Who must provide a written report to the CNO when there are concerns about a nurse's ability to practice safely due to a physical or mental condition?

• A. A facility operator
• B. The nurse themselves
• C. The patient
• D. A regulatory body not involved with nursing

Answer: (A)

When there are concerns about a nurse’s ability to practice safely due to a physical or mental condition, the entity closest to the daily practice and responsible for patient safety is the employer, the facility operator. The facility observes performance, documents incidents, and has a duty to protect patients. Because of this duty, it is appropriate—and typically required—that the facility submit a written report to the nursing regulatory authority (the CNO) to trigger formal review, assessment, and any necessary actions to protect the public. This creates a formal pathway for evaluation, possible temporary restrictions, remediation, or other safeguards.

The nurse themselves may seek assessment or disclosure, but the immediate responsibility to initiate regulatory contact rests with the employer. Patients do not have a standard obligation to report to the CNO, and a regulatory body not involved with nursing would not be the correct conduit for reporting nursing-related impairment.