ONTARIO PHYSIOTHERAPISTS DISCIPLINE TRIBUNAL
Tribunal File No.: 25-004-PT
BETWEEN:
College of Physiotherapists of Ontario
College
- and -
Yulia Sternin
Registrant
FINDING AND PENALTY REASONS
Heard: April 21, 2026
Panel:
Sherry Liang (panel chair)
Frank Massey (public)
Kate Moffett (physiotherapist)
Rick O’Brien (public)
Jim Wernham (physiotherapist)
Appearances:
Joanna Birenbaum, for the College
Ruba El-Sayegh and Wudassie Tamrat, for the registrant
RESTRICTION ON PUBLICATION
Pursuant to Rule 2.2.2 of the HPDT Rules of Procedure and ss. 45-47 of the Health Professions Procedural Code, no one shall publish or broadcast the names of patients or any information that could identify patients or disclose patients’ personal health information or health records referred to at a hearing or in any documents filed with the Tribunal. There may be significant fines for breaching this restriction.
Introduction
1For over eight years, the registrant referred patients to a Pilates studio and allowed the studio to bill services that did not qualify as physiotherapy or supervised physiotherapy using her name and College registration number. The College alleges and the registrant admits that her conduct constitutes professional misconduct.
2Based on an agreed statement of facts and after hearing submissions, the panel found that the registrant committed professional misconduct, including failing to maintain the standards of practice of the profession, submitting an account or charge for services that the registrant knows or ought to know is false or misleading and failing to take reasonable steps to ensure that any accounts submitted in the registrant’s name or billing number are fair and accurate. We found that the registrant engaged in conduct that members of the profession would reasonably regard as disgraceful, dishonourable or unprofessional.
3We accepted the parties’ joint submission on penalty and costs, which includes a suspension of the registrant’s certificate of registration of up to fifteen months, training and practice enhancement, coaching and a reprimand. We also ordered the registrant to pay the College $7,000 in costs.
Professional misconduct
4At the relevant time, the registrant practised as a physiotherapist at her own clinic in Ontario. Over an eight-year period, her practice included referring patients for one-on-one Pilates sessions at locations outside of her clinic (the “Pilates studio”). Those services, which were delivered by staff at the studio, were invoiced as “physio-Pilates,” under the registrant’s name and College registration number.
5The College obtained clinical charts for 11 patients, including an undercover investigator, and gave them to a peer reviewer for assessment. The reviewer observed, among other things, that:
a. regardless of the presenting problem of the patient, the charts were quite similar, and all patients were recommended or referred to Pilates as a treatment modality;
b. none of the charts contained a treatment plan;
c. rarely was a performed treatment documented;
d. in charts where there was an analysis or diagnosis, it was generalized, such as “muscle imbalance” and “weak core,” without outcome measures or testing to corroborate these findings;
e. the reviewer found “it was incredibly difficult to determine how the [registrant] arrived at a diagnosis”;
f. none of the charts contained outcome measures;
g. the charts contained no documentation of ongoing consent for assessment, treatment or involvement of a physiotherapist assistant (PTA) in the patients’ care;
h. the majority of handwritten notes were illegible;
i. the charts contained no communication between the registrant and the persons working (or purportedly working) as PTAs at the Pilates studio;
j. the charts contained no details regarding the care assigned to the PTA nor any treatment plan for the PTA to follow;
k. none of the charts contained an invoice issued by the registrant’s clinic to the patient (although some charts contained insurance claim submissions); and
l. most contained invoices for Pilates services issued by the Pilates studio, using the registrant’s name and College registration number, under the name and address of the Pilates studio and not the registrant’s clinic.
6In a striking example that illustrates the risks of delegating treatment without proper oversight, one of the registrant’s patients received “physio-Pilates” at the Pilates studio six weeks after open-heart surgery. The registrant was not aware that the patient had undergone open-heart surgery or that the Pilates studio staff person developed and delivered a treatment plan for the postoperative patient. The “physio-Pilates” was delivered before the registrant conducted any reassessment of the patient.
7Under para. 1 of s. 1 of Ontario Regulation 388/08 made under the Physiotherapy Act, 1991, SO 1991, c. 37 (Professional Misconduct Regulation) failing to maintain the standards of practice of the profession is professional misconduct.
