DISCIPLINE COMMITTEE OF THE COLLEGE OF NURSES OF ONTARIO
PANEL:
- David Edwards, RPN Chairperson
- Carly Hourigan, Public Member
- Michael Schroder, NP Member
- Andrew Sharpe, NP Member
BETWEEN:
COLLEGE OF NURSES OF ONTARIO (Douglas Montgomery for College of Nurses of Ontario)
- and -
JENNIFER L. BELLEFEUILLE Registration No. JB03851 (Madeline Mackenzie for Jennifer L. Bellefeuille)
Independent Legal Counsel: Christopher Wirth
Heard: August 30, 2023
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 August 30, 2023, via videoconference.
The Allegations
The allegations against Jennifer L. Bellefeuille (the “Member”) as stated in the Notice of Hearing dated May 25, 2023 are as follows:
IT IS ALLEGED THAT:
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 Hôpital Glengarry Memorial Hospital, in Alexandria, 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 2016 to 2017, you submitted and/or accepted payment for false claims under the Facility’s employee group benefit plan.
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 Hôpital Glengarry Memorial Hospital, in Alexandria, Ontario (the “Facility”), you misappropriated property from a client or workplace, and in particular, in or around 2016 to 2017, you submitted and/or accepted payment for false claims under the Facility’s employee group benefit plan.
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 Hôpital Glengarry Memorial Hospital, in Alexandria, Ontario (the “Facility”), you falsified a record relating to your practice, and in particular, in or around 2016 to 2017, you submitted and/or accepted payment for false claims under the Facility’s employee group benefit plan.
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 Hôpital Glengarry Memorial Hospital, in Alexandria, Ontario (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 2016 to 2017, you submitted and/or accepted payment for false claims under the Facility’s employee group benefit plan.
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 Hôpital Glengarry Memorial Hospital, in Alexandria, Ontario (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 2016 to 2017, you submitted and/or accepted payment for false claims under the Facility’s employee group 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 as amended reads, unedited, as follows:
MEMBER
Jennifer L. Bellefeuille (the “Member”) registered with the College of Nurses of Ontario (“CNO”) as a Registered Practical Nurse (“RPN”) in the General Class on March 19, 2002.
At the time of the incidents described below, the Member was employed at Hôpital Glengarry Memorial Hospital, Ontario (the “Facility”).
BENEFIT PLAN
The Facility offers its employees a self-insured group insurance policy, which provides employees with coverage for extended health care, dental, and other insurance benefits (the “Benefit Plan”). Cowan Insurance Group (“CIG”) 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.
In order to submit a benefit claim, members of the Benefit Plan complete a medical expense claim form provided by CIG. 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 all goods and services being claimed have been received by me and/or my spouse or dependents if applicable.” The plan member must go on to “certify that the information in this form is true and complete” and sign each claims form.
INCIDENTS RELEVANT TO ALLEGATIONS OF PROFESSIONAL MISCONDUCT
Between November 2016 and March 2017, the Member submitted a number of claims for prescription glasses and massage therapy on behalf of her and her dependents which totaled $1,884. The Member and her dependents received some of the services claimed. However, in some instances the Member altered the amount on the receipts in order to either claim for a greater amount than the service had cost. In other instances, she altered the receipts in order to claim for additional products or services that were not received.
In April 2017, CIG conducted an investigation into the Member’s claims. CIG contacted a number of service providers regarding the Member’s claims. The service providers informed CIG that the receipts submitted to CIG were not accurate reflections of services rendered.
The Member ultimately admitted to CIG that the claims were not accurate. The Member reimbursed CIG for the sum of $1,080 on July 12, 2017. This figure represented the amount of overpayment made to the Member.
In September 2017, the Member met with representatives of the Facility regarding the matter. The Member initially denied altering the receipts, but later admitted it. The Member indicated that she submitted the altered receipts while on leave and did not know what she was thinking.
The Member was terminated, but was later reinstated on a Last Chance Agreement. The Member has continued to work at the Facility since these incidents.
If the Member were to testify, she would admit that it was wrong to alter the receipts submitted to CIG in order to obtain a personal benefit. The Member would further testify that she is remorseful for her actions.
BENEFIT FRAUD CASES
- To date, over 80 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
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.
