CENTRAL MAINE MEDICAL CENTER FAMILY MEDICINE RESIDENCY RESIDENT EMPLOYMENT AGREEMENT This Resident Employment Agreement (“Agreement”) made this day of by and between Central Maine Medical Center (“CMMC”) and MD/DO PGY Resident (the “Resident”). In consideration of their mutual promises, CMMC hereby agrees to employ the Resident, and the Resident hereby agrees to perform services for CMMC, in accordance with the terms and conditions set forth below. 1. Term. This Agreement will be effective and will end (“Effective Date”). 2. Duties of the Resident. a) The Resident agrees to work full-time at CMMC and at such other offices or facilities in the Central Maine Healthcare (“CMHC”) service areas as are related to the operation of the CMMC. The Resident agrees to devote his/her best efforts and attention to the diligent performance of his/her duties herein. The Resident agrees to act in accordance with the Citizenship Standards as outlined in Appendix D attached hereto and incorporated herein by reference. The Resident shall comply with CMHC’s handbook, rules, regulations, policies and any/all applicable state and federal statutes, rules, or regulations, relating to teaching, which may be revised from time to time. The Resident shall work under the administrative supervision of the Director of the Family Medicine Residency Program (the “Program Director”) or designee. b) The Residents work schedule shall be set by the Program Director or designee and will be communicated to the Resident reasonably in advance. c) The Resident’s duties will also include but not be limited to: (1) Develop a personal program of self study and professional growth with guidance from the teaching staff; (2) Participate in safe, effective and compassionate patient care under supervision, commensurate with his/her level of advancement and responsibility; (3) Demonstrate an ability to assume graded responsibility; (4) Participate fully in the educational activities of this program and, as required, assume responsibility commensurate with his/her level of advancement for teaching and supervising other residents and students; (5) Participate in CMMC programs and activities involving the medical staff; (6) Participate in CMMC committees and councils, especially those that relate to patient care review activities; (7) Apply cost containment measures in the provision of patient care; and (8) read, understand and comply with the requirements of (a) the certification by the American Board of Family Medicine, the ACGME and AOA accreditation requirements, (b) the Program’s Policy and Procedure Manual and (c) CMMC’s Medical Staff By-laws. d) It is the Resident's responsibility to provide the Program Director with the appropriate documentation of the specific procedures they have performed as is more particularly described in the Program’s Policy and Procedure Manual. The documentation will be tabulated and returned to the Resident. 1 3. Duties of CMMC. a) CMMC agrees to provide the Resident with the facilities, equipment, supplies, and support personnel necessary to allow the Resident to fulfill his/her duties under this agreement. CMMC reserves the right to determine what facilities, equipment, supplies and support personnel are necessary and appropriate. b) CMMC shall provide professional and general liability insurance coverage for the Resident, with respect to any claim which arises out of the services performed pursuant to this Agreement, and which is asserted during the term of this Agreement, through a licensed insurance plan, an affiliated Health Care Providers Liability Policy, or through a self-insurance plan administered by CMHC for its healthcare system, and such policy or plan shall provide for limits of at least Two Million Dollars ($2,000,000) per covered claim or Twelve Million Dollars ($12,000,000) for all claims in any one year.. c) CMMC assumes no rights obligations, or liabilities of the Resident or any former employer or the Resident, and in particular, CMMC shall not be responsible for any claim arising before the effective date of the Resident’s employment with CMMC. 4. Covenants of the Resident. This Agreement is contingent upon the following: a) The Resident agrees that during the term of this Agreement, he/she will not provide or assist in providing medical services, except as an employee of CMMC as provided in this Agreement, without the express prior written consent of the Program Director or designee. Should such approval for the Resident to provide medical services outside this agreement be granted, the Resident shall obtain professional and general liability insurance coverage in amounts and types deemed suitable by CMHC. Such proof of insurance coverage shall be presented to the Program Director or President of CMMC prior to the Resident engaging in any services outside his/her employment at CMMC and at such times as coverage is changed or amended b) The Resident must be licensed as a Resident in the State of Maine throughout the term of this Agreement. c) The Resident must be eligible to participate in Medicare and Medicaid. d) The Resident must maintain his/her regular place of residence at a place within a distance that is reasonable for him/her to commute between shifts of work/call or to complete his/her call responsibilities from home (applied to Rural Track residents in their second and third years of training only). e) CMMC must be able to acquire and maintain professional liability insurance within the median premium range for the Resident. f) The Resident must satisfactorily complete an employment, reference, criminal history, and other standard CMMC background checks under applicable CMMC policies and practices. 