8The College’s Fees, Billing and Accounts Standard requires registrants to ensure that any fee, billing or account that uses their name and registration number is an accurate reflection of the services and/or products provided. It states that physiotherapists must never charge fees or create billings or accounts that are inaccurate, false or misleading.
9In addition to invoicing patients for services they provide directly, physiotherapists may invoice patients for exercise programs delivered by a physiotherapy assistant, in specified circumstances. College of Physiotherapists of Ontario v. Lapierre, 2023 ONCPO 62 describes the conditions in which exercise programs qualify as supervised physiotherapy, at para. 45:
Exercise programs under the supervision of a physiotherapist only qualifies as supervised physiotherapy if certain conditions are met which were not present in this case, including that the treatment plan must: be specific to an identified condition or deficit and reflective of the client’s stage of recovery; include specific exercises and target identified deficits; and be supported by objective quantifiable measures to assess progress and determine whether the treatment goals are being met.
10The registrant admits and we find that she failed to maintain the standards of practice of the profession when she issued invoices to patients or submitted claims to a third-party insurer and when she authorized the Pilates studio to issue or submit invoices or claims for physiotherapy treatments under her name and College registration number, when these services were one-on-one Pilates sessions and did not constitute physiotherapy or supervised physiotherapy.
11The registrant’s conduct also contravened the College’s Record Keeping Standard, which requires that information in clinical records support a physiotherapist’s rationale for the care that they provide. The records must contain relevant information about a patient's care, including: details about analysis, diagnosis, patient goals, treatment plan, and treatments performed; progress notes; outcomes; reassessments and resulting changes to the treatment plan; and details about any care that has been assigned to another person or care provided collaboratively with other health providers, including consultations and correspondence. The registrant admits and we find that in the charts described above, her assessments, diagnoses, clinical analysis, treatment plans, reassessments and record keeping failed to maintain the standards of practice of the profession.
12The College’s Working with Physiotherapist Assistants Standard sets out the standards of practice of the profession when working with a PTA. The registrant admits and we find that the registrant: failed to adhere to the requirements of this standard by failing to properly assess patients and develop a detailed treatment plan that could be followed by a person working as a PTA; failed to have a communications protocol for working with PTAs; permitted PTAs to develop and change the treatment/treatment plan; and failed to ensure that the name of the PTA was included on all invoices.
13Through her conduct as described above, the registrant failed to maintain the standards of practice and engaged in misconduct as defined in para. 1 of s.1 of the Professional Misconduct Regulation. Her actions also amount to misconduct under the following additional paragraphs of s. 1:
paragraph 26 (failing to keep records in accordance with the standards of practice of the profession);
paragraph 32 (submitting an account or charge for services that the member knows or ought to know is false or misleading);
paragraph 33 (failing to take reasonable steps to ensure that any accounts submitted in the member’s name or billing number are fair and accurate); and
paragraph 41 (failing to supervise, in accordance with the standards of practice of the profession).
14Finally, the registrant engaged in misconduct under para. 18 of s. 1 of the Professional Misconduct Regulation in that her conduct would reasonably be regarded by registrants as disgraceful, dishonourable or unprofessional.
Penalty and costs
15The parties’ agreement on penalty must be implemented unless it is so “unhinged from the circumstances” that implementing it would bring the administration of the College’s professional discipline system into disrepute: see R. v. Anthony-Cook, 2016 SCC 43 and Bradley v. Ontario College of Teachers, 2021 ONSC 2303 (Div. Ct.). We are satisfied that the proposed penalty is not contrary to the public interest in this manner.
16The parties provided us with decisions of this Tribunal to establish that the proposed penalty is proportionate to the misconduct. These cases establish that fraudulent billing practices are treated as serious matter, resulting in penalties that include suspensions in the range of 4 to 12 months.
17The most comparable circumstances are those in College of Physiotherapists of Ontario v. Vaishnav, 2025 ONCPO 77 and College of Physiotherapists of Ontario v. Yardley, 2023 ONCPO 61. In both cases, the registrants provided physiotherapy services through clinics they owned. They issued invoices for physiotherapy treatments under their names and College registration numbers, when the services provided to patients were in fact personal training and/or general exercise and did not qualify as or constitute physiotherapy treatments or services. Both registrants were given penalties that included a 15-month suspension of their certificate of registration, with the possibility of a reduction to an 8-month suspension if they completed specified remediation activities.
18While every decision is based on its own set of unique facts, we conclude that the suspension proposed here is reasonably within the range of penalties for similar misconduct.
