College of Nurses of Ontario v. Rondina, 2023 ONCNO 149375

DISCIPLINE COMMITTEE OF THE COLLEGE OF NURSES OF ONTARIO

PANEL: Mary MacNeil, RN Chairperson Grace Fox, NP Member Sandra Larmour Public Member Sharon Moore, RN Member

BETWEEN:

COLLEGE OF NURSES OF ONTARIO DOUGLAS MONTGOMERY for College of Nurses of Ontario

• and -

RACHEL RONDINA Registration No. 11465773 VANESSA YANAGAWA for Rachel Rondina CHRISTOPHER WIRTH Independent Legal Counsel

Heard: August 28, 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 28, 2023, via videoconference.

The Allegations

The allegations against Rachel Rondina (the “Member”) as stated in the Notice of Hearing dated June 12, 2023 are as follows:

IT IS ALLEGED THAT:

1. You have committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended, and defined in subsection 1(1) of Ontario Regulation 799/93, in that while working as a Registered Nurse at 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.

2. You have committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended, and defined in subsection 1(8) of Ontario Regulation 799/93, in that while working as a Registered Nurse at 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.

3. You committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended, and defined in subsection 1(14) of Ontario Regulation 799/93, in that while working as a Registered Nurse at 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.

4. You committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended, and defined in subsection 1(15) of Ontario Regulation 799/93, in that while working as a Registered Nurse at 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.

5. You have committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended, and defined in subsection 1(37) of Ontario Regulation 799/93, in that while working as a Registered Nurse at 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

1. Rachel Rondina (the “Member”) registered with the College of Nurses of Ontario (“CNO”) as a Registered Nurse (“RN”) in the General Class on August 9, 2011.

2. At the time of the incidents described below, the Member was employed full time in the Coronary Intensive Care Unit (CICU) at Toronto General Hospital, located in Toronto, Ontario (the “Facility”).

BENEFIT PLAN

3. 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.

4. 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

5. Between December 2015 and January 2017, the Member submitted false claims totaling $3,727.50 to the Benefit Plan for medical products and services ostensibly received at two service providers: Downtown Wellness and Foot Care (“Downtown Wellness”), which was later called Elm Orthotics and Foot Care (“Elm Orthotics”).

6. 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 and delisted by SunLife were Downtown Wellness and Elm Orthotics.

7. The Facility initiated an internal investigation on the basis of Sun Life’s information. The Facility interviewed the Member on April 12, 2018, as part of its internal investigation. During the interview, the Member admitted to having submitted claims for medical products and services (such as orthotics and compression stockings), and using the reimbursement money to purchase non-medical brand-named products (such as purses).

8. 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 $3,727.50.

BENEFIT FRAUD CASES

9. 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

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 8 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 8 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 8 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 8 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 8 and 10 to 16 above.

Submissions on Liability

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 all the allegations as set out in paragraphs 17-21 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, and 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 $3,727.50 through the Toronto General Hospital’s (the “Facility”) employee group benefit Plan (the “Benefit Plan”) between December 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 members of the profession would reasonably regard the Member’s conduct to be dishonourable and unprofessional. 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 provided the Panel with CNO v. Verde-Balayo (Discipline Committee, 2021) for reference on liability as this was the test case for how to characterize benefit fraud misconduct and it involved the same type of misconduct. The panel in that decision found the member committed acts of professional misconduct and found the misconduct to be dishonourable and unprofessional.

The Member’s Counsel’s Submissions on Liability

The Member’s Counsel agreed with College Counsel’s submissions. She asked that the Panel accept the facts in the Agreed Statement of Facts and make findings of professional misconduct as alleged in the Notice of Hearing.

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 10 to 17 in the Agreed Statement of Facts. The Member admitted to submitting false claims through the Facility’s Benefit Plan between December 2015 and January 2017 for orthotics and compression stockings and to receiving $3,727.50 in relation to those false claims and using the reimbursement money to buy non-medical brand-named products such as purses.

The Member contravened the College’s Professional Standards and the Ethics Standard when she submitted false claims to the Facility’s Benefit Plan. The Professional Standards provides that nurses are accountable to the public and for conducting themselves in ways that promote respect for the profession. The leadership standard requires that nurses are expected to act with trust and integrity. The Ethics Standard provides that nurses are to be truthful and are to speak or act without intending to deceive. The Member was deceitful and not truthful when she signed and submitted the false claims to the Facility’s Benefit Plan.

Allegation #2 in the Notice of Hearing is supported by paragraphs 5 to 8 and 18 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, received money in relation to those false claims and purchased non-medical brand-name products with that money. Receiving money for false benefit claims constitutes misappropriation of property.

