College of Nurses of Ontario v. Ananora Dizon, 2023 CanLII 69930

DISCIPLINE COMMITTEE OF THE COLLEGE OF NURSES OF ONTARIO

PANEL: Michael Hogard, RPN Chairperson Lalitha Poonasamy Public Member Susan Roger, RN Member Terah White, RPN Member

BETWEEN:

COLLEGE OF NURSES OF ONTARIO JOSEPH BERGER for College of Nurses of Ontario

• and -

ANANORA DIZON Registration No. 0205849 MICHELLE THOMARAT for Ananora Dizon CHRISTOPHER WIRTH Independent Legal Counsel

Heard: March 24, 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 March 24, 2023, via videoconference.

The Allegations

The allegations against Ananora Dizon (the “Member”) as stated in the Notice of Hearing dated February 6, 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 Bridgepoint Active Healthcare - Sinai Health System 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 2016, 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 Bridgepoint Active Healthcare - Sinai Health System in Toronto, Ontario (the “Facility”), you misappropriated property from a client or workplace, and in particular, in or around 2015 to 2016, 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 Bridgepoint Active Healthcare - Sinai Health System in Toronto, Ontario (the “Facility”), you falsified a record relating to your practice, and in particular, in or around 2015 to 2016, 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 Bridgepoint Active Healthcare - Sinai Health System 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 2016, 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 Bridgepoint Active Healthcare - Sinai Health System 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 2016, 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

1. Ananora Dizon (the “Member”) registered with the College of Nurses of Ontario (“CNO”) as a Registered Nurse (“RN”) on March 5, 2002.

2. At the time of the incidents described below, the Member was employed as an RN at Bridgepoint Active Healthcare – Sinai Health System, located in Toronto, Ontario (the “Facility”).

BENEFIT PLAN

3. The Facility offers its employees a self-insured group insurance policy by which the Facility provides coverage to employees for extended health care, dental, and other insurance benefits (the “Benefit Plan”). SunLife 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. Employees contribute to the cost of the Benefit Plan as set out in their employment agreement and/or collective agreement, based on their election for individual or family coverage.

4. To submit a benefit claim online, members of the Benefit Plan must confirm that the information submitted is accurate and true, and agree, if requested, to provide original receipts and/or supporting documents.

INCIDENTS RELEVANT TO ALLEGATIONS OF PROFESSIONAL MISCONDUCT

5. On May 4, 2015, May 26, 2015, June 29, 2016, July 5, 2016, and August 3, 2016, the Member submitted claims totaling approximately $5,130 to the Benefit Plan for items not received as claimed.

6. On October 27, 2017, the Facility and Sun Life interviewed the Member. The Member admitted that she had taken part in a scheme whereby she would obtain a receipt for items or services that she did not receive and split the profits with a service provider.

7. The Member voluntarily resigned from her employment at the Facility. If the Member were to testify, she would state that she offered to make restitution, but this ultimately did not occur.

BENEFIT FRAUD CASES

8. To date, the CNO reports that at least 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 allegedly false claims involved range from under $500 to over $45,000.

CNO STANDARDS

Professional Standards

9. 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.

10. 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.

11. 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

12. 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.

13. 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.

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

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

ADMISSIONS OF PROFESSIONAL MISCONDUCT

16. The Member admits that she committed the acts of professional misconduct as alleged in paragraph 1 of the Notice of Hearing in that she contravened a standard of practice of the profession or failed to meet the standards of practice of the profession, as described in paragraphs 5 to 7 and 9 to 15 above.

17. The Member admits that she committed the acts of professional misconduct as alleged in paragraph 2 of the Notice of Hearing in that she misappropriated property from a workplace, as described in paragraphs 5 to 7 above.

18. The Member admits that she committed the acts of professional misconduct as alleged in paragraph 3 of the Notice of Hearing in that she falsified a record relating to her practice, as described in paragraphs 5 to 7 above.

19. The Member admits that she committed the acts of professional misconduct as alleged in paragraph 4 of the Notice of Hearing in that she signed or issued, in her professional capacity, a document that she knew or ought to have known contained a false or misleading statement, as described in paragraphs 5 to 7 above.

20. The Member admits that she committed the acts of professional misconduct as alleged in paragraph 5 of the Notice of Hearing, and in particular her conduct was dishonourable and unprofessional, as described in paragraphs 5 to 7 and 9 to 15 above.

College Counsel asked the Panel to accept the Agreed Statement of Facts as presented, in conjunction with the Member’s admissions to all of the allegations as set out in the Agreed Statement of Facts. College Counsel further requested that the Panel, on the basis of those facts and admissions, make findings of professional misconduct as alleged. The Panel was reminded that the Member’s plea was voluntary, informed and made on advice of experienced counsel. The Member’s admissions are identified in paragraphs 16 – 20 in the Agreed Statement of Facts.

