Progression - BCCNP · we are working towards. Progression owes much to the history of an organization, ... and other health care professionals to submit feedback on the nurse’s

2 Message from Chair & Registrar/CEO

4 Year in review

8 Nursing in the public interest

9 Resources and services

14 Complaints process

17 Our board

18 Boardchairprofile

19 Annual committee reports

26 Financial statements

2017-2018 Annual Report

Progression

2

An organization that sits still and doesn’t change with the times is an ineffective

organization. This is why we have chosen “progression” for our 2017-18 Annual

Report theme.

Progression reflects a fundamental aspect of our approach to regulation in British

Columbia. It requires an appreciation of the past, an understanding of the current

state, and a plan for the future.

Nursing has always been a complex profession, and that complexity has only

increased in recent years. And that is why progression is so important for us as a

regulatory body.

It is why we engaged the United Kingdom’s Professional Standards Authority to

help us benchmark our performance against other regulators around the world, to

determine where we are performing well, and to identify areas for improvement.

It is why we have moved forward with our vision for a single nursing regulator

in British Columbia, bringing together the three regulatory bodies — College

of Licensed Practical Nurses of British Columbia, College of Registered Nurses

of British Columbia, and College of Registered Psychiatric Nurses of British

Columbia — to better meet our mandate to protect the public.

But progression isn’t just about what we do today, nor is it about the future state

we are working towards. Progression owes much to the history of an organization,

and CRNBC certainly has a proud history of progress.

In 2012 we celebrated CRNBC’s centenary. Specifically, we celebrated

Helen Randal, Sharley Bryce Brown and the other 66 nurses who met in a

New Westminster church basement in 1912 to lay the groundwork for nursing

Rob Calnan, boaRD CHaIR

CyntHIa JoHansen, ReGIstRaR/Ceo

Progression reflects a

fundamental aspect of our

approach to regulation in

British Columbia. It requires

an appreciation of the past,

an understanding of the

current state, and a plan for

the future. 1Message from Chair & Registrar/CEO

3

regulation in the province. The trailblazing staff of our organization have been

stewards of progress as we evolved from the Graduate Nurses Association in

1912, to an association that also regulated nurses; to an association, regulator

and union; then into an association and regulator; and finally, in 2005, to a

purely regulatory body.

Our mandate to protect the public is a powerful motivator, a constant driver,

and a catalyst for progress — it always has been.

That’s why we look to our past for guidance, and why we strive for continuous

improvement every day, always mindful of the public we are mandated

to protect.

This Annual Report will be the last for CRNBC. A half-year report will be

prepared that highlights the final few months of work for CRNBC between

March 1, 2018 and Sept. 3, 2018. For 2018-19 and beyond we will be a new

single regulatory body: the British Columbia College of Nursing Professionals,

or BCCNP.

Our progression will definitely not stop here. If 2017-18 is any indication,

our work is only going to increase and grow in scope and complexity. We are

confident that our long-standing commitment to progress will serve us well,

as we begin the next chapter of nursing regulation in B.C.

Our mandate to protect

the public is a powerful

motivator, a constant

driver, and a catalyst

for progress — it always

has been.

© Copyright CRNBC / June 2018

Pub. No. 245

4

Complex cases, complex investigations

In 2017-18 CRNBC embarked on

its busiest year ever for inquiry and

discipline cases, with a significant

increase in new complaints.

These cases included serious and

complex matters dealing with sexual

misconduct, financial abuse, the

concealment of errors and other

troubling patterns of patient neglect, and

privacy breaches. The cases resulted in

serious outcomes to protect the public,

including suspensions and fines, and

generated significant media interest.

In addition to the work required to

investigate cases, the College also

took more steps to mitigate the risks

associated with cases to ensure that the

public was protected, while CRNBC

undertook its investigative work.

The increase in matters being brought

to the attention of the College is a

testament to the hard work of staff and

an increasing recognition of CRNBC’s

work to protect the public.

My Professional Plan and multisource feedback

In January 2018, CRNBC launched the

My Professional Plan app, as part of a

preventative and proactive program to

help nurses better manage their quality

assurance requirements and receive

real-time multisource feedback on their

practice.

To support ongoing professional

development and continued competence,

registered nurses and nurse practitioners

must complete a number of quality

assurance requirements annually and

periodically in order to be eligible to

practice as an RN or NP in British

Columbia. After a pilot in fall 2016

and a soft launch in summer 2017, My

Professional Plan and multisource

feedback was formally rolled out to over

20 per cent of practising registrants

during the 2018-19 registration renewal

process. Those selected to participate in

My Professional Plan and multisource

feedback were asked to invite colleagues

and other health care professionals to

submit feedback on the nurse’s practice

2Year in review

As part of a responsive and

collaborative community effort,

CRNBC has been working

closely with our partners to

enable and support nurses and

nurse practitioners to practise

safely and competently...

5

in accordance with the criteria outlined

in CRNBC’s Professional Standards.

The application, developed by CRNBC,

streamlines the process for gathering

multisource feedback from the nurses’

colleagues to produce an anonymized,

easy-to-use report that helps nurses

to identify areas of their practice for

professional improvement, and achieve

high practice standards and maintain

their competence.

Nurses are expected to complete

multisource feedback once every five

years as part of their ongoing quality

assurance requirements. Multisource

feedback will, over time, provide real-

time data to support measurement of

regulatory effectiveness.

Student and faculty engagement

Over the past year, CRNBC staff

engaged faculty and students in several

consultations to inform the development

of a new engagement program. The

program will enable student nurses to

broaden their understanding of how the

profession is governed, and what this

means for them and their obligations for

competent and safe care to the public.

To date, activities have revolved around

the identification of touchpoints

requiring knowledge translation to

support ongoing regulatory learning by

students and faculty. Ongoing program

development will include continued

consultation with students and faculty,

as well as incorporation of best practice

evidence. An early product to be pilot

tested this year is a letter and pamphlet

welcoming students to the profession,

introducing essential public protection

obligations. This will be followed by

content development and delivery with

provincial reach.

One nurse regulator

Over the 2017-18 period, the vision to

create a single nursing college in British

Columbia moved closer to becoming a

reality. Whereas 2016-17 was typified

by agreements, research and plans, the

last 12 months have seen many tangible

milestones and results.

The most important milestone was

the introduction of legislative changes

that formally allow the three nursing

regulators — College of Licensed

Practical Nurses of British Columbia,

College of Registered Nurses of British

Columbia, and College of Registered

Psychiatric Nurses of British Columbia

— to amalgamate and form a single

nursing college.

Royal Assent was granted by the B.C.

Legislature on Nov. 2, 2017 for Bill 10 —

the Health Professions Amendment Act.

The changes to the Health Professions

Act, which governs all the health

professions in B.C., passed through the

legislature quickly, confirming that

government shared the vision of the

three colleges to create the new regulator

for B.C. nurses.

With the successful passage of the Bill

through the legislature, the regulation

changes were posted for public feedback.

Recently these amendments were signed

into law by the Lieutenant Governor,

finalizing the name of the new college

— British Columbia College of Nursing

Professionals — and the amalgamation

date for the new college, which has been

set for Sept. 4, 2018.

Other important steps taken to create

the new regulator included:

• Finding a new physical location to

accommodate the three colleges. The

new college will be located at 200

Granville Street, Vancouver

• Listing and selling the CRNBC

property located at 2855 Arbutus

Street, Vancouver

• Developing bylaws that will guide

the work of the new regulator and

ensure that it can fulfill the regulatory

mandate to protect the public

• Initiating the search for the new

college’s first CEO.

The future of nursing regulation in B.C.

looks bright, as staff from the three

colleges will be able to continue their

tradition of collaboration, now as one

unified college.

When the new body comes into

existence, staff will work towards

streamlining regulatory services for

nurses, as well as other stakeholders

such as nurse educators and nurse

employers. Some of the goals of the new

college include providing greater clarity

6

around the professional roles and duties

of nurses; offering the public a single

point of contact for nursing regulation

in the province, and; creating a unified

regulatory voice for nursing in B.C. —

while respecting and maintaining the

four nursing designations.

New and revised scope of practice standards

The standards, limits and conditions set

by the College require regular review

to ensure they are appropriate for

guiding nurses in their practice, in line

with the current realities of the health

care system, always with the goal of

protecting the public.

In September 2016, the board approved

three significant revisions and updates to

the Scope of Practice for Registered Nurses

that were put into effect in 2017:

• Acting within Autonomous Scope

of Practice

• Acting with Client-specific Orders

• Giving Client-specific Orders

These changes included updates to the

language in the Scope of Practice for

Registered Nurses document to more

clearly reflect registered nursing’s

autonomous scope of practice. These

standards were also reviewed to

ensure they support interdisciplinary

communication and collaboration

among nurses, other health care

professionals, and team members in

meeting client needs when acting with

client-specific orders.

The Scope of Practice for Registered Nurses

standards were updated with the concept

of Giving Client-specific Orders. These

scope standards set out the requirements

when giving a client-specific order for an

activity within autonomous scope

of practice.

There were also updates made to the

Scope of Practice for Nurse Practitioners,

including revising the “Ordering

Diagnostic Tests and Managing Results”

standards to reflect a more principle-

based approach, and aligning definitions

within the Advanced Procedures and

Activities to align with the BC Medical

Quality Initiative.

Opioid treatment

The opioid crisis continues to impact

health care professionals in British

Columbia. As part of a responsive and

collaborative community effort, CRNBC

has been working closely with our

partners to enable and support registered

nurses and nurse practitioners to practise

safely and competently, and to support

people with opioid use disorders.

In April 2017, the board approved

rescinding the RN scope of practice

limits and conditions related to

compounding, administration and

dispensing of naloxone; and revisions

to the Dispensing Medications practice

standard for dispensing naloxone to treat

opioid overdose.

We also collaborated with the BC

Centre on Substance Use, College of

Physicians and Surgeons of BC, the

College of Pharmacists of BC, the B.C.

Ministry of Health and others, on

the new nurse practitioner standards,

limits and conditions. In June 2017, the

board approved these new standards,

limits and conditions, which set out

the requirements for both induction

(initiation) and continuation/

maintenance prescribing of opioid

agonist treatment for opioid use disorder.

These came into effect in February 2018,

to allow nurse practitioners to play a

more active role in treating people with

opioid use disorders.

Streamlining the ordering of controlled prescription pads

The Controlled Prescription Program

is a multi-stakeholder program (which

includes the Ministry of Health and

several health professions regulators) that

monitors the prescribing of controlled

drugs and substances to prevent forgeries

and reduce inappropriate prescribing.

7

The drugs listed in the Controlled

Drug Program Information and Drug

List require the use of a duplicate

prescription. CRNBC oversees the

provision of duplicate controlled

prescription pads to nurse practitioners.

In February 2018, and in collaboration

with the Ministry of Health, the College

announced an improved ordering

system to provide personalized duplicate

prescription pads for nurse practitioners

prescribing controlled drugs, substances

and methadone for opioid agonist

treatment.

2017-18 Budget

In December 2017, the CRNBC Board

approved the 2017-18 budget, which

included the first fee increase to

CRNBC’s portion of funds in over six

years. The board approved an increase

to the CRNBC registration renewal fee

of $98.55 for RNs and NPs. The increase

was due to a number of factors including

a significant increase in the cost of the

college’s regulatory work and preparing

for the amalgamation of the three

nursing regulators.

The co-creation of a new single nursing

college with CLPNBC and CRPNBC

and the move to a shared space is part of

CRNBC’s long-term strategy to mitigate

against significant fee increases in the

future. In addition, CRNBC has also

entered into a cost-sharing arrangement

for information systems and back office

services with a number of other health

regulators across Canada.

