College of Nurses of Ontario v. Taylor, 2022 CanLII 135423

DISCIPLINE COMMITTEE OF THE COLLEGE OF NURSES OF ONTARIO

PANEL: Michael Hogard, RPN Chairperson Janet Adanty, RN Member Carly Hourigan, Public Member Mary MacNeil, RN Member Ian McKinnon, Public Member

BETWEEN:

COLLEGE OF NURSES OF ONTARIO (DENISE COONEY for College of Nurses of Ontario)

• and -

NICOLE TAYLOR, Registration No. IC13131 (NO REPRESENTATION for Nicole Taylor)

CHRISTOPHER WIRTH, Independent Legal Counsel

Heard: September 26, 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 September 26, 2022, via videoconference.

The Allegations

The allegations against Nicole Taylor (the “Member”) as stated in the Notice of Hearing dated August 24, 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 Practical Nurse at Baycrest 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 2018, you submitted and/or accepted payment for 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 Practical Nurse at the Facility, you misappropriated property from a client or workplace, and in particular, in or around 2018, you submitted and/or accepted payment for 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 Practical Nurse at the Facility, you falsified a record relating to your practice, and in particular, in or around 2018, you submitted and/or accepted payment for 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 Practical 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 2018, you submitted and/or accepted payment for 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 Practical 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 2018, you submitted and/or accepted payment for 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 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. Nicole Taylor (the “Member”) registered with the College of Nurses of Ontario (“CNO”) as a Registered Practical Nurse (“RPN”) on June 25, 1993.

2. The Member was employed as an RPN at Baycrest Hospital located in Toronto, Ontario (the “Facility”), at the time of the incidents described below. The Facility terminated the Member’s employment on July 10, 2019 as a result of the incidents.

BENEFIT PLAN

3. The Facility offers its employees a self-insured group insurance policy by which the Facility provides coverage to employees for extended health care, dental, and other insurance benefits (the “Benefit Plan”). Coughlin & Associates Ltd (“Coughlin”) administers the Benefit Plan on behalf of the Facility. The Facility, however, is the plan sponsor for the Benefit Plan, and therefore funds the cost of claims paid out to employees under the plan. Employees contribute to the cost of the Benefit Plan as set out in their employment agreement and/or collective agreement, based on their election for individual or family coverage.

4. To submit a benefit claim, members of the Benefit Plan would complete a medical expense claim form provided by Coughlin. The medical expense claim form requires certain information, including information on the plan member, any dependents, and the nature of the claim. The plan member must certify “that the information given is true, correct and complete to the best of [their] knowledge”.

INCIDENTS RELEVANT TO ALLEGATIONS OF PROFESSIONAL MISCONDUCT

5. In 2018, the Member submitted several false claims to the Benefit Plan totalling $4,195. The Member submitted false claims for medical services such as physiotherapy, and for products such as custom orthotics, orthopedic shoes, knee support stabilizer braces, and medical compression pantyhose. She used at least part of the funds received from the claims to purchase a purse.

6. In January 2019, the Facility uncovered benefits irregularities and conducted an internal investigation. On February 26, 2019, the Member was interviewed by the Facility regarding her claims. The Member admitted to participating in a benefits fraud scheme.

7. The Facility terminated the Member’s employment on July 10, 2019 as a result of this conduct. The Member did not make restitution.

8. If the Member were to testify, she would apologize for her conduct and state she takes full responsibility. The Member would further testify that she feels as though she let herself, her patients, and co-workers down, and this was the biggest mistake she has ever made.

BENEFIT FRAUD CASES

9. To date, a total of 75 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

10. 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.

11. 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 standards 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.

12. 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

13. 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.

14. 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.

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

16. The Member admits and acknowledges that she contravened CNO’s Professional Standards and Ethics Standard.

ADMISSIONS OF PROFESSIONAL MISCONDUCT

17. 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 5 to 7 and 10 to 16 above.

18. 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 5 to 7 above.

19. 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 5 to 7 above.

20. 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 5 to 7 above.

21. 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 5 to 7 and 10 to 16.

Submissions on liability were made by College Counsel.

College Counsel asked the Panel to make findings with respect to all allegations. The Member admitted to each of the allegations and her plea was voluntary and informed. With regard to allegation #1, the Member admitted that her conduct was a breach of the College standards and the evidence of this admission, as well as the relevant College standards, are contained within the Agreed Statement of Facts. College Counsel submitted that the Panel has a basis to make a finding that the College standards were breached.