Allegation #3 in the Notice of Hearing is supported by paragraphs 5 to 8 and 19 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 to the Facility’s Benefit Plan and certified that the information in the form was true and complete. 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 20 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 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, 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, 10 to 16 and 21 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 as it was only through her employment as an RN at the Facility, that she had access to the Facility’s Benefit Plan. It was unprofessional as it demonstrated a serious and persistent disregard for her professional obligations of acting with truth and integrity and 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 submitting false benefit claims to the Facility’s Benefit Plan and receiving money in relation to those false claims. The Member knew or ought to have known that her conduct was unacceptable and fell below the standards of a professional.

Penalty

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

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

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

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

a) The Member will attend 2 meetings with a Regulatory Expert (the “Expert”), at 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;

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. 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:

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;

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:

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

College Counsel’s Submissions on Liability

College Counsel submitted that the goals of penalty include public protection, maintaining high professional standards and enhancing public confidence in the College’s ability to govern nurses. These are all met within the Joint Submission on Order, which was a negotiation between the College and the Member by experienced Counsel. The three elements of the Joint Submission on Order are an oral reprimand, a 3-month suspension of the Member’s certificate of registration and terms, conditions and limitations on the Member’s certificate of registration. The Panel is obligated to accept a Joint Submission on Order unless to do so would bring the administration of justice into disrepute or would not be in the public interest.

The aggravating factors in this case were:

• The Member’s conduct involved serious dishonesty and deceit at the expense of the Facility’s Benefit Plan;
• The Member’s conduct was repeated over a 14-month period; and
• The Member took advantage of the trust placed in her by the Facility.

The mitigating factors in this case were:

• The Member paid restitution;
• The Member took responsibility with the Facility;
• The Member took responsibility with the College by admitting 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.

College Counsel submitted that the Panel should accept the Joint Submission on Order as it meets the goals of public protection, by applying the principles of specific and general deterrence, and rehabilitation and remediation of the Member.

The proposed penalty provides for specific deterrence through the oral reprimand and the 3-month suspension of the Member’s certificate of registration. The oral reprimand will allow the Member to gain a greater understanding of how her actions are perceived by the profession and the public. The 3-month suspension will demonstrate to the Member that this type of conduct is unacceptable.

General deterrence must be addressed as there have been over 80 similar benefit fraud cases that have been reported to the College. The College needs to send a clear signal to the profession that this type of conduct is not acceptable and will not be tolerated.

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 remediation and rehabilitation through the 2 meetings with a Regulatory Expert and the review of the College’s Code of Conduct, which will assist the Member with her transition 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.

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): College Counsel submitted this case to illustrate the considerations in making the decision for the same misconduct and how to craft the length of suspension. In this case, the hearing 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. The suspension in this case was longer than in the case before this Panel as the amount of the benefit fraud is significantly higher and no restitution was made.

CNO v. Im (Discipline Committee, 2023): College Counsel submitted the signed Panel Order for this case as the Decision and Reasons had not yet been released. In this case, the hearing proceeded by a way of an Agreed Statement of Facts and a Joint Submission on Order. The member admitted to submitting false benefit claims in the amount of approximately $3,727.00. The member made restitution and received a five-day unpaid suspension from her employer. The penalty included an oral reprimand and the member signed an undertaking to permanently resign as a member of the College.

CNO v. Padillo (Discipline Committee, 2022): College Counsel submitted that this case was similar to the case before this Panel. In this case, the hearing proceeded by a way of an Agreed Statement of Facts and a Joint Submission on Order. The member admitted to summitting false benefit claims 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.

The Member’s Counsel’s Submissions on Penalty

The Member’s Counsel agreed with College Counsel that the Joint Submission on Order should be accepted by the Panel.

The Member’s Counsel submitted the following mitigating factors:

• The Member has been consistently cooperative with the discipline process, accepted responsibility for her conduct and made restitution;
• The Member has expressed remorse;
• The Member is currently employed and is being supported by her employer;
• At the time of the conduct, the Member had recently emigrated to Canada; and
• The Member believed that she was submitting legitimate claims but quickly realized that the claims were not legitimate and has lost the trust of the Facility, her co-workers and the public.

Penalty Decision

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

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

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

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

a) The Member will attend 2 meetings with a Regulatory Expert (the “Expert”), at 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;

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. 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:

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;

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:

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. General deterrence is achieved through the 3-month suspension of the Member’s certificate of registration, which sends a clear message to the membership that benefit fraud is a serious offence and will not be tolerated. Specific deterrence is achieved 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 actions are perceived by the membership and the public so as not to repeat the conduct. Remediation and rehabilitation are achieved through the 2 meetings with a Regulatory Expert and the review of the College’s Code of Conduct, which will help transition the Member back to ethical nursing practice and will provide the Member greater insight into her professional obligations. Overall, 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, Mary MacNeil, 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.