Committing to a safer health system for First Nations and Aboriginal People

In 2017, CRNBC made a commitment

and pledge to make the health care

system more culturally safe for First

Nations and Aboriginal people by

signing the Declaration of Commitment

to Cultural Safety and Humility.

On March 1, 2018, CRNBC Registrar

and CEO Cynthia Johansen was one of

23 B.C. health regulation leaders who

signed the Declaration of Commitment

to Cultural Safety and Humility. The

signing was accompanied by a ceremony

to honour the commitment of the health

regulators, which included a traditional

Blanket Ceremony, led by Elder Leonard

George (Səl i̓lwətaɁɬ First Nation).

The declaration, an initiative endorsed

by the First Nations Health Authority

and B.C. Ministry of Health, commits

CRNBC and other health regulators to

take action and develop processes that

will embed culturally safe practices

within all levels of health professional

regulation.

The commitment is just the first step

in the College’s effort to understand and

maintain cultural competency, as well

as safety and humility towards all

peoples, including First Nations and

Aboriginal people.

2016-17 Annual General Meeting

CRNBC held its annual general meeting

on June 16, 2017 at its Vancouver office.

Twenty-three registrants participated in

the meeting, including two who attended

by webcast.

The board chair, Mary Kjorven,

highlighted the accomplishments

achieved by the board and the College,

including the great strides made by

CRNBC and the College of Licensed

Practical Nurses of BC and the College

of Registered Psychiatric Nurses of BC

to create a single nursing regulator in

British Columbia.

The board chair also provided an

overview of the auditor’s report and

highlighted key points within the

financial statements.

The Registrar/CEO, Cynthia Johansen,

highlighted the work of the College to

serve the public and ensure their safety

through regulation of the profession,

including: CRNBC’s partnerships with

the nursing community, government

and stakeholders, as well as overall

improvements to the College’s core

regulatory processes across registration,

inquiry and discipline, policy, practice

and quality assurance.

No resolutions were submitted to the

2016-17 annual general meeting.

8

The College’s legal obligation is to protect the public through the regulation of

registered nurses and nurse practitioners. The College meets this obligation by:

• Setting standards for practice and registration

• Supporting nurses to meet practice and registration renewal standards, and

• Acting if standards are not met.

Nursing in British Columbia has been a self-regulating profession since 1918.

Regulation helps to protect the public by ensuring that professional care or service

received by the public is provided by competent and ethical individuals who meet

the standards society views as safe and acceptable.

Through the College, registered nurses — as a group of professionals — have

the authority and responsibility for self-regulation and governing the practice of

registered nursing. In turn, the College is responsible for registering and regulating

registered nurses and nurse practitioners.

Registered nurses and nurse practitioners in B.C. participate in self-regulation

through the election of registered nurses and nurse practitioners to the CRNBC

Board, participation in annual general meetings, membership on committees,

providing input on standards development and participating in other college

activities. The board also includes members of the public, bringing other

professional perspectives to the table.

3Nursing in the public interest

The College of Registered

Nurses of British Columbia

is the regulatory body for

registered nurses and nurse

practitioners in British

Columbia. The College

receives its authority from the

Government of B.C. through

the Health Professions Act.

2855 Arbutus Street

Vancouver, British Columbia

Canada V6J 3Y8

Tel: 604.736.7331

Toll-free: 1.800.565.6505

www.crnbc.ca

9

Communications

Email and newsletters

As part of our commitment to being a

relational regulator, we work to improve

communication and engagement with

nurses and other stakeholders, including

opportunities to provide feedback and

two-way communication. Email is our

primary method for notifying nurses

and others of information relevant to the

regulation of registered nurses and nurse

practitioners.

Electronic newsletters published

in 2017-18

In 2017-18 we sent 11 issues of Nursing

Matters, our registrant newsletter that

delivers current regulatory information

that nurses need to know for their

practice, including regulatory changes,

news and case studies. Additionally, we

tailored each issue to create editions for

registered nurses, nurse practitioners,

and nurses with certified practice

designation. All current newsletters are

posted on our website.

Regulation Matters is a quarterly

subscription-based newsletter emailed

to employers of registered nurses

and nurse practitioners. It includes

timely information about nursing

regulation that may have an impact on

employers. Four issues were sent

in 2017-18 and are posted on the

CRNBC website.

Nurses with the certified practice

designation were sent Decision

Support Tools notification along

with a summary of key changes in

December 2017.

CRNBC website

In 2017-18, the CRNBC website traffic

grew seven per cent, up to 987,000

visits over the 12 months. Traffic to

the website translated into more than

2,520,000 page views, up 10 per cent

from the previous period.

Desktop computers continue to be the

preferred device (67 per cent) used to

visit our website. However, the mobile

segment grew to represent about 27

per cent of the web traffic, growing by

16 per cent.

4Resources and services

As part of our commitment

to being a relational

regulator, we work to

improve communication and

engagement with nurses and

other stakeholders...

CRNBC Nursing Matters electronic newsletter

10

Most CRNBC website visitors originate

from Canada and predominantly from

British Columbia. However, we also

receive visitors from all over the world.

The top 5 origin of website visitors from

outside of Canada

Country %

United states 9

United Kingdom 2.5

australia 1.5

Philippines 1.5

India 1

Professional liability protection fees

Professional liability protection is

a registration requirement for all

practising registrants. In 2016, The

Canadian Nurses Protective Society

(CNPS) began providing professional

liability protection for all CRNBC

practising registrants.

A five-year supplemental fee of $29.25

was required to bring B.C. registrants’

insurance investment to the same level

as other provincial registrants who

have been paying into CNPS for years.

This supplemental fee ensured CRNBC

registrants are fully protected, even for

liabilities prior to 2016.

This fee was scheduled to end after five

years in 2021. However, in December

2017, CRNBC paid for the remainder

of the CNPS supplemental fee on

behalf of all registered nurses, nurse

practitioners and employed student

nurses. Registrants of the College will no

longer need to pay the supplemental fee

for CNPS, meaning their professional

liability protection is now in line with

other nurses in Canada.

Quality Assurance program

CRNBC’s Quality Assurance (QA)

Program supports CRNBC’s mandate

to regulate in the public interest. The

QA Program incorporates CRNBC’s

regulatory philosophy, is proactive,

and supports nurses to meet high

practice standards for the provision of

safe, competent and ethical care. QA

Program oversight is provided by the

QA Committee, which determines the

intervals and results of nurses’ periodic

assessments such as the NP onsite

peer review, multisource feedback and

prescription review.

The QA Committee also reviews

prescribing practices for selected

drugs or drug classes to identify

trends or issues to be considered for

communication to registrants and

in the development of standards of

practice and professional ethics. The

QA Program continues to work closely

with our partners, the College of

Physicians and Surgeons of BC, College

of Pharmacists of BC, BC Centre on

Substance Use, Ministry of Health, as

well as NPs and employers, to establish

and implement prescription review

policy and operational processes that

reflect provincial research, experience

and evaluation.

The QA Program also efficiently

administers, in collaboration with

the Ministry of Health and College of

Physicians and Surgeons of BC, NPs’

access to the BC Controlled Prescription

Program duplicate prescription pads for

the prescribing of controlled drugs and

substances and methadone maintenance

treatment.

Quality Assurance requirements

that must be completed annually by

registered nurses and nurse practitioners

include self-assessment, seeking and

receiving peer feedback, creating

and implementing a professional

development plan and evaluating

the impact of their learning on their

practice. This cycle of activities, which

is incorporated into all QA assessments,

guides nurses to identify and act on

opportunities for their professional

development and demonstrates to the

public how nurses responsibly maintain

and improve their competence and meet

CRNBC’s Standards of Practice.

Nurse practitioners also complete

an onsite peer review two years after

acquiring their initial registration. The

onsite review provides a structured

way for nurse practitioners to receive

feedback from a peer assessor,

through the review of recent client

documentation and identification of

professional development opportunities

and strategies developed by the NP

and the assessor to address these

opportunities. In some cases, the

QA Committee will also make

recommendations or recommendations

and follow-up to further support NP’s

strategies for improvement.

In 2017 CRNBC conducted a second

pilot of multisource feedback, where

1005 registrants were selected to receive

online, anonymized feedback from

colleagues. Multisource feedback is

a central feature of My Professional

Plan, a CRNBC web app that helps

nurses manage their quality assurance

CRNBC website homepage

11

requirements and professional

development plans more effectively.

In June 2017, 553 nurses and 23 nurse

practitioners completed the pilot

and received constructive feedback

from their colleagues on where they

are meeting standards, and on areas

where they can improve. As a result of

this second successful pilot, beginning

in 2018 and every year thereafter,

approximately 20 per cent of all

practising registrants will be selected

to complete multisource feedback at

five-year intervals.

Registrants invite their colleagues

(nursing and non-nursing) to provide

feedback via an online questionnaire.

At the end of the multisource feedback

process, registrants will receive

their anonymized report and can

seek support from CRNBC Quality

Assurance nurse advisors, who

are available to coach and support

registrants with their professional

development action plans.

For the January 2018 implementation

of multisource feedback, 7824

registrants were selected. By the end

of the 2018-19 registration renewal

period, 72 per cent of those selected

had successfully completed the

process after receiving feedback from

at least three colleagues or more.

Continuing professional development

and the principle of lifelong learning

are important to maintaining

competence. We continue to provide

and refine tools and resources

to assist nurses in implementing

and evaluating their professional

development plans. Our web-based

learning resources help nurses and

employers to understand and apply

the standards of practice in day-to-

day practice and include:

• 14weblearningmodulesandan

onlinetutorial: These modules

stimulate systematic, reflective

thinking and understanding

of how the standards provide

direction and guidance with

practice. Together, these

learning modules were viewed

approximately 8,000 times during

2017-18:

- A new module, highlighting

the application journey for

internationally educated nurses

seeking registration in B.C., was

launched in March 2017

- In January 2018, we launched

our revised module,

Understanding the Scope of

RN Nursing Practice, reflecting

significant changes to the RN

Scope of Practice Standards.

• 42casestudiesonavariety

oftopicssuchasprofessional

boundaries,dutytoreport,

consent,confidentiality,scopeof

practiceandsocialmediause: In

2017-18 we developed eight new

case studies; these include How

do I know if I have a conscientious

objection? and Protecting vulnerable

seniors in your care.

- We also updated four other case

studies to reflect current practice

and changes to standards. These

case studies, along with other

practice resources and tools,

support standards application

and reflection on practice and

are featured in Nursing Matters

each month.

Standards of practice and regulatory practice support

CRNBC sets the standards of practice

for registered nurses and nurse

practitioners in British Columbia.

We collaborate with the CRNBC

Board, registrants, health regulators,

employers, the government and other

external stakeholders to update or

create standards that address changes

in practice and legislation. The policy

program at CRNBC works closely

with the College of Licensed Practical

Nurses of BC and the College of

Registered Psychiatric Nurses of BC in

standards development.

Projects of note for CRNBC’s policy

and practice programs in 2017-18

include updates and revisions to the

RN and NP standards of practice,

focussed work on medication

management including nurse

prescribing, clarification of roles of

nurses when working with medications

not scheduled provincially or federally,

as well as continued attention to

medical assistance in dying and opioid

agonist therapy as provincial-level

approaches and efforts continue to

develop and evolve. CRNBC is also

working as part of a joint project led

by the B.C. Ministry of Health related

to defining terms such as delegation,

assignment and supervision.

To support the translation of the

standards of practice into day-to-

day nursing practice, our regulatory

practice consultants are available

to support registered nurses, nurse

practitioners, employers and other

stakeholders to understand and apply

the regulation, legislation and the

standards of practice to diverse and

complex practice situations.

