{"id":31430,"date":"2026-07-24T22:43:15","date_gmt":"2026-07-24T22:43:15","guid":{"rendered":"https:\/\/healthcareethicscourses.com\/can\/?page_id=31430"},"modified":"2026-07-25T00:39:04","modified_gmt":"2026-07-25T00:39:04","slug":"what-happens-during-a-cno-investigation","status":"publish","type":"page","link":"https:\/\/healthcareethicscourses.com\/can\/what-happens-during-a-cno-investigation\/","title":{"rendered":"What happens during a CNO investigation?"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"31430\" class=\"elementor elementor-31430\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-f635545 e-flex e-con-boxed e-con e-parent\" data-id=\"f635545\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-938099b elementor-widget elementor-widget-html\" data-id=\"938099b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\r\n<!-- What happens during a CNO investigation? | Elementor Custom HTML fragment -->\r\n<!-- Body only. 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Support<\/a><span>\/<\/span><a href=\"\/can\/knowledge-support\/\">Nurses &amp; Midwives &mdash; Ontario<\/a><span>\/<\/span>What happens during a CNO investigation\r\n  <\/nav>\r\n\r\n  <p class=\"eyebrow\">Ontario &middot; College of Nurses of Ontario<\/p>\r\n  <h1>What happens during a CNO investigation?<\/h1>\r\n  <div class=\"meta\"><b>8 min read<\/b><span>Last updated July 14, 2026<\/span><\/div>\r\n\r\n  <p class=\"lede\">The investigation stage is where the record is built &mdash; and where nurses are most often surprised by how broad the College&rsquo;s powers are, and how few procedural protections apply compared with a hearing.<\/p>\r\n\r\n  <div class=\"callout\">\r\n    <p><b>Do this first:<\/b> Assume everything you say and every document you produce will be read by a panel of the ICRC. Route your contact with the investigator through CNPS or a regulatory lawyer, produce what is properly requested, and keep your records exactly as they stand &mdash; never tidy a chart after a complaint arrives.<\/p>\r\n  <\/div>\r\n\r\n  <h2>How an investigation starts<\/h2>\r\n  <p>Once the College has a complaint or a report, it is obliged to investigate and act on it. An investigator may be appointed to gather the evidence. The scope varies enormously with the case: a straightforward documentation concern may need little more than the chart and your response, while an allegation of misconduct can involve the complainant, colleagues, your employer, and you.<\/p>\r\n  <h2>What the investigator can do<\/h2>\r\n  <p>Nurses are frequently taken aback by the breadth of these powers. An investigator can obtain records, attend at a practice site, and interview the complainant, witnesses and the nurse. You are obliged to cooperate with the process. And you have fewer procedural protections here than you would at a hearing &mdash; there is no cross-examination, no live testing of the evidence, and no adjudicator weighing it in real time. The material simply accumulates into a report.<\/p>\r\n  <p>One point catches nurses off guard more than any other: <strong>patient records<\/strong>. Under the Personal Health Information Protection Act, 2004, a health information custodian may disclose personal health information to the College without the patient&rsquo;s consent for the purposes of the College&rsquo;s regulatory work. You cannot resist a proper records request on the basis that the patient has not agreed to it.<\/p>\r\n  <h2>Never touch the chart<\/h2>\r\n  <p>The instinct to clarify a record once a complaint lands is understandable and dangerous. Altering, back-dating or &ldquo;completing&rdquo; documentation after you learn of a concern converts a defensible clinical case into an integrity case &mdash; and integrity cases are the ones that end in referrals. A late entry made properly, transparently and identified as a late entry is a different thing entirely from a chart quietly improved after the fact. If the record is imperfect, explain it in your response; do not fix it.<\/p>\r\n  <h2>Section 75: the Registrar&rsquo;s investigation<\/h2>\r\n  <p>Alongside the ordinary complaints route, section 75 of the Health Professions Procedural Code allows the Registrar to appoint an investigator where there are reasonable and probable grounds to believe a member has committed professional misconduct or is incompetent. These <strong>Registrar&rsquo;s investigations<\/strong> are considerably broader in scope than the standard process, and they are typically reserved for more serious matters.