Sample One: Physician and Hospital Contract This Agreement is entered into this DATE day of MONTH, YEAR by and between HOSPITAL, a NAME OF STATE nonprofit corporation ("HOSPITAL"), and ______________________, M.D., an individual physician ("Physician"). WHEREAS, HOSPITAL provides health care services in the State of NAME OF STATE in the geographic areas covered by the counties of NAME OF COUNTIES (the "Service Area"); and WHEREAS, HOSPITAL has determined that the health care needs of the residents of the Service Area would be better served by attracting additional physicians to the community, and HOSPITAL desires to ensure that adequate medical care is available to residents of the Service Area through the recruitment of qualified physicians; WHEREAS, in particular, there are an insufficient number of physicians in Physician's specialty of ___________________ to meet the needs of the residents of the Service Area and HOSPITAL desires to ensure that adequate medical care is accessible and available throughout the community through the recruitment and retention of _______________ to the Service Area, and WHEREAS, in order to attract and retain such physicians, HOSPITAL has explored alternative methods of recruiting physicians and has determined that the only feasible way to accomplish its goals is through the use of recruitment incentives and assistance to physicians, including but not limited to, financial assistance with the costs associated with establishing a practice within the Service Area; WHEREAS, Physician is duly licensed and qualified to practice medicine in the State of NAME OF STATE and Physician desires to relocate to the Service Area; WHEREAS, HOSPITAL, in order to recruit Physician to relocate to and remain in the Service Area, has determined that the incentives and assistance provided for herein are reasonable and appropriate in light of the benefits to the residents of the Service Area of recruiting Physician to establish a medical practice; WHEREAS, Physician is willing to make a long-term commitment to practice in the Service Area, and to become and remain a member of the active medical staff of HOSPITAL NAME (the “Hospital”); and NOW, THEREFORE, for and in consideration of the mutual covenants and agreements contained herein, the parties agree as follows: I. OBLIGATIONS, QUALIFICATIONS AND REPRESENTATIONS OF PHYSICIAN 1.1. Establishment of Practice. The Physician agrees, upon execution of this Agreement, to initiate the necessary steps to relocate to the Service Area and establish a medical practice in NAME OF CITY, NAME OF STATE, pursuant to the terms of this Agreement. Such steps shall include, but shall not be limited to, obtaining office space, leasing or purchasing appropriate equipment, leasing or employing appropriate office personnel, and any other steps to begin a medical practice so that Physician may begin practice on or about _____________, YEAR (the actual date on which Physician begins rendering patient care services is referred to as the "Commencement Date"). 1.2. Full-Time Practice. Physician agrees to practice medicine on a full-time basis in the Service Area during the term of this Agreement and to maintain Physician's sole professional office in NAME OF CITY, NAME OF STATE or at another location within the Service Area which is approved by HOSPITAL in its sole discretion upon the showing of adequate community need for the relocation. Physician's primary area of practice will be in _____________, and Physician will provide appropriate medical care to all persons presenting themselves for treatment regardless of race, age, religion, national origin, handicap, ability to pay, third party payor or participation in any federal or state health care program. The parties agree that "full-time" as used herein shall mean at least forty (40) hours per week for forty-six (46) weeks per year. 1.3. Medical Staff Membership. Physician agrees to maintain, at all times during the term of this Agreement, membership on the Medical Staff of HOSPITAL NAME, consistent with HOSPITAL NAME’s regular requirements and process for such application and membership, and to obtain and maintain such clinical privileges as are necessary and appropriate to carry on the practice as contemplated hereby. During the term of this Agreement, Physician shall undertake all ordinary services and obligations expected of members of the Medical Staff and the Hospital, including on-call services on a rotating basis with other staff members, if required, and participation on Medical Staff committees as reasonably requested by the Hospital and approved by the Medical Staff and shall at all times comply with all bylaws, rules and regulations of the Medical Staff and with the corporate bylaws and policies of the Hospital. 1.4. Maintenance of Books and Records. Physician agrees that, during the term of this Agreement, he shall maintain accurate books and records regarding the Practice, and the Physician shall make the same available to HOSPITAL for inspection and copying within ten (10) business days of a request by HOSPITAL. 