12

Registration

Anyone wanting to practise as a

registered nurse or nurse practitioner

in B.C. must have current practising

registration with CRNBC. Registered

nurses and nurse practitioners must

meet annual requirements and renew

their registration each year.

To become registered, an applicant

must meet all registration requirements,

including passing the required

examination(s). Applicants who do not

meet all requirements may be granted

provisional registration, which allows a

person to work as a nurse while meeting

outstanding requirements. Applicants

granted provisional registration are

assigned conditions that must be met

to be eligible for practising registration.

Provisional registration is granted only

if the College is satisfied that the nurse

can practise safely while meeting the

conditions.

Where your fees go

Operations $6,400,000 30%

CNPSRetroactiveCoverage $3,600,000 17%

InquiryandDisciplineActivities $2,500,000 11%

ManagingourRegistry $2,000,000 9%

CollegeOversight $1,800,000 8%

NurseQualityAssurance $1,400,000 6%

PracticeSupport $1,300,000 6%

Amalgamation $1,100,000 5%

EducationReview,Exams&NewApplicants $900,000 4%

RegulatoryPolicyDevelopment $800,000 4%

Total $21,800,000 100%

EducationReview,ExamsandNewApplicants

ManagingourRegistry

AmalgamationNurseQualityAssurance

RegulatoryPolicy

Development

CNPSRetroactiveCoverage

Operations InquiryandDisciplineActivities

CollegeOversight

PracticeSupport

*ARNBCandCNPSannualduesarecollectedandremittedseparately

Comparison of renewal fees year-over-year (RN practising)

2015-16 2016-17 2017-18

ARNBC / CNA 98.82 110.55 110.55

CRNBC 351.36 350.40 448.95

Total 450.18 460.95 559.50

Number %

Philippines 79 32.24%

United States 57 23.27%

India 48 19.59%

Australia 14 5.71%

United Kingdom 7 2.86%

Top 5 countries of initial education for international RN new registrants in 2017-18

13

New RN registrants by registration year and initial education

2015-16 2016-17 2017-18

BC Grad 1,205 1,483 1,489

CA Grad 132 156 196

CA Applicant 595 687 601

IEN 273 214 245

RN TOTAL 2,205 2,540 2,531

New NP registrants by registration year and initial education

2015-16 2016-17 2017-18

BC Grad 22 48 44

CA Grad 4 17 11


IEN 1 4 2

NP TOTAL 33 86 68

New RN certified practice registrants by registration year and initial education

2015-16 2016-17 2017-18

BC Grad 95 115 111

CA Grad 3 2 2


IEN 5 12 6

TOTAL 132 164 149

Registrant breakdown as of Feb. 28, 2018

*RN-certifiedpracticemusthaveavalidRNpractisingstatus.

**Totalsdonotincluderegistrantswhohavelimitsandconditionsplacedontheirpractice,orhaveasuspendedregistration.ThisinformationcanbefoundinSection5:Complaintsprocess.

BC Grad:newgraduateofaB.C.nursingprogram

CA Grad:newgraduatesinanotherjurisdictioninCanada

CA Applicant:practisingRNinanotherjurisdictioninCanada

IEN:internationallyeducatednurse

Definitions:

RN & NP registration applications received by registration year (submitted by applicants)

2015-16 2016-17 2017-18

BC Grad 1,334 1,395 1,350

CA Grad 192 207 222


IEN 325 529 494

TOTAL 2,522 2,973 2,739

Feb29,2016 Feb28,2017 Feb 28, 2018

Registerednurses

Practising 36,400 37,699 38,728

Provisional 341 301 217

Non-Practising 3,079 2,136 1,733

RN-certified practice* 1,013 1,086 1,152

Nursepractitioners

Practising 339 413 476

Provisional 26 13 9

Non-practising 24 29 27

Licensedgraduatenurses

Practising 52 46 39

Non-practising 4 2 2

Employedstudentnurses

Practising 756 824 794

TOTAL** 42,034 42,549 43,177

14

As part of our mandate to protect the

public, CRNBC investigates complaints

about registered nurses, nurse

practitioners and licensed graduate

nurses.

Investigations are overseen by the

Inquiry Committee, an impartial

decision-making committee made up

of registered nurses and members of the

public. The Inquiry Committee also has

the authority to initiate investigation on

its “own motion” upon receiving certain

types of information, such as notice that

a registrant has failed to meet the terms

of a current consent agreement.

The nature of an investigation

depends on the allegations. Common

investigative steps include:

• Obtaining additional information

from the complainant

• Obtaining medical documents

• Conducting witness interviews

• Reviewing relevant health care policies

and procedures.

In every case the registrant is provided

an opportunity to review the evidence

and respond to the allegations. This

is required by law. In most cases,

the complainant is then given the

opportunity to review and comment

on the registrant’s response to the

complaint.

Registrar’s actions

Upon review of a written complaint, the

Registrar is authorized under Section

32 of the Health Professions Act (the

Act) to dismiss the complaint or request

remedial actions of the registrant in

specific circumstances, including when

the subject matter of the complaint

would not ordinarily result in limits or

conditions on practice, or suspension.

The Inquiry Committee reviews all

decisions made by the Registrar and can

direct additional investigation if deemed

necessary.

In 2017-18, a total of 46 decisions were

made by the Registrar. Three complaints

resulted in registrant agreement to

complete remedial action. Letters of

impact or expectation were provided

5Complaints process

Investigations are overseen by

the Inquiry Committee, an

impartial decision-making

committee made up of

registered nurses and members

of the public.

In every case the

registrant is provided

an opportunity to

review the evidence

and respond to the

allegations.

15

to registrants in seven cases. Two cases

were concluded because the complaints

were not serious and the individuals

had relinquished registration. Thirty-

four complaints were dismissed as

outside regulatory jurisdiction, or not

warranting regulatory intervention

to protect the public. The Inquiry

Committee reviewed and approved the

46 decisions.

Inquiry Committee investigation

In the majority of cases, the Inquiry

Committee investigates complaints.

In 2017-18, the Inquiry Committee

directed further investigation into 164

matters. Complaints were received from

employers, colleagues and members

of the public. Investigation was also

directed on the Inquiry Committee’s

own motion.

Investigations directed by the Inquiry

Committee in 2017-18

employer 98

own motion 35

Public 18

Peer/colleague/health professional 13

Interim action to protect the public

In urgent circumstances, the Inquiry

Committee is authorized — following

a legal proceeding under Section 35 of

the Act — to order limits or conditions

on, or suspend, a nurse’s registration, if

necessary, to protect the public during

the course of an investigation or pending

a discipline hearing.

In many cases, registrants enter

voluntary undertakings to protect the

public while CRNBC investigates and,

for this reason, the committee is not

required to impose additional measures

by way of interim order. For example,

more than 25 per cent of registrants

currently under investigation are not

entitled to practise nursing due to

voluntary interim agreements to become

non-practising registrants, or because

they opted not to renew practising

registration. Many registrants have

agreed to other risk mitigation terms,

such as limiting their area of practise

and disclosing allegations to all current

employers. The Inquiry Committee did

not resort to imposing an interim order

in the 2017-18 period. One registrant

remains suspended pursuant to a Section

35 order made in the previous year, while

investigation continues.

Inquiry Committee dispositions

When an investigation is complete,

the Inquiry Committee reviews the

complaint and evidence to direct the

appropriate outcome.

In 2017-18, the Inquiry Committee

convened on 88 occasions to review

complaint files related to 165 complaints

(including the Registrar’s decisions),

with the following directions:

• 82 no further action

• 11 other actions deemed appropriate

to resolve the matter by the Inquiry

Committee

• 7 investigations were closed because

the registrant allowed practising

registration to expire and the

complaint would be considered by

the Registration Committee should

reinstatement of registration be sought

• 62 consent resolutions were obtained,

which included as the most significant

intervention:

- 9 suspensions (may have conditions

and limits on return and other

terms)

- 21 limits and conditions (may have

educational and other terms)

- 1 public reprimand (may have


- 3 voluntary relinquishment of

registration

- 10 reprimands (may have


- 9 educational or regulatory practice

consultation programs

- 4 medical monitoring or counselling

terms (may have educational and

other terms)

- 5 agreements not to repeat.

16

• 3 citations for hearing by the

Discipline Committee were directed.

Two of these citations were cancelled

following consensual resolution.

Hearings by the Discipline Committee

Following the investigation of a written

complaint, the Inquiry Committee may

direct the Registrar to issue a citation for

a discipline hearing. This is most likely

to occur when the Inquiry Committee

determines that a competency, conduct,

or fitness concern impacting practice is

supported by evidence, but the registrant

denies the allegations, or — despite

admission — is unwilling to enter an

appropriate resolution agreement to

remedy the matter in the public interest.

In this case, the competency, conduct,

or fitness concern will be evaluated by

the Discipline Committee in a hearing

setting in which witnesses are called to

testify, and documentary evidence is

presented.

Discipline Committee members work

in panels of three to conduct hearings.

The Discipline Committee weighs the

evidence to make factual findings about

what happened and determine whether

and what type of regulatory intervention

in a registrant’s practice is required to

ensure public safety.

Five discipline hearings were held in

2017-18:

• One citation charged a registrant with

removing and retaining confidential

client documents

• Another charged a registrant with

failure to employ aseptic techniques

• A third charged a registrant with

entering a sexual relationship with a

client soon after discharge.

All three hearings have concluded,

but the decisions of the Discipline

Committee remain outstanding.

Two additional hearings took place

when the College learned that other

jurisdictions had found CRNBC

registrants guilty of unprofessional

conduct when working in another

province. One of these hearings

resulted in the imposition of limits and

conditions in British Columbia.

Monitoring compliance

CRNBC staff monitor registrants’

compliance with the remedial actions,

limits and conditions on registration

agreed to in consensual resolution or

imposed by order. On Feb. 28, 2018,

CRNBC was monitoring 145 registrants

for compliance with consent agreements.

When information is received that

demonstrates a registrant may not be

in compliance with the conditions of

their consent agreement or other orders,

staff prepare a report for review by the

Inquiry Committee for consideration

of authorizing an “own motion”

investigation.

Review by Health Professions Review Board

When the Inquiry Committee directs

a final disposition of a complaint, the

complainant is advised of the outcome.

In accordance with Section 50.6 of

the Act, a complainant has the right

to request that the Health Professions

Review Board conduct a review of the

adequacy of the investigation and the

reasonableness of the disposition.

A review of the Inquiry Committee’s

decision was requested by 10

complainants in 2017-18. Two

applications for review were dismissed

by the Health Professions Review

Board. Eight remain open at this

time. Four applications from the

prior fiscal year were also dismissed

in 2017-18. No applications for review

in 2017-18 determined that a CRNBC

investigation failed to meet adequacy or

reasonableness standards.

17

StephanieBuckingham,registrantmember–

at-large,NanooseBay

Retired university-college professor, Bachelor

of Science in Nursing Program, Human Health

and Services Department, Vancouver Island

University

RobCalnan,registrantmember–urbanand

boardchair,CobbleHill

Coordinator of Site Operations and Patient

Flow, Victoria General and Royal Jubilee

Hospitals (casual); former co-chair of ARNBC

and past president and chair of CNA and

RNABC.

BrendaCanitz,registrantmember–at-large,

Victoria

Consultant; health care researcher, policy and

education; adjunct faculty, sessional lecturer,

University of Victoria School of Nursing and

School of Public Health and Social Policy.

