APPOINTMENT TO HOUSE STAFF AGREEMENT

This Appointment to House Staff Agreement (this “Agreement”) is entered into as of March 17, 2017, by and between THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY d/b/a CAROLINAS MEDICAL CENTER (“CMC”) and «First Name» «Middle Name» « Last-name», «Degree» (“Resident”).

Statement of Purpose

CMC desires to appoint Resident as a member of Carolinas Medical Center’s (“CMC”) House Staff participating in CMC’s graduate medical education resident training program and Resident desires to accept such appointment, on the terms and conditions set forth in this Agreement. CMC is an affiliate of Carolinas HealthCare System (“CHS”) and, as such, adheres to certain CHS policies and practices.

In consideration of the foregoing, the mutual agreements contained herein, and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties agree as follows:

Duration of Appointment

Appointment and Term. Subject to the terms and conditions of this Agreement, CMC hereby appoints Resident as a member of CMC’s House Staff and assigned to the department of «Program» (“Program”) and Resident desires to accept such appointment, commencing on July 1, 2017 (first day of Orientation), or such later date that the conditions precedent set forth in Section 12 have been met, and ending on June 30, 2018 (the “Term”), unless earlier terminated pursuant to Sections 14 and 15.

Financial Support

Salary. CMC shall provide to Resident an annual salary of $«Salary», payable in biweekly installments in accordance with CHS’s customary payroll practices. The annual salary may be increased by CMC from time to time. CMC may withhold from any amounts payable under this Agreement such federal, state and local taxes or other amounts required to be withheld pursuant to applicable law.

Benefits, Professional Liability Insurance, and Leaves of Absence

Benefits. During the Term, CMC shall provide Resident with health and dental insurance, life and disability insurance, and professional liability insurance (including a reporting endorsement (tail coverage) (see “Certificate of Liability Insurance” in policy packet). CMC shall also provide leave of absence benefits in accordance with CMC’s Division of Education and Research’s House Staff Policies entitled “Policy for Medical and Family Medical Leave,” and counseling and psychological support services in accordance with CMC’s Division of Education and Research’s House Staff Policy entitled “Policy Regarding Counseling and/or Psychological Support of Residents During Their Graduate Training,” in each case, as generally made available to similarly situated employees of CMC from time to time. Health, dental, life and disability insurance as well as professional liability insurance shall begin on the first day of the Term.

Vacation & Continuing Medical Education

Vacation and Continuing Medical Education. Resident shall be entitled to ten (10) days (or, if this Agreement governs Resident’s third or subsequent year of training with CMC, fifteen (15) days) for vacation and five (5) days for continuing medical education during the Term. Such vacation and continuing medical education days must be scheduled with  the chief resident of the Program and otherwise taken in accordance with CMC’s Division of Education and Research’s House Staff Policy entitled “House Staff Vacation Policy.” Vacation or continuing medical education days not taken during the Term may not be carried forward and shall expire if not used during the Term.  No additional payments shall be made to Resident for vacation or continuing medical education days not taken upon termination of this Agreement or otherwise.

Duty Hours & Supervision

Duty Hours and Call Schedules. Resident shall perform his or her duties under this Agreement during such hours as the Program Director may direct in accordance with CMC’s Division of Education and Research’s House Staff Policy entitled “Policy Regarding Resident Duty Hours,” a p p l i c a b l e federal, state and local laws, rules, regulations and policies, and Accreditation Council for Graduate Medical Education (“ACGME”) requirements. If a scheduled duty assignment is inconsistent with such policies, laws, rules, regulations or requirements, Resident shall bring such inconsistency to the Program Director as soon as possible who shall take the necessary steps to reconcile or cure such inconsistency.

Moonlighting. Moonlighting is defined as working for compensation in addition to performing the regular duties as a resident at CMC. Moonlighting is not encouraged but may be permitted when in compliance with CMC’s Division of Education and Research’s House Staff Policy entitled “Policy for Resident Moonlighting.”

Faculty Responsibilities and Supervision. CMC will provide, to the best of its ability, appropriate faculty supervision of Resident at all levels of training to ensure that Resident provides safe and effective care and ensure that Resident is not subjected to responsibilities beyond his/her capabilities.

Obligations & Accommodations

Obligations of CMC. During the Term, CMC shall use its best efforts, with available resources, to provide an educational training program and environment that meets the applicable ACGME accreditation standards. In addition, CMC shall provide Resident with appropriate meals and sleeping quarters during such times as Resident is taking formal night call, laboratory coats, laundry service for laboratory coats, and parking. CMC will provide to the Resident all information related to his/her eligibility for specialty board examinations.

9.Accommodation for Disabilities. CMC will comply with all legal obligations to Residents with disabilities. Procedures for accommodations are set forth in CHS’s Human Resource Policy (HR 4.02) entitled “Disabilities: Team Members & Persons Applying for Jobs.”

Harassment and Discrimination. CMC will not tolerate harassment or discrimination. See CHS’s Human Resource Policy (HR 5.07) entitled “Protection from Discrimination, Harassment and Retaliation” for further details.