<\/p>\r\n  <p>The consequence matters for you: an ICRC decision made following a section 75 report is <strong>not reviewable by HPARB<\/strong>. Where a complaint decision can be taken to the Board, a Registrar&rsquo;s report decision can only be challenged by judicial review in the Divisional Court, which is a slower, narrower and more expensive route.<\/p>\r\n  <h2>Interim orders during the investigation<\/h2>\r\n  <p>The ICRC can impose an <strong>interim order<\/strong> while the investigation is still running, where the concerns suggest that patients may be exposed to harm. This can mean terms, conditions or limitations on your certificate of registration, and it can extend to suspension for the duration of the case. It is a protective measure rather than a finding, but its practical effect on your employment is immediate.<\/p>\r\n  <h2>How long does it take?<\/h2>\r\n  <p>The Code sets a disposal target of <strong>150 days<\/strong> from the receipt of the complaint. In practice that target is frequently extended, and the College is required to notify you and the complainant when it will not be met. Cases involving employer reports, multiple witnesses, or a section 75 investigation routinely run well beyond it. Delay is not, by itself, a defence &mdash; the courts have set a high bar, requiring delay that is inordinate <em>and<\/em> significantly prejudicial before it becomes an abuse of process &mdash; but a long investigation can be relevant to whether a remedial order still makes sense by the time the ICRC decides.<\/p>\r\n  <h2>How it ends<\/h2>\r\n  <p>The investigator&rsquo;s report, the complaint or report that started it, and your written response go to a panel of the ICRC, which decides on the papers. The outcome can be no action, advice or recommendations, a written or oral caution, an undertaking, a SCERP, or a referral to the Discipline Committee or the Fitness to Practise Committee. Because the ICRC does not weigh credibility, a matter can be referred to discipline where there is admissible evidence on both sides &mdash; a fact that surprises many nurses who assume their account will simply be accepted.<\/p>\r\n  <p>For the mechanics of responding, read <a href=\"https:\/\/healthcareethicscourses.com\/can\/knowledge-support\/nurses-midwives\/ontario\/complaints\/\">how to respond to a CNO complaint<\/a>. For the corrective record that shapes what the ICRC does with the report, read <a href=\"https:\/\/healthcareethicscourses.com\/can\/knowledge-support\/nurses-midwives\/ontario\/remediation\/\">remediation and reflection for Ontario nurses and midwives<\/a>.<\/p>\r\n\r\n  <section class=\"kt\">\r\n    <h2>Key takeaways<\/h2>\r\n    <ul>\r\n      <li>An investigator may be appointed to gather records and interview the complainant, witnesses and you.<\/li>\r\n      <li>Under PHIPA, the College can obtain patient records without the patient&rsquo;s consent &mdash; you cannot refuse on privacy grounds.<\/li>\r\n      <li>Nurses have fewer procedural protections at the investigation stage than at a hearing, and the College&rsquo;s powers are wider than most expect.<\/li>\r\n      <li>A Registrar&rsquo;s (section 75) investigation is broader still and carries no right of HPARB review.<\/li>\r\n      <li>The Code sets a 150-day disposal target, but many cases take considerably longer.<\/li>\r\n      <li>Everything gathered goes into the report that the ICRC reads alongside your written response.<\/li>\r\n    <\/ul>\r\n  <\/section>\r\n\r\n  <section class=\"courses\">\r\n    <h2>Related courses<\/h2>\r\n    <p class=\"sub\">Courses that map to what an investigation examines &mdash; your records, your candour and your insight:<\/p>\r\n    <div class=\"cgrid\">\r\n      <a class=\"ccard\" href=\"https:\/\/healthcareethicscourses.com\/can\/courses\/dealing-with-a-complaint-or-investigation-professionally\/\"><b>Dealing with a Complaint or Investigation Professionally<\/b><span>How to handle a College letter and prepare a measured written response.<\/span><\/a>\r\n      <a class=\"ccard\" href=\"https:\/\/healthcareethicscourses.com\/can\/courses\/documentation-for-healthcare-professionals\/\"><b>Documentation for Healthcare Professionals<\/b><span>The chart is the evidence the ICRC reads &mdash; how to keep records that hold up.