ColeenDriscoll,registrantmember–rural,

Nelson

Registered nurse, Daycare/Pre-surgical

screening, Kootenay Lake Hospital, Interior

Health

SheilaFarrell,registrantmember–urbanand

boardvice-chair,Kelowna

Clinical practice educator, Health Services for

Community Living, Interior Health

ColleenHay,registrantmember–rural,

DawsonCreek

Registered nurse (casual), Emergency Room,

ICU and Post-Anesthetic Recovery, Northern

Health

MaryKjorven,registrantmember–ruraland

boardchair,Peachland

Clinical nurse specialist, Gerontology, nurse

continence advisor, ALC Support Team,

Interior Health and clinical instructor, UBC

Department of Medicine and associate member,

Division of Geriatric Medicine.

GwenHarrington,registrantmember–rural,

PouceCoupe

Primary care nurse, Dawson Creek Health unit

– Public Health, Northern Health

HelenJackson,registrantmember–urban,

Burnaby

Certified Practice (STI), Nurse educator/Clinic

Nurse, Langara College-BCCDC STI - Clinic-

Surrey Youth Clinic

DavidKruyt,publicmember,CampbellRiver

VP Finance, AllWest Insurance Services Ltd.

MarilynLoewenMauritz,publicmember,

Vancouver

General Counsel and corporate secretary,

International Forest Products Ltd.

BACK ROW (FROM LEFT): David Kruyt, Brenda Canitz

MIDDLE ROW (FROM LEFT): Helen Jackson, Michelle Mollineaux, Stephanie Buckingham, Rob Calnan (board chair), Stan Marchuk

FRONT ROW (FROM LEFT): Coleen Driscoll, Jocelyn Stanton, Gwen Herrington, Colleen Hay, Cynthia Johansen (Registrar/CEO)

NOT SHOWN: Marilyn Loewen Mauritz, Sheila Farrell, Rick Turner, Tricia Marck, Mary Kjorven

TriciaMarck,registrantmember-at-large,

Victoria

Professor and dean, Faculty of Health and Social

Development, University of Victoria

StanMarchuk,registrantmember–urban,

Vancouver

Nurse Practitioner, St. Paul’s Hospital Renal

Program, Providence Health Care

MichelleMollineaux,publicrepresentative,

Vancouver

CEO and co-founder of KoolProjects Media Inc.

JocelynStanton,publicmember,Victoria

Previously communications advisor for Island

Health and chief of staff to the minister of

Health in B.C.

RickTurner,publicrepresentative,Kamloops

President of the Kamloops Aboriginal

Friendship Society Board, former co-chair of

the BC Health Coalition and past president of

the Kamloops District Teachers Association

6Our board

18

Rob Calnan was elected CRNBC

board chair in September 2017, having

joined the board earlier in the year.

A registered nurse, Rob continues to

maintain his nursing practice and is

currently coordinator of site operations

in acute care facilities in Duncan and

Victoria, B.C. He also brings a wealth

of leadership experience; Rob has held

senior roles with the Association of

Registered Nurses of BC, the Canadian

Nurses Association, and even CRNBC’s

predecessor organization, the Registered

Nurses Association of BC (RNABC).

This gives Rob a unique perspective on

his role as board chair for CRNBC.

As a nurse who has worked closely with

the College over a number of years, Rob

has seen the organization change from

a combined association and regulator

known as RNABC, to regulator-only as

CRNBC. And now, in his role as board

chair for CRNBC, Rob is helping the

college prepare for its next chapter: as

British Columbia College of Nursing

Professionals (BCCNP), a single nursing

regulator for licensed practical nurses,

nurse practitioners, registered nurses,

and registered psychiatric nurses.

Rob appreciates the value of a single

regulatory body for nurses in B.C.

“Nurses are collaborative by nature, and

bringing together the expertise of the

three colleges — CLPNBC, CRNBC and

CRPNBC — will have a powerful impact

on future regulation,” he said. “Not

to mention the broader goals a single

regulatory body will be able to achieve,

such as clarifying scopes of practice

for the four nursing designations,

creating a single point of contact for

nurses and the public alike, as well as

managing costs and using registrants’

fees more efficiently. These are just a few

examples of how the new college will

have a positive influence on the nursing

community.”

Rob recognizes that the college’s most

important duty is to fulfill its mandate

to protect the public. “The staff of the

college have done a phenomenal job

planning for the future, and they have

done so while maintaining a laser-sharp

focus on the core regulatory work that is

the foundation of CRNBC.”

In 2017-18, CRNBC worked on a number

of complex cases that ranged from

7Board chair profile: Rob Calnan

dealing with sexual misconduct and

financial abuse, to privacy breaches,

the concealment of errors and other

troubling patterns of patient neglect.

“CRNBC’s commitment to investigating

these cases and ensuring the public is

protected is one of the most satisfying

aspects of my role,” Rob said. “CRNBC’s

staff have handled some very serious

issues with professionalism and care.

When we move to the next phase, as a

single regulatory body, we will be well

positioned to continue this difficult, but

critical work.”

Rob’s past experience with CRNBC gives

him confidence for the future. “There

is still a lot of work to be done as we

prepare to co-create BCCNP with the

other two colleges,” he said. “But I know

the history of this organization, and the

talent and commitment of our people. I

have no doubt that we will continue to be

successful as a single regulator in 2018-19

and beyond.”

19

Board Review Panel

Committee Members: Stephanie

Buckingham, Colleen Hay, Coleen

Driscoll, Sheila Farrell, Dave Kruyt,

Brenda Canitz, Stan Marchuk, and

Michelle Mollineaux.

The College Bylaws provide that the

board may meet in panels to review

specific issues related to the granting

of certified practice registration, the

approval of a fourth or further writing of

an examination required for registration,

and a review of a decision made by

the Nurse Practitioner Examination

Committee regarding an applicant’s

score on the Objective Structured

Clinical Examination.

Effective Nov. 1, 2016, there is no limit

to the number of times candidates can

write the NCLEX-RN, as long as they

have a valid CRNBC application. This

change was made to harmonize exam

administration policy, by regulators,

across the country. The Board Review

Panel will only review requests to re-take

NCLEX-RN for a fourth or additional

time if the Registrar brings forward

applicants who have circumstances

which, in the Registrar’s opinion,

warrant review by the board. The Board

Review Panel will continue to meet as

required to review requests for a fourth

or greater attempt at the Objective

Structured Clinical Examination.

In 2017-18, the Board Review Panel did

not meet as there were no requests for a

fourth or greater attempt at the Objective

Structured Clinical Examination, nor

any other request requiring review by

the Panel.

Certified Practices Approval Committee

Committee Members: Janine Lennox

(Co-Chair), Susanne Niewiadomski

(Co-Chair), Virginia Ann Jacklin, Helen

Jackson, Sherry Katz, Gulshan Khudra,

Janet Murphy, Avtar Dhillon, Wanda

Pierson, and Blake Reynolds.

The Certified Practices Approval

Committee approves the Decision

Support Tools (DSTs) and reviews

certified practice courses according

8Annual committee reports

Committee decisions... are

made in the public interest, to

sustain public confidence in

nurses’ self-regulation and to

support nurses to meet high

practice standards in order that

the public experience nurses to

be safe, competent and ethical

practitioners.

20

to standards and indicators for

certified practice education, and

makes recommendations to the board

regarding approval. The committee

also reviews and recommends policies

and procedures pertaining to certified

practice to the board.

The committee held four meetings

in 2017-18. The committee reviewed

and approved 16 DSTs based on the

recommendations from Think Research,

in accordance with the agreement

between CRNBC and Think Research.

The CRNBC Certified Practices Decision

Support Tool (DST) Review Policy was

reviewed, and proposed changes were

submitted to the board for approval. Two

certified practice courses were reviewed

and a recommendation was made to the

board for approval.

Discipline Committee

Committee Members: M. (Star) Mahara

(Co-Chair), Tracey Martindale (Co-

Chair), Sheila Cessford (Vice-chair), Kira

Antinuk, Lori Charvat, Brenda Downey,

Robert Halliday, Vesna Jojin, Laurie

Ledger, Marilyn Loewen Mauritz, Shirley

Nakata, Catharine Schiller, Lorine Scott,

and Dr. Thomas Ward

Following the investigation of a

written complaint under Part 3 of the

Health Professions Act, the Inquiry

Committee may direct the Registrar to

issue a citation for a discipline hearing.

This is most likely to occur when the

Inquiry Committee determines that a

competency conduct, or fitness concern

impacting practice is supported by

evidence, but the registrant denies

the allegations, or despite admissions

is unwilling to enter an appropriate

resolution agreement to remedy the

matter in the public interest. In this

case the competency, conduct, or

fitness concern will be evaluated by

the Discipline Committee in a hearing

setting in which witnesses are called

to testify, and documentary evidence

is presented.

Discipline Committee members work

in panels of three to conduct hearings.

The Discipline Committee weighs the

evidence to make factual findings about

what happened and determine whether

and what type of regulatory intervention

in a registrant’s practice is required to

ensure public safety.

Two hearings that were started in

2016-17 concluded in 2017-18, and an

additional five discipline hearings were

commenced in 2017-18.

Hearings commenced in 2016-17 and

concluded in 2017-18:

One citation alleged a registrant failed

to respond to CRNBC communications

regarding a complaint about her

practice. After a hearing, the Discipline

Committee found that the registrant had

committed unprofessional conduct and

made the following order:

• The Registrant will be suspended until

the later of two events: the expiry of

a three-month suspension period

or until such time as the registrant

delivers to the Inquiry Committee a

substantive written response regarding

the complaint

• Costs in the amount of $8,027.75

payable to the College by Dec. 31,

2017, and

• Publication of the committee’s order

pursuant to s. 39.3(1) of the Health

Professions Act, as well as notification

to registrants and regulatory bodies

governing registered nursing in other

Canadian jurisdictions.

The second citation alleged a registrant

accepted an appointment of power

of attorney and personal financial

benefits from two individuals to

whom she provided nursing care. The

Discipline Committee determined that

the registrant was providing nursing

care to an elderly client and that it was

professional misconduct for her to have

accepted the power of attorney and title

to the mobile home from the client. The

Discipline Committee ordered:

• A fine of $17,500

• Costs of $16,535.69

• A reprimand, and

• Publication of the committee’s order

pursuant to s. 39.3(1) of the Health

Professions Act, as well as notification

to registrants and regulatory bodies

governing registered nursing in other

Canadian jurisdictions.

The Discipline Committee also indicated

that if she were still registered they

would have cancelled registration and

imposed strict limits on her practice

were she ever to reinstate.

Hearings Commenced in 2017-18

A citation alleged that between 2003

and 2012, a registrant took and retained

Health Authority documents which

referenced staff and patients and

contained third-party information.

Further, she declined to return the

documents to the Health Authority and

then used certain documents as exhibits

in a human rights complaint. To date the

documents in question continue to be

retained by the registrant. The Discipline

Committee determined that the

registrant’s conduct was unprofessional

and contrary to the standards expected

of a nurse and ordered the following:

21

• A six-month suspension (which

could be reduced by one month) if

the registrant returns the documents

within 30 days of receiving the

panel’s decision

• The suspension will not be lifted

until the registrant returns the

documents in accordance with the

Discipline Committee’s order

• Also, the suspension will not be

lifted until the registrant meets

the condition of completing

several courses and attends 3–5

meetings with a practice consultant

satisfactory to the Registrar

• The issuance of a reprimand

• As a condition of practice, for

a period of 24 months after the

conclusion of her suspension, provide

any person or institution that

employs the registrant, a copy

of the Discipline Committee’s

reasons for decision and order. And

at the end of the 24-month period

provide a list to the College of every

person or institution that employed

her and confirmation that the

reasons for the decision and order

were provided to them

• Costs of $34,251.34 to be paid by

Sept. 1, 2018, and

• Publication of the committee’s

order pursuant to s. 39.3(1) of

the Health Professions Act, as

well as notification to registrants

and regulatory bodies governing

registered nursing in other Canadian

jurisdictions.