1.5. Professional Fees. Physician shall promptly charge and collect all professional fees for services rendered by Physician, or under Physician's direction, to individual patients and/or their third party payors, including but not limited to, those patients seen as inpatients and in emergency rooms, outpatient departments, clinics, and Physician's office. 1.6. Medicare and Medicaid. Physician agrees that, during the term of this Agreement, Physician shall maintain eligibility to, and shall participate in, the Medicare and Medicaid programs and such other third party payor programs designated by HOSPITAL. Physician further agrees that during the term of this Agreement, he shall accept as patients any persons seeking medical services who participate in the Medicare and Medicaid programs. 1.7. Compliance with Legal Requirements. Physician agrees that, during the term of this Agreement, the services to be provided by Physician hereunder will be provided in accordance with all applicable federal and state laws, regulations, and rules governing the services, rules and regulations of the Hospital and its Medical Staff, all as may be amended from time to time. 1.8. Professional Liability Insurance. Physician agrees that, during the term of this Agreement, Physician shall maintain professional liability insurance coverage in compliance with the bylaws of the Medical Staff. In the event such coverage is terminated or canceled for any reason, and if coverage is on a claims-made basis, Physician agrees to purchase a reporting endorsement to permit coverage of claims arising prior to the termination of coverage, but not reported during the period of insurance coverage. 1.9. Professional Licensure. Physician shall at all times during the term of this Agreement maintain an unrestricted license to practice medicine in the State of NAME OF STATE and shall maintain all necessary licenses, registrations, certifications and other approvals necessary for the practice of medicine as contemplated hereunder, including federal and state registration to dispense and prescribe controlled substances. 1.10. No Revocation or Suspension. Physician represents and warrants to HOSPITAL that Physician's ability to provide professional medical services in any state, commonwealth or other jurisdiction has never been revoked, limited, suspended or otherwise restricted in any manner. Physician further represents and warrants to HOSPITAL that Physician is not currently and has never been suspended from participation in or subjected to any type of criminal or civil sanction, fine, civil money penalty, debarment or other penalty by any private or public health insurance program, including Medicare, Medicaid or any other federal or state health insurance program. 1.11 Confidentiality of Agreement. Except with the prior written consent of HOSPITAL, Physician shall not disclose the contents of this Agreement to any third party, except as may be reasonably required for Physician to obtain the services of their respective professional advisors or as may be required by law. Physician shall notify any professional advisor to whom Physician discloses the contents of this Agreement of the nondisclosure requirements of this Agreement. This Section 1.11 shall survive the termination of this Agreement. 1.12. Duration of Obligations. The Physician’s obligations as set forth in this Section I. and elsewhere in this Agreement shall continue as long as any loan amount remains outstanding and unpaid (or not forgiven) as provided in Sections II and III. of this Agreement. II. SIGN ON, RELOCATION AND INCOME GUARANTEE LOANS 2.1. Sign-On Loan. Upon execution of this Agreement by all parties, the HOSPITAL shall loan to Physician ______________ Dollars ($________) as a sign-on loan (the "Sign-On Loan") to enable Physician to pay for other reasonable expenses related to relocation to the service area. 2.2. Relocation Loan. In consideration of Physician's establishment of a medical practice in the Service Area and Physician's agreements hereunder, upon execution of this Agreement by all parties, the HOSPITAL shall (i) loan to Physician up to Twelve Thousand, Five Hundred Dollars ($12,500) to be used to reimburse Physician for certain relocation and other expenses that Physician has actually incurred as a result of relocating Physician's residence to the Service Area and establishing a medical practice pursuant to Section 1.1 hereof (the "Relocation Loan"). The Physician shall obtain three (3) bids from qualified moving companies and shall utilize the company providing the lowest bid unless HOSPITAL consents otherwise in writing, and (ii) loan to Physician up to three thousand six hundred dollars ($3,600.00) for the actual rent paid by Physician to house Physician and his family for a period not exceeding ninety (90) days The Physician must submit or cause to be submitted to HOSPITAL receipts evidencing the payment of such relocation expenses prior to receiving any disbursement of the Relocation Loan. 2.3. Income Guarantee Loan. Beginning with the first month following the month in which the Commencement Date occurs, HOSPITAL shall, for a period of not more than twenty-four (24) consecutive months thereafter (the “Loan Period”), lend to the Physician on or before the 15th day of each month, an amount by which the Physician’s Net Collections during the preceding month are less than the amount of the Physician’s Approved Operating Expenses for the month. (i) The term “Net Collections” shall mean the total cash amount actually received after payment of all costs of billing and collection. (ii) The term “Approved Operating Expenses” shall mean the actual costs paid by Physician up to a maximum amount of $____________ per month, including but not limited to the Physician’s salary and benefits; the salaries and benefits of any personnel hired, leased or contracted for by the Practice to work exclusively with or for Physician; Physician’s insurance; and rent for space and equipment used by or for Physician. (iii) In the event the Physician’s Net Collections for any month during the Loan Period exceed the Physician’s Approved Operating Expenses for that month, the amount by which the Net Collections exceed the Approved Operating Expenses shall be carried forward to the next succeeding month and counted as Net Collections in the succeeding month solely for the purpose of determining whether any loan shall be made for any for the succeeding month. (iv) Physician will report and certify to HOSPITAL as true and correct, on or before the tenth (l0th) day of each month, the amount of Net Collections collected by Physician during the preceding month in such form as HOSPITAL shall direct. HOSPITAL shall have the right, during normal business hours, to inspect or cause its auditors to inspect, at its own expense, the books and records of Physician, from time to time, to verify such collections and expenses. (v) Notwithstanding any provision of this Agreement to the contrary, HOSPITAL shall not be obligated to make any further loan advance if any Event of Default (as defined in Section 4.1 hereof) shall have occurred. (vi) In no event shall HOSPITAL have any obligation to loan any amounts to Physician for a period of more than twenty-four (24) consecutive months beginning with the Commencement Date, unless HOSPITAL determines in its sole discretion that it is necessary to lend additional funds to Physician to enable Physician to establish a medical practice in Service Area. Any additional funds provided to Physician shall be on such terms and conditions as HOSPITAL deems reasonable and appropriate in its sole discretion. (vii) All payments under this section 2.3 shall be made by HOSPITAL to Physician. 2.4. Documentation. Contemporaneous with the execution of this Agreement, the Physician shall execute and deliver to HOSPITAL (i) a secured promissory note substantially in the form of Exhibit B attached hereto (the “Note”) evidencing the amount loaned to the Physician pursuant to Section 2.3. above, and (ii) a security agreement substantially in the form of Exhibit C attached hereto (the “Security Agreement”) securing the obligations set forth in the Note. 2.5. Repayment of Note Except as otherwise provided under the Agreement, the Note or the Security Agreement, the outstanding principal amount of the Note, together with accrued interest thereon, shall be payable by Physician to HOSPITAL in forty-eight (48) equal monthly installments (each a "Monthly Installment") commencing on the first day of the nineteenth (19th) month following of the Commencement Date, or the first day of the month following the month in which the last loan payment is made to Physician if HOSPITAL determines that additional funds should be loaned to Physician in accordance with section 2.3.(vii) above, and continuing for forty-eight consecutive (48) months thereafter. Physician shall pay simple interest on the outstanding principal amount of the Note at the per annum rate equal to the "prime rate" as published in the Wall Street Journal on the Commencement Date, plus one percent (1%). The Note may be prepaid at any time, in whole or in part, without penalty. III. FORGIVENESS OF NOTE 3.1. Forgiveness of Note. Notwithstanding anything herein to the contrary, HOSPITAL agrees to forgive the debt owed by Physician to HOSPITAL as evidenced by the Note, by forgiving each monthly payment thereunder as each payment becomes due, as long as the Physician complies with all the terms and conditions of this Agreement and is continuing to practice medicine in the specialty of _____________ in the Service Area as of the due date of each payment, and is not otherwise in default of any provision in this Agreement. 