Ontario · College of Nurses of Ontario
How to respond to a CNO complaint
Your written response is, in most cases, the only chance you get to speak. A panel of the Inquiries, Complaints and Reports Committee decides your case on the paper record alone — it hears no witnesses and holds no hearing. What you put in writing is what it reads.
Do this first: Note the response deadline in the College’s letter — usually 30 days — and contact the Canadian Nurses Protective Society (CNPS) before you write anything. CNPS Supplementary Protection exists specifically to fund legal assistance with a complaint to your regulator. Do not send an informal explanation, and do not contact the person who complained.
Who regulates you — and who is reading the file
Nurses in Ontario are regulated by the College of Nurses of Ontario (CNO) under the Regulated Health Professions Act, 1991 (RHPA), the Health Professions Procedural Code in Schedule 2 of that Act, and the Nursing Act, 1991. Midwives are regulated separately, by the College of Midwives of Ontario — but because both are RHPA colleges governed by the same Code, the process described here works the same way for both. Throughout this guide, “the College” means whichever regulator holds your certificate of registration.
The body that will decide your complaint is the Inquiries, Complaints and Reports Committee (ICRC), a statutory committee made up of professional and public members. It is important to understand what the ICRC is not: it is not a tribunal. It does not hold a hearing, hear live witnesses, or decide who is telling the truth. It screens the paper record and asks whether the concerns, if true, are serious enough to go further.
Where complaints come from
A complaint can come from a patient, a family member, a colleague, or an employer. But a great many nursing matters never start as a complaint at all. Under the RHPA, employers, facility operators and other regulated health professionals have mandatory reporting duties — a termination, a resignation while under investigation, or a finding of incompetence or negligence must be reported to the College. The College can also act on information it obtains itself. If you have lost a job over allegations, assume the College will hear about it.
The 30-day deadline — and why the response matters so much
The College will write to you, enclose the complaint, and ask for a written response, normally within 30 days. It is easy to underestimate this letter. In practice your written response is often the single opportunity you have to comment on the allegations, and it forms part of the written record on which the ICRC decides — including whether to refer you to the Discipline Committee. There is no later stage at which you get to explain yourself in person unless the matter is referred to a hearing.
You are also obliged to cooperate with the College’s process, which can include taking part in an interview. Cooperation is not the same as volunteering an unconsidered narrative. Get advice, then respond properly and on time.
What a strong response looks like
A response that helps you usually does four things. It sets out the clinical or professional reasoning behind what you did, in your own words, anchored to the record. It encloses the relevant documents — the chart, the policy you were working to, the staffing reality on the shift. It addresses the standard directly rather than talking around it. And, where the complaint has some merit, it says so.
That last point is the one nurses most often get wrong. Where a concern is well founded, acknowledging it and showing what you have done about it — reflection, targeted education, a change in practice — can give the ICRC confidence that you have learned from the experience and that no order is needed to make it stick. Denial in the face of a clear record does the opposite.
What the ICRC can do
After considering the investigation report and your response, a panel of the ICRC can take no further action; make recommendations or give advice about your practice; issue a written caution; require you to attend in person to receive an oral caution; require an undertaking; require a Specified Continuing Education or Remediation Programme (SCERP); refer specified allegations to the Discipline Committee; or refer you to the Fitness to Practise Committee. It may also dismiss a complaint it considers frivolous, vexatious, made in bad faith, moot or otherwise an abuse of process — but only after giving you and the complainant 30 days’ notice.
Three of those outcomes are public. SCERPs, oral cautions and referrals to discipline are published on your profile on the Public Register, where an employer or a member of the public can find them. That is why the difference between advice and a SCERP is worth taking seriously at the response stage, not after.
Interim orders: the risk that arrives early
Where the concerns are serious enough that patients may be exposed to harm, the ICRC can make an interim order during the investigation — terms, conditions or limitations on your certificate of registration, up to and including suspension — which can last for the duration of the case. An interim order is not a finding against you, but it has an immediate effect on your ability to work, and it is one more reason to take advice early rather than after a decision lands.
If the decision goes against you
Where the ICRC has disposed of a complaint, both you and the complainant can ask the Health Professions Appeal and Review Board (HPARB) to review the decision, generally within 30 days. HPARB’s power is narrow: it looks at whether the investigation was adequate and whether the decision was reasonable — it does not rehear the case. Decisions to refer to the Discipline Committee or to Fitness to Practise cannot be reviewed by HPARB, and decisions made on a Registrar’s report under section 75 are outside HPARB’s jurisdiction altogether, leaving judicial review as the only route.
For what the investigation stage itself involves, read what happens during a CNO investigation. For how to build the corrective record that changes an outcome, read remediation and reflection for Ontario nurses and midwives.
Key takeaways
- The College of Nurses of Ontario must investigate and act on complaints about a nurse’s conduct or competence; it cannot simply ignore one.
- You normally have 30 days to respond in writing, and the response forms part of the record the ICRC decides on.
- The ICRC is a screening committee. It works on paper, hears no live witnesses, and makes no credibility findings.
- Complaints are not the only route: employers must report terminations, resignations during an investigation, and findings of incompetence or negligence.
- SCERPs, oral cautions and referrals to discipline appear on your entry on the Public Register.
- Midwives in Ontario are regulated by the College of Midwives of Ontario, which runs the same RHPA process.
Related courses
Courses that map to what the ICRC actually reads — your account, your records and your standards:
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Frequently asked questions
How long do I have to respond to a CNO complaint?
Can I just explain informally and clear this up?
Does the ICRC hold a hearing?
Will the complaint show up on the Public Register?
My employer reported me rather than a patient complaining. Is that different?
Does this apply to midwives as well as nurses?
This guide describes the process of the College of Nurses of Ontario and, for midwives, the College of Midwives of Ontario. It is general information about how the regulator works and is not legal advice. Every case turns on its own facts. Before you respond to the College, contact the Canadian Nurses Protective Society (CNPS) or, for midwives, your professional liability protection provider, and consider a lawyer experienced in RHPA regulatory matters. Completing a course does not resolve a College matter and does not guarantee any outcome. Last updated July 14, 2026.