2 g) The Program Director shall determine, with input from the faculty, preceptors, attendings, and whatever other resources he/she determines to be appropriate, whether the Resident has demonstrated abilities to assume graded and increasing responsibility for patient care. Performance, assessments and feedback mechanisms may include, but are not limited to, written evaluations, oral feedback from faculty and preceptors, or video monitoring. The Resident will be accorded the opportunity to provide a written response to any evaluations provided to him/her while this Agreement is in force. Unless impracticable, a decision as to whether a contract for the next year will be offered to the Resident will be made by May 1 of the current year. If the Resident demonstrates a continued and ongoing ability to assume graded responsibility, is complying with the requirements set forth herein, and meeting conditions of specific educational plans, he/she will be offered a contract until completion of all requirements for graduation. Academic decisions relating to advancement or graduation are reserved to the discretion of the Director subject only to review under the Grievance provisions set forth below. 5. Compensation. For the services hereunder, CMMC shall pay the Resident the annual base salary rate of Forty-Eight Thousand Nine Hundred Dollars ($48,900.00), payable in bi-weekly installments over twelve (12) months beginning on the effective date provided herein. The Resident will also receive additional consideration as outlined in Appendix C attached hereto and incorporated herein by reference. CMMC may elect, at its sole discretion, to provide cost of living adjustments from time to time, and any such adjustments shall be communicated to the Resident in the form of a letter. 6. Benefits. The Resident shall be entitled to employee benefits as set forth in the employee benefits summary, which is attached hereto and incorporated herein by reference in Appendix B. These benefits, terms and conditions are subject to change from time to time, and any change shall be effective upon 30 days prior written notice to the Resident, unless another, longer effective date is stated, and any former provisions shall be void, superseded, and of no further effect. 7. Disability. In the event that the Resident is unable to perform the duties set forth in this Agreement, due to the Resident’s illness, injury, or disability, The Resident shall be eligible to receive paid sick leave, to the extent provided under the benefit summary. To the extent that the Resident is not eligible for paid leave, or has exhausted eligibility for paid sick leave, The Resident may be entitled to the balance of eligible time as unpaid leave, pursuant to the federal and state Family and Medical Leave laws. If the Resident is not eligible for leave, or has exhausted available leave, it shall be grounds for termination of this Agreement. Notwithstanding any other provision of this Agreement, The Resident shall be paid only for weeks in which the Resident is performing the duties under this Agreement, or is eligible for paid leave under benefit summary. 8. Termination. This Agreement may be terminated before the expiration of any contract term, as follows: 3 a. Should the Resident engage in misconduct or other serious action or omission, which causes or threatens material harm to CMMC patients or employees, staff and volunteers as determined by the Program Director, CMMC may terminate this agreement immediately with written notice. b. Either party may terminate this Agreement for material breach of this Agreement by the non breaching party giving written notice to the breaching party of it’s intent to terminate the Agreement due to the material breach of the other party, such notice shall specify in detail the breach and shall be given at least twenty (20) days before termination is to be effective; said termination to be effective only if the breaching party has failed to cure the material breach within said twenty (20) days. c. Either party may terminate this Agreement, without cause, by giving the other party at least one hundred and twenty (120) days written notice prior to the effective date of such termination. d. The parties may terminate this agreement by mutual written agreement at any time e. By CMMC, immediately upon written notice to the Resident, in the event that the Resident’s license to practice as a Resident in Maine, his/her participation in the Medicare or Medicaid programs, or if CMMC is not able to acquire and maintain professional liability insurance as specified in Section 4(e). f. By CMMC, immediately upon written notice to the Resident, in the event that the Resident does not satisfactorily complete the background check as specified in Section 4(f). g. Upon expiration or termination permitted by this section, neither party shall have any further rights or duties under this Agreement except as expressly provided elsewhere in this Agreement, provided such termination shall not affect any rights or duties accrued prior to the effective date of termination, and shall not relieve the breaching party under paragraph (b), of its liability for damages under this section. 