In February and March 2018, CRNBC’s

Discipline Committee commenced a

hearing regarding allegations about a

registrant’s sub-standard practices in

wound care.

In February and March 2018, CRNBC’s

discipline committee commenced

a hearing regarding the allegations

that a registrant failed to maintain

nurse-client boundaries with a

recently former client by engaging in a

romantic/sexual relationship.

s. 39.1 Health Professions Act Hearings

The College regularly receives

notifications from other Canadian RN

regulators about disciplinary outcomes

of their registrants. On occasion the

College receives notifications about

individuals who are registered in

another Canadian jurisdiction as well

as with CRNBC. In 2017-18 CRNBC

received two such notifications and the

Discipline Committee convened two

hearings in writing pursuant to s. 39.3 of

the Health Professions Act.

In one case the Discipline Committee

determined that no action was required

by CRNBC as the discipline and

remedial actions imposed by the other

jurisdiction were sufficient and the nurse

had shown insight. However, in the case

of another registrant, the Discipline

Committee found that due to serious

competency concerns, it was necessary to

impose a number of limits to protect the

public in British Columbia.

Early Intervention Program Health (EIPH) – Inquiry Sub-Committee

Committee Members: Damen De leenheer

(Chair), Judy Chorney, (Co-Chair), Don

Dixon (Co-Chair), Hilary Planedin,

Sharon Thomson, and Betty Jo Tunks.

The Inquiry Sub-Committee (EIPH)

works in panels of three to review

health information about registrants

with an ailment that could, but has not

yet, impacted their ability to provide

safe patient care. The panel reviews

information electronically and by

teleconference in order to establish

agreements with registrants permitting

CRNBC to receive information about the

health monitoring protocals established

in their employment relationships.

There are currently 97 active EIPH

cases. Between March 21, 2017 and

Feb. 28, 2018 the EIPH Sub-Committee

concluded 30 agreements based on the

registrants’ successful completion of the

terms of their EIPH agreement.

CRNBC continues to collaborate with

health employers and registrants in order

to identify and intervene in cases in

which an emerging health issue may lead

to negative impacts in the workplace.

22

Education Program Review Committee

Committee Members: Kristine

Weatherman (Chair), Dr. Landa

Terblanche (Vice-chair), Nicholas

Fitterer, Dr. Darlaine Jantzen, Virginia

Jacklin, Cat Martin, Edna McLellan,

Dianne Millette and Dr. Esther Sangster

Gormley.

The Education Program Review

Committee (EPRC) reviews

nursing education programs and

qualifying courses required by

applicants for registration and makes

recommendations about whether the

board should recognize them for the

purpose of registration, and any terms

or conditions of recognition. The

committee also regularly reviews and

recommends policies and procedures

pertaining to the review of nursing

education programs and courses.

Nursing Education Programs/Courses reviewed

Registered nurse 3 baccalaureate Program

Registered nurse Qualifying 4 Courses

The committee held four meetings for

the above reviews and to consider its

processes for applying key policies,

including risk assessment of any

program/course deficiencies. The

EPRC implemented revised guidelines

completed in 2016.

Guidelines supplement board policy for

the purposes of facilitating the program

review process. EPRC found the goals

of the revisions were met, that is, they

clarified the evidence EPRC requires in

program self-evaluation reports, and

they streamlined the submission of the

reports by educational institutions.

Finance and Audit Committee

Committee Members: Dave Kruyt

(Chair), Mary Kjorven (Vice-Chair), Barb

Crook, Marti Harder, Gwen Herrington,

Stephanie Buckingham, and Sheila

Farrell.

The Finance and Audit Committee

advises the board on the needs of

the College in regard to financial

administration and the financial

implications of board decisions; the

application of legislative, regulatory

and other financial requirements

to the College; and financial risk

management and audit issues related

to the administration of the College. In

addition, the committee recommends,

for board approval, financial policies

essential to the financial administration

of the College.

Recommendations from the Finance and

Audit Committee include:

• Approving updates to financial

policies

• Approving the 2017-18 audited

financial statements

• Approving operational and risk

budgets for the 2018-19 fiscal year

• Approving changes to fees.

Inquiry Committee

Committee Members: Linda Nelson

(Chair), Jim Hunter (Vice-Chair),

Richard Walker (Vice-Chair), Meghan

Shannon (Vice-Chair), Christina

Lumley(Vice-Chair), Deborah Austin,

Landon James, Tracy Christianson,

Brenda Canitz, Jason Faulkner, Shelley

Scarlett, Gerry McIntyre, Joshua Tan,

Kevin Ryan, Leonard (Jim) Aldrich,

Catherine Czechmeister, Jackie Demmy,

Lynn Dowsley, Patty Garrett, Alison

Swalwell-Franks, Daphne Williscroft,

Michelle Mollineaux, Graham

Brownmiller, Graham Garner and Gary

Noble, Enid O’Hara, David Williams,

Joelle Berry, and Caroline Ehmann.

Inquiry Committee members work in

panels of three to review complaints

about registrants that are received

by CRNBC. A member of the public

participates in every panel meeting.

23

The committee authorizes investigations

of complaints, reviews investigative

materials, and makes decisions about

a registrant’s professional conduct,

competence, and fitness to practice.

After reviewing investigative materials,

if the committee is of the view that a

complaint is supported by evidence and

warrants action to protect the public,

it can request that a registrant consent

to remedial actions such as: education

and counselling; limits or conditions

on practice, such as supervision or

prohibitions from working with specific

client populations; and disciplinary

action including reprimands and

suspensions and, in the most serious

cases, cancellation. Where consensual

resolution is not possible, the committee

also has the authority to issue a citation

for hearing by the Discipline Committee.

Public notice of the outcome must

be made in cases resulting in more

than a reprimand, unless the public

notice would disclose a relevant health

condition.

If deemed necessary to protect the

public while investigation is underway,

or pending a Discipline Committee

hearing, the Inquiry Committee

may set limits and conditions on the

practice of the registrant in question

or suspend registration. In order

to do so, the Inquiry Committee

convenes for an in-person proceeding

that allows the registrant in question

to provide submissions about why

an interim order is not necessary.

If the Inquiry Committee limits or

suspends registration at the close of the

proceeding, the decision is appealable to

the B.C. Supreme Court.

The committee also reviews and makes

decisions regarding a registrant’s

compliance with and fulfillment of

terms, limits or conditions on the

registrant’s practice.

Meetings and resolutions

The committee held 88 panel meetings

in 2017-18, and approved an additional

65 e-resolutions.

New complaints

In total, the committee directed CRNBC

staff to further investigate 164 written

complaints. Investigation of many of

these matters remains underway. (The

Registrar also directed investigation into

an additional 63 complaints that were

assessed as less serious on the spectrum

of risk.)

Completed investigations

The Inquiry Committee oversaw

and concluded investigation into 165

complaints, including reviewing and

approving the Registrar’s investigation

of 46 complaints. The investigations

resulted in the following outcomes:

• 82 no further action

• 11 other actions deemed appropriate

to resolve the matter by the Inquiry

Committee

• 7 investigations were closed because

the registrant allowed practising

registration to expire and the

complaint would be considered by

the Registration Committee should

reinstatement of registration be sought

• 62 consent resolutions were obtained

• 3 citations for hearing by the

Discipline Committee were directed.

Monitoring consent resolutions

CRNBC monitors a registrant’s

compliance with the terms of consent

resolutions. As of Feb. 28, 2018,

145 consent agreements were being

monitored. Prior to 2014, registrants

were required to seek committee

approval to conclude their consent

agreement. Eight such conclusions

occurred in 2018 (related to agreements

drafted prior to 2014). Since 2014,

consent agreements are brought to the

committee during the monitoring period

only when breaches of the terms occur.

Nominations Committee

Committee members: Gwen

Herrington (Chair), Pam O’Sullivan

and Suzanne Tytler.

The Nominations Committee

implements the procedure established

by the Registrar/CEO for obtaining

nominations for elected board member

positions. Committee duties include

determining whether the nominations

received comply with the eligibility

requirements set out under the College

Bylaws and presenting a Ticket of

Nominations to the Registrar/CEO.

Ticket of Nominations

The 2017-18 Nominations Committee

members actively participated in

activities related to communicating

nominations-related information,

including the Feb. 9, 2018 nominations

deadline. Committee members

encouraged registrants to consider

becoming a board candidate, or

alternatively, encourage a colleague to

consider becoming a board candidate.

At the close of nominations, three

registrants submitted nomination forms

for the At-Large Board member position.

One registrant submitted a nomination

form for the Urban Board member

position. The nominations deadline

was extended to Feb. 23, 2018 for the

24

Rural Board member position. No

nominations were received at the close of

the extended call for nominations for the

Rural Board member position.

The nominations forms were reviewed

to ensure candidates met the eligibility

criteria set out in the Bylaws. The 2018

Ticket of Nominations was submitted

to the Registrar/CEO. The At-Large

Candidates are: Paula Araujo, Brenda

Canitz and Marcia Carr. The Urban

Candidate is Rob Calnan (Election by

Acclamation). Rural Candidates: No

nominations.

Depending on the timing of the future

appointment of a Transitional Board by

the Minister of Health, the 2018 CRNBC

Board election could be postponed. In

previous CRNBC Board elections, ballots

for contested positions were mailed

in late June to all registrants in good

standing and the ballot count conducted

in early August, under the supervision of

the election trustee.

Nurse Practitioner Examination Committee

Committee Members: Morley Jameson

(Chair), Phil Sweeney (Vice-Chair),

Alyson Chin, Clea Bland, Kathleen Fyvie,

Dr. Keith White, Misty Reis, Narinder

(Nancy) Parmar, Sherry Katz and Steven

Hashimoto.

The Nurse Practitioner Examination

Committee directs the development

and administration of the CRNBC

nurse practitioner Objective Structured

Clinical Examination and scores the

OSCE.

The committee held five meetings in

2017-18 to consider and render decisions

on the Objective Structured Clinical

Examination.

Examination Results

Objective Structured Clinical Examination Pass Rate:

June 2017 (Family and Pediatric) 91%

December 2017 (Family and adult) 86%

Nurse Practitioner Standards Committee

Committee Members: Esther Sangster-

Gormley (Chair), Mina K. Miller

(Vice-Chair), Tracey Day, Dr. Trevor

Corneil, Shirin Abadi, Kimberly Hayter,

Stan Marchuk, Erica Maynard, Jocelyn

Stanton, Barbara Eddy, Lynn Guengerich,

Kelvin Bei, and Natasha Prodan-Bhalla.

The Nurse Practitioner Standards

Committee develops and recommends

to the board standards, limits and

conditions for the practice of nurse

practitioners in accordance with

the Nurses (Registered) and Nurse

Practitioners Regulation.

In 2017 the committee met two times

in person and held three conference

calls. The major focus of the committee’s

work has been on the following complex

items:

• The review of the Scope of Practice

for Nurse Practitioners: Standards,

Limits and Conditions, including the

standards on regulatory supervision,

advanced procedures, ordering

diagnostic services, consultation and

referral, and prescribing

• The removal of the limit on NP

prescribing of controlled drugs and

substances (e.g. testosterone) for self-

injection by the client

• The standards, limits and conditions

for the NP role in prescribing opioid

agonist treatment.

CRNBC’s Board approved the standards,

limits and conditions for advanced

procedures and activities, ordering

diagnostic services and managing

results, regulatory supervision of nurse

practitioner student activities, opioid

agonist treatment, and the removal of

the limit on NP prescribing of controlled

drugs and substances for self-injection.

These changes and new authorities have

now been incorporated into the NP

scope of practice.

Quality Assurance Committee

Committee members: Jacqueline Per

(Chair 2017/18), Barbara Korabeck (Co-

chair 2017/18), Cammie Lewis (Co-chair

until September 2017), Annaliese Hasler

(Co-chair September 2017/18), Ed Kry,

Barb Thompson, Heather Kelsall, Cheryl

Prescott, Susan Shumay, Eliza Henshaw.

The Quality Assurance (QA) Committee

is responsible for administering and

maintaining CRNBC’s QA Program.

The committee responsibilities include:

policy development and implementation,

and review of individual registrant QA

data to determine whether high practice

standards are being achieved.

On Jan. 18, 2017, the Ministry approved

quality assurance bylaw amendments

regarding the QA Committee

composition, and to support the

introduction of prescription review

and strengthen provisions for data

confidentiality. Throughout 2017, the

QA Committee further developed

QA Program policy pertaining to

QA Program support for registrants,

multisource feedback, prescription

review and deferral from professional

performance assessments.

QA Committee decisions are made in

the public interest to sustain public

confidence in nurses’ self-regulation,

25

and to support nurses to meet high

practice standards in order that the

public experience nurses to be safe,

competent and ethical practitioners.

When assessing QA data to determine

a registrant’s QA standing, the

committee meet in private and apply

the Health Professions Act sections

26.1 and 26.2; other legislation relevant

to registrants’ practice; CRNBC

Bylaws, section 1.19 and Part 5;

CRNBC Standards of Practice; and,

CRNBC and QA Program policies.

In the majority of cases, the committee

finds that standards are being met

or exceeded. When it appears that

higher standards could be achieved by

a registrant, the committee may make

specific recommendations that may

also require follow-up support with

the individual registrant to raise the

standard of their practice.

The QA Committee works closely

with NP assessors who are appointed

and evaluated by the QA Committee

and who conduct the NP onsite peer

review assessments. The onsite peer

review involves a review of client

documentation by an NP assessor,

as well as a post-review discussion

between the NP and the assessor. The

review criteria used by the assessor, the

NP and the QA Committee are based

on the CRNBC Standards of Practice

and the Entry-Level Competencies for

NPs in Canada, adopted by CRNBC.

In 2017, the QA Committee met 13

times and determined decisions for 43

onsite reviews and 48 deferral requests.

Registration Committee

Committee Members : Donna Murphy

(Chair); Jocelyn Stanton (Vice-Chair and

Board Member), Anita Buchanan, Sheila

Gordon-Payne, Janine Lennox, Tracy

Hoot, Amelia Chauvette, Ann Laing,

Catharine Schiller, Kyle Pearce, Robert

Halliday, Sandy Judge , Signy Novak, Barb

Thompson, Beverly Maxwell, and David

Holt.

The Registration Committee requires

initial and reinstating applicants for

practising status to demonstrate to

the satisfaction of the committee their

English fluency, identity, that they have

obtained the required documentation,

and are of good character, fit, and

competent. Those granted registration

may be renewed by the Registration

Committee if the registrant is able to

demonstrate they have met continuing

competence requirements. The

committee is responsible for registration

policies, which guide the committee

in managing applications consistently

and allow staff to carry out the daily

processing of applications. When

an applicant does not clearly meet

registration requirements, and policy

does not direct otherwise, an applicant’s

file and supporting documentation are

presented to the Registration Committee

for consideration and decision.

Committee meetings

The committee normally meets

every two weeks in panels, with two

in-person committee meetings per

year. Additional meetings are added

as needed.

The committee met 34 times in 2017-

18 to consider 229 files and to approve

changes to six policies and to create one

new policy. There were three in-person

meetings, and four in-person panels.

Health Professions Review Board

CRNBC informs applicants and

registrants when they can request a

review of a committee decision by the

Health Professions Review Board.

During 2017-18, 12 requests for review

by the HPRB were received in relation

to registration decisions: eight were

internationally educated RNs applying

for registration, two were Canadian

registered applicants and two were

reinstating applicants. Two were

dismissed, two withdrawn and nine

remain open. CRNBC is moving into the

mediation stage with four of these files.

26

To the registrants of College of Registered Nurses of British Columbia

We have audited the accompanying consolidated financial statements of the

College of Registered Nurses of British Columbia (“CRNBC”) which comprise

the Consolidated Statement of Financial Position as at Feb. 28, 2018, and the

Consolidated Statement of Operations and Changes in Net Assets and Cash Flows

for the year then ended, and a summary of significant accounting policies and other

explanatory information.

Management’s responsibility for the Consolidated Financial Statements

Management is responsible for the preparation and fair presentation of these

consolidated financial statements in accordance with Canadian accounting

standards for not-for-profit organizations, and for such internal control as

management determines is necessary to enable the preparation of consolidated

financial statements that are free from material misstatement, whether due to

fraud or error.

Auditor’s responsibility

Our responsibility is to express an opinion on these consolidated financial

statements based on our audit. We conducted our audit in accordance with

Canadian generally accepted auditing standards. Those standards require that

we comply with ethical requirements and plan and perform the audit to obtain

reasonable assurance about whether the consolidated financial statements are free

from material misstatement.

9Financial statements

Financial Statements

Consolidated Statement of 28

Financial Position


Operations


Changes in Net Assets


Cash Flows

Notes to Consolidated 32 - 44

Financial Statements

27

An audit involves performing procedures to obtain audit evidence about the

amounts and disclosures in the consolidated financial statements. The procedures

selected depend on the auditor’s judgment, including the assessment of the risks of

material misstatement of the consolidated financial statements, whether due to fraud

or error. In making those risk assessments, the auditor considers internal control

relevant to the entity’s preparation of the consolidated financial statements in order

to design audit procedures that are appropriate in the circumstances, but not for the

purpose of expressing an opinion on the effectiveness of the entity’s internal control.

An audit also includes evaluating the appropriateness of accounting policies used

and the reasonableness of accounting estimates made by management, as well as

evaluating the overall presentation of the consolidated financial statements.

We believe the audit evidence we have obtained is sufficient and appropriate to

provide a basis for our audit opinion.

Opinion

In our opinion, the consolidated financial statements present fairly, in all material

respects, the financial position of CRNBC as at Feb. 28, 2018, and the results of

its operations, changes in net assets, and cash flows for the year then ended in

accordance with Canadian accounting standards for not-for-profit organizations.

Other Matter

Without modifying our audit report, we draw your attention to Note 20 to the

adjustment of prior year financial statements to record the CNPS supplementary fee

upon its issuance. These adjustments were applied retrospectively by management to

the comparative information in these consolidated financial statements.

Chartered Professional Accountants

Vancouver, British Columbia

May 24, 2018

9Financial statements

28

Consolidated Statement of Financial PositionThe accompanying notes are an integral part of these financial statements

Restated (note 20)

F e b r u a r y 2 8 , F e b r u a r y 2 8 ,For the year ended 2 0 18 2 0 17

assetsCurrent

Cash and cash equivalents (Note 2) $ 18,847,942 $ 14,555,278Short-term investments (Note 3) 5,027,980 561,869 accounts receivable 560,273 1,110,854 Government remittances recoverable 425,294 -Income taxes recoverable - 24,557Prepaid expenses 1,025,393 376,667

25,886,882 16,629,225 Investments (Note 3) 10,727,385 11,446,967 Property and equipment (Note 4) 254,537 2,589,609 Intangible asset (Note 5) 1,023,444 1,098,463

$ 37,892,248 $ 31,764,264 LIabILItIes and net assetsLiabilitiesCurrent

accounts payable and accrued liabilities $ 1,203,777 $ 1,237,889 Government remittances payable - 153,016 amounts due to arNbC (Note 7) 2,624,789 2,663,933 CNPS supplemental liability - 4,725,045 amounts due to CNPS (Note 18) 1,414,846 2,394,361accrued sick, vacation and severance 428,341 450,317 Deferred revenue 18,342,585 15,019,265 Capital leases payable current portion (Note 6) 14,043 13,800

24,028,381 26,657,626

Capital leases payable (Note 6) 14,292 28,335

24,042,673 26,685,961

net assetsunrestricted 12,599,928 432,366 Internally restricted - 1,000,000 equity in capital (Note 1(c)) 1,249,647 3,645,937

13,849,575 5,078,303

$ 37,892,248 $ 31,764,264

Contingent liability (Note 15)

29

Consolidated Statement of Operations The accompanying notes are an integral part of these financial statements

F e b r u a r y 2 8 , F e b r u a r y 2 8 ,F o r t h e y e a r e n d e d 2 0 18 2 0 17

revenueregistration $ 14,460,581 $ 14,053,771 Credentials processing 866,307 827,825 examinations 178,640 154,600 Investment income (Note 12) 447,870 1,224,285 Miscellaneous income 102,896 19,741

16,056,294 16,280,222

e xPensesamortization 766,319 472,827Communications and human resources 1,763,646 1,657,859 equipment lease interest 648 887 executive office 2,243,873 1,838,899 Information and finance 4,983,033 3,611,553 Insurance administration expenses 105,447 103,194 Policy, practice and quality assurance 3,244,376 3,531,735 registration, inquiry and discipline 5,078,693 4,838,731 18,186,035 16,055,685

deFICIenCy oF revenue over e xPenses beFore other Items (2,129,741) 224,537

other revenues (e xPenses)Gain on disposal of capital assets (Note 4) 10,459,330 - IT shared services (Note 9) 67,351 45,355 registrants professional liability protection

(net of recoveries from registrants) 1,124,208 (7,478,244)amalgamation costs (Note 11) (749,876) (209,540)CrNbC contribution to NCaS pilot (Note 10) - (25,531)

10,901,013 (7,667,960)

e xCess (deFICIenCy) oF revenue over e xPenses beFore InCome ta xes 8,771,272 (7,443,423)

Income tax recovery (Note 14) - 2,562

e xCess (deFICIenCy) oF revenue over e xPenses For the year $ 8,771,272 $ (7,440,861)

Restated (note 20)

30

Consolidated Statement of Changes in Net AssetsThe accompanying notes are an integral part of these financial statements

u n r e s t r I C t e d I n t e r n a L Ly e q u I t y I n F e b r u a r y 2 8 , F e b r u a r y 2 8 ,F o r t h e y e a r e n d e d r e s t r I C t e d C a P I ta L 2 0 18 2 0 17

balance, beginning of year $ 432,366 $ 1,000,000 $ 3,645,937 $ 5,078,303 $ 12,519,164 Restated (note 20)

Deficiency of revenues over expense (921,739) - 9,693,011 8,771,272 (7,440,861)

Proceeds on disposal of capital assets 12,500,060 - (12,500,060) - -

Purchase of property and equipment (202,845) - 202,845 - -

Capital lease principle repayments (13,800) - 13,800 - -

GST recovery on reinstatement of election to recover GST 297,299 - (297,299) - -

additions of intangible assets (491,413) - 491,413 - -

Transfers 1,000,000 (1,000,000) - - -

balance, end of year $ 12,599,928 $ - $ 1,249,647 $ 13,849,575 $ 5,078,303

31

Consolidated Statement of Cash Flows The accompanying notes are an integral part of these financial statements

F e b r u a r y 2 8 , F e b r u a r y 2 8 ,F o r t h e y e a r e n d e d 2 0 18 2 0 17

Cash FLows From oPeratIng aCtIvItIesexcess (deficiency) of revenues over expenses $ 8,771,272 $ (7,440,861) Items not affecting cash

amortization of property and equipment 199,888 194,651 amortization of intangible assets 566,432 278,176 Gain on disposal of capital assets (10,459,330) - unrealized investment (gains) losses 42,845 (761,464)Lease expense 110,133 -

(768,760) (7,729,498) Changes in non-cash working capital items

amounts receivable 550,581 (424,352) Prepaid expenses (358,797) 2,643,770 Income taxes recoverable 24,557 (2,562) accounts payable and accrued liabilities (34,115) 543,962 Government remittances (recoverable) payable (281,011) 132,658 amounts due to arNbC and CNPS (5,743,704) 7,499,726 accrued sick, vacation and severance (21,976) (52,107) Deferred revenue and grants 3,323,321 1,249,113

(3,309,904) 3,860,710

Cash FLows From InvestIng aCtIvItIesacquisition of investments (3,789,374) (815,909) Purchase of property and equipment (202,845) (16,418) Purchase of intangible assets (491,413) (523,952) Shared system participation contribution - 642,168Proceeds on disposal of capital assets 12,100,000 -

7,616,368 (714,111)

Cash FLows From FInanCIng aCtIvIt yCapital lease principal repayments (13,800) (13,561)

net change in cash and cash equivalents 4,292,664 3,133,038 Cash and cash equivalents, beginning of year 14,555,278 11,422,240

Cash and cash equivalents, end of year $ 18,847,942 $ 14,555,278

suPPLementary InFormatIonNon-cash financing and investing activities

Value of prepaid lease from disposal of land and building $ 400,060 $ -adjustment to government remittance coverable and property and equipment on reinstatement of election to recover GST $ 297,299 $ -

Restated (note 20)

32

Notes to Consolidated Financial StatementsFebruary 28, 2018

1. nature oF oPeratIons and summary oF sIgnIFICant aCCountIng PoLICIes

(a) nature and Purpose of the College

Pursuant to the Health Professions Act, the College of Registered Nurses of British Columbia (“CRNBC”) is

a corporation consisting of the members of the board and committees, the staff and registrants of CRNBC.

CRNBC’s Board is composed of nine nurses elected from amongst the registrants and five members of the

public appointed by the provincial government. CRNBC works in the public interest by regulating registered

nurses, nurse practitioners and licensed graduate nurses in British Columbia.

CRNBC, with the support of the Association of Registered Nurses of British Columbia, purchases

professional liability protection and commercial general liability insurance for the College’s practicing

registrants.

CRNBC provides back-office support to other health profession organizations, including a shared

information system on a cost recovery basis. The College also collaborates with other stakeholders on

projects of shared interest, including operating a Nursing Community Assessment Service.

On April 13, 2018, the Health Professions Designation Regulation was amended to cause CRNBC to

amalgamate with two other nursing colleges as of Sept. 4, 2018. The name of the new entity will be British

Columbia College of Nursing Professionals. As further described in Note 11, CRNBC is working with

the other two nursing colleges to plan and prepare for the amalgamation. At the time of amalgamation,

CRNBC’s assets and liabilities balances, operations and commitments will be amalgamated with the other

two nursing colleges. No adjustments have been deemed necessary to carrying values of assets, as all are

expected to have benefits to the newly amalgamated college.

(b) basis of accounting

The consolidated financial statements have been prepared using Canadian accounting standards for not-for-

profit organizations (“ASNPO”).

These consolidated financial statements include the accounts of CRNBC and 0359298 BC Ltd. (formerly

CRNBC Captive Insurance Corporation), a wholly owned subsidiary. Balances and transactions between

0359298 BC Ltd. and CRNBC have been eliminated on consolidation.

(c) Internally restricted net assets

The total net assets amounts, less those invested in capital and intangible assets and internally restricted

funds, are available for any appropriate use in future.

The “Equity in Capital” fund represents the net funds invested in property, equipment and intangibles, net of

accumulated amortization and related capital lease obligations.

Internally Restricted Funds represent operating funds that have been appropriated by CRNBC’s Board for

specific purposes.

33


1. nature oF oPeratIons and summary oF sIgnIFICant aCCountIng PoLICIes - ContInued

(d) revenue recognition

Revenue is recognized as it is earned in accordance with the following:

- Registration fee revenues are recognized as revenue in the period that corresponds to the registration year to which they relate. Registration fees collected for the following year are deferred as appropriate.

- Credentials processing revenue is recognized as revenue in the year fees are received once applications are completed.

- Grants received are deferred and recognized as revenue in the year in which the related expenses were incurred.

- Examination fees received are deferred and recognized as revenue in the year the applicant completes the exam.

- Investment revenue includes interest and dividend revenue, realized gains and losses on sale of investments and unrealized gains and losses from changes in the fair market value of investments during the year ended.

- Consulting services are recognized when the service is performed, the revenue can be reasonably measured and collection can be reasonably assured.

- Through collaboration with other stakeholders, CRNBC entered into various cost sharing agreements. Where CRNBC acts as an agent, the revenue earned on the cost-sharing transactions is recognized on a net basis against the costs incurred.

(e) use of estimates

The preparation of financial statements in accordance with Canadian Accounting Standards for Not-For-Profit Organizations requires management to make estimates and assumptions that affect the amounts reported in the financial statements and accompanying notes. Significant estimates included in these financial statements are the estimate of useful lives of property and equipment and intangible assets for calculating amortization, the allocation of salary expense to the appropriate programs, and the estimate of the staff severance liability. Actual results could differ from management’s best estimates as additional

information becomes available in the future.

(f) Financial Instruments

Financial instruments are recorded at fair value when acquired or issued. In subsequent periods, equities traded in an active market and derivatives are reported at fair value, with any unrealized gains or losses reported in operations. In addition, all bonds and guaranteed investments certificates have been designated to be in the fair value category, with gains and losses reported in operations. All other financial instruments are reported at costs or amortized cost less impairment, if applicable. Financial assets are tested for impairment when changes in circumstances indicate the asset could be impaired. Transaction costs on the acquisition, sale or issue of financial instruments are expensed for those items remeasured at fair value at each statements of financial position date and charged to the financial instrument for those measured at amortized cost.

34



(g) Property and equipment

Purchased property and equipment are recorded at cost less accumulated amortization. Amortization is

based on the estimated useful life of the assets as follows:

building - 5% diminishing balance basis building improvements - 3-10% straight line basis Office furniture and equipment - 10% straight line basis electronic office equipment - 33% straight line basis equipment under capital lease - Straight line over lease term Leasehold improvements - Straight line over lease term

(h) Intangible assets

Intangible assets represents internally customized software and other purchased software. Intangible assets

are recorded at cost less accumulated amortization. Amortization is based on the estimated useful life of the

assets as follows:

Custom developed software 20% straight line basis Other software 50% straight line basis

(i) Leases

Leases are classified as capital or operating leases. A lease that transfers substantially all of the benefits and

risks incidental to the ownership of property is classified as a capital lease. At the inception of a capital lease,

an asset and an obligation are recorded at an amount equal to the lesser of the present value of the minimum

lease payments and the property’s fair value at the beginning of the lease. Assets recorded under capital

leases are amortized on a basis that is similar to other assets. All other leases are accounted for as operating

leases; wherein, rental payments are expensed as incurred or where lease obligations exist, payments are

expensed on a straightline basis over the length of the operating lease term, unless another systematic basis is

more representative.

(j) related Party transactions

All monetary transactions in the normal course of operations are measured at the exchange value. Non-

monetary transactions in the normal course of operations that have commercial substances and do

not involve the exchange of property or product held for sale are also measured at exchange value. The

commercial substance requirement is met when the future cash flows associated with the transfer of property

are expected to change significantly as a result of the transaction. All other related party transactions are

measured at carrying value.

35



(k) allocation of salaries and wages

Salaries and wages are allocated proportionately on the basis of time spent by each employee on each of the

programs.

(l) Cash and Cash equivalents

Cash and cash equivalents include investments having a maturity date of three months or less from the

date of purchase.

(m) accrued sick, vacation and severance Pay

CRNBC accrues all earned but unpaid cash entitlements for severance pay, sick leave and vacation pay.

(n) Income taxes

CRNBC is exempt from income tax under Section 149(1)(c) of the Canadian Income Tax Act. 0359298 BC

Ltd. is subject to income tax and income taxes are accounted for using the taxes payable method.

2 . Cash and Cash equIvaLents

Cash and cash equivalents are comprised of the following:

2 0 18 2 0 17

Cash $ 11,260,228 $ 13,506,657

Cash equivalent 7,587,714 1,048,621

$ 18,847,942 $ 14,555,278

CRNBC’s cash is held in bank accounts and investment accounts held at a Canadian credit union and at a Canadian

investment brokerage. Cash equivalents consist of money market funds, which are redeemable at any time.

36


3. Investments

2 0 18 2 0 17

Government bonds $ 8,997,096 $ 2,558,412

Corporate bonds and notes 6,758,269 9,450,424

15,755,365 12,008,836

Less short term investments 5,027,980 561,869

Long term investments $ 10,727,385 $ 11,446,967

Government bonds consist of provincial and municipal bonds and bear interest ranging from 1.35% to 3.70%

(2017 - 1.75% to 3.70%) with maturities ranging from June 2017 to June 2024. Corporate bonds and notes

bear interest ranging from 2.20% to 4.89% (2017 - 2.20% to 4.89%) and have maturities ranging from

October 2017 to June 2023.

4. ProPert y and equIPment

2 0 18 2 0 17

a C C u m u L at e d n e t b o o k n e t b o o k

C o s t a m o r t I z at I o n va L u e va L u e

Land $ - $ - $ - $ 472,500 building - - - 1,260,823 building improvements - - - 699,605 Office furniture and equipment 623,416 589,196 34,220 104,267 electronic office equipment 616,631 613,025 3,606 10,818 equipment under capital lease 140,840 126,974 13,866 41,596 Leasehold improvements 202,845 - 202,845 -

$ 1,583,732 $ 1,329,195 $ 254,537 $ 2,589,609

On Nov. 7, 2017, CRNBC sold the land and building to a third party for total cash proceeds of

$12,100,000 resulting in a gain on disposal of $10,459,330 after closing costs of $363,000.

As part of the sale of the land and building, CRNBC entered into leaseback of the premises sold from

Dec. 22, 2017 to Sept. 1, 2018 for $1. The fair value of this leaseback was valued at $400,060 and

has been accounted for as an increase on sales proceeds and corresponding increase in prepaid expenses.

During the year, CRNBC reinstated their election to recover GST ITC on the building sale. As a result,

CRNBC is expected to receive $297,299 related to previous capital asset additions related to land and building.

37


5. IntangIbLe assets

a C C u m u L at e d n e t b o o k

C o s t a m o r t I z at I o n va L u e

balance, March 1, 2016 $ 3,376,000 $ 1,881,145 $ 1,494,855 additions, CrNbC portion 523,952 - 523,952 One time Shared System Contributions (642,168) - (642,168)amortization - 278,176 (278,176)

balance, February 28, 2017 $ 3,257,786 $ 2,159,322 $ 1,098,463

balance, March 1 2017 3,257,786 2,159,322 1,098,463 additions, CrNbC portion 491,413 - 491,413 amortization - 566,432 (566,432)

balance, February 28, 2018 $ 3,749,199 $ 2,725,754 $ 1,023,444

Intangible assets are comprised of an information technology system which was initially configured

and customized for CRNBC’s purpose.

Due to the similarity in the nature of information technology requirements for CRNBC and other

Health Professional Organizations (HPOs), CRNBC has entered into a Shared System Participation

Agreement with various HPOs to fund the development and support services of the information

technology system on a cost recovery basis.