19The suspension and reprimand serve the goals of specific and general deterrence. The penalty reminds the registrant of the importance of ethical billing practices, robust record keeping, and proper supervision and accountability for the services provided by those she has assigned to care for her patients. General deterrence is achieved by demonstrating to other registrants that maintaining professional standards is essential to continuing to enjoy the privilege of practising the profession.
20The terms, conditions and limitations imposed on the registrant’s certificate of registration serve the purpose of remediation and ensure that she has the tools to return to practice in keeping with the standards of practice of the profession. The penalty shows the public that the College takes seriously its responsibility to govern the profession and enhances public confidence in the College’s ability to protect the public.
21We considered as mitigating the fact that by admitting to the misconduct and participating in the proceedings, the registrant has shown insight and spared the parties and the Tribunal the time and expense of having a contested hearing.
22Having regard to the relevant penalty principles as well as the caselaw, we are satisfied that the joint submission is not contrary to the public interest. We also accept the parties’ joint submission that the registrant pay $7,000 in installments to the College for costs.
Order
23We made the following order:
Penalty
The Tribunal requires the registrant to appear before the panel to be reprimanded. The fact of the reprimand and the text of the reprimand shall appear on the public register of the College.
The Tribunal directs the Registrar to:
a. suspend the registrant’s certificate of registration for a period of fifteen (15) months, as follows:
i. The registrant will be required to only serve the first eight (8) months of the suspension, the balance being suspended, provided they successfully complete the remediation activities set out in paragraphs 3(a) and (b) below.
ii. The eight (8) month served suspension shall be served commencing at 12:01 am on Monday, May 4, 2026 at 12:01am and ending at 11:59pm on Friday January 1, 2027.
iii. While the registrant is serving their suspension, they shall not use the title Physiotherapist, Physical Therapist, or any abbreviation thereof including PT nor can their name along with PT title and/or registration number be used for billing purposes. All social media and web presence will be updated accordingly.
b. impose the following specified terms, conditions or limitations on the Registrant’s certificate of registration, all of which are to be completed at the Registrant’s own expense:
i. The registrant shall review the following standards of practice, tools and resources and confirm completion of same in writing to the Registrar within 60 days of the Discipline Tribunal’s Order.
Standards and Supportive Resources
Essential Competency Profile for Physiotherapists
Professional Misconduct Regulation
Assessment, Diagnosis and Treatment
Assessment, Diagnosis and Treatment – effective August 1, 2024
Physiotherapy Scope
Code of Ethical Conduct
Code of Ethical Conduct – effective August 1, 2024
Inappropriate Business Practices
Ethics and Professionalism Tool Kit — CPA (free access)
Conflict of Interest
Conflict of Interest - Effective Feb. ,1 2025
FAQs
Fees, Billing, and Accounts
Funding, Fees and Billing Standard
Code of Ethical Conduct
FAQs
Module: Business Practices
Module: Inappropriate Business Practices
Record Keeping / Documentation
Documentation Standard & Checklist
E-learning: Record Keeping (including final quiz)
Working with PTAs
Supervision Standard
Essential Competency Profile for PTAs in Canada
FAQs
E-Learning: Working with Physiotherapist Assistants
PTA Competency Checklist
Sample Skills Inventory
ii. The registrant shall, prior to their return to practice on January 2, 2027, successfully complete the PBI Ethics program – Ethics and Professionalism ME-15 https://pbieducation.com/courses/me-15/ course, and provide proof of their successful completion to the Registrar by December 15, 2026. The College must receive the Accomplishments, Impressions and Recommendations (AIR) letter and the personal protection plan.
iii. For a one-year period following the registrant’s return to practice, the Registrant shall participate in practice enhancement coaching, which program shall involve no more than eight (8) sessions.
iv. For a one -year period following the registrant’s return to practice, the Registrant may not supervise physiotherapists, physiotherapist students or physiotherapist residents, nor may the Registrant supervise any of the above persons until such time as the Registrant has successfully completed all remediation set out in this order.
v. During the period that the registrant’s Certificate of Registration is suspended, the registrant shall not provide services as a Physiotherapist Assistant (PTA).
Costs
- The Tribunal requires the registrant to pay costs to the College in the amount of $7,000, payable in monthly instalments commencing January 4, 2027 and continuing to December 31, 2028.