With regard to allegation #1, College Counsel submitted that the Member failed to meet the standards of practice of the profession, by submitting and accepting payment for false benefits claims. The Member admitted that this conduct was a breach of the Professional Standards and Ethics Standards.

Regarding allegation #5, College Counsel submitted that the Agreed Statement of Facts indicate that the Member agreed that her conduct in submitting false claims for herself was an action that is relevant to the practice of nursing. College Counsel requested that the Panel consider the fact that the Member had submitted these claims to a nursing-funded benefit program that she was entitled to, only as a result of her employment in nursing. The Member admitted that her conduct would be considered both unprofessional and dishonourable. By admitting to these allegations, the Member recognized that she acted with a serious disregard for her professional obligations to act with honesty and integrity. Her misconduct, having occurred over a period of one year and in five separate instances reveled elements of dishonest and deceitful conduct.

Member’s Counsel acknowledged that the Member’s conduct was unprofessional and dishonourable, in that she knew or ought to have known that her conduct was unacceptable.

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 7 and 9 to 16 in the Agreed Statement of Facts. The Member admitted to submitting false claims through the Bridgepoint Active Healthcare – Sinai Health System’s (the “Facility”) employee group benefit plan (the “Benefit Plan”) on May 4, 2015, May 26, 2015, June 29, 2016, July 5, 2016 and August 3, 2016 and to receiving approximately $5,130.00 in relation to those false claims. The Member admitted to participating in a scheme whereby she would obtain a receipt for items or services that she did not receive and split the proceeds of the false claims with the service provider.

The Member breached the College’s Professional Standards in submitting the false claims. The Professional Standards provides that nurses are responsible for ensuring that their practice and conduct meets legislative requirements. It requires nurses to be accountable to the public for their actions and to promote respect for the profession. It states that nurses are responsible for their actions and the consequences of those actions and further provides that a nurse must have self-knowledge, respect, trust and integrity.

The Member breached the College’s Ethics Standard which provides the ethical values that are important to the nursing profession. These include maintaining commitments, truthfulness and that being a member of the profession brings with it the respect and trust of the public. Truthfulness means speaking or acting without intending to deceive.

Allegation #2 in the Notice of Hearing is supported by paragraphs 5 to 7 and 17 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 money for those false claims. Receiving money with respect to false benefit claims constitutes misappropriation of property.

Allegation #3 in the Notice of Hearing is supported by paragraphs 5 to 7 and 18 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. The Member had access to the Benefit Plan by virtue of her employment as a Registered Nurse (‘RN”) at the Facility and so her actions when she signed and submitted false claims to the Facility’s Benefit Plan were related to her practice as a nurse. Accordingly, the facts support the allegation that the Member falsified a record relating to her practice.

Allegation #4 in the Notice of Hearing is supported by paragraphs 5 to 7 and 19 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. The Member submitted false claim forms to the Facility’s Benefit Plan in which she had to confirm that the information submitted was accurate and true. 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 claims 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 7, 9 to 15 and 20 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 and was unprofessional as it demonstrated a serious and persistent disregard for her professional obligations as set out in the Professional Standards and the Ethics Standard. The Member failed to meet the expectations of respect, trust and integrity of the profession when she submitted and financially benefitted from false benefit claims.

The Panel also finds that the Member’s conduct was dishonourable. It demonstrated an element of dishonesty and deceit by misappropriating property from the Facility’s Benefit Plan. The Member’s conduct exhibited elements of moral failing. The Member submitted five separate false claims over a period of approximately one year and had many opportunities to amend her behaviour. Further, the Member participated in a scheme to split the proceeds of her false claims with a service provider. The Member knew or ought to have known that her conduct was unacceptable and fell below the standards of a nurse. The Member’s conduct did not meet the requirements for honourable conduct expected of nurses by the public or fellow professionals.

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 4 months. This suspension shall take effect from the date that this Order becomes final and shall continue to run without interruption as long as the Member remains in a practicing class.

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

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

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

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

1. the Panel’s Order,

2. the Notice of Hearing,

3. the Agreed Statement of Facts,

4. this Joint Submission on Order, and

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

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

1. Code of Conduct,

2. Professional Standards, and

3. Ethics;

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

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

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

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

3. strategies for preventing the misconduct from recurring,

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

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

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

1. the dates the Member attended the sessions,

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

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

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

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

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

i. 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

Submissions were made by College Counsel.

