Maryland Health - General Section 19-1402
§ 19-1402.
  (a)   If a deficiency exists, the Secretary may impose sanctions that include:
    (1)   A directed plan of correction with corrective measures necessary to protect residents;
    (2)   Imposing adequate staffing levels in a nursing home;
    (3)   Appointing a State monitor subject to § 19-1405 of this subtitle; and
    (4)   Imposing a civil money penalty.
  (b)   A civil money penalty may be imposed when a deficiency exists or an ongoing pattern of deficiencies exists in a nursing home.
  (c)   In determining whether a civil money penalty is to be imposed, the Secretary shall consider, pursuant to guidelines set forth in regulations promulgated by the Secretary, the following factors:
    (1)   The number, nature, and seriousness of the deficiencies;
    (2)   The extent to which the deficiency or deficiencies are part of an ongoing pattern during the preceding 24 months;
    (3)   The degree of risk to the health, life, or safety of the residents of the nursing home caused by the deficiency or deficiencies;
    (4)   The efforts made by, and the ability of, the nursing home to correct the deficiency or deficiencies; and
    (5)   A nursing home's prior history of compliance.
  (d)   Upon determination by the Department that a deficiency or deficiencies exist, the Department shall notify the nursing home that:
    (1)   Unless corrective action taken pursuant to this section is substantially completed, a civil money penalty will be imposed; or
    (2)   An order imposing a civil money penalty will be issued, pursuant to § 19-1403 of this subtitle which shall include a list of all deficiencies and notice that a civil money penalty may be imposed until the time that the cited deficiencies have been rectified.