DISCIPLINE COMMITTEE OF THE COLLEGE OF NURSES OF ONTARIO
PANEL: Susan Roger, RN Chairperson Grace Fox, NP Member Sandra Larmour Public Member Kerrie Naylor, RPN Member
BETWEEN:
COLLEGE OF NURSES OF ONTARIO ) DOUGLAS MONTGOMERY for ) College of Nurses of Ontario
- and - )
SHERELI SOLDEVILLA RODRIGUEZ ) REBECCA YOUNG for Registration No. 12502561 ) Shereli Soldevilla Rodriguez ) PATRICIA HARPER ) Independent Legal Counsel ) Heard: July 31, 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 July 31, 2023, via videoconference.
The Allegations
The allegations against Shereli Soldevilla Rodriguez (the “Member”) as stated in the Notice of Hearing dated March 6, 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 Nurse at 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 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 Nurse at Toronto General Hospital in Toronto, Ontario (the “Facility”), you misappropriated property from a client or workplace, and in particular, in or around 2015 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 Nurse at Toronto General Hospital in Toronto, Ontario (the “Facility”), you falsified a record relating to your practice, and in particular, in or around 2015 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 Nurse at Toronto General Hospital in Toronto, 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 2015 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 Nurse at Toronto General Hospital in Toronto, 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 2015 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 reads, unedited, as follows:
MEMBER
Shereli Soldevilla-Rodriguez (the “Member”) registered with the College of Nurses of Ontario (“CNO”) as a Registered Nurse (“RN”) in the Temporary Class on June 6, 2012. The Member subsequently registered as an RN in the General Class on July 20, 2012, and then in the Extended (Nurse Practitioner) Class on November 6, 2017.
At the time of the incidents described below, the Member was employed as an RN in the Acute Care Unit at Toronto General Hospital, located in Toronto, Ontario (the “Facility”).
BENEFIT PLAN
The Facility offers its employees a self-insured group insurance policy which provides employees with extended health care, dental, and other insurance benefits (the “Benefit Plan”). Sun Life Insurance (“Sun Life”) 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.
To submit a benefit claim, members of the Benefit Plan were required to complete a medical expense claim form provided by Sun Life. 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 had to certify that all goods or services were received as claimed, and that “the information provided for this claim is true and complete”.
INCIDENTS RELEVANT TO ALLEGATIONS OF PROFESSIONAL MISCONDUCT
Between November 2015 and January 2017, the Member submitted false claims totaling $4,030 to the Benefit Plan for medical products and services ostensibly received at Downtown Wellness and Foot Care (“Downtown Wellness”), which subsequently became Elm Orthotics and Foot Care (“Elm Orthotics”).
In August 2017, Sun Life alerted the Facility that it had identified higher than expected costs in certain benefits categories and had conducted a review of benefits use at the Facility. Sun Life delisted a number of suppliers that Sun Life concluded had facilitated the submission of fraudulent claims. Two of the service providers investigated by SunLife were Downtown Wellness and Elm Orthotics.
The Facility initiated an internal investigation on the basis of Sun Life’s information. The Facility interviewed the Member on January 8, 2018, as part of its internal investigation. During the interview, the Member admitted to having submitted claims for medical products and services, and having received non-medical brand-named products instead of the medical products or services for which she had submitted claims.
The Facility suspended the Member from her employment without pay for five days. The Facility also required the Member to make restitution, which she paid in the amount of $4,030.
If the Member were to testify, she would express remorse for her actions, and would further testify that she has taken responsibility by making admissions to the Facility and CNO.
BENEFIT FRAUD CASES
- To date, at least 82 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 8 and 11 to 17 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 8 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 8 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 8 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 8 and 11 to 17 above.
College Counsel’s Submissions on Liability
College Counsel asked the Panel to accept the Agreed Statement of Facts, as well as the Member’s admissions to the allegations as set out in paragraphs 18-22 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 this allegation is supported by the Agreed Statement of Facts, which contained evidence of the relevant College standards of the profession, as well as the Member’s admissions that those standards were breached.