<\/span><\/a>\r\n      <a class=\"ccard\" href=\"https:\/\/healthcareethicscourses.com\/can\/courses\/probity-and-honesty-for-healthcare-professionals\/\"><b>Probity and Honesty for Healthcare Professionals<\/b><span>Why candour with an investigator matters more than the original concern.<\/span><\/a>\r\n      <a class=\"ccard\" href=\"https:\/\/healthcareethicscourses.com\/can\/courses\/insight-for-fitness-to-practise\/\"><b>Insight for Fitness to Practise<\/b><span>Evidencing that you understand what went wrong and why it mattered.<\/span><\/a>\r\n    <\/div>\r\n  <\/section>\r\n\r\n  <section class=\"nextset\">\r\n    <h2>Continue reading<\/h2>\r\n    <div class=\"ngrid\">\r\n      <a class=\"ncard\" href=\"https:\/\/healthcareethicscourses.com\/can\/how-to-respond-to-a-cno-complaint\">How to respond to a CNO complaint<\/a>\r\n      <a class=\"ncard\" href=\"https:\/\/healthcareethicscourses.com\/can\/remediation-and-reflection-for-ontario-nurses-and-midwives\">Remediation and reflection for Ontario nurses and midwives<\/a>\r\n    <\/div>\r\n  <\/section>\r\n\r\n  <section class=\"faq\">\r\n    <h2>Frequently asked questions<\/h2>\r\n      <details>\r\n        <summary>Do I have to cooperate with a CNO investigation?<\/summary>\r\n        <div class=\"ans\">Yes. Nurses are obliged to cooperate with the College&rsquo;s process, which may include taking part in an interview. Cooperating fully is not the same as volunteering an unconsidered account &mdash; take advice from CNPS or a regulatory lawyer first.<\/div>\r\n      <\/details>\r\n      <details>\r\n        <summary>Can the College see my patients&rsquo; records without their consent?<\/summary>\r\n        <div class=\"ans\">Yes. Under PHIPA, personal health information may be disclosed to the College for the purposes of its regulatory work without patient consent. You cannot refuse a proper records request on privacy grounds.<\/div>\r\n      <\/details>\r\n      <details>\r\n        <summary>Can I correct or complete my notes after a complaint?<\/summary>\r\n        <div class=\"ans\">No. Altering or back-dating a record after learning of a concern turns a clinical case into an integrity case. If the documentation is imperfect, explain that in your written response rather than changing it.<\/div>\r\n      <\/details>\r\n      <details>\r\n        <summary>What is a section 75 investigation?<\/summary>\r\n        <div class=\"ans\">It is a Registrar&rsquo;s investigation, appointed where there are reasonable and probable grounds to suspect professional misconduct or incompetence. It is broader in scope than the ordinary process, and the resulting ICRC decision cannot be reviewed by HPARB &mdash; only by judicial review.<\/div>\r\n      <\/details>\r\n      <details>\r\n        <summary>How long does a CNO investigation take?<\/summary>\r\n        <div class=\"ans\">The Code sets a 150-day disposal target from receipt of the complaint, but extensions are common and the College must notify you when the target will not be met. Complex matters and section 75 investigations often take substantially longer.<\/div>\r\n      <\/details>\r\n      <details>\r\n        <summary>Can I be suspended before any decision is made?<\/summary>\r\n        <div class=\"ans\">Yes. Where the concerns suggest patients may be exposed to harm, the ICRC can make an interim order during the investigation, imposing terms, conditions or limitations on your certificate of registration, up to suspension, for the duration of the case.<\/div>\r\n      <\/details>\r\n  <\/section>\r\n\r\n  <p class=\"disc\">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 <strong>not legal advice<\/strong>. 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.<\/p>\r\n\r\n<\/article>\r\n\r\n<script type=\"application\/ld+json\">\r\n{\r\n  \"@context\": \"https:\/\/schema.org\",\r\n  \"@graph\": [\r\n    {\r\n      \"@type\": \"Article\",\r\n      \"headline\": \"What happens during a CNO investigation?\",\r\n      \"description\": \"What happens during a CNO investigation: the investigator&rsquo;s powers, records access under PHIPA, section 75, the 150-day target, and what the ICRC decides.