ABRAZO CLINICAL ROTATIONS AGREEMENT PE.PDF

AGREEMENT FOR AMBULATORY CLINICAL ROTATIONS
THIS AGREEMENT FOR AMBULATORY CLINICAL ROTATIONS (“Agreement”) is made and
entered into the later of July 1, 2021, or the execution of the Agreement by both parties (“Effective
Date”), by and between VANGUARD HEALTH MANAGEMENT, INC., a Delaware corporation, doing
business as ABRAZO COMMUNITY HEALTH NETWORK (the “Home Hospital”), whose principal
office is located at 2000 W. Bethany Home Rd., Phoenix, AZ 85015 and MARICOPA COUNTY, BY
AND FOR ITS CORRECTIONAL HEALTH SERVICES DEPARTMENT, and its PUBLIC HEALTH
DEPARTMENT (the “Ambulatory Facility”), whose principal office is located at 4041 N. Central
Ave., Ste. 1400, Phoenix, AZ 85012.
R E C I T A L S:
A. Home Hospital is the sponsoring institution for an approved medical residency
program (as defined at 42 C.F.R 413.75(b)) in the specialty of Family Medicine with Obstetrics
(the “Program”), and in connection therewith provides training to interns, residents and fellows
formally accepted, enrolled, and participating in the Program in order to become certified by the
appropriate specialty board (collectively, “Residents”).
B. Home Hospital is the primary provider training site for the Program and its
Residents, and is the employer of each such Resident.
C. Home Hospital has determined that the Residents would benefit from additional
clinical experience in which Resident spends his or her time in patient care activities in another
setting to supplement the Residents’ training in the specialty of Family Medicine.
D. Ambulatory Facility agrees to provide such additional experience and training at its
Ambulatory Facility and is willing to accept Residents for such purpose.
E. The parties desire to set forth their respective duties and obligations relating to the
operation of the Program at Ambulatory Facility
NOW, THEREFORE, in consideration of the mutual promises contained herein, the parties
hereby agree as follows:
1. AMBULATORY FACILITY ROTATIONS. Throughout the term of this Agreement,
Ambulatory Facility shall accept Residents for clinical rotations as shown on Exhibit A, attached
hereto and made a part hereof by this reference. Such rotations shall be of a duration not to exceed
twelve (12) months per Resident. Each such Resident shall be in the PGY1 to PGY3 year of
training. The number and scheduling of Residents shall be determined by mutual agreement of the
Home Hospital’s Director of Medical Education and a program coordinator to be designated by
Ambulatory Facility (the “Program Coordinator”) who shall serve as principal liaison between the
Home Hospital and Ambulatory Facility for all matters concerning the Program. Home Hospital
shall submit to Ambulatory Facility the names and educational background of the Residents at least
two weeks prior to their scheduled rotations at Ambulatory Facility.

2. RESPONSIBILITIES OF AMBULATORY FACILITY. Ambulatory Facility shall be
responsible for the following: (a) provide an appropriate orientation to Ambulatory Facility; (b)
schedule Resident assignments, taking into account the educational requirements of the Program.
Residents shall attend lectures and conferences as scheduled within the appropriate department at
Ambulatory Facility while on rotation to Ambulatory Facility; (c) provide teaching faculty at
Ambulatory Facility who shall be responsible for supervision of clinical services rendered by
Residents at Ambulatory Facility. Faculty shall be duly licensed and shall meet the professional
standards established by federal, state and local laws and regulations, The Joint Commission, and
the ACGME, CHBPE, or other accrediting body for the Program; (d) provide a written evaluation
of the Resident’s performance according to the guidelines outlined in the Program’s policies and
procedures following that Resident’s completion of his or her rotation at Ambulatory Facility; (e)
make its facilities, including parking, lockers and storage facilities, to the extent available, on-duty
living quarters and cafeteria accessible to Residents; (f) make its library, classroom and conference
room space available to Residents; and (g) operate the rotations at Ambulatory Facility in
accordance with Program requirements and federal, state and local laws, rules and regulations.
3. RESPONSIBILITIES OF HOME HOSPITAL. Home Hospital shall be responsible for the
following: (a) ensure that the Director of Medical Education shall be available for consultation with
Ambulatory Facility, the Resident, and supervising faculty for all purposes associated with the
Program; (b) retain responsibility for the overall planning, administration and coordination of the
Program at Ambulatory Facility and the Director of Medical Education shall exercise overall
control and direction over the training received by Residents at the two institutions; (c) require that
all of its Residents who rotate through Ambulatory Facility abide by the policies, rules and
regulations and bylaws of Ambulatory Facility; Ambulatory Facility may, after consultation with
the Director of Medical Education, remove from the rotation and from Ambulatory Facility any
Resident who materially fails to follow such policies, rules and regulations; (d) require each
Resident to carry an identification card issued by Ambulatory Facility and to conspicuously display
his/her name badge when engaging in activities at Ambulatory Facility; (e) operate the Program in
accordance with federal, state and local laws, rules and regulations; (f) require each Resident to
sign a Statement of Responsibility in the form attached hereto as Exhibit B, and a Statement of
Confidentiality in the form attached hereto as Exhibit C; and (g) provide Ambulatory Facility with
academic goals and objectives as provided in Exhibit D.
4. RESIDENT DISCIPLINE. An individual Resident’s disciplinary problems shall be
evaluated jointly by Home Hospital and Ambulatory Facility in conference. Any corrective action
shall be undertaken consistent with the policies of the Program. Ambulatory Facility may
immediately remove from the premises any student who poses an immediate threat or danger to
personnel or to the quality of medical services. Such removal shall, where practicable in the opinion
of Ambulatory Facility, be discussed in advance with the Director of Medical Education.
5. HEALTH OF PARTICIPANTS. Each Resident assigned to Ambulatory Facility shall
be required to provide to Ambulatory Facility satisfactory evidence that each Resident is free from
contagious disease and does not otherwise present a health hazard to Ambulatory Facility patients,
employees, volunteers or guests prior to his or her participation at Ambulatory Facility. Such
evidence shall include without limitation the results of a recent tuberculin skin test, chest x-ray and