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.
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
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.
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.
CNO’s Ethics Standard also provides, in relation to truthfulness, that truthfulness means speaking and acting without intending to deceive.
The Member admits and acknowledges that she contravened CNO’s Professional Standards and Ethics Standard.
ADMISSIONS OF PROFESSIONAL MISCONDUCT
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 10 and 12 to 18 above.
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 10 above.
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 10 above.
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 10 above.
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 10 and 12 to 18 above.
Submissions
Submissions on liability were made by College Counsel.
College Counsel asked the Panel to accept the Agreed Statement of Facts, as well as the Member’s admissions to all the allegations as set out in paragraphs 19-23 of the Agreed Statement of Facts and, on the basis of those facts and admissions, make findings of professional misconduct with respect to the allegations in the Notice of Hearing. College Counsel submitted that the Panel has taken the Member’s plea, conducted a verbal plea inquiry, and received a written plea inquiry which confirmed that the plea was voluntary, informed, and made on the advice of experienced Counsel. College Counsel submitted that based on the Agreed Statement of Facts, which specifically describes the facts in relation to the allegations, the Panel has enough evidence to find that the Member committed professional misconduct as set out in all of the allegations in the Notice of Hearing.
College Counsel reviewed allegations #1 and #5 with the Panel. With regard to allegation #1, College Counsel submitted that the Member failed to meet the provisions of the College’s Professional Standards and the Ethics Standard, and the Member admitted that these standards were breached. College Counsel submitted that based on this, the Panel has a basis to make a finding with respect to a breach of the standards.
With regard to allegation #5, College Counsel submitted that the parties agreed that the Member's conduct is relevant to the practice of nursing and would reasonably be regarded by members of the profession to be dishonourable and unprofessional. College Counsel submitted that this agreement is part of a resolution reached between the College and the Member.
The Member’s conduct and admission of submitting a number of claims to Hôpital Glengarry Memorial Hospital’s (the “Facility”) employee group benefit plan (the “Benefit Plan”) totalling $1,080.00 is clearly relevant to the practice of nursing as she was entitled to participate in the Benefit Plan by virtue of her employment at the Facility. College Counsel submitted that having regard to all of the circumstances, members of the profession would regard this conduct to be unprofessional and dishonourable as submitting false claims to the Benefit Plan constitutes a serious and persistent disregard for the professional obligations to act with honesty and integrity required of a nurse. College Counsel further submitted that the Member’s conduct is dishonourable as it involved dishonesty and deceit for the Member’s own personal financial gain. The College asked the Panel to make findings of professional misconduct with respect to all allegations.
Submission on liability were made by the Member’s Counsel.
The Member’s Counsel submitted that the Member agrees with the facts as outlined in the Agreed Statement of Facts and the liability submissions which were made by College Counsel. The Member’s Counsel submitted that the Member is deeply remorseful and is present to take accountability for her actions.
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 dishonourable and unprofessional.
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 5-10 and 12-19 in the Agreed Statement of Facts. The Member admitted to submitting false claims between November 2016 and March 2017, to the Facility’s Benefit Plan, with altered receipts for services and products that she did not receive and to receiving the sum of $1,080.00 in relation to those false claims. The College’s Professional Standards outline that all nurses are expected to demonstrate leadership and leadership involves exemplifying trust and integrity. The College’s Ethics Standard outlines that members are to exemplify truthfulness, which means “speaking or acting without intending to deceive”. The Member contravened the Professional Standards and the Ethics Standard when she displayed a lack of trust and integrity and she intended to deceive the Benefit Plan when she submitted false claims with receipts that she had altered to the Facility’s Benefit Plan.
Allegation #2 in the Notice of Hearing is supported by paragraphs 5-10 and 20 in the Agreed Statement of Facts. The Member admitted to misappropriating property from the Facility when she submitted false claims to the Facility’s Benefit Plan, with supporting receipts that she had altered by adjusting dollar amounts and adding products that she did not receive to the receipts, and, received money 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 4-10 and 21 in the Agreed Statement of Facts. The Member admitted to falsifying a record relating to her practice when she signed and submitted false claim forms with altered supporting receipts to the Facility’s Benefit Plan and certified that the information in the form was true and complete. The Member, as a Registered Practical Nurse (“RPN”) employed at the Facility, had access to the Benefit Plan by virtue of her employment as a nursing professional and so her actions were related to her practice as a nurse. Accordingly, the facts support the allegation that the Member falsified a record relating to her practice and did so in the context of her employment as an RPN at the Facility.