3.2. Event of Default or Termination. From and after the occurrence of an Event of Default, or if this Agreement is terminated for any reason prior to the repayment or forgiveness of all amounts due pursuant to the Note, no further amounts shall be forgiven under the Note pursuant to Section 3.1; but to the extent permitted under applicable law (including laws applicable to HOSPITAL by reason of HOSPITAL's tax-exempt status) any amounts forgiven under the Note pursuant to Section 3.1 prior to such Event of Default or termination shall remain forgiven. IV. DEFAULT 4.1. Events of Default. The occurrence of anyone or more of the following events shall constitute an "Event of Default" under this Agreement: a) Any representation or warranty of Physician contained in this Agreement, the Note, the Guaranty, the Security Agreement or in any agreement, instrument or certificate related thereto (collectively, the "Loan Documents") shall prove to have been false or misleading in any material respect at the time it was made or delivered; or b) Physician fails or neglects to perform, keep or observe any material term, provision, condition, obligation or covenant contained in this Agreement which is required to be performed, kept or observed by Physician, and the same is not cured to HOSPITAL's reasonable satisfaction within thirty (30) days after HOSPITAL gives Physician written notice identifying such default; or c) Any action or conduct of the Physician which would be grounds for suspension, restriction or termination of Physician's Medical Staff membership or clinical privileges at HOSPITAL NAME, or other disciplinary or corrective action, pursuant to the HOSPITAL NAME Medical Staff Bylaws, regardless of whether such disciplinary or corrective action is actually taken; or d) Conduct by Physician involving unethical conduct, moral turpitude or fraud, including, without limitation, any violation by Physician of any law or regulation relating to Medicare, Medicaid or other governmental programs; or e) The suspension or revocation of Physician's license to practice medicine in any state or Physician's federal or state registration to prescribe or dispense controlled substances; or any other formal disciplinary action taken by any regulatory or licensing agency, or f) An application is made for the appointment of a receiver, trustee or custodian for by Physician; a petition under the federal Bankruptcy Code or any other federal or state bankruptcy, insolvency or other similar law or regulation is filed by Physician; a proceeding or case is commenced against Physician under the federal Bankruptcy Code or any other federal or state bankruptcy, insolvency or other similar law or regulation, and such proceeding or case is not dismissed or stayed within sixty (60) days of filing or Physician makes an assignment for the benefit of his creditors. g) HOSPITAL fails or neglects to perform, keep or observe any material term, provision, condition, obligation or covenant contained in the Agreement which is required to be performed, kept or observed by HOSPITAL and the same is not cured within thirty (30) days after Physician gives HOSPITAL written notice identifying such default. 4.2. Effect of Default. Upon the occurrence of an Event of Default: a) If there is an Event of Default by Physician, HOSPITAL may i) at its option add all unpaid accrued interest to the principal of the Note for purposes of calculating interest and, in addition thereto, at its option, may accelerate the payment of all unpaid and unforgiven principal and accrued interest on the Note in which event the entire unpaid or unforgiven principal of the Note, and all accrued interest shall be immediately due and payable in full; ii)pursue such other remedies as may be available to it under this Agreement and the other Loan Documents; and iii) take whatever action at law or in equity may appear necessary or desirable to collect payments then due (to the extent not previously forgiven) or thereafter to become due and to enforce performance of the any covenant, condition or agreement of Physician under this Agreement. b) If there is an Event of Default by HOSPITAL which remains uncured, Physician may i) elect to terminate the Agreement in which event all amounts previously loaned to Physician, and all accrued interest, shall be forgiven in full, or ii) pursue such other remedies as may be available to Physician under this Agreement and the other Loan Documents, including the right to specific performance. V. TERM AND TERMINATION 5.1. Term. The term of this Agreement shall commence on the Commencement Date and, unless earlier terminated in accordance with the terms hereof, shall remain in force until all amounts loaned to Physician have been repaid or forgiven in full in accordance with the terms of this Agreement. 5.2. Automatic Termination. This Agreement shall be automatically terminated upon the occurrence of any of the following events: a) the death of the Physician; b) the suspension or termination of Physician's Medical Staff membership or the involuntary reduction of Physician's clinical privileges at HOSPITAL NAME in accordance with the procedures for such actions set forth in the Hospital Medical Staff bylaws; or c) the suspension or revocation of Physician's license to practice medicine in any state or Physician's federal or state registration to prescribe or dispense controlled substances. 