physical examination and evidence of immunity from rubella and measles. Hospital and/or the
Resident shall be responsible for arranging for the Resident’s medical care and/or treatment, if
necessary, including transportation in case of illness or injury while participating in the Program at
Ambulatory Facility. In no event shall Ambulatory Facility be financially or otherwise responsible
for said medical care and treatment.
6. OSHA COMPLIANCE. Home Hospital shall be responsible for compliance by
Residents with the final regulations issued by the Occupational Safety and Health Administration
governing employee exposure to blood borne pathogens in the workplace under Section VI(b) of
the Occupational Safety and Health Act of 1970, which regulations became effective March 6, 1992
and as may be amended or superseded from time to time (the “Regulations”), including but not
limited to responsibility as “the employer” to provide all employees with (a) information and
training about the hazards associated with blood and other potentially infectious materials, (b)
information and training about the protective measures to be taken to minimize the risk of
occupational exposure to blood borne pathogens, (c) training in the appropriate actions to take in
an emergency involving exposure to blood and other potentially infectious materials, and (d)
information as to the reasons the employee should participate in hepatitis B vaccination and post-
exposure evaluation and follow-up. Hospital’s responsibility with respect to the Regulations also
shall include the provision of the hepatitis B vaccination in accordance with the Regulations.
7. REIMBURSEMENT. During their rotation through Ambulatory Facility under this
Agreement, the Residents assigned to Ambulatory Facility shall be included in Home Hospital’s
FTE count of residents for direct and indirect medical education reimbursement purposes for the
time spent by Residents at Ambulatory Facility. Ambulatory Facility is providing supervisory
teaching activities on a voluntary basis and shall receive no compensation for such services. During
the time such Residents are on rotation in Ambulatory Facility under this Agreement, Home
Hospital will incur the salary, fringe benefits, and other direct costs with respect to each Resident.
Ambulatory Facility shall not bill for any professional services rendered by Residents at
Ambulatory Facility.
8. INSURANCE.
a. Ambulatory Facility shall maintain, at Ambulatory Facility’s sole expense,
professional liability insurance covering Ambulatory Facility and shall ensure that all physicians
and surgeons furnishing services in connection with the Program or in conjunction with Residents,
including the Program Coordinator and all teaching faculty, maintain professional liability
insurance in amounts of at least One Million Dollars ($1,000,000) per occurrence and Three Million
Dollars ($3,000,000) annual aggregate. Ambulatory Facility shall also maintain comprehensive
general liability insurance for bodily injury and property damage, worker’s compensation and other
legally mandated coverages for all its employees in amounts as may be required by law. Such
coverage may be afforded via commercial insurance, self-insurance, a captive, or some combination
thereof. Ambulatory Facility shall provide Home Hospital with a certificate of such insurance
coverage prior to the effective date of this Agreement and at any subsequent date during the term
of this Agreement in accordance with the provisions of this Subsection 8.a. or upon Ambulatory
Facility’s request.