College Counsel submitted that the Joint Submission on Order must be accepted unless the terms of the Joint Submission on Order 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 was dishonest. Despite this, she made multiple false claims totaling approximately $5,130.00 over a prolonged period of time for her own personal financial or material gain;

• The Member’s conduct came at the expense of the Facility’s Benefit Plan to which she had access due to her employment in nursing;

• The Member knew or ought to have known her conduct was wrong; and

• The Member took advantage of the employer/employee relationship and abused the privileges of having a benefit plan as a result.

The mitigating factors in this case were:

• The Member took responsibility for her actions by resigning from her position with the Facility and offering restitution;

• The Member admitted to the allegations and entered into an Agreed Statement of Facts and a Joint Submission on Order with the College; and

• The Member has no prior discipline history with the College.

College Counsel submitted that the goals of professional discipline are two-fold: to protect the public and to enhance the public’s confidence in the ability of nurses to regulate themselves. College Counsel submitted that an appropriate penalty is one that includes general and specific deterrence and provides for remediation and rehabilitation. College Counsel submitted to the Panel that the penalty proposed in the Joint Submission on Order meets all the required goals of penalty.

The proposed penalty provides for general deterrence through the 4-month suspension of the Member’s certificate of registration, which will signal to other members of the profession and the public that dishonesty and this type of misconduct will not be tolerated. College Counsel submitted that with greater than 80 similar cases of false benefits claims currently referred to the Discipline Committee, there is clearly a need to send a strong, consistent message to the membership that this type of behaviour will be dealt with severely.

The proposed penalty provides for specific deterrence through the oral reprimand and the 4-month suspension of the Member’s certificate of registration. The oral reprimand will assist the Member in understanding how her actions are perceived by the members of the profession and by the public, thus deterring the Member from repeating the conduct. The suspension sends a strong signal to the Member that this type of behaviour is unacceptable and will not be tolerated.

The proposed penalty provides for remediation and rehabilitation through the 2 meetings with a Regulatory Expert and review of the College’s publications. College Counsel submitted that these steps would prepare the Member to return to ethical, professional practice that meets the standards expected of nurses.

Overall, the public is protected through the 12 months of employer notification as there will be employer oversight as the Member returns 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. Cumba (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 made false claims to her employer-funded benefit plan totalling $4,710.00. 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. Gepilano (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 made false claims to her employer-funded benefit plan totalling $4,695.00. 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. Pasajol (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 made false claims to her employer-funded benefit plan totalling $5,070.00. 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.

These three cases contained similar allegations, similar findings and the value of benefits claims were approximately the same in each case. As with the case before this Panel, in none of the cases provided did the member pay restitution. These three cases resulted in similar orders and therefore demonstrate that the Joint Submission on Order falls within a reasonable range of penalties.

Submissions were made by the Member’s Counsel.

The Member’s Counsel agreed substantially with the submissions of College Counsel. The Member’s Counsel submitted that all three cases relied on CNO v. Verde-Balayo (Discipline Committee, 2021) which was a test case in which the issues were contested in part. Accordingly, the Panel could have comfort that the matters in issue had been fully deliberated by another panel of the Discipline Committee. The Member’s Counsel submitted that the Member had served the public and public health throughout her career, had offered to pay restitution and had acknowledged that her conduct was unprofessional and dishonourable by admitting to the allegations.

Penalty Decision

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

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

2. The Executive Director is directed to suspend the Member’s certificate of registration for 4 months. This suspension shall take effect from the date that this Order becomes final and shall continue to run without interruption as long as the Member remains in a practicing class.

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

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

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

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

1. the Panel’s Order,

2. the Notice of Hearing,

3. the Agreed Statement of Facts,

4. this Joint Submission on Order, and

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

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

1. Code of Conduct,

2. Professional Standards, and

3. Ethics;

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

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

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

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

3. strategies for preventing the misconduct from recurring,

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

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

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

1. the dates the Member attended the sessions,

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

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

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

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

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

i. 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. Specific deterrence is met through the oral reprimand and the 4-month suspension of the Member’s certificate of registration, which will send a clear message to the Member that employee benefit fraud will not be tolerated. General deterrence is met through the 4-month suspension of the Member’s certificate of registration, which will send a strong message to the membership at large that this type of behaviour will not be tolerated. The 2 meetings with a Regulatory Expert and review of the College’s publications will provide for remediation and rehabilitation. The public will be protected through the 12 months of employer notification, which will make the employer aware of the misconduct so that the employer can appropriately monitor the Member upon her return to practice.

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

I, Michael Hogard, RPN, sign this decision and reasons for the decision as Chairperson of this Discipline panel and on behalf of the members of the Discipline panel.