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 is dishonourable and unprofessional. College Counsel submitted that this agreement is part of a resolution reached between the College and the Member.
The conduct at issue is that the Member submitted false claims in the amount of $4,030.00 through the Toronto General Hospital’s (the “Facility”) employee group benefit plan (the “Benefit Plan”) between November 2015 and January 2017, which is relevant to the practice of nursing as claims were submitted as part of her nursing employment at the Facility.
College Counsel submitted that having regard to all of the circumstances members of the profession would consider the Member’s conduct to be unprofessional and dishonourable. The Member’s conduct is unprofessional as submitting false claims to the Benefit Plan constitutes a serious and persistent disregard for her professional obligations to act with the honesty and integrity required of a nurse. The Member’s conduct is dishonourable as it involved an element of moral failing with repeated acts of dishonesty. The Member failed to act with integrity which the public expects from the nursing profession.
College Counsel submitted the CNO v. Verde-Balayo (Discipline Committee, 2021) decision on liability. In that case, the same categories of allegations were made against the member as in this case. In that case, there was a partial Agreed Statement of Facts in which the member admitted to a breach of the Standards and to misappropriating property, but the member disputed allegations #3 and #4 with respect to falsifying a record related to practice and issuing, in her professional capacity, a document that she knew or ought to have known contained a false or misleading statement. The panel in the Verde-Balayo case found that the member had committed misconduct with respect to each of the allegations. The facts in this case are almost the same and consistent with previous decisions of the Discipline Committee, including the liability decision in Verde-Balayo.
The Member’s Counsel Submissions on Liability
The Member’s Counsel provided no further evidence and submitted that the Agreed Statement of Facts ought to be accepted.
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 to 8 and 11 to 18 in the Agreed Statement of Facts. The Member admitted to submitting false claims through the Facility’s Benefit Plan between November 2015 and January 2017 for medical products and services and to receiving non-medical brand-named products in the amount of $4,030.00 in relation to those false claims.
The Member breached the College’s Professional Standards which provide with respect to leadership that leadership requires self-knowledge, that nurses are expected to act with integrity and the requirement for role-modelling professional values. With respect to accountability, nurses are responsible for their actions and the consequences of those actions and are accountable for conducting themselves in ways that promote respect for the profession.
The College's Ethics Standard describes ethical values such as maintaining commitments, truthfulness and fairness. Nurses are expected to uphold the standards of the profession and conduct themselves in a manner that reflects well on the profession. By submitting false claims through the Facility’s Benefit Plan the Member breached this standard.
Allegation #2 in the Notice of Hearing is supported by paragraphs 5 to 8 and 19 in the Agreed Statement of Facts. The Member admitted to misappropriating property from the Facility when she submitted false claims through the Facility’s Benefit Plan and received non-medical brand-named products for those false claims. Receiving non-medical brand-named products with respect to false benefit claims constitutes misappropriation of property.
Allegation #3 in the Notice of Hearing is supported by paragraphs 5 to 8 and 20 in the Agreed Statement of Facts. The Member admitted to falsifying a record relating to her practice when she signed and submitted false medical expense claim forms to the Facility’s Benefit Plan. The Member, as a Registered Nurse (“RN”) 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 RN at the Facility.
Allegation #4 in the Notice of Hearing is supported by paragraphs 5 to 8 and 21 in the Agreed Statement of Facts. The Member admitted to signing or issuing, 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 forms that required her to certify that all goods or services were received as claimed and that “the information provided for this claim 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 RN employee of the Facility. Accordingly, the facts support the allegation that the Member signed or issued, 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 8, 11 to 17 and 22 in the Agreed Statement of Facts. The Panel finds that the Member’s conduct in submitting false 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 breaching 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 the repeated acts of submitting false claims to the Facility’s Benefit Plan. 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:
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 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.