9. Arbitration. Any claim or dispute arising out of this Agreement, including the termination of this Agreement, shall be resolved exclusively by arbitration, in Androscoggin County, Maine. Upon written request of either party to arbitrate any such claim or dispute, the parties shall confer in good faith on the selection of a single arbitrator. If, sixty (60) days after notice of the request for arbitration, the parties have not agreed upon selection of an arbitrator, either party may petition the Superior Court for Androscoggin County, to appoint a single arbitrator. The arbitrator shall be bound by the written terms of this Agreement, any modifications hereto, and any other written document incorporated herein by reference and the course of conduct of the parties. Both parties waive any claim for non-economic damages. Neither party shall initiate or join any civil action, lawsuit, or administrative proceeding against the other party with respect to any claim which is subject to this arbitration provision, except to enforce this section or any arbitration award, and both parties waive any right or claim to attachment or trustee process prior to a final judgment after an arbitration award. The parties shall share equally the costs of the arbitrator and the arbitration proceeding, but each party shall pay 4 its own attorneys fees and costs of its witnesses or experts. A written request to arbitrate must be delivered to the other party no later than 120 days after the date on which the party was aware, or should have been aware through the exercise of reasonable diligence, of the claim or dispute. This Section shall survive the expiration or termination of this Agreement. 10. Confidential Information. The Resident understands, acknowledges and agrees that in providing services to CMMC he/she may encounter information or materials of or relating to CMMC, its patients, employees, contractors, agents or other representatives, including but not limited to information on CMMC or CMHC operations, methods of doing business, research and development, trade secrets, computer programs, finances, and patient “individually identified health information” as defined at 45 CFR Parts 160 and 164 and “health care information” as defined at 22 M.R.S.A. § 1711-C (all of which information is collectively referred to as the “Confidential Information”); that Confidential Information may be in any form, including written, electronic, oral, overheard or observed; that Resident has no rights whatsoever to the Confidential Information; and that Resident will hold the Confidential Information in strict confidence, will not use, copy or acquire the Confidential Information except as required to provide the services hereunder, will not disclose the Confidential Information, and will not act or fail to act in any manner that may, directly or indirectly, compromise the security or confidentiality of the Confidential Information. Upon termination of his/her employment, the Resident shall deliver to CMMC all Confidential Information that are then in his/her possession or control. Resident agrees that the obligations of Resident with respect to the confidentiality and security of the Confidential Information shall survive the termination of any agreement or relationship between Resident and CMMC. 11. Grievance. Should the Resident seek review of any disciplinary or other action taken with respect to his/her employment or academic status with CMMC, the Resident may file a grievance as designated in the Program Policy and Procedure Manual. 12. Waiver. Waiver by CMMC of any breach of any provision of this agreement by the Resident shall not operate or be construed as a waiver of any subsequent breach by the Resident. 13. Assignment. CMMC may assign its rights and obligations under this Agreement to any other corporation, provided that the corporation is an affiliate of CMMC. This Agreement is not assignable by the Resident. 14. Governing Law. This Agreement will be construed and enforced in accordance with the laws of the State of Maine, without regard to its conflict of laws provisions. 15. Notices. Any notices required or permitted to be given under this Agreement will be deemed sufficiently given if hand-delivered or mailed by U.S. mail, postage prepaid, addressed to in the case of the Resident at the address shown on the payroll record of CMMC, and if to CMMC, addressed to the Program Director, or at such other addresses may be furnished in writing to the notifying party. 16. General. Both parties will comply with all applicable laws and regulations of governmental bodies or agencies in their performance under this Agreement. The waiver by one party of a breach of any provision of this Agreement by the other party will 5 not operate or be construed as a waiver of any subsequent breach of the same or any other provision by the other party. If any provision of this Agreement is held to be invalid, void or unenforceable, the remaining provisions will nevertheless continue in full force. This Agreement may be signed by the parties in separate counterparts which will together constitute one and the same agreement. 