b. Home Hospital shall maintain, at Home Hospital’s sole expense,
professional liability insurance covering Home Hospital and the Residents. Such coverage may be
afforded via commercial insurance, self-insurance, a captive, or some combination thereof at limits
of $1,000,000 per occurrence. Home Hospital shall also maintain comprehensive general liability
insurance for bodily injury and property damage, worker’s compensation and other legally
mandated coverages for all its employees in amounts as may be required by law. Such coverage
may be afforded via commercial insurance, self-insurance, a captive, or some combination thereof.
Home Hospital shall provide Ambulatory Facility with a certificate of such insurance coverage
prior to the effective date of this Agreement and at any subsequent date during the term of this
Agreement in accordance with the provisions of this Subsection 8.b. or upon Ambulatory Facility’s
request.
9. INDEMNIFICATION AND RISK MANAGEMENT.
a. Each party (the “Indemnifying Party”) agrees to indemnify and hold
harmless any other party (the “Indemnified Party”) from any and all liability, loss, damage, claim,
fine or expense, including costs and attorney’s fees, arising solely out of the acts or omissions of
the Indemnifying Party, its employees and agents in performance of this Agreement.
b. The parties recognize that during the term of this Agreement and thereafter,
certain risk management issues, legal issues, claims or actions may arise which involve or could
potentially involve the parties and their respective employees and agents. The parties further
recognize the importance of cooperating with each other in good faith when such issues, claims or
actions arise, to the extent that such cooperation does not violate any applicable laws, cause the
breach of any duties created by any policies of insurance, or otherwise compromise the
confidentiality of communications or information regarding the issues, claims or actions to effect
such cooperation including but not limited to:
(1) Each party agrees to notify the other within ten days of receipt of any
lawsuits, claims or notices of intent to file a lawsuit based in any manner upon services rendered
pursuant to this Agreement;
(2) Each party agrees to provide the other with reasonable access to and
copies of all records including patient records which impact in any manner upon any lawsuit or
claim filed against the other party based in any manner upon services rendered pursuant to this
Agreement.
c. Where the parties are named as joint defendants in any claim or cause of
action arising out of the Program, it is the intent of the parties to cooperate and coordinate in the
areas of risk management and control, claims investigation and litigation to the extent practicable
and within appropriate considerations of conflict of interest; provided, each party shall retain
ultimate control of its own risk management and defense.
10. INDEPENDENT CONTRACTOR. The parties hereby acknowledge that they each are
independent parties contracting solely for the purpose of effectuating this Agreement, and neither
party nor any agents, representatives, or employees of that party shall be considered agents,

representatives, or employees of the other party. In no event shall this Agreement be construed as
establishing a partnership or joint venture or similar relationship between the parties hereto.
11. NON-DISCRIMINATION.
a. The parties covenant that there shall be no discrimination on the basis of
race, national origin, religion, creed, sex, age, veteran status, or handicap in either the selection of
Residents for participation in the Program, or as to any aspect of the clinical training; provided,
however, that with respect to handicap, the handicap must not be such as would, even with
reasonable accommodation, in and of itself preclude the Resident’s effective participation in the
Program. To the extent applicable to this Agreement, both parties agree to comply with all state
and federal employment laws, rules, regulations and executive orders, including Arizona Executive
Order 2009-09.
b. Ambulatory Facility agrees to treat in a non-discriminatory manner any and
all patients receiving medical benefits or assistance under any federal health care program.
12. CONFIDENTIALITY. With respect to any patient or medical record information
regarding the other party’s patients, each party shall comply with all federal and state laws and
regulations, and all bylaws, rules, regulations, and policies of the other party and its medical staff,
regarding the confidentiality of such information, including, without limitation, all applicable
provisions and regulations of the Health Insurance Portability and Accountability Act of 1996
(“HIPAA”).
13. CONFIDENTIAL INFORMATION OF HOME HOSPITAL. As between Home Hospital,
its affiliates, and Ambulatory Facility, any Confidential Information of Home Hospital or its
affiliates or Data provided to or learned by Ambulatory Facility for any purpose, in connection with
any software pursuant to this Agreement, shall be deemed to be the exclusive property of Home
Hospital. In no event shall Ambulatory Facility claim any rights with respect to such Confidential
Information or Data or take any action with respect to such Confidential Information or Data that
is inconsistent with the duties of a bailee for hire or in addition to the services Ambulatory Facility
is authorized to provide under this Agreement, without prior written consent of Home Hospital or
its affiliates. Additionally, Ambulatory Facility shall not use, authorize to use or disclose the Data
received from Home Hospital for the purpose of developing information or statistical compilations
for use by third parties or other division or subsidiary of Ambulatory Facility or for any commercial
exploitation, unless otherwise agreed upon in writing by Home Hospital or its affiliates. Moreover,
Ambulatory Facility hereby waives any and all statutory and common law liens it may now or
hereafter have with respect to data derived from Home Hospital’s or any of its affiliate’s
Confidential Information or Data. For purposes hereof, “Data” means all tangible data elements
belonging to Home Hospital or its affiliates under the terms of this Agreement. Data specifically
includes, but is not limited to, patient identification information, patient medical records, financial
information, business forecasts, personnel information, customer lists, marketing information,
Medicare, Medicaid and other payor information, reimbursement information, and other
information relating to the business of Home Hospital or any affiliate thereof or their respective
patients, clients or customers.

14. TERM. The term of this Agreement (“Term”), shall be from the Effective Date
through June 30, 2026.
15. TERMINATION.
a. Termination Without Cause. Except as otherwise provided herein, any
party may terminate this Agreement at any time without cause upon at least thirty (30) days' prior
written notice to the other parties; provided that all Residents currently rotating through the
Receiving Hospital at the time of notice of termination shