DISCIPLINE COMMITTEE OF THE COLLEGE

OF NURSES OF ONTARIO

PANEL: Carly Gilchrist, RPN Chairperson Sylvia Douglas Public Member Fidelia Osime Public Member Patricia Sullivan-Taylor, RN Member Ingrid Wiltshire-Stoby, NP Member

BETWEEN:

COLLEGE OF NURSES OF ONTARIO ) NICK COLEMAN for ) College of Nurses of Ontario

• and - )

HYUN-SEUNG LEE ) MICHELLE GIBBS for Registration No. 08366252 ) Hyun-Seung Lee

) CHRISTOPHER WIRTH ) Independent Legal Counsel

) Heard: May 13, 2022

DECISION AND REASONS

This matter came on for hearing before a panel of the Discipline Committee (the “Panel”) of the College of Nurses of Ontario (the “College”) on May 13, 2022, via videoconference.

The Allegations

The allegations against Hyun-Seung Lee (the “Member”) as stated in the Notice of Hearing dated April 11, 2022 are as follows:

IT IS ALLEGED THAT:

1. You have committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended, and defined in subsection 1(1) of Ontario Regulation 799/93, in that while working as a Registered Nurse at University Health Network – Toronto General Hospital in Toronto, Ontario (the “Facility”), you contravened a standard of practice of the profession or failed to meet the standards of practice of the profession, and in particular, in or around 2015-2017, you submitted false claims under the Facility’s employee group benefit plan (the “Benefit Plan”).

2. You have committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended, and defined in subsection 1(8) of Ontario Regulation 799/93, in that while working as a Registered Nurse at the Facility, you misappropriated property from a client or workplace, and in particular, in or around 2015-2017, you submitted false claims under the Benefit Plan.

3. You committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended, and defined in subsection 1(14) of Ontario Regulation 799/93, in that while working as a Registered Nurse at the Facility, you falsified a record relating to your practice, and in particular, in or around 2015-2017, you submitted false claims under the Benefit Plan.

4. You committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended, and defined in subsection 1(15) of Ontario Regulation 799/93, in that while working as a Registered Nurse at the Facility, you signed or issued, in your professional capacity, a document that you knew or ought to have known contained a false or misleading statement, and in particular, in or around 2015-2017, you submitted false claims under the Benefit Plan.

5. You have committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended, and defined in subsection 1(37) of Ontario Regulation 799/93, in that while working as a Registered Nurse at the Facility, you engaged in conduct or performed an act, relevant to the practice of nursing, that, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable or unprofessional, and in particular, in or around 2015-2017, you submitted false claims under the Benefit Plan.

Member’s Plea

The Member admitted the allegations set out in paragraphs 1, 2, 3, 4 and 5 in the Notice of Hearing. The Panel received a written plea inquiry which was signed by the Member. The Panel also conducted an oral plea inquiry and was satisfied that the Member’s admission was voluntary, informed and unequivocal.

Agreed Statement of Facts

College Counsel and the Member’s Counsel advised the Panel that agreement had been reached on the facts and introduced an Agreed Statement of Facts, which reads, unedited, as follows:

MEMBER

1. Hyun-Seung Lee (the “Member”) obtained a degree in nursing from the Catholic University of Korea in Seoul, Republic of Korea in 2003.

2. The Member registered with the College of Nurses of Ontario (“CNO”) as a Registered Nurse (“RN”) on September 23, 2008.

3. The Member has been employed as an RN at University Health Network – Toronto General Hospital (the “Facility) since 2008.

BENEFIT PLAN

4. The Facility’s employee benefit plan (the “Benefit Plan”) is a group insurance policy which provides coverage for extended health care, dental, and other insurance benefits. The Facility is the Plan Sponsor for the Benefit Plan and funds the cost of claims paid out under the plan. SunLife Insurance (“SunLife”) administers the Benefit Plan on behalf of the Facility.

5. The Member, as an RN at the Facility represented by the Ontario Nurses’ Association (“ONA”), was a member of the Benefit Plan through the collective agreement between ONA and the Facility. The Member’s spouse also had coverage under the Benefit Plan.

6. In relation to extended health care, the Benefit Plan provided the Member and her family with coverage for medical equipment and supplies, among other things. In particular, the Benefit Plan provided 100% reimbursement for up to 4 pairs of support stockings annually (per person), as well as braces, provided they are not solely for athletic use.

7. The Benefit Plan also provided the Member with coverage for the reasonable and customary charges for orthopaedic shoes, including modifications to stock orthopedic shoes (up to $250/year), and for orthotics (2 pairs up to $225/year). To be eligible, the shoes and/or orthotics must be “required for the correction of deformity of the bones and muscles and provided they are not solely for athletic use”. They must also be prescribed by a physician, podiatrist, chiropodist or chiropractor.

8. The Benefit Plan also provided the Member and her family with coverage for treatment by a registered massage therapist, up to $400/year.

9. Claims for equipment and supplies under the Benefit Plan, including orthotics, shoe modifications, braces and support stockings, were to be submitted using a paper claim form with the receipt and prescription attached. The claim form included the following declaration to be signed by the employee submitting a claim:

Authorization and Signature

I certify that all goods and services being claimed have been received by me and/or my spouse or dependents, if applicable. I certify that the information in this form is true and complete and does not contain a claim for any expense previously paid for by this or any other plan. [emphasis added]

In the event there is suspicion and/or evidence of fraud and/or Plan abuse concerning this claim, I acknowledge and agree that Sun Life may investigate and that information about me, my spouse and/or dependents pertaining to this claim may be used and disclosed to any relevant organization including regulatory bodies, government organizations, medical suppliers and other insurers, and where applicable my Plan Sponsor, for the purpose of investigation and prevention of fraud and/or Plan abuse.

10. Claims for massage therapy were to be submitted online on behalf of the Member and her family.

INCIDENTS RELEVANT TO ALLEGATIONS OF PROFESSIONAL MISCONDUCT

11. Between 2015 and 2017, the Member submitted false claims under the Benefit Plan and received $2,315 in relation to the false claims.

12. Downtown Wellness and Foot Care (“DWFC”) is a supplier of orthotics, braces and compression stockings. It is connected with Elm Orthotics and Foot Care Inc. (“EOFC”). Renzy Ercia is the owner of DWFC and was, at the time of the incidents, a registered massage therapist.

13. In or around March 2017, SunLife conducted a secret shopper investigation of DWFC and EOFC. The investigation was initiated following a tip from a nurse manager with the University Health Network that alleged DWFC was running a scheme whereby benefit plan members would obtain designer handbags and shoes from DWFC, but DWFC would provide the benefit plan members with documentation that allowed them to submit false benefit claims for these items. During the secret shopper visit, an employee of DWFC suggested to the secret shopper that expenses could be billed in a way that did not comply with the benefit plan but would ensure that the secret shopper was not out of pocket for any costs.

14. SunLife’s investigation resulted in a “delist” recommendation, meaning that SunLife would not pay claims from this provider due to suspicions of fraud.

15. SunLife identified the Member as having submitted a series of claims involving DWFC and EOFC that required review. In particular, the Member submitted several claims in 2014-2017 for products and services from DWFC and EOFC, including shoe modifications, compressions stockings, non-custom-made orthotics, and braces, as well as claims for massage therapy services from Renzy Ercia.

16. The Facility and SunLife interviewed the Member on August 1, 2017, to review these claims. At this interview, the Member admitted that she submitted false claims for massage therapy not actually received. She further admitted that that in exchange for making these false claims, she received store credit to purchase non-orthopaedic shoes at DWFC. The Member denied fraud in relation to the shoe modification, orthotics, braces and compression stocking claims at this interview; however, the Member subsequently admitted to submitting false claims for shoe modifications.

17. The Member received a five-day unpaid suspension from the Facility for her conduct. Additionally, the Member and the Facility entered a “Payment Agreement” which required the Member to pay back $2,315 for “benefit claim abuse”, which included $1,600 for false massage claims and $715 for the false shoe modification claims. The Member did not grieve the suspension.

18. If the Member were to testify, she would state that she is deeply embarrassed by the events and is both regretful and remorseful for her conduct. She would further testify that at the time she did not fully appreciate the seriousness of her actions and the implications of same, but she now appreciates that her conduct was a gross breach of the trust placed in her by her employer.

BENEFIT FRAUD CASES

19. To date, a total of 52 benefit fraud cases involving substantially similar schemes as the one identified in this case, involving either cash or products not covered by the benefit plan, have been referred to the Discipline Committee. The dollar amounts of the false claims involved range from under $500 to over $45,000.

CNO STANDARDS

Professional Standards

20. CNO’s Professional Standards provides an overall framework for the practice of nursing and a link with other standards, guidelines and competencies developed by CNO. It includes seven broad standard statements pertaining to accountability, continuing competence, ethics, knowledge, knowledge application, leadership and relationships.

21. CNO’s Professional Standards provides, in relation to the accountability standard, that nurses are accountable to the public and responsible for ensuring their practice and conduct meets the legislative requirements and the standard of the profession. Nurses are responsible for their actions and the consequences of those actions as well as for conducting themselves in ways that promote respect for the profession. Nurses demonstrate this standard by actions such as ensuring their practice is consistent with CNO’s standards of practice and guidelines as well as legislation.

22. CNO’s Professional Standards provides, in relation to the leadership standard, that leadership requires self-knowledge (understanding one’s beliefs and values and being aware of how one’s behaviour affects others), respect, trust, integrity, shared vision, learning, participation, good communication techniques and the ability to be a change facilitator. The leadership expectation is not limited to nurses in formal leadership positions and all nurses, regardless of their position, have opportunities for leadership. Nurses demonstrate this standard by actions such as role-modelling professional values, beliefs and attributes.

Ethics

23. CNO’s Ethics Standard describes ethical values that are important to the nursing profession in Ontario including patient well-being, patient choice, privacy and confidentiality, respect for life, maintaining commitments, truthfulness and fairness.

24. CNO’s Ethics Standard provides, in relation to maintaining commitments, that nurses have a commitment to the nursing profession and being a member of the profession brings with it the respect and trust of the public. To continue to deserve this respect, nurses have a duty to uphold the standards of the profession, conduct themselves in a manner that reflects well on the profession, and to participate in and promote the growth of the profession.

25. CNO’s Ethics Standard also provides, in relation to truthfulness, that truthfulness means speaking and acting without intending to deceive.

26. The Member admits and acknowledges that she contravened CNO’s Professional Standards and Ethics Standard when she submitted false claims under the Benefit Plan between 2015 and 2017.

ADMISSIONS OF PROFESSIONAL MISCONDUCT

27. The Member admits that she committed the acts of professional misconduct as alleged in paragraph 1 of the Notice of Hearing in that she contravened a standard of practice of the profession or failed to meet the standards of practice of the profession, as described in paragraphs 11 to 17 and 20 to 26 above.

28. The Member admits that she committed the acts of professional misconduct as alleged in paragraph 2 of the Notice of Hearing in that she misappropriated property from a workplace, as described in paragraphs 11 to 17 above.

29. The Member admits that she committed the acts of professional misconduct as alleged in paragraph 3 of the Notice of Hearing in that she falsified a record relating to her practice, as described in paragraphs 11 to 17 above.

30. The Member admits that she committed the acts of professional misconduct as alleged in paragraph 4 of the Notice of Hearing in that she signed or issued, in her professional capacity, a document that she knew or ought to have known contained a false or misleading statement, as described in paragraphs 11 to 17 above.

31. The Member admits that she committed the acts of professional misconduct as alleged in paragraph 5 of the Notice of Hearing, and in particular her conduct was dishonourable and unprofessional, as described in paragraphs 11 to 17 and 20 to 26 above.

Decision

The College bears the onus of proving the allegations in accordance with the standard of proof, that being the balance of probabilities based upon clear, cogent and convincing evidence.

Having considered the evidence and the onus and standard of proof, the Panel finds that the Member committed acts of professional misconduct as alleged in paragraphs 1, 2, 3, 4 and 5 of the Notice of Hearing. As to allegation 5, the Panel finds that the Member engaged in conduct that would reasonably be regarded by members of the profession to be unprofessional and dishonourable.

Reasons for Decision

The Panel considered the Agreed Statement of Facts and the Member’s plea and finds that this evidence supports findings of professional misconduct as alleged in the Notice of Hearing.