17. Third Parties. This Agreement is entered into for the benefit of the parties hereto, and nothing in this Agreement shall be construed as creating or giving rise to any rights in any third parties or any persons other than the parties hereto, except as expressly set forth herein. 18. Survival. Notwithstanding any of the provisions in this Agreement, Sections 3(c), 8(g), 9, 10, 11, 15 and 18 shall survive termination of this Agreement. 19. Entire Agreement. This Agreement terminates and replaces any prior written or oral agreement between these parties. This Agreement and its attachments are the complete and entire Agreement between the parties hereto. Any discrepancy between the Agreement and any attachment thereto shall be resolved in favor of the Agreement. The Agreement may be amended only by agreement in writing that specifically mentions this Agreement and is signed by both parties, provided that CMMC may revise the benefit plan, as set forth herein, without a written agreement 6 Appendix B Resident Benefits Summary A. Choice Time (CT) All Residents covered by this benefits summary are eligible for paid time off each contract year and this time is approved by the residency’s accrediting organizations (American Osteopathic Association (AOA) and the Accreditation Council on Graduate Medical Education (ACGME)). Each Resident will receive a choice time bank of 192 hours on the first day of the contract year. These hours represent fifteen (15) days of vacation and nine (9) holidays. Residents must use up this bank of time before the start of the next contractual year (no carry over from one contract year to another is allowed). No payment of any positive balance choice time hours is paid to any Resident who separates employment from CMH either by choice, is asked to leave or successfully completes the residency program. The six holidays (Residency and associated Family Medicine Center are closed) are: 1. New Year’s Day (January 1st) 2. Memorial Day (last Monday in May) 3. Independence Day (July 4th) 4. Labor Day (1st Monday in September) 5. Thanksgiving Day (4th Thursday in November) 6. Christmas Day (December 25th) In addition, each Resident is awarded three (3) “floating” holidays that they can choose to take (with a approved residency leave request) on the actual holiday days (President’s Day, Patriot’s Day, Day after Thanksgiving) or choose to take at another time that is more convenient with their educational schedule. If a Resident has a medical or family leave need that exceeds their choice time bank, the Residents are able, with the Program Director’s permission, to have time off without pay and those educational days will be added to the end of their residency cycle. B. Sick Bank Plan Each Resident will receive a sick bank of 48 hours (6 days) on the first day of the contract year. The balance available will appear on their pay stubs. Sick time hours are paid at 100% of the Resident’s salary. As with normal base pay, Sick Bank is taxable and withholding will be applied by the CMH Payroll Department. If the Sick Bank time is not used in the Resident’s contractual year (1st, 2nd or 3rd), the hours are removed prior to the start of next academic year or at the time of successful completion (no carry over from one contract year to another is allowed). 7 Residents may elect to participate, at their own cost, in the CMH voluntary benefit of Short Term Disability (see Voluntary Benefit H-5 below) to further protect income and supplement the sick time payments during medical leaves of absence. C. Bereavement Leave In the event of a death in a Resident’s immediate family, a Resident is eligible for paid time off equal to 100% of their normal scheduled number of hours up to a period of one week (see CMH policy HC-HR-3406 for more details). If Bereavement Leave is exercised by the resident, it may result in an extension of the residency cycle, per accreditation requirements. In addition, a Resident cannot utilize more than thirty (30) days of total leave (vacation, sick and bereavement leave); per contract year or it will result in an extension of the residency cycle, per accreditation requirements. D. Jury Duty A Resident called for jury duty on a day when the Resident was scheduled to work is paid regular earnings for the scheduled shift. See CMH policy Jury Duty and Hospital Related Court Appearances CMMF-HR-3407 for more details. If Jury Duty is exercised by the resident, it may result in an extension of the residency cycle, per accreditation requirements. E. Adoption Assistance CMH supports Residents who are adopting children by providing reimbursement for certain adoption related expenses. Residents with at least two consecutive years of service immediately prior to adoption are eligible. Documented expenses will be covered to a maximum of $2,500 (subject to tax withholding) per child adopted for all combined expenses. See CMH policy HC-HR-3602 (R2) for more details. F. CME Residents in their second and third year of residency training receive forty (40) hours (prorated) per contract year – or five (5) 8 hour days - of paid CME time off for educational purposes. Over the course of three (3) years, Residents may be reimbursed up to a maximum of $1,800 for expenses associated with CME including up to $200 for the purchase of a tablet/phone for educational use. Unused CME time or reimbursable expenses cannot be carried over from one fiscal year to another, and a Resident is not entitled to be paid any amount in lieu of CME time or expenses. 