Allegation #4 in the Notice of Hearing is supported by paragraphs 4-10 and 22 in the Agreed Statement of Facts. The Member admitted to signing, in her professional capacity, a document that she knew or ought to have known contained a false or misleading statement. When the Member signed the medical expense claim form that required her to certify that “all goods and services being claimed have been received by me and/or my spouse or dependents if applicable” and that “the information in this form is true and complete”, she knew or ought to have known that she was signing a document that contained a false or misleading statement and that it was a false claim under the Facility’s Benefit Plan. As noted above, the Member had access to the Facility’s Benefit Plan by virtue of her employment as a nursing professional. When she signed and submitted claim forms on her behalf, she did so in her capacity as an RPN employee of the Facility. Accordingly, 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 4-10, 12-18 and 23 in the Agreed Statement of Facts. The Panel finds that the Member’s conduct in submitting false benefit claims was clearly relevant to the practice of nursing. It was unprofessional as it demonstrated a serious and persistent disregard for her professional obligations in breach of the College’s Professional Standards and the Ethics Standard.
The Panel also finds that the Member’s conduct was dishonourable. It demonstrated an element of dishonesty and deceit through submitting false benefit claims with altered receipts to the Facility’s Benefit Plan. Her conduct was discovered through a random audit by the Benefit Plan administrator. The Member’s conduct demonstrated an element of moral failing. 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 requested that this Panel make an order as follows:
Requiring the Member to appear before the Panel to be reprimanded within 3 months of the date that this Order becomes final.
Directing the Executive Director to suspend the Member’s certificate of registration for 2 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.
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:
the Panel’s Order,
the Notice of Hearing,
the Agreed Statement of Facts,
this Joint Submission on Order, and
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):
- Code of Conduct;
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:
the acts or omissions for which the Member was found to have committed professional misconduct,
the potential consequences of the misconduct to the Member’s patients, colleagues, profession and self,
strategies for preventing the misconduct from recurring,
the publications, questionnaires and modules set out above, and
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:
the dates the Member attended the sessions,
that the Expert received the required documents from the Member,
that the Expert reviewed the required documents and subjects with the Member, and
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. Inform any employer of the decision prior to commencing or prior to resuming employment in any nursing position;
ii. 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;
iii. Provide the Member’s employer(s) with a copy of:
the Panel’s Order,
the Notice of Hearing,
the Agreed Statement of Facts,
this Joint Submission on Order, and
a copy of the Panel’s Decision and Reasons, once available;
iv. 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:
that they received a copy of the required documents, and
that they agree to notify CNO immediately upon receipt of any information that the Member has breached the standards of practice of the profession.
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 and reviewed the principles concerning them.
College Counsel further submitted that the aggravating factors in this case were:
The Member’s conduct involved dishonesty and deceit at the expense of her employer funded Benefit Plan;
The Member’s conduct occurred multiple times over several months;
The Member took advantage of the trust placed in her by the Facility, the public and the Benefit Plan; and
The Member took advantage of the privilege of having an employer funded Benefit Plan which is not something that all nurses have access to.
The mitigating factors in this case were:
The Member made full restitution;
The Member has expressed her remorse;
The Member took responsibility with the Facility;
The Member was reinstated on a “last chance agreement” and the Member is still working at the Facility which is indicative of the Member adhering to the terms of the agreement;
The Member has taken responsibility with the College by admitting to the allegations and entering into an Agreed Statement of Facts and a Joint Submission on Order with the College which has saved the time and expense of having a contested hearing; and
The Member has been practicing for over 20 years and has no prior discipline history with the College.
The proposed penalty provides for general deterrence through the 2-month suspension of the Member’s certificate of registration, which will send a message to the membership that benefit plan misuse will not be tolerated. There is a particular need to convey general deterrence given that over 80 similar benefit fraud cases have been referred to the Discipline Committee.