Allegation #1 in the Notice of Hearing is supported by paragraphs 11 to 17 and 20 to 27 in the Agreed Statement of Facts. Between 2015 and 2017, the Member submitted false claims under the University Health Network – Toronto General Hospital’s (the “Facility”) employee group benefit plan (the “Benefit Plan”) and received $2,315.00 in relation to those false claims. The Member admitted that she submitted false claims for massage therapy not actually received. She further admitted that in exchange for making these false claims, she received store credit to purchase non-orthopaedic shoes. While the Member initially denied fraud in relation to the shoe modification, orthotics, braces and compression stocking claims; she subsequently admitted to submitting false claims for shoe modifications. The College’s Ethics Standard, in relation to truthfulness, provides that “truthfulness means speaking and acting without intending to deceive.” The Member attempted to deceive her employer by submitting false claims to the Benefit Plan. The College’s Ethics Standard also provides, in relation to maintaining commitments, that nurses have a commitment to the nursing profession and being a member of the profession brings with it the respect and trust of the public. To continue to deserve this respect, nurses have a duty to uphold the standards of the profession, conduct themselves in a manner that reflects well on the profession, and to participate in and promote the growth of the profession which the Member by her conduct, failed to do. In relation to accountability, the College’s Professional Standards provides that “Each nurse is accountable to the public and responsible for ensuring that her/his practice and conduct meets legislative requirements and the standards of the profession.” The Member demonstrated that she was not accountable to the public when she submitted false claims through the Benefit Plan.

Allegation #2 in the Notice of Hearing is supported by paragraphs 11 to 17 and 28 in the Agreed Statement of Facts. Between 2015-2017, the Member misappropriated property from a client or workplace, and in particular, by submitting false claims under the Benefit Plan that she only had access to as a result of her professional role with the organization. The Member submitted several claims in 2015-2017 for products and services, including shoe modifications, compressions stockings, non-custom-made orthotics, and braces, as well as claims for massage therapy services. The Member admitted that she submitted false claims for massage therapy not actually received. She further admitted that in exchange for making these false claims, she received store credit to purchase non-orthopaedic shoes. The Member initially denied fraud in relation to the shoe modification, orthotics, braces and compression stocking claims; however, she subsequently admitted to submitting false claims for shoe modifications. The submission of false claims by the Member constituted the misappropriation of benefits from the Facility in the amount of $2,315.00.

Allegations #3 and #4 in the Notice of Hearing are supported by paragraphs 11 to 17, 29 and 30 in the Agreed Statement of Facts. Between 2015-2017, the Member submitted several claims for products and services, including shoe modifications, compressions stockings, non-custom-made orthotics, and braces, as well as claims for massage therapy services. The claim form contained a declaration which the Member had to sign. The declaration included that “all goods and services being claimed have been received by me and/or my spouse or dependents” and “I certify that the information in this form is true and complete.”, The Member admitted that she made false claims for massage therapy in exchange for which she received store credit to purchase non-orthopaedic shoes. By completing and submitting false claims, the Member falsified a record relating to her practice, as she did so in the context of her employment as an RN. When the Member signed the claim form containing the declaration, she signed a false or misleading statement in her professional capacity as an RN employee.

With respect to allegation #5 in the Notice of Hearing which is supported by paragraphs 11 to 17, 20 to 26 and 31 in the Agreed Statement of Facts, the Member’s conduct was clearly relevant to the practice of nursing. The Panel finds that the Member’s conduct was unprofessional as it demonstrated a serious and persistent disregard for her professional obligations. The Member failed to maintain the Ethics Standard as well as the Professional Standards. Patients and the public trust that nurses will demonstrate appropriate and ethical conduct. The Member’s conduct breached the Professional Standards through falsifying claims and financially benefitting from her misconduct.

The Panel also finds that the Member’s conduct was dishonourable. It demonstrated an element of dishonesty and deceit through making fraudulent submissions to the employee Benefit Plan in the total amount of $2,315.00 for products and services, including false claims for massage therapy not actually received, and shoe modifications. The Member knew or ought to have known that her conduct was unacceptable and fell below the standards of a professional.

Penalty

College Counsel and the Member’s Counsel advised the Panel that a Joint Submission on Order had been agreed upon. The Joint Submission on Order requests that this Panel make an order as follows:

1. Requiring the Member to appear before the Panel to be reprimanded within 3 months of the date that this Order becomes final.