Pursuant to the Shared System Participation Agreement, each participating HPO pays the following cost:

i) A one-time Shared System Contribution to CRNBC based upon the net book value of the shared

system and the proportionate amount of health professional members registered to that HPO.

ii) Shared system annual costs based on approved budget.

iii) A license fee if a withdrawing participating HPO wants to acquire a license to use the

CRNBC technology.

iv) To recognize the financial contribution of each participating HPO towards the Shared System,

CRNBC agrees to distribute and pay a portion of the Shared System Contribution and any license

fee to existing participants.

38


6. CaPItaL Leases PayabLe

CRNBC has entered into various lease agreements for photocopiers.

2 0 18 2 0 17

Obligations under capital lease $ 28,335 $ 42,135

Less current portion of capital lease payments 14,043 13,800

$ 14,292 $ 28,335

7. assoCIatIon membershIP Fees

Pursuant to the Health Professions Act and CRNBC’s Bylaws, CRNBC collects fees on behalf of an association. The

fees are remitted to the association in the year they are received. During the year, the total fees collected on behalf

of the Association of Registered Nurses of British Columbia (“ARNBC”) were $4,587,416 (2017 - $4,331,743). As at

Feb. 28, 2018, CRNBC had collected but not yet transferred $2,624,789 to ARNBC (2017 - $2,663,933). The

amounts to be remitted are non-interest bearing.

8. munICIPaL PensIon PL an

The employer and its employees contribute to the Municipal Pension Plan (a jointly trusteed pension plan).

The board of trustees, representing the plan members and employers, is responsible for administering the plan,

including investment of assets and administration of benefits. The plan is a multi-employer defined benefit

pension plan. Basic pension benefits are based on a formula. As at Dec. 31, 2017, the plan has about 193,000

active members and approximately 90,000 retired members. Active members include approximately 38,000

contributors from local governments.

Every three years, an actuarial valuation is performed to assess the financial position of the plan and adequacy

of plan funding. The actuary determines an appropriate combined employer and member contribution rate to

fund the plan. The actuary’s calculated contribution rate is based on the entry-age normal cost method, which

produces the long- term rate of member and employer contributions sufficient to provide benefits for average

future entrants to the plan. This rate is then adjusted to the extent there is amortization of any funding deficit.

The most recent valuation of the Municipal Pension Plan as at Dec. 31, 2015, indicated a $2,224 million

funding surplus for basic pension benefits on a going concern basis. As a result of the 2015 basic account actuarial

valuation surplus and pursuant to the joint trustee agreement, $1,927 million was transferred to the rate stabilization

account and $297 million of the surplus ensured the required contribution rates remained unchanged.

The College of Registered Nurses of B.C. paid $936,258 (2017 - $836,496) for employer contributions to the

plan in fiscal 2018.

The next valuation will be as at Dec. 31, 2018, with results available in 2019.

Employers participating in the plan record their pension expense as the amount of employer contributions made

during the fiscal year (defined contribution pension plan accounting). This is because the plan records accrued

liabilities and accrued assets for the plan in aggregate, resulting in no consistent and reliable basis for allocating the

obligation, assets and cost to individual employers participating in the plan.

39


9. ContrIbutIons From other heaLth ProFessIon organIz atIons

During the year, contributions were received from other Health Profession Organizations (HPO) that have agreed

to participate in adopting a shared information technology system and support services. The funds were received

as consideration for the shared system support services and a corresponding overhead allocation.

2 0 18 2 0 17

Contributions from HPO $ 2,754,140 $ 1,986,058

expenses allocated to HPO 2,686,789 1,940,703

Net overhead recovery $ 67,351 $ 45,355

10. ContrIbutIons From the bC mInIstry oF heaLth - nursIng CommunIt y assessment servICe ProjeCt

During fiscal 2016, contributions were received from the British Columbia Ministry of Health (“BC MoH”) to

pilot their Nursing Community Assessment Services (“NCAS”) project. The funds were received on behalf of

the BC MoH to pay for the NCAS program pilot ending March 31, 2017. In April 2017, CRNBC received a grant

of $1.4 million from the BC MoH to support placing the NCAS program into operation. CRNBC received an

additional $1.4 million in March 2018 supporting the NCAS program’s 2018 operations.

2 0 18 2 0 17

NCaS pilot contribution by bC MoH $ - $ -

Pilot expenses - 25,531

CrNbC contribution to NCaS pilot $ - $ (25,531)

2 0 18 2 0 17

NCaS operating grant $ 1,274,955 $ 761,476

Operating expenses 1,274,955 761,476

CrNbC contribution to NCaS operations $ - $ -

40


11. Co-CreatIon oF “one nursIng reguL ator”

In anticipation of an amalgamation, the College of Registered Psychiatric Nurses of BC (“CRPNBC”), the

College of Licensed Practical Nurses of BC (“CLPNBC”) and CRNBC agreed to cost share certain incremental

costs in order to plan and prepare for the amalgamated organization. These shared amalgamation costs are

allocated to each college based on their proportion of the total registrant population. In addition to CRNBC’s

share of amalgamation costs, other non-shared costs incurred by the College for this amalgamation are included

in the Statement of Operations under Executive Office expenses.

2 0 18 2 0 17

Total shared amalgamation costs $ 905,842 $ 294,483

Shared costs allocated to other colleges (155,966) (84,943)

CrNbC’s share of amalgamation costs $ 749,876 $ 209,540

12 . Investment InCome

2 0 18 2 0 17

Interest and dividend revenue $ 385,614 $ 366,668

realized gain on sale of investments 105,101 96,153

unrealized gain (loss) from changes in fair market value (42,845) 761,464

$ 447,870 $ 1,224,285

13. reL ated Part y transaCtIons

Pursuant to the Health Professions Act (“HPA”), the College’s board has the authority to set its own remuneration

for its member’s involvement in the College. The board has approved both an honorarium and employer salary

replacement option for its members. The total payments for honorarium and salary replacement claims for board

members was $63,354 (2017 - $31,501).

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14. InCome ta xes

Income taxes for 0359298 BC Ltd. for the year ended Feb. 28, 2018 was a recovery of nil (2017 - tax recovery of

$2,562), net of refundable taxes.

15. ContIngent LIabILIt y

In 2014, the BC Nurses’ Union (“BCNU”) initiated a civil claim against CRNBC, 0359298 BC Ltd. and

CRNBC’s Registrar/CEO, challenging CRNBC’s authority to have made a $1,500,000 grant to ARNBC, using

funds derived from the redemption of preferred shares. These matters are ongoing and their outcome and an

estimate of loss, if any, is not determinable.

CRNBC has also received notification of other claims related to various matters arising in the ordinary course

of its business. These matters are at a preliminary stage and their outcome and an estimate of loss, if any, is

not determinable. CRNBC has no reason to expect that the ultimate disposition of any of these matters will

have a material adverse impact on its financial position, results of operations or its ability to carry on any of

its business activities.

16. aLLoCated e xPenses

Salaries and wages are allocated as follows:

2 0 18 2 0 17

executive office $ 1,464,576 $ 1,130,939

Information and finance 2,100,716 1,311,915

Communications and human resources 1,415,714 1,175,419

Policy, practice and quality assurance 3,132,665 3,263,643

registration, inquiry and discipline 3,472,866 3,564,686

Capitalized to intangible assets 224,014 523,952

total $ 11,810,551 $ 10,970,554

42


17. FInanCIaL Instrument rIsks CRNBC’s activities result in exposure to a variety of financial risks including risks related to credit and market,

foreign exchange, interest rate and liquidity. The risks that CRNBC are exposed to this year are consistent with

those identified in prior years.

(a) Credit risk and market risk

Credit risk is the risk that CRNBC will incur a loss due to the failure by its debtors to meet their contractual

obligations. Financial instruments that potentially subject CRNBC to significant concentrations of credit

risk consist primarily of cash and cash equivalents, long-term investments and accounts receivable. Market

risk is the risk that the value of an investment will f luctuate as a result of changes in market prices, whether

those changes are caused by factors specific to the individual investment or factors affecting all securities

traded in the market. CRNBC limits its exposure to credit risk by placing its cash and cash equivalents and

short term investments with high credit quality governments, financial institutions and corporations in

accordance with investment policies adopted by the board. Risk and volatility of investment returns are

mitigated through the diversification of investments in different geographic regions and different investment

vehicles.

(b) Foreign exchange risk

Foreign exchange risk is the risk that the fair value or future cash flows of a financial instrument will

f luctuate because of changes in foreign exchange rates. CRNBC limits its exposure to foreign exchange risk

through its investment policy, which sets a maximum percentage of equity investments that can be held in

foreign currencies

(c) Interest rate risk

Interest rate risk is the risk that the fair value or future cash flows of a financial instrument will f luctuate

because of changes in market interest rates. CRNBC is not exposed to interest risk on its capital leases

payable as lease payments are fixed to the end of the lease term. The interest rates and terms of cash and cash

equivalents and long-term investments are as disclosed in Notes 2 and 3.

(d) Liquidity risk

Liquidity risk is the risk that CRNBC will not be able to meet its obligations as they fall due. CRNBC

maintains adequate levels of working capital to ensure all its obligations can be met when they fall due. Long-

term investments are also held in securities that can be liquidated within a few days’ notice.

43


18. CommItments CRNBC entered into an agreement with the Canadian Nurses Protective Society (CNPS) to provide retroactive

and ongoing Professional Liability Protection (“PLP”) for CRNBC’s practicing registrants over five years at

approximately $2.8 million per year expiring in 2021. During the year, CRNBC remitted $3,594,503 to CNPS

to pay off the remaining commitment related to the retroactive PLP, reducing the annual obligation to $2.14

million expiring to 2021. As at Feb. 28, 2018, CRNBC had collected but not yet remitted $1,414,846 to CNPS (2017

- $2,394,361) with respect to annual dues collected by CRNBC on behalf of CNPS.

CRNBC’s total obligations under operating leases for occupied premises, exclusive of property taxes and other

occupancy charges are as follows:

2019 $ 1,313,805

2020 1,572,014

2021 1,608,928

2022 1,645,842

2023 1,682,757

2024 and thereafter 18,857,849

$ 26,681,195

19. subsequent event CRNBC has entered into a number of agreements following the fiscal year to complete leasehold improvements

for its new office location. The total cost of these agreements is approximately $10 million before expected

recovery from the landlord toward tenant improvements of $3.1 million.

44


20. PrIor PerIod adjustment In 2015, CRNBC entered in an agreement with CNPS to provide its registrants with retroactive Protection Liability

Insurance commencing March 1, 2016. The College recorded the fee as period costs over the expected payment term

instead of recording it as a liability upon entering into the agreement.

The effects of the financial statements for the year ended Feb. 28, 2018 are as follows:

a s P r e v I o u s Ly a d j u s t m e n t r e s tat e d

r e P o r t e d I n 2 0 17

Consolidated statement of Financial Position CNPS supplemental liability $ - $ 4,725,045 $ 4,725,045 unrestricted net assets $ 5,157,411 $ (4,725,045) $ 432,366

Consolidated statement of operations and Changes in net assets registrants professional liability protection (net of recoveries from registrants) $ 2,753,199 $ 4,725,045 $ 7,478,244

excess (deficiency) of revenue over expenses for the year $ (2,715,816) $ (4,725,045) $ (7,440,861)

unrestricted net assets, beginning of the year $ 5,157,411 $ (4,725,045) $ 432,366

Consolidated statement of Cash Flows excess (deficiency) of revenue over expenses for the year $ (2,715,816) $ (4,725,045) $ (7,440,861)

amounts due to arNbC and CNPS $ 2,774,681 $ 4,725,045 $ 7,499,726

Documents

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