With regard to allegation #5, College Counsel submitted that the parties agree that the Member’s conduct was relevant to the practice of nursing and that it was unprofessional and dishonourable. This admission was part of the resolution reached and is appropriate for the circumstances. The Member submitted a total of $4,195.00 in false claims, which was clearly relevant to her practice as it was part of her participation in the Baycrest Hospital’s (the “Facility”) employee benefit plan (the “Benefit Plan”). Having regard to the circumstances, College Counsel submitted that members of the profession would consider the Member’s conduct to be unprofessional. Her conduct showed a serious disregard for her professional obligations that require nurses to act with integrity, honesty and in an ethical manner. The Member’s conduct was also dishonourable. The Member admitted to submitting $4,195.00 in false claims through repeated submissions of false claim forms which was a breach of the trust placed in her by the Facility, the claims administrator and the public. The Member’s conduct brings discredit to the nursing profession. College Counsel asked the Panel to make findings on all allegations.

The Member made no submissions on liability.

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 5 to 7 and 10 to 17 in the Agreed Statement of Facts. During an investigation in 2019 by the Facility related to benefits irregularities, the Member was interviewed and admitted that she submitted several false claims in 2018 under the Facility’s Benefit Plan. The Member submitted false claims for physiotherapy, custom orthotics, orthopedic shoes, knee support stabilizer braces and medical compression pantyhose. The College’s Professional Standards indicate 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 are expected to act with trust and integrity and role model professional values and attributes. The Ethics Standard also states that nurses have a duty to uphold the standards of the profession and conduct themselves in a manner that reflects well on the profession. The medical expense claim forms that the Member submitted required that she certify that the information submitted on the forms was true and accurate. The Member admitted that the claim forms she submitted were false claims totalling $4,195.00. Submitting false claims was a breach of the standards. The Member also admitted that the claims were false and that she had participated in a benefits fraud scheme. Accordingly, the Member contravened the College’s Professional Standards and the Ethics Standard.

Allegation #2 in the Notice of Hearing is supported by paragraphs 5 to 7 and 18 in the Agreed Statement of Facts. The Member misappropriated property from the Facility by submitting false claims under the Facility’s Benefit Plan in 2018 and receiving a total sum of $4,195.00 in relation to those false claims. Receiving money with respect to false benefit claims constitutes misappropriation of property.

Allegation #3 in the Notice of Hearing is supported by paragraphs 5 to 7 and 19 in the Agreed Statement of Facts. The Member admitted to committing an act of professional misconduct, when she falsified a record relating to her practice. As a Registered Practical Nurse (“RPN”) employed at the Facility, the Member had access to the Benefit Plan and submitted claims using a medical expense claim form. To complete the form, the Member had to sign the form and certify “that the information given is true, correct and complete to the best of [their] knowledge”. The Member admitted to submitting several false claims to the Benefit Plan. Accordingly, the facts support the allegation that the Member falsified a record relating to her practice, while participating in the Facility’s Benefit Plan as an RPN employee.

Allegation #4 in the Notice of Hearing is supported by paragraphs 5 to 7 and 20 in the Agreed Statement of Facts. The Member admitted to committing an act of professional misconduct, when she signed, in her professional capacity, a document that she knew or ought to have known contained a false or misleading statement. The Member signed false benefit claim forms for various medical services in 2018. When submitting the form, the Member had to certify that the information submitted was “true and complete”. The Member knew or ought to have known that she was misleading the Facility and the insurance company when she signed the forms. Since the Member could only sign and submit the claim forms in her capacity as an RPN employee, the facts support the allegation that the Member signed, in her professional capacity, a document that she knew contained a false or misleading statement.

Allegation #5 in the Notice of Hearing is supported by paragraphs 5 to 7, 10 to 16 and 21 in the Agreed Statement of Facts. The Panel finds that the Member’s conduct in submitting several false claims under the Facility’s Benefit Plan was clearly relevant to the practice of nursing as the Benefit Plan was only available to her as an RPN employee. The Professional Standards and the Ethics Standard require nurses to be accountable, truthful, have integrity and act without intending to deceive. The Member ignored these standards repeatedly when she submitted multiple false insurance claims. By ignoring these standards, she showed a persistent disregard for her professional obligations. The Panel finds this conduct to be unprofessional.