5.3. Termination by HOSPITAL. At any time during the term of this Agreement, HOSPITAL, may, in its sole discretion, terminate this Agreement upon the occurrence of anyone of the following events, effective upon delivery of written notice of termination to Physician: a) the existence of any physical, mental or emotional disability that renders Physician unable to fulfill substantially Physician's obligations hereunder for a period of sixty (60) days in any consecutive twelve (12) months; b) the enactment of any state or federal law or regulation which prevents HOSPITAL or any of its affiliates from receiving Medicare, Medicaid or other reimbursement for services provided by HOSPITAL or any affiliate thereof to patients referred by Physician, if such law or regulation would prohibit or deny reimbursement because of the arrangements between HOSPITAL and Physician pursuant to this Agreement; c) HOSPITAL determines after consultation with legal counsel that any provision of this Agreement or any of the Loan Documents may violate any applicable federal, state or local law or regulation, or may adversely affect the taxexempt status of HOSPITAL; or d) Physician. the occurrence of any Event of Default under this Agreement by 5.4. Termination by Agreement. This Agreement may be terminated at any time by mutual written agreement of the parties upon such terms and on such date as the parties shall agree in writing. 5.5 Termination Due to Legal Requirements. The parties intend that this Agreement comply at all times with all existing and future applicable laws, including but not limited to, state and federal anti-kickback laws, the restrictions on Hospital by virtue of its taxexempt status, the federal law relating to physician referrals (“Stark II”), as well as state laws relating to physician referrals. If at any time, the Hospital receives advice of counsel that there is a substantial risk that this Agreement does not comply with an applicable law, or that this Agreement jeopardizes the exempt status of Hospital or its bonds, or that Hospital would be legally precluded as a result of this Agreement from billing a third party payor for services ordered by the Physician, then the parties will use good faith efforts to reform this Agreement in such a manner so that it complies with applicable law or does not preclude Hospital from billing a third party payor, as applicable. If, after the exercise of such good faith efforts for a period of at least thirty (30) days, the parties have not agreed on amendment(s) to this Agreement that resolve the legal issues referred to above, Hospital may terminate this Agreement immediately. 5.6. Effect of Termination. Termination of this Agreement by any party shall not terminate any obligations of any party which arose prior to termination of this Agreement, nor shall such termination terminate any obligations under the Note or any of the other Loan Documents; provided, however, that if this Agreement is terminated pursuant to Section 4.2. (b), 5.2(a) or Section 5.3(a), then, to the extent permitted by applicable law (including laws applicable to the HOSPITAL by reason of the HOSPITAL' tax-exempt status), HOSPITAL shall forgive the unpaid balance of the principal amount and accumulated interest on the Note. Any termination of this Agreement shall be without prejudice to any other right or remedy to which the terminating party may be entitled, either at law or in equity, under this Agreement or otherwise. In the event of termination of this Agreement by HOSPITAL pursuant to 5.2. (b) or (c), or 5.3. (b), (c) or (d), any amounts loaned to the Physician which remain unpaid or unforgiven shall become immediately due and payable in full. VI. ACCESS TO BOOKS, DOCUMENTS, AND RECORDS OF THE PHYSICIAN To the extent Section 952 of the Omnibus Reconciliation Act of 1980 (the "Act") and the regulations promulgated thereunder are found applicable to this Agreement, until the expiration of four (4) years after the furnishing of services pursuant to this Agreement, Physician and the organizations related to Physician, if any, performing any of the duties of this Agreement valued at Ten Thousand Dollars ($10,000) or more in a twelve (12)month period shall comply with requests by the Inspector General of the United States, the Secretary of the Department of Health and Human Services or their duly authorized representatives for access (in accordance with Section 952 of the Act) to any contract or agreement between Physician and such related organization, as well as the books, documents, and records of the Physician and Physician's related organizations, if any, that are necessary to certify the extent of any costs of HOSPITAL arising from the Agreement. VII. RELATIONSHIP OF PARTIES 7.1. Independent Status. It is agreed that in performing the obligations hereunder, Physician will be and is an independent physician and shall nothing herein shall be so construed as to establish an employment, master-servant, agency or other like relationship between HOSPITAL and Physician. HOSPITAL shall neither have nor exercise any control or discretion over the methods by which Physician will perform Physician's duties and functions. Physician will pay and be responsible for all applicable federal, state, and local income taxes, gross receipts taxes, F.I.C.A., unemployment, and disability benefits and workers' compensation obligations that may arise in connection with the services provided by Physician pursuant to this Agreement. 