CNO’s reporting guide will help you to decide whether you should or must report a nurse, how to do that and what happens after you file a report. This page outlines who should file a report and in what situations.
This information is not intended as legal advice. You are encouraged to seek legal advice and/or contact CNO if you have any questions about reporting.
Visit our other pages to learn about these topics:
If you are a member of the public and you want to make a complaint about a nurse's conduct, please follow the instructions for making a complaint.
What must be reported
CNO’s mandate is to protect the public. To achieve this, we partner with employers, facility operators, nurses and those who work with nurses. Patient safety is our collective responsibility. We need you to send us a report when you believe a nurse poses a serious risk of harm to patients.
This chart includes legal reporting requirements under the Regulated Health Professions Act. We also want you to report to CNO if you have a serious concern about a nurse’s practice.
Other legislation and practice settings may require additional reports, such as reporting requirements under the Fixing Long-Term Care Act and the Personal Health Information Protection Act.
This chart is intended only as a summary. If you have questions about whether to report a nurse’s conduct, please contact CNO or seek legal advice.
What must be reported?
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Who must report?
(The roles with a * are defined in the Glossary)
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Employers
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Facility operators*
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Nurses and other Regulated health Professionals
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A nurse who poses a serious risk of harm to patients
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X
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X
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A nurse who is suspected of sexually abusing a patient (Sexual abuse has a broader definition in health care than other settings. Learn what constitutes sexual abuse in health care.)
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X
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X
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X
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A nurse who is incompetent in their care of a patient; who displays a significant and repeated lack of knowledge, skill or judgment; who demonstrates they are unfit to continue to practice; or whose practice should be restricted to ensure patient safety
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X
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X
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A nurse who is incapacitated by a physical or mental condition that negatively impacts their nursing care, creating a patient safety concern
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X
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X
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A nurse who is terminated, and there are concerns about the nurse’s competence, conduct or capacity, or who resigns in lieu of being terminated, or resigns when there is an investigation into their conduct
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X
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A nurse whose privileges have been revoked, suspended or restricted due to concerns about the nurse’s competence, conduct or capacity
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X
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When a partnership, health professional corporation or association with a nurse is dissolved due to the nurse’s professional misconduct, incompetence or incapacity
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X |
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If you have concerns about a nurse in relation to patient safety, please submit your report immediately. When there is a legal requirement to report under the Regulated Health Professions Act, you must report within 30 days of the incident. We encourage you to always submit your report as quickly as possible.
Issues you should not report to CNO
CNO cannot address the following issues:
- labour relations (for example, workload issues and nurse-patient ratios)
- health care professionals who are not nurses (for example, reports about an occupational therapist or physician)
- concerns about health care facilities
These issues are better handled by the workplace, a nursing union, an association or the appropriate regulatory body. If your issue with a nurse falls under one of these categories, talk to the appropriate person in your workplace.
If you’re not sure whether your issue is something CNO can address, please contact legal counsel or contact CNO.
Legal obligations to report
Employers, facility operators and nurses have certain legal obligations to report information to CNO. If you are sending a report to CNO because of a legal obligation, you must send it no more than 30 days after the incident, and sooner if possible. If you miss the 30-day window, please still send the report to CNO as soon as possible.
What must be reported by law about a nurse’s practice?
- sexual abuse
- terminations, or the nurse’s resignation in lieu of termination
- revocations, suspensions, or restrictions on a nurse’s privileges
Each of these obligations is described in detail in the following sections. A person or facility may be fined if they don’t make a report when they have a legal obligation. Individuals may be fined up to $50,000 and corporations may be fined up to $200,000.
Sexual abuse
In the context of regulated health care professionals, the term “sexual abuse” has a specific legal meaning. It is not the same as the criminal act of sexual assault, which refers to a sexual act without consent. For a regulated health professional, any sexual or romantic relationship with a patient is considered abusive, even if it is perceived to be, or actually is, consensual.
As soon as a nurse engages professionally with a patient, they have established a therapeutic relationship, where the components of trust, respect, empathy, professional intimacy and power are present. This therapeutic patient relationship exists no matter the context or length of the interaction.
A person is considered to be a patient for one year after the end of their therapeutic relationship. A nurse must not have a sexual or romantic relationship with the patient during that year. The nurse is responsible for establishing and maintaining the limits or boundaries in the therapeutic nurse-patient relationship.
Sexual abuse of a patient occurs when a nurse:
- has physical sexual relations with a patient
- touches a patient in a sexual manner (for example, touching a patient’s genitals when it is not required in caring for the patient)
- behaves in a sexual manner toward a patient (for example, touching a patient’s shoulder or hand unnecessarily and in a manner that implies a sexual interest in the patient)
- makes remarks of a sexual nature to a patient (for example, commenting on the size of a patient’s breasts or genitals)
Nurses, other health care professionals, nurse employers, or individuals who operate a facility where nurses work, are legally required to report any suspected sexual abuse by a nurse to CNO.
You can include the patient’s name in your report only if you obtain the patient’s written consent to share it (or the consent of the patient’s representative, if the patient is incapable of consent). If the patient has not consented in writing, the patient’s name must not be included in the report.
Terminations or the nurse’s resignation in lieu of termination
Employers are legally required report to CNO when they terminate a nurse for reasons of professional misconduct, incompetence or incapacity. Employers are also required to submit a report if the nurse resigns in lieu of being terminated.
Employers must submit the report no more than 30 days after terminating the nurse or after the nurse resigns in lieu of termination, and sooner if possible. The report must include reasons for the termination of employment.
Revocations, suspensions or restrictions on a nurse’s privileges
Employers are legally required to submit a report to CNO when they revoke, suspend or place restrictions on a nurse’s privileges for reasons of professional misconduct, incompetence or incapacity.
Employers must submit the report no more than 30 days after the nurse’s privileges are revoked, suspended or restricted, and sooner if possible. The report must include reasons for the revocation, suspension or restrictions imposed on the nurse’s privileges.
Nurses’ professional accountability in reporting
Nurses have a professional accountability to act in the best interests of patients by speaking up to protect them from harm. As a nurse, you are in a position of trust. You are well-placed to notice harmful behaviour by another nurse, and your first priority must be to protect the patient.
Your accountability is fundamental to nursing practice and is found in:
Nurses are also legally obligated to report certain conduct to CNO, including suspected sexual abuse of a patient by a nurse. See the previous section of this page for details.
CNO uses your report to evaluate the level of risk associated with the nurse’s behaviour and take the appropriate steps to protect the public.
Self reporting: Information a nurse must report about themselves
A nurse practicing in Ontario is required to report certain information about themselves to CNO; this is called “self-reporting.” A nurse is required to self-report to CNO if they:
- have been charged with any offence
- have been found guilty of any offence
- have a finding of professional negligence and/or malpractice
- have a finding of professional misconduct, incompetence or incapacity, or any similar finding in relation to the practice of nursing or any other profession
- are the subject of a current investigation, inquiry or proceeding for professional misconduct, incompetence or incapacity or any similar investigation or proceeding in relation to the practice of nursing in another jurisdiction or any other profession
Even if a nurse receives an absolute or conditional discharge instead of a conviction from a criminal offence, they must still self-report to CNO. A nurse must self-report even if they are pardoned.
Nurses must self-report no more than 30 days from the date of the finding or initiation of a proceeding, and sooner if possible. They use the Self-Reporting form.
Reporting information about CNO applicants and nursing students
If you have concerns about an applicant registering with CNO, including nursing students, please call the Registration team at 416 963-7645.