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
College Counsel’s Submissions
College Counsel submitted that the Panel should accept the Joint Submission on Order as it meets the goal of public protection, by applying the principles of specific and general deterrence and remediation and rehabilitation of the Member.
The aggravating factors in this case were:
The Member’s conduct was serious dishonesty and deceit and not just a single lapse in judgement; and
The Member took advantage of the privilege of having a Benefit Plan.
The mitigating factors in this case were:
The Member has made full restitution;
The Member has expressed remorse;
The Member has taken responsibility with the Facility 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 no prior discipline history.
The goals of penalty include to maintain high professional standards leading to public trust as well as remediation and rehabilitation of the Member.
The proposed penalty provides for specific deterrence through the oral reprimand as the Member will gain a greater understanding of how the public and members of the profession perceive her conduct. The 3-month suspension of the Member’s certificate of registration is also a form of specific deterrence and will demonstrate to the Member that this type of conduct is unacceptable.
General deterrence must be addressed as there are over 80 similar cases of false benefit claims that have been reported to the College. It is a systemic issue, and the College needs to send a strong signal that this type of conduct is unacceptable.
The proposed penalty provides for general deterrence through the 3-month suspension of the Member’s certificate of registration, which will send a signal to other members of the profession that this type of conduct is unacceptable.
The proposed penalty provides for rehabilitation and remediation through the 2 meetings with a Regulatory Expert and review of the Code of Conduct, so that the Member will return to ethical practice.
Overall, the public is protected through the 12 months of employer notification, which will allow for the Member’s employer to have a greater oversight over her practice upon her return to nursing 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): In this case, the hearing proceeded by way of an Agreed Statement of Facts and a Partial Joint Submission on Order. The member submitted false claims to her employee group benefit plan 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.
CNO v. Padillo (Discipline Committee, 2022): In this case, the hearing proceeded by way of an Agreed Statement of Facts and a Joint Submission on Order. The member submitted false claims to her employee group benefit plan in the amount of $4,000.00. The member made restitution. 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.
CNO v. Lamasan (Discipline Committee, 2022): In this case, the hearing proceeded by way of an Agreed Statement of Facts and a Joint Submission on Order. The member submitted false claims to his employee group benefit plan in the amount of $4,500.00. The member received a five-day unpaid suspension and entered into a payment agreement with the Facility to pay back the $4,500.00. 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 Member’s Counsel’s Submissions
The Member’s Counsel agreed that the Joint Submission on Order meets the goals of penalty and that benefit fraud is a widespread issue. The dollar amount of the false claims submitted by the Member is small compared to other cases. The Member made full restitution and took responsibility with the Facility and the College. The Member also has no discipline history with the College.
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 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.
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.
There are over 80 similar benefit fraud cases before the College’s Discipline Committee to date. The Discipline Committee needs to send a clear signal to the profession that this type of conduct will not be tolerated as integrity and trust must be maintained to meet the needs and protection of the public. The proposed penalty provides for general deterrence through the 3-month suspension of the Member’s certificate of registration, which sends a clear message to members of the profession that this type of conduct will not be tolerated.
Specific deterrence is met through the oral reprimand and the 3-month suspension of the Member’s certificate of registration, which will give the Member a greater understanding of how her conduct is perceived by members of the profession.
The proposed penalty provides for remediation and rehabilitation through the 2 meetings with a Regulatory Expert, which will give the Member a greater understanding of her professional obligations and help her return to the profession as an ethical nurse.
Overall, the public is protected through the 12 months of employer notification as the Member will be monitored on her return to practice.
The penalty is also in line with what has been ordered in previous cases in similar circumstances, as is demonstrated in the cases relied upon by College Counsel.
I, Susan Roger, RN, sign this decision and reasons for the decision as Chairperson of this Discipline Panel and on behalf of the members of the Discipline Panel.