 fine.
Second Offense:	Probation and $1,000 fine.	Revocation.

(jj) Delegating or contracting for the performance of professional responsibilities by a person when the licensee delegating or contracting for performance of such responsibilities knows, or has reason to know, such person is not qualified by training, experience, and authorization when required to perform them.

(Section 456.072(1)(p), F.S.)

First Offense:	Reprimand and $500 fine.	Probation and $500 fine.
Second Offense:	Probation and $1,000 fine.	Revocation.

(kk) Improperly interfering with an investigation or inspection authorized by statute, or with any disciplinary proceeding.

(Section 456.072(1)(r), F.S.)

First Offense:	Reprimand and $1,000 fine.	6 months suspension followed by probation and $1,000 fine.
Second Offense:	6 months suspension followed by probation and $1,000 fine.	Revocation.

(ll) Engaging or attempting to engage a patient in verbal or physical sexual activity.

(Section 456.072(1)(v), F.S.)

First Offense:	Probation and $1,000 fine.	1 year suspension, followed by probation and $1,000 fine.
Second Offense:	1 year suspension followed by probation and $1,000 fine.	Revocation.

(mm) Failing to report to the Board within 30 days after the licensee has been convicted or found guilty of, or entered a plea of nolo contendere to, regardless of adjudication, a crime in any jurisdiction.

(Section 456.072(1)(x), F.S.)

First Offense:	Reprimand and $500 fine.	$750 fine.
Second Offense:	$750 fine.	$1,000 fine.
Third Offense:	$1,000 fine.	Probation and $1,000 fine.

(nn) Using information about people involved in motor vehicle accidents which has been derived from accident reports made by law enforcement officers for the solicitation of the people involved in the accidents.

(Section 456.072(1)(y), F.S.)

First Offense:	Reprimand.	$500 fine.
Second Offense:	$500 fine.	$1,000 fine.
Third Offense:	Reprimand and $1,000 fine.	Probation and $1,000 fine.

(oo) Any license disciplined by another jurisdiction.

(Section 456.072(1)(f), F.S.)

Same penalty as imposed by other jurisdiction, if consistent with Florida law and these guidelines for similar cases.

(pp) Testing positive for preemployment or employer ordered drug screen.

(Section 456.072(1)(aa), F.S.)

First Offense:

Probation and $500 fine.

Suspension to be followed by probation and $750 fine.

(qq) Being terminated from a treatment program for impaired practitioners, which is overseen by an impaired practitioner consultant as described in Section 456.076, F.S., for failure to comply, without good cause, with the terms of the monitoring or treatment contract entered into by the licensee, or for not successfully completing any drug-treatment or alcohol-treatment program.

First Offense:	Reprimand.	Probation and $500 fine.
Second Offense:	Probation and $1,000 fine.	Revocation.

(rr) Being convicted of, or entering a plea of guilty or nolo contendere to, any misdemeanor or felony, regardless of adjudication, under 18 USC s. 669, ss. 285-287, s. 371, s. 1001, s. 1035, s. 1341, s. 1343, s. 1347, s. 1349, or s. 1518, or 42 USC ss. 1320a-7b, relating to the Medicaid program.

(Section 456.072(1)(ii), F.S.)

First Offense:

Revocation and a $2,500 fine or in the case of application for licensure, denial of license.

(ss) Failing to remit the sum owed to the state for overpayment from the Medicaid program pursuant to a final order, judgment, or settlement.

(Section 456.072(1)(jj), F.S.)

First Offense	A letter of concern.	probation and a fine of $500 to $1,000.
Second Offense	Reprimand.	Revocation.

(tt) Being terminated from the state Medicaid program, or any other state Medicaid program or the federal Medicare program.

(Section 456.072(1)(kk), F.S.)

First Offense:	Letter of concern.	Suspension and a fine of $500 to $1,000.
Second Offense:	Reprimand.	Revocation.

(uu) Being convicted of, or entering into a plea of guilty or nolo contendere to, any misdemeanor or felony, regardless of adjudication, which relates to health care fraud.

(Section 456.072(1)(ll), F.S.)

First Offense:

Revocation and a fine of $10,000 or in the case of application for licensure, denial of license.

(vv) Failure to comply with parental consent requirements of Section 1014.06, F.S.

(Section 456.072(1)(rr), F.S.)

First Offense:	Reprimand and a fine of $250.00 to $500.00 or in the case of application for licensure, denial of license.	Probation for six (6) months and a fine of $500.00 to $750.00 or in the case of application for licensure, denial of license.
Second Offense:	One (1) year probation and a fine of $500.00 to $750.00 or in the case of application for licensure, denial of license.	Suspension to be followed by one (1) year probation and a fine of $750.00 to $1,000.00 or in the case of application for licensure, denial of license.
Third Offense:	Suspension followed by a minimum of two (2) years probation and a fine of  $750.00 to $1,000.00 or in the case of application for licensure, denial of license.	Revocation or in the case of application for licensure, denial of license.

(ww) Conviction of or plea to crimes enumerated in section 456.074(5), F.S. or similar offense in another jurisdiction.

(Section 456.072(1)(ss), F.S.)

First Offense:

Revocation and a fine of $5,000.00 to $10,000.00 or in the case of application for licensure, denial of license.

(3)(a) The Board shall be entitled to deviate from the foregoing guidelines upon a showing of aggravating or mitigating circumstances by clear and convincing evidence, presented to the Board prior to the imposition of a final penalty at informal hearing. If a formal hearing is held, any aggravating or mitigating factors must be submitted to the hearing officer at formal hearing. At the final hearing, the Board will not hear additional aggravating or mitigating evidence.

(b) Circumstances which shall be considered for purposes of mitigation or aggravation of penalty shall include the following:

1. The danger to the public.

2. The number of repetitions of offenses.

3. Previous disciplinary action against the licensee in this or any other jurisdiction.

4. The length of time the licensee has practiced.

5. The actual damage, physical or otherwise, caused by the violation.

6. The deterrent effect of the penalty imposed.

7. The effect of the penalty upon the licensee’s livelihood.

8. Any efforts at rehabilitation.

9. Attempts by the licensee to correct or stop violations, or refusal by the licensee to correct or stop violations.

10. Any other mitigating or aggravating circumstances.

(4) The Board shall impose one or more of the following penalties, listed in increasing order of severity:

(a) Fine not to exceed $1,000 for each separate count or offense.

(b) Reprimand.

(c) Probation, with terms including but not limited to: reports from the licensee, and his employer, supervision of practice by the Board or another licensee, continuing education courses, personal appearances before the Board, and counseling or treatment.

(d) Suspension.

(e) Revocation.

Rulemaking Authority 456.072, 456.073(3), 456.079, 468.1685(1) FS. Law Implemented 456.072, 456.073(3), 456.074, 456.079, 1014.06, 468.1685(4), (5), (6), 468.1755(1)(a), (j), (q) FS. History–New 11-23-86, Amended 4-22-87, Formerly 21Z-14.004, 61G12-14.004, 59T-14.004, Amended 10-12-97, 10-16-00, 2-13-01, 2-10-03, 5-1-03, 7-27-06, 8-10-08, 5-23-10, 7-11-17, 11-30-21.