7.2. Representations and Warranties. The HOSPITAL and Physician stipulate, represent and warrant each unto the other that: a) There is no express or implied condition or understanding between the HOSPITAL and the Physician which conditions this Agreement or the benefits to be provided hereby upon referral by Physician of patients or other business to the HOSPITAL, or any of its affiliates; b) Physician is free to establish medical staff privileges at, to refer patients and business to, and to provide services in health care facilities and/or entities other than the HOSPITAL and its affiliates; c) The benefits to be provided to Physician pursuant to the terms of this Agreement will not, under any circumstances, vary based upon the volume or value of business Physician generates for HOSPITAL or its affiliates; d) The purpose of the benefits provided by HOSPITAL to Physician pursuant to the terms of this Agreement is to assist Physician in starting a medical practice in the Service Area; and e)No provision of this Agreement is intended as a means of offering compensation to Physician as an inducement for referrals of patients or business by Physician to HOSPITAL or any of its affiliates. VIII. MISCELLANEOUS PROVISIONS 8.1. Notice. All notices, requests, demands, approvals, and other communications required or permitted by this Agreement shall be in writing and sent by certified mail or by personal delivery, and shall conclusively be deemed to have been received on the date such notice is delivered at the address specified below (or hereto), or, in the case of certified mail, on the fifth (5th) business day following the date on which it was mailed: If to HOSPITAL: HOSPITAL Attention: President and Chief Executive Officer ADDRESS NAME OF CITY, NAME OF STATE, ZIPCODE If to Physician: _______________________ M.D. (NAME OF STATE address to be determined) 8.2. Entire Agreement: Physician and HOSPITAL agree that this Agreement, together with the other Loan Documents, constitutes the entire agreement among them with respect to the subject matter hereof, and that any and all prior discussions, negotiations, commitments, and understandings relating thereto are hereby superseded and merged herein. The terms and provisions of this Agreement shall not be changed, amended, waived, modified, or terminated in any respect whatsoever except by a written instrument executed by the parties hereto. Either HOSPITAL or Physician may request a modification of this Agreement by written notice in the event of a change in or binding interpretation of a law, regulation, or administrative policy by any governmental entity that adversely affects the material terms of this Agreement. In the event that the parties are unable to agree upon an acceptable modification, then either party shall have the right to terminate this Agreement upon ten (10) days' written notice to the other party. 8.3. Governing Law. This Agreement shall be governed by and construed in accordance with the laws of the State of NAME OF STATE. 8.4. Assignment. This Agreement shall be binding upon and shall inure to the benefit of HOSPITAL and the Physician, and their respective heirs, successors and assigns. The Physician shall not have the right to assign any of the Physician’s rights, or obligations hereunder, in whole or in part, without the 'prior written consent of HOSPITAL. HOSPITAL may assign its rights and obligations under this Agreement without the consent of Physician. 8.5. No Waiver of Rights. Neither any failure nor any delay on the part of any party in exercising any right, power, or privilege hereunder shall operate as a waiver thereof on the part of such party, nor shall a single or partial exercise thereof preclude any other or further exercise, or the exercise of any other right, power or privilege by such party. 8.6. Headings. The articles and other headings of this Agreement are for reference purposes only and shall not affect in any way the meaning or interpretation of this Agreement. 8.7. Severability. If any of the provisions of this Agreement is held to be illegal, invalid or unenforceable in any respect, HOSPITAL and Physician agree that such term or provision shall be deemed to be modified to the extent necessary to permit its enforcement to the maximum extent permitted by applicable law, if practical. If any of the provisions of this Agreement is held to be illegal, invalid or unenforceable in any respect, the remainder of this Agreement and all other provisions hereof shall not be affected thereby, if practical. 8.8. Counterparts. This Agreement may be executed in one or more counterparts, each of which shall be considered an original, and all of which taken together shall be considered one and the same instrument. IN WITNESS WHEREOF, the parties hereto have set their hands and seals to this Agreement, in duplicate originals, one of which is retained by each party. ATTEST: ___________________________ [SEAL] Secretary or Assist. Secretary HOSPITAL By:______________________________ President or Vice President PHYSICIAN: ___________________________, M.D.