1. Types of Expenses to be paid utilizing a Resident’s CME Account • Additional specialty specific association dues including: o Society of Teachers in Family Medicine o Maine Osteopathic Association (D.O Residents) o American College of Osteopathic Family Physicians (D.O Residents) 8 • • • • 2. Dues for membership in o Maine Medical Association o Androscoggin County Medical Society o Lewiston Auburn Resident Association Books that are not kept in the office or left in the practice at resignation Travel expenses Computer purchases and/or PDAs (once every three years) Types of Expenses to be paid by the CMH Organization up to $1,000.00 for second and third year Residents • Original licensure and renewals for State of Maine • Original licensure and renewals with the Drug Enforcement Agency • Re-appointment fees and medical staff dues to all hospitals assigned to work 3. Cost of Board Certification: • CMH will reimburse each Resident the cost of taking the American Board of Family Medicine (ABFM) and the American Board of Osteopathic Family Practice (ABOFP) boards. CMH will reimburse Resident the cost of registering for the ABOFP as long as they are taken before graduating residency. CMH will also reimburse Resident the cost for two (2) nights lodging necessary to perform the practical skills portion of the ABOFP exam. All other travel-related expenses may be reimbursed through Resident’s CME account • CMH will reimburse Resident for either the USMLE or the COMLEX Step 3, which must be taken during PGYI year or PGYII year. • CMH will reimburse Resident for residency-sponsored time and tuition for BLS, ACLS, PALS, ALSO, Neonatal Resuscitation, plus other program meetings. 4. Cost of American Association of Family Practitioners (AAFP) and and American Osteopathic Association (AOA) Annual Memberships G. Flexible, or Voluntary, Benefits Available 1. Health Insurance CMH offers Residents and their eligible dependents a health insurance plan managed by UMR, a Third Party Administrator affiliated with United Healthcare. In addition to accessing the services and favorable 90% co-insurance of CMH PHO providers and facilities, the insurance plan offers access and reasonable levels of co-insurance for United Healthcare Options PPO network participants throughout Maine, New England and the country, as well. All hospitals in Maine are participants in the UHC Options PPO network at this time. 9 A Resident may choose one of two plans: the “lower deductible” plan or the “higher deductible” plan. Both plans offer the same coverage for medical services and prescription drugs. The differences between the plans are a) the monthly premiums b) the level of deductible a Resident must reach before certain, additional benefits kick in and c) the amount of their maximum out-ofpocket costs for the year. There are no co-pays or limits on “well visits.” The details of the health insurance options in place at any point in time are available for review at www.cmmfhealthydecisions.com. 2. Dental Insurance CMH offers Residents and their eligible dependents a comprehensive Dental Plan managed by UMR that is designed to encourage regular checkups and preventive care to correct minor dental problems—before they become serious—and to help cover the cost of more expensive dental procedures. 3. Group Term Life Insurance CMH automatically provides Residents with Basic Life Insurance equal to one times base salary. This coverage includes Accidental Death and Dismemberment (AD&D). The Basic Life Insurance amount will double in the event of an accidental death. Additional benefits are received for accidental dismemberment. A Resident has the option of purchasing supplemental life insurance covering an additional one to four times their base annual salary. If Residents wish to enroll or increase more than one level, an EOI (Evidence of Insurability) form is required. The maximum benefit limit for employee life insurance (i.e. the total sum of basic and supplemental life insurance that would be paid upon death) is $650,000. 4. Dependent Life Insurance is available to cover spouses, partners and children. 5. Short-Term Disability Insurance (STD) CMH’s STD insurance carrier offers guaranteed acceptance, regardless of a Resident’s health. Pre-existing conditions are not covered until Residents have been covered for at least 12 consecutive months. Benefits begin on the 15th day of disability for off-the-job accidents and sickness. Benefits can be paid out for a maximum of 13 weeks. STD plans are available to replace anywhere from 50-70% of a Resident’s predisability income, with a $3,000 a week maximum benefit. STD premiums paid by the employee are withheld after-tax, and any STD benefits paid out to the Resident would also be tax free. 10 A Resident’s Sick days may be used to supplement short-term-disability benefits (not to exceed 100% of pre-disability income.) 