The proposed penalty provides for specific deterrence through the oral reprimand and the 2-month suspension of the Member’s certificate of registration. The oral reprimand will afford the Member an opportunity to hear how her conduct is perceived by both members of the profession and the public. The 2-month suspension of the Member’s certificate of registration will send a strong message to the Member that her conduct is unacceptable.
The proposed penalty provides for remediation and rehabilitation through the 2 meetings with a Regulatory Expert and the review of the College’s publications. These remedial activities will assist the Member with her transition back to ethical nursing practice.
Overall, the public is protected through the 12 months of employer notification, which will provide for a heightened level of employer oversight on the Member’s return to practice.
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 proceeded by a way of an Agreed Statement of Facts and a Partial Joint Submission on Order. The member admitted to submitting false benefit claims in the amount of $7,982.50. The member did not make restitution. 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. This case is different from the case before this Panel in that the amount of the benefit fraud is significantly higher.
CNO v. Lagrimas-Mendiola (Discipline Committee, 2022): This case proceeded by way of an Agreed Statement of Facts and a Joint Submission on Order. The member admitted to submitting false benefit claims and to receiving approximately $750.00 in relation to those false claims. The member made restitution. The penalty included an oral reprimand, a 2-month suspension of the member’s certificate of registration, 2 meetings with a Regulatory Expert and 12 months of employer notification.
CNO v. Shenouda (Discipline Committee, 2023): This case proceeded by way of an Agreed Statement of Facts and a Joint Submission on Order. The member admitted to submitting false benefit claims and to receiving $750.00 in relation to those false claims. The member made restitution. The penalty included an oral reprimand, a 2-month suspension of the member’s certificate of registration, 2 meetings with a Regulatory Expert and 12 months of employer notification.
Submissions were made by the Member’s Counsel.
The Member’s Counsel submitted that she agreed with the Joint Submission on Order and that it was consistent with the Discipline Committee’s prior decisions.
The Member’s Counsel submitted the following mitigating factors:
The Member has taken full responsibility for her conduct;
The Member has an otherwise unblemished 20-year history in the profession;
The Member made restitution; and
The Member has saved the College time and resources by agreeing to an Agreed Statement of Facts and a Joint Submission on Order.
Penalty Decision
The Panel accepts the Joint Submission on Order and accordingly orders:
The Member is required to appear before the Panel to be reprimanded within 3 months of the date that this Order becomes final.
The Executive Director is directed to suspend the Member’s certificate of registration for 2 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.
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:
the Panel’s Order,
the Notice of Hearing,
the Agreed Statement of Facts,
this Joint Submission on Order, and
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):
- Code of Conduct;
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:
the acts or omissions for which the Member was found to have committed professional misconduct,
the potential consequences of the misconduct to the Member’s patients, colleagues, profession and self,
strategies for preventing the misconduct from recurring,
the publications, questionnaires and modules set out above, and
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:
the dates the Member attended the sessions,
that the Expert received the required documents from the Member,
that the Expert reviewed the required documents and subjects with the Member, and
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. Inform any employer of the decision prior to commencing or prior to resuming employment in any nursing position;
ii. 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;
iii. Provide the Member’s employer(s) with a copy of:
the Panel’s Order,
the Notice of Hearing,
the Agreed Statement of Facts,
this Joint Submission on Order, and
a copy of the Panel’s Decision and Reasons, once available;
iv. 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:
that they received a copy of the required documents, and
that they agree to notify CNO immediately upon receipt of any information that the Member has breached the standards of practice of the profession.
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. General deterrence is achieved through the 2-month suspension of the Member’s certificate of registration, which will send a message to the membership that benefit plan misuse will not be tolerated. Specific deterrence is achieved through the oral reprimand and the 2-month suspension of the Member's certificate of registration, which will send a clear message to the Member that misuse of employer funded benefits is unacceptable. Rehabilitation and remediation are achieved through the 2 meetings with a Regulatory Expert and review of the College’s publications, which will help transition the Member back to ethical nursing practice. The public is protected through the 12 months of employer notification, which will provide for a heightened level of oversight on the Member’s return to nursing practice.
The penalty is also in line with what has been ordered in previous cases in similar circumstances as demonstrated by the cases submitted and referred to by College Counsel.
I, David Edwards, 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.