\",\r\n      \"inLanguage\": \"en-CA\",\r\n      \"datePublished\": \"2026-07-14\",\r\n      \"dateModified\": \"2026-07-14\",\r\n      \"author\": {\r\n        \"@type\": \"Person\",\r\n        \"name\": \"Dr Shehzad Iqbal\",\r\n        \"jobTitle\": \"MRCS, MRCGP, PG Cert Healthcare Law & Ethics (University of Dundee)\"\r\n      },\r\n      \"publisher\": {\r\n        \"@type\": \"Organization\",\r\n        \"name\": \"Healthcare Ethics Courses\",\r\n        \"url\": \"https:\/\/healthcareethicscourses.com\/can\/\"\r\n      },\r\n      \"mainEntityOfPage\": {\r\n        \"@type\": \"WebPage\",\r\n        \"@id\": \"https:\/\/healthcareethicscourses.com\/can\/knowledge-support\/nurses-midwives\/ontario\/investigation\/\"\r\n      },\r\n      \"url\": \"https:\/\/healthcareethicscourses.com\/can\/knowledge-support\/nurses-midwives\/ontario\/investigation\/\",\r\n      \"about\": \"College of Nurses of Ontario\"\r\n    },\r\n    {\r\n      \"@type\": \"BreadcrumbList\",\r\n      \"itemListElement\": [\r\n        {\r\n          \"@type\": \"ListItem\",\r\n          \"position\": 1,\r\n          \"name\": \"Knowledge & Support\",\r\n          \"item\": \"https:\/\/healthcareethicscourses.com\/can\/knowledge-support\/\"\r\n        },\r\n        {\r\n          \"@type\": \"ListItem\",\r\n          \"position\": 2,\r\n          \"name\": \"Nurses & Midwives \u2014 Ontario\",\r\n          \"item\": \"https:\/\/healthcareethicscourses.com\/can\/knowledge-support\/nurses-midwives\/ontario\/\"\r\n        },\r\n        {\r\n          \"@type\": \"ListItem\",\r\n          \"position\": 3,\r\n          \"name\": \"What happens during a CNO investigation?\",\r\n          \"item\": \"https:\/\/healthcareethicscourses.com\/can\/knowledge-support\/nurses-midwives\/ontario\/investigation\/\"\r\n        }\r\n      ]\r\n    },\r\n    {\r\n      \"@type\": \"FAQPage\",\r\n      \"mainEntity\": [\r\n        {\r\n          \"@type\": \"Question\",\r\n          \"name\": \"Do I have to cooperate with a CNO investigation?\",\r\n          \"acceptedAnswer\": {\r\n            \"@type\": \"Answer\",\r\n            \"text\": \"Yes. Nurses are obliged to cooperate with the College\u2019s process, which may include taking part in an interview. Cooperating fully is not the same as volunteering an unconsidered account \u2014 take advice from CNPS or a regulatory lawyer first.\"\r\n          }\r\n        },\r\n        {\r\n          \"@type\": \"Question\",\r\n          \"name\": \"Can the College see my patients\u2019 records without their consent?\",\r\n          \"acceptedAnswer\": {\r\n            \"@type\": \"Answer\",\r\n            \"text\": \"Yes. Under PHIPA, personal health information may be disclosed to the College for the purposes of its regulatory work without patient consent. You cannot refuse a proper records request on privacy grounds.\"\r\n          }\r\n        },\r\n        {\r\n          \"@type\": \"Question\",\r\n          \"name\": \"Can I correct or complete my notes after a complaint?\",\r\n          \"acceptedAnswer\": {\r\n            \"@type\": \"Answer\",\r\n            \"text\": \"No. Altering or back-dating a record after learning of a concern turns a clinical case into an integrity case. If the documentation is imperfect, explain that in your written response rather than changing it.\"\r\n          }\r\n        },\r\n        {\r\n          \"@type\": \"Question\",\r\n          \"name\": \"What is a section 75 investigation?\",\r\n          \"acceptedAnswer\": {\r\n            \"@type\": \"Answer\",\r\n            \"text\": \"It is a Registrar\u2019s investigation, appointed where there are reasonable and probable grounds to suspect professional misconduct or incompetence. 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Where the concerns suggest patients may be exposed to harm, the ICRC can make an interim order during the investigation, imposing terms, conditions or limitations on your certificate of registration, up to suspension, for the duration of the case.\"\r\n          }\r\n        }\r\n      ]\r\n    }\r\n  ]\r\n}\r\n<\/script>\r\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Knowledge &amp; Support\/Nurses &amp; Midwives \u2014 Ontario\/What happens during a CNO investigation Ontario \u00b7 College of Nurses of Ontario What [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"site-sidebar-layout":"no-sidebar","site-content-layout":"","ast-site-content-layout":"full-width-container","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"disabled","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"class_list":["post-31430","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>What Happens During a CNO Investigation? 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