The Panel also finds that the Member’s conduct was dishonourable. It demonstrated an element of dishonesty and deceit through multiple instances of falsifying claim forms and misappropriating funds from the Facility’s Benefit Plan. Her actions exhibited an element of moral failing. The Member admitted to her misconduct as set out in the Agreed Statement of Facts and therefore knew her conduct was unacceptable and fell below the standards the public and the College expect of nurses.

Penalty

College Counsel and the Member 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 4 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 the Member’s 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 the Member’s 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 the Member’s 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 the Member’s 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 the Member’s 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 the Member’s employer(s) will be delivered by verifiable method, the proof of which the Member will retain.

Penalty Submissions

Submissions were made by College Counsel.

College Counsel asked the Panel to accept the Joint Submission on Order as it was a product of negotiations between the College and the Member. College Counsel reminded the Panel that a Joint Submission on Order is to be accepted unless it was contrary to the public interest or would bring the administration of justice into disrepute.

College Counsel submitted aggravating and mitigating factors for the Panel to consider.

The aggravating factors in this case were:

• The Member engaged in benefit fraud which was serious and for a significant amount;

• The Member’s employer was a publicly funded institution so the benefits the Member defrauded from the Facility's Benefit Plan was funded from the public purse;

• The Member’s conduct showed repeated acts of dishonesty; and

• The Member’s conduct was a breach of trust that the employer, the claims administrator and the public had put in the Member.

The mitigating factors in this case were:

• The Member took responsibility with her employer and the College by admitting to the allegations and entering into an Agreed Statement of Facts and a Joint Submission on Order with the College; and

• The Member has been a nurse for almost 30 years and has no prior discipline history with the College.

College Counsel submitted that the goals of penalty are to protect the public, maintain high professional standards and enhance the public confidence in the College’s ability to regulate the profession. The goals of penalty are achieved through specific deterrence, so that this particular Member is deterred from engaging in similar conduct again, and also through general deterrence to deter the membership at large. Specific deterrence is provided through the oral reprimand and the 4-month suspension of the Member’s certificate of registration. The oral reprimand will help the Member gain an understanding of how her actions are perceived by her peers, fellow members of the profession and the public. The suspension of the Member’s certificate of registration also sends a strong signal to the Member that this behaviour is unacceptable and is not to be repeated. General deterrence is achieved through the 4-month suspension of the Member’s certificate of registration, which sends a strong signal to all members of the profession that this conduct is unacceptable.

The Agreed Statement of Facts indicates that 75 cases have been referred to the Discipline Committee to date with over two dozen orders made by the Discipline Committee panels. Clearly the profession has a problem with benefit fraud and needs to send a signal to members that this kind of dishonesty is not acceptable and will not be tolerated.

Remediation and rehabilitation of the Member will be achieved through 2 meetings with a Regulatory Expert and the review of the College’s publications which will prepare the Member to meet the ethical practice expectations of the profession. The public will also be protected through the 12 months of employer notification as it will provide oversight of the Member’s practice upon her return to work.

College Counsel submitted the following cases to the Panel to demonstrate that the proposed penalty fell within the range of similar cases from this Discipline Committee:

CNO v. Verde-Balayo (Discipline Committee, 2021): This case was the first case to go before the Discipline Committee in a series of benefit fraud cases. The benefit fraud in this case was in the amount of $7,982.50. The member did not make restitution and the Joint Submission on Order that was made was identical to the penalty ordered in the case before this Panel. 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. Padillo (Discipline Committee, 2022): In this case, the member received $4,000.00 from false benefit claims which is similar to the amount in the case before this Panel. 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. The distinguishing factors between this case and the case before this Panel is that the member made restitution and received a 3-month suspension of her certificate of registration.

In the case before this Panel, College Counsel submitted that there was no mitigating factor of restitution so a 4-month suspension of the Member’s certificate of registration is appropriate and within the range established by the Verde-Balayo case.

The Member made no submissions on penalty.

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 4 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 the Member’s 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 the Member’s 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 the Member’s 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 the Member’s 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 the Member’s 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 the Member’s 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. The oral reprimand and the 4-month suspension of the Member’s certificate of registration will provide specific deterrence. The 4-month suspension of the Member’s certificate of registration will provide general deterrence. The 2 meetings with a Regulatory Expert will provide for rehabilitation and remediation and the 12 months of employer notification will ensure the public is protected with ongoing monitoring.

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

I, Michael Hogard, 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.