Legal Obligations

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Overview

Employers, facility operators and nurses have certain legal obligations to report information to CNO. If you are sending a report to CNO in accordance with a legal obligation, you should send it as soon as possible, but no more than 30 days after the incident. If you miss the 30-day window, please still send us the report as quickly as possible.

What has to 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 

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, even if it is perceived to be or actually is consensual, is considered abusive. 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 a period of one year following the termination 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.

In your report, you can only include the patient’s name if you obtain the patient’s written consent to share it (or the consent of the patient’s representative, if the patient is incapable). If the patient has not consented in writing, the patient’s name must not be included in the report.

A person or facility may be fined if they don’t make a report relating to sexual abuse. Individuals may be fined up to $50,000, while corporations may be fined up to $200,000.

Terminations, or the nurse’s resignation in lieu of termination 

Employers are legally required to submit a 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 can submit the report as soon as possible, but no more than 30 days after terminating the nurse or the nurse resigns in lieu of termination. The report must include reasons for the termination of employment.

A person or facility may be fined if they don’t make a report relating to a nurse’s termination. Individuals may be fined up to $50,000, while corporations may be fined up to $200,000. 

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 can submit the report as soon as possible, but no more than 30 days after the nurse’s privileges are revoked, suspended or restricted. The report must include reasons for the revocation, suspension or restrictions imposed on the nurse’s privileges.

A person or facility may be fined if they don’t make a report relating to the revocation, suspension or restriction of a nurse’s privileges. Individuals may be fined up to $50,000, while corporations may be fined up to $200,000.

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Page last reviewed July 21, 2020