6. Long-Term Disability Insurance (LTD) The Long-Term Disability (LTD) Plan provides Residents with 60% of their base earnings when they are disabled due to illness or injury for longer than ninety (90) calendar days. This plan is available to all full time and regular part time Residents at no cost. The maximum monthly benefit is $15,000. A Resident’s benefits may be reduced by the amount of other disability benefits they receive such as Social Security, workers’ compensation or rehabilitation benefits. Residents may choose to be taxed on either the premium or the monthly benefit, if disabled. 7. Healthcare Spending Account (HSA) Residents may contribute between $100 and $5,000 per year pre-tax to a Health Care Spending Account. By participating, they set aside money from their paycheck on a pre-tax basis and then use the money to pay for eligible health care expenses. The net effect is that a Resident reduces their amount of out-of-pocket costs by the amount of taxes they otherwise would have had to pay. 8. Dependent Care Spending Account By contributing to a Dependent Care Spending Account, the Resident can set aside pre-tax money to pay the cost of caring for a child or other eligible dependent while they and their spouse or partner are at work. Deductions and reimbursements are tax-free. CMH will subsidize the Resident with an additional 15% contribution on top of the Resident’s contribution election. The total account, including the subsidy, can be between $100 and $5,000 per year. 9. Wellness Center. The CMMC Wellness Center is located on the lower level of 12 High Street on the CMMC campus. The facility offers an assortment of cardiovascular and strength equipment, well equipped locker rooms, personal trainer services and a variety of facilitated exercise classes. A membership fee is required and can be payroll deducted. Additional Benefits Resources Additional benefits information can be accessed and reviewed independently on the CMH Healthy Decisions website, www.cmmfhealthydecisions.com 11 APPENDIX C— (“Name of Resident”) CENTRAL MAINE MEDICAL CENTER – (“CMMC”) ADDITIONAL CONSIDERATION Medical School Loan Repayment Plan. CMMC shall pay the Resident’s medical school loans up to a maximum annual reimbursement of $6,900.00. Based on receipt of loan documentation, CMMC will pay such amount at the successful completion of each full year of employment subject to residency advancement to the next year or graduation. Wellness Center Membership. CMMC shall pay the Resident’s monthly wellness center membership at CMMC Call Room. CMMC shall provide Residents on call with a call room. Moving Expenses. CMMC shall pay Resident up to One Thousand Hundred Dollars ($1,000.00) in additional compensation for actual moving expenses. Resident must provide CMMC with a copy of any/all moving related receipts to receive reimbursement. Taxable Income. The parties acknowledge that some or all of the amounts paid by CMMC pursuant to this Appendix C may be viewed as taxable compensation by federal and state taxing authorities and in such event such amounts will constitute taxable income to the Resident. Any such taxable income will be subject to reporting by CMMC to the Internal Revenue Service and Maine Revenue Services. Such taxable income so generated will also be subject to applicable federal and state wage withholding requirements. 12 APPENDIX D CENTRAL MAINE HEALTHCARE CITIZENSHIP STANDARDS The Resident understands and agrees to adhere to the behavioral expectations regarding appropriate individual conduct and behaviors. The Resident understands and agrees to exhibit the following behaviors: 1. Effective communication with all patients, families, staff, (no matter what their position within the organization) and other providers both within and external to CMH with respect, courtesy and dignity 2. Effective hand off of critical patient information to other providers assuming care of your patients 3. Active participation in peer review 4. Cooperative working relationship with practice management including timely submission of schedule changes, vacation time and CME activities to ensure proper coverage of practice. 5. Hospital committee participation 6. Participation in PI projects 7. Timely, accurate and complete documentation of medical records 8. The Resident will refrain from: a. Dishonesty or falsification of records b. Inaccurate submission of billing information c. Any illegal behavior relating to the practice of medicine or employment with CMH, or which is likely to adversely affect public respect for CMH or its the Residents. 9. In addition, it is expected that the Resident will follow any other CMH policies related to conduct. Examples include, but are not limited to, the following policies: a. Drug and Alcohol Free Workplace b. Harassment policy c. Expectations Regarding Romantic Relationships d. Violence in the Workplace e. Smoke Free Workplace f. Confidentiality policy g. Vendor Relationships These standards described in this document are subject to change from time to time by CMH. Any change shall be effective no sooner than 30 days after written notice has been provided to the Resident, and any former provision shall then be superseded, and of no further effect. 13
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