CNO Nursing Complaints in Ontario: What Registrants Should Know
The College of Nurses of Ontario (CNO) regulates Registered Nurses, Registered Practical Nurses, and Nurse Practitioners in Ontario under the Nursing Act, 1991 and the Regulated Health Professions Act, 1991. Most complaints are handled by the Inquiries, Complaints and Reports Committee (ICRC), which decides whether to take no action, issue advice or a caution, accept an undertaking, or refer the matter to the Discipline Committee. Ontario also has an external review body, the Health Professions Appeal and Review Board (HPARB), where registrants and complainants can appeal most ICRC decisions.
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Governing statute
Nursing Act, 1991, SO 1991, c. 32 and the Regulated Health Professions Act, 1991 (RHPA)
First-stage committee
Inquiries, Complaints and Reports Committee (ICRC)
Registrant response window
At least 30 days (statutory minimum under the RHPA)
Mailing address
101 Davenport Road Toronto, ON M5R 3P1
1-800-387-5526
Understanding the CNO complaints process
Ontario operates the largest nursing regulator in Canada. The College of Nurses of Ontario oversees more than 195,000 registrants across three classes: Registered Nurses, Registered Practical Nurses, and Nurse Practitioners. Because Ontario uses the umbrella Regulated Health Professions Act, the same procedural backbone that governs physicians, pharmacists, and other regulated health professionals also applies to nurses. That uniformity is the reason a lot of CNO procedure looks familiar to anyone who has worked in another Ontario health profession.
When a complaint reaches the College, intake staff log it, assign a file number, and forward a complete copy of the materials to the registrant. The statutory floor for your written response is 30 days, but in practice the ICRC almost always grants a reasonable extension if you ask in writing before the deadline. The Committee then reviews the file on the written record. There is no oral hearing at the ICRC stage. The quality and clarity of your written response is therefore the single most important factor at this level.
Ontario is one of the only Canadian jurisdictions with a formal Alternative Dispute Resolution stream built into the College's process. ADR is voluntary, confidential, and unavailable in sexual abuse cases or matters that present moderate-or-higher public risk, but for communication and interpersonal complaints it can produce a faster and less adversarial outcome. Either side may also seek review of most ICRC decisions at the Health Professions Appeal and Review Board, which is an independent tribunal that can confirm, vary, or send a matter back to the Committee.
Mandatory reporting drives a meaningful share of CNO intake. Ontario employers, facility operators, and other regulated health professionals all have statutory obligations to report certain conduct, terminations, and resignations. If you are the subject of an employer report, expect CNO to contact you even if no patient or family has filed anything. Most matters at the ICRC level resolve without a finding of professional misconduct; preparing a calm, organized, allegation-by-allegation response, ideally with CNPS or private insurer support, is how registrants reach that outcome.
What's distinctive about the CNO complaints process
- Ontario's RHPA gives registrants a minimum of 30 days to provide a written response to a complaint.
- CNO offers a formal Alternative Dispute Resolution (ADR) process where both the complainant and registrant agree. ADR is confidential and cannot be used in other proceedings, but it is not available for sexual abuse allegations or matters involving moderate-or-higher public risk.
- Either side can apply to the Health Professions Appeal and Review Board (HPARB) for a review of most ICRC decisions, which is a meaningful external check on the College.
- Mandatory reports from employers, facility operators, and other regulated professionals are a common source of intake in Ontario.
What triggers complaints against nurses in Ontario
Administrative concerns
- •Practising with an expired or lapsed registration
- •Failing to complete required continuing competence or quality assurance activities
- •Not reporting a change of name, address, or employer within the required timeframe
- •Failing to disclose a finding, charge, or condition on renewal
Conduct or practice concerns
- •Medication administration concerns or documentation errors
- •Professional boundary or therapeutic relationship concerns
- •Substance use or fitness-to-practise concerns
- •Scope of practice questions and delegation issues
- •Communication concerns raised by a patient, family member, or colleague
- •Confidentiality or privacy breaches under PIPEDA or provincial health-information law
How a CNO complaint typically moves
- 1
Complaint received and acknowledged
The College receives the written complaint, assigns a file number, and sends a written acknowledgement to both the complainant and the registrant.
- 2
Notice to the registrant
You are sent a copy of the complaint and supporting materials, and invited to provide a written response. The College's professional conduct staff is typically your point of contact.
- 3
Investigation
An investigator gathers records (charting, schedules, employer policies), interviews witnesses, and asks you targeted questions. You have a duty to cooperate, but you may have counsel and you may decline to admit fault.
- 4
Written response from the registrant
You submit a written response addressing the allegations point by point, with supporting documentation. This is usually the most important document in the file.
- 5
Review by the Inquiries, Complaints and Reports Committee (ICRC)
The Inquiries, Complaints and Reports Committee (ICRC) reviews the investigation file and your response. It can dismiss the matter, issue advice or a caution, accept an undertaking, or refer the matter forward.
- 6
Possible referral to the Discipline Committee
Serious matters or unresolved factual disputes may be referred to the Discipline Committee for a formal hearing on the merits.
Possible outcomes
No further action or dismissal
The committee determines the complaint is unfounded, outside its jurisdiction, or does not warrant further action. The file is closed.
Advice, caution, or reminder
A non-disciplinary measure intended to help you reflect on practice. It is typically recorded on your College file but not on the public register.
Undertaking or remedial agreement
A voluntary written agreement to take specific steps, such as additional coursework, a practice review, or a period of supervised practice.
Referral to discipline or formal hearing
A formal, hearing-style proceeding before a panel that can issue findings of professional misconduct or incompetence and impose conditions, suspension, or revocation.
Suspension or revocation of registration
Reserved for the most serious findings. These outcomes are published on the College's public register.
Practical tips for nurses in Ontario
- Use your full 30 days. CNO will usually grant a reasonable extension if you ask in writing before the deadline; it almost never benefits you to rush the response.
- Request the complete investigation package (the complainant's submission, any documents the investigator has gathered, and the specific questions you are being asked to address) before you draft your response.
- Do not alter charting after the fact. If you discover an error, follow your employer's late-entry policy and disclose it in your response.
- Notify your professional liability protection (CNPS for RNPC members, or your private insurer) as soon as you receive the complaint letter. Coverage often includes legal representation.
- Consider whether ADR is appropriate before formal investigation deepens, particularly for communication or interpersonal complaints.
Explore More Licensing Guidance
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Frequently asked questions
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support@boardwise.onlineThis guide is general educational information for Canadian Registered Nurses and is not legal advice. Always confirm current policy on the CNO website and consider engaging the Canadian Nurses Protective Society (CNPS), your private liability insurer, or a Canadian lawyer experienced in professional regulation before responding to the College.