2. Directing the Executive Director to suspend the Member’s certificate of registration for 3 months. This suspension shall take effect from the date that this Order becomes final and shall continue to run without interruption as long as the Member remains in a practicing class.

3. Directing the Executive Director to impose the following terms, conditions and limitations on the Member’s certificate of registration:

a) The Member will attend 2 meetings with a Regulatory Expert (the “Expert”), at her own expense and within 6 months from the date that this Order becomes final. To comply, the Member is required to ensure that:

i. The Expert has expertise in nursing regulation and has been approved by CNO in advance of the meetings;

ii. At least 5 days before the first meeting, or within another timeframe approved by the Expert, the Member provides the Expert with a copy of:

1. the Panel’s Order,

2. the Notice of Hearing,

3. the Agreed Statement of Facts,

4. this Joint Submission on Order, and

5. if available, a copy of the Panel’s Decision and Reasons;

iii. Before the first meeting, the Member reviews the following CNO publications and completes the associated Reflective Questionnaires, online learning modules and decision tools (where applicable):

1. Code of Conduct,

2. Professional Standards, and

3. Ethics;

iv. At least 5 days before the first meeting, or within another timeframe approved by the Expert, the Member provides the Expert with a copy of the completed Reflective Questionnaires;

v. The subject of the sessions with the Expert will include:

1. the acts or omissions for which the Member was found to have committed professional misconduct,

2. the potential consequences of the misconduct to the Member’s patients, colleagues, profession, and self,

3. strategies for preventing the misconduct from recurring,

4. the publications, questionnaires and modules set out above, and

5. the development of a learning plan in collaboration with the Expert;

vi. Within 30 days after the Member has completed the last session, the Member will confirm that the Expert forwards their report to CNO, in which the Expert will confirm:

1. the dates the Member attended the sessions,

2. that the Expert received the required documents from the Member,

3. that the Expert reviewed the required documents and subjects with the Member, and

4. the Expert’s assessment of the Member’s insight into her behaviour;

vii. If the Member does not comply with any one or more of the requirements above, the Expert may cancel any session scheduled, even if that results in the Member breaching a term, condition or limitation on her certificate of registration;

b) For a period of 12 months from the date the Member returns to the practice of nursing, the Member will notify her employer(s) of the decision. To comply, the Member is required to:

i. Ensure that CNO is notified of the name, address, and telephone number of all employer(s) within 14 days of commencing or resuming employment in any nursing position;

ii. Provide her employer(s) with a copy of:

1. the Panel’s Order,

2. the Notice of Hearing,

3. the Agreed Statement of Facts,

4. this Joint Submission on Order, and

5. a copy of the Panel’s Decision and Reasons, once available;

iii. Ensure that within 14 days of the commencement or resumption of the Member’s employment in any nursing position, the employer(s) forward(s) a report to CNO, in which it will confirm:

1. that they received a copy of the required documents, and

2. that they agree to notify CNO immediately upon receipt of any information that the Member has breached the standards of practice of the profession.

3. All documents delivered by the Member to CNO, the Expert or her employer(s) will be delivered by verifiable method, the proof of which the Member will retain.

Penalty Submissions

Submissions were made by College Counsel.

The aggravating factors in this case were that there were multiple claims over a period of several years. The value of the claims was in excess of $2,300.00, resulting in a financial loss to the Facility. The claims were accompanied by a false declaration made by the Member. The Member’s blatant dishonest conduct is a serious breach of the Member’s professional responsibility.

The mitigating factors in this case were that the Member accepted full responsibility for her conduct by admitting to all the allegations of professional misconduct and by entering into an Agreed Statement of Facts and a Joint Submission on Order with the College. The Member saved the College time and resources. The Member made restitution in the sum of $2,315.00. The Member also received a five-day unpaid suspension from her employer. The Member has no prior discipline history with the College.

The proposed penalty provides for general deterrence through the 3-month suspension of the Member’s certificate of registration and communicates a message to other members of the profession that similar conduct will attract a significant penalty sanction. General deterrence is an important element in this case given the significant number of pending similar cases before the Discipline Committee.

The proposed penalty provides for specific deterrence through the oral reprimand and the 3-month suspension of the Member’s certificate of registration as it demonstrates to the Member the seriousness of her conduct and that this misconduct will not be tolerated.