Resident Responsibilities

Certain Obligations of Resident. During the Term, Resident shall do the following:

Participate fully in the educational and scholarly activities of CMC’s residency training program;

Use his or her best efforts to provide safe, effective, and compassionate patient care and present at all times a courteous and respectful attitude toward all patients, colleagues, employees and visitors at CMC and CHS;

Provide clinical services commensurate with his or her level of advancement and responsibilities under appropriate supervision under circumstances and at locations covered by CHS’s professional liability insurance maintained for Resident;

Abide by all applicable federal, state and local laws, rules, regulations and policies, including the North Carolina Medical or Dental Board, as applicable, and other appropriate governmental agencies and departments and by the standards required to maintain accreditation by ACGME, the Residency Review Committee and the Joint Commission on Accreditation of Healthcare Organizations and any other relevant accrediting, certifying, or licensing organization, including the legible and timely completion of patient medical/dental records, charts, reports, statistical operative and procedure logs, evaluations, and other documentation required by such agencies and organizations;

Abide by all applicable rules, regulations, bylaws, policies, practices, and procedures of CMC and CHS, its clinical departments and its facilities and the Medical or Dental Staff as in effect from time to time, including the House Staff Policies. A copy of the House Staff Policies in effect as of the date hereof have been provided to Resident as part of the contract package and Resident hereby acknowledges that he or she has read and understands such policies;

Submit to drug screens pursuant to CHS’s pre-employment, random, and reasonable suspicion drug screening program for its employees;

Refrain from taking any action or making any statements with the intention or effect of disparaging the goodwill or reputation of CMC or CHS;

Take the USMLE Step 3 exam prior to the end of the first year of the Term; and

Furnish such further information, execute and deliver such other documents, and do such other acts and things, in each case as CMC or CHS reasonably requests at any time for the purpose of carrying out the intent of this Agreement.

Conditions Precedent to Effectiveness. This Agreement shall become effective on the date that each of the following conditions has been satisfied:

The Designated Institutional Official of CMC shall have received (i) a completed ERAS common application form, including an official medical school transcript, (ii) proof of legal employment status (i.e., birth certificate, passport, naturalization papers, valid visa, etc.), (iii) a copy of a resident training license or full/unrestricted license (as required by CHS) in Resident’s name from the North Carolina Medical or Dental Board,  as applicable;

Resident shall have submitted to a pre-employment drug screen under CHS’s pre- employment drug screening program and such drug screen shall have been negative;

Resident shall have active certification in the relevant life support course or courses (i.e., Basic Life Support, Advanced Cardiovascular Life Support, Pediatric Advanced Life Support, Advanced Trauma Life Support, and/or Neonatal Resuscitation Program); and

Resident shall have complied with all other pre-employment requirements of CMC and CHS that are generally applicable to similarly situated residents and employees.

Grievance Procedures & Due Process

Reappointment and Promotion to Subsequent PGY level. Resident will be monitored and counseled regarding his or her status within the Program, including whether or not he or she is on track to reach the milestones as set by the Program. If the milestones are met in each of the six competencies, Resident shall be appointed to the next PGY level for a subsequent term. If milestones are not reached, CMC may take corrective action, up to and including suspension or termination in accordance with the policy entitled “Policy Regarding the Right to Grievance for Academic Extention of Residency Training or Termination from a Residency Program.”

Grievance & Termination. This Agreement is subject to termination prior to expiration of the Term in accordance with CMC’s Division of Education and Research’s House Staff Policy entitled “Policy Regarding the Right to Grievance for Academic Extention of Residency Training or Termination from a Residency Program.” as follows:

By CMC due to Resident’s failure to comply with the terms of this Agreement, substandard or unsatisfactory performance, unprofessional or illegal conduct (including a positive drug screen pursuant to CHS’s policy), debarment or exclusion from federal program participation, or conduct disruptive to the operation of CMC, CHS, or the Program; or

By Resident upon thirty (30) days prior written notice.

Effect of Termination. If this Agreement is terminated prior to the expiration of the Term or if this Agreement is terminated as a result of the expiration of the Term, Resident shall be entitled to receive the compensation and benefits earned through the effective date of termination. Except as expressly provided above or as otherwise required by law, CHS shall have no obligations to Resident in the event of the expiration or termination of this Agreement for any reason. CHS shall comply with the obligations imposed by state and federal law and regulations to report instances in which Resident is not reappointed or is terminated for reasons related to alleged mental or physical impairment, incompetence, malpractice or misconduct, or impairment of patient safety or welfare.

Professional Liability Insurance

Litigation Support. If CMC or CHS is investigating, evaluating, pursuing, contesting or defending any incident, proceeding, charge, complaint, claim, demand, notice, action, suit, litigation, hearing, audit, investigation, arbitration or mediation, in each case whether initiated by or against CMC or CHS (collectively, “Proceeding”), Resident shall cooperate with CMC or CHS and its counsel in the evaluation, pursuit, contest or defense of the Proceeding and provide such testimony and access to books and records as may be necessary in connection therewith. If the Resident or anyone with whom the Resident works receives, on his/her behalf, any summons, complaint, subpoena, or court paper of any kind relating to activities in connection with this Agreement or the Resident’s activities at CMC or a CHS facility, the Resident agrees to immediately report this receipt and submit the document received to CHS’s Office of The General Counsel. This section 16 shall survive termination of the Agreement.

Miscellaneous.

All paragraph and item headings are inserted for convenience only and do not expressly or by implication limit, define, or extend the specific terms of the section so designated. The word “including” in this Agreement means “including without limitation.” All words in this Agreement shall be construed to be of such gender or number as the circumstances require.

This Agreement contains the entire understanding of the parties and shall be amended only by written instrument signed by both parties.

This Agreement shall be governed by and interpreted under North Carolina law, without giving effect to the conflict of laws provisions thereof.

Whenever a notice is required to be given in writing under this Agreement, such notice shall be given by certified mail, return receipt requested, and returned to the respective party at his or her last known address.

The failure by either party to promptly exercise a right hereunder or to seek a remedy available hereunder because of a breach of this Agreement shall not be construed as a waiver of that right or a waiver of any remedy for that breach or any future breach of this Agreement.

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.

IN WITNESS WHEREOF, the parties hereto have executed and delivered this Agreement as of the date first written above.