The proposed penalty provides for remediation and rehabilitation through the 2 meetings with a Regulatory Expert. The Member will also review the College’s publications and complete reflective questionnaires, online learning modules, decision tools and online participation forms, including the development of a learning plan in collaboration with the Expert. These requirements will help to deepen the Member’s understanding of her misconduct and will help to ensure that this conduct is not repeated in her future practice.

Overall, the public is protected because this process will assist the Member in gaining additional insight and knowledge into her practice. This will inform her future practice. The public is also protected through the 12 months of employer notification requirements whereby the Member is required to notify her employers of the Panel’s decision. This penalty sends a message to the public about the profession’s ability to self-regulate and to ensure this conduct is not repeated in her future practice. The public must have confidence that what the Member says is valid and true, even in the absence of direct patient care.

College Counsel also provided the Panel with the following prior decisions:

CNO v. Verde-Balayo (Discipline Committee, 2021): In this case, the hearing proceeded by way of a partial Agreed Statement of Facts and a Partial Joint Submission on Order. Similarities to the case before this Panel includes the member making fraudulent claims under its employee group benefit plan. In 2012-2016, the member submitted false claims under the Benefit Plan and was paid $7,982.50. No restitution was made. The penalty included an oral reprimand, a 4-month suspension of the member’s certificate of registration, 2 meetings with a Regulatory Expert and 12 months of employer notification.

CNO v. Velasquez (Discipline Committee, 2021): In this case, the hearing proceeded by way of an Agreed Statement of Facts and a Joint Submission on Order. Similarities to the case before this Panel includes the member making fraudulent claims under its employee group benefit plan. In 2013-2016, the member submitted false claims under the Benefit Plan and was paid $11,080.00. Restitution was made. The penalty included an oral reprimand, a 3-month suspension of the member’s certificate of registration, 2 meetings with a Regulatory Expert and 12 months of employer notification.

CPSO v. Moore (Divisional Court, 2003): The physician involved in this case pleaded guilty of defrauding OHIP of $75,000.00 over three years. Restitution was made. The penalty included an oral reprimand, a 12-month suspension of the member’s certificate of registration, which would be reduced to 6 months if certain conditions were met. College Counsel submitted that this case indicates that general deterrence can be given special emphasis if there is a widespread problem in the profession.

Submissions were made by the Member’s Counsel.

The Member’s Counsel submitted that on the whole she agreed with the submissions of College Counsel.

The mitigating factors in this case were that the Member accepted full responsibility for her conduct in 2019 by admitting to all the allegations of professional misconduct and by entering into an Agreed Statement of Facts and a Joint Submission on Order. The Member’s admission demonstrates, to members of the public and the College, her accountability and willingness to be governed. The Member saved the College time and resources, avoiding the need to call witnesses. The Member made full restitution in the sum of $2,315.00. The Member also received a five-day unpaid suspension, from her employer, which she did not grieve. The Member has no prior discipline history with the College.

The Member’s Counsel submitted that the Member was deeply remorseful and accepted the Joint Submission on Order.

The oral reprimand meets the goals of specific deterrence, general deterrence and rehabilitation and remediation and will provide an opportunity for the Member to hear from fellow members of the profession and public members about the seriousness of her conduct. It is a meaningful opportunity for the Member to receive insight about the expectations of the College and members of the public.

The 2 meetings with a Regulatory Expert will meet the goals of rehabilitation and remediation and public protection as they will educate the Member to an issue that is specifically significant to her profession and to the importance of honesty.

The 3-month suspension will have a strong deterrent effect by sending an important message to the Member reflecting the seriousness of the misconduct and to members of the profession that this type of misconduct is not acceptable.

The 12-month employer notification will protect the public through ensuring the Member’s employer is aware of the misconduct. The employer will be afforded an opportunity to be vigilant in monitoring the Member’s practice on her return to the profession.

Penalty Decision

The Panel accepts the Joint Submission on Order and accordingly orders:

1. The Member is required to appear before the Panel to be reprimanded within 3 months of the date that this Order becomes final.

2. The Executive Director is directed to suspend the Member’s certificate of registration for 3 months. This suspension shall take effect from the date that this Order becomes final and shall continue to run without interruption as long as the Member remains in a practicing class.

3. The Executive Director is directed to impose the following terms, conditions and limitations on the Member’s certificate of registration:

a) The Member will attend 2 meetings with a Regulatory Expert (the “Expert”), at her own expense and within 6 months from the date that this Order becomes final. To comply, the Member is required to ensure that:

i. The Expert has expertise in nursing regulation and has been approved by CNO in advance of the meetings;

ii. At least 5 days before the first meeting, or within another timeframe approved by the Expert, the Member provides the Expert with a copy of:

1. the Panel’s Order,

2. the Notice of Hearing,

3. the Agreed Statement of Facts,

4. this Joint Submission on Order, and

5. if available, a copy of the Panel’s Decision and Reasons;

iii. Before the first meeting, the Member reviews the following CNO publications and completes the associated Reflective Questionnaires, online learning modules and decision tools (where applicable):

1. Code of Conduct,

2. Professional Standards, and

3. Ethics;

iv. At least 5 days before the first meeting, or within another timeframe approved by the Expert, the Member provides the Expert with a copy of the completed Reflective Questionnaires;

v. The subject of the sessions with the Expert will include:

1. the acts or omissions for which the Member was found to have committed professional misconduct,

2. the potential consequences of the misconduct to the Member’s patients, colleagues, profession, and self,

3. strategies for preventing the misconduct from recurring,

4. the publications, questionnaires and modules set out above, and

5. the development of a learning plan in collaboration with the Expert;

vi. Within 30 days after the Member has completed the last session, the Member will confirm that the Expert forwards their report to CNO, in which the Expert will confirm:

1. the dates the Member attended the sessions,

2. that the Expert received the required documents from the Member,

3. that the Expert reviewed the required documents and subjects with the Member, and

4. the Expert’s assessment of the Member’s insight into her behaviour;

vii. If the Member does not comply with any one or more of the requirements above, the Expert may cancel any session scheduled, even if that results in the Member breaching a term, condition or limitation on her certificate of registration;

b) For a period of 12 months from the date the Member returns to the practice of nursing, the Member will notify her employer(s) of the decision. To comply, the Member is required to:

i. Ensure that CNO is notified of the name, address, and telephone number of all employer(s) within 14 days of commencing or resuming employment in any nursing position;

ii. Provide her employer(s) with a copy of:

1. the Panel’s Order,

2. the Notice of Hearing,

3. the Agreed Statement of Facts,

4. this Joint Submission on Order, and

5. a copy of the Panel’s Decision and Reasons, once available;

iii. Ensure that within 14 days of the commencement or resumption of the Member’s employment in any nursing position, the employer(s) forward(s) a report to CNO, in which it will confirm:

1. that they received a copy of the required documents, and

2. that they agree to notify CNO immediately upon receipt of any information that the Member has breached the standards of practice of the profession.

3. All documents delivered by the Member to CNO, the Expert or her employer(s) will be delivered by verifiable method, the proof of which the Member will retain.

Reasons for Penalty Decision

The Panel understands that the penalty ordered should protect the public and enhance public confidence in the ability of the College to regulate nurses. This is achieved through a penalty that addresses specific deterrence, general deterrence and, where appropriate, rehabilitation and remediation. The Panel also considered the penalty in light of the principle that joint submissions should not be interfered with lightly.

The Panel concluded that the proposed penalty is reasonable and in the public interest. The Member has co-operated with the College and, by agreeing to the facts and a proposed penalty, has accepted responsibility.

The Panel finds that the penalty satisfies the principles of specific and general deterrence, rehabilitation and remediation, and public protection. Specific and general deterrence are achieved through the oral reprimand and a 3-month suspension of the Member’s certificate of registration. This will send a clear message to both the Member and the membership that fraud directed towards employer sponsored benefits will not be tolerated. Rehabilitation and remediation will be achieved through the 2 meetings with a Regulatory Expert and associated learning modules. The public will be protected through the 12-month employer notification which will make the employer aware of the misconduct so that the employer can appropriately monitor the Member on her return to practice.

The penalty is also in line with what has been ordered in previous cases in similar circumstances.

I, Carly Gilchrist, RPN, sign this decision and reasons for the decision as Chairperson of this Discipline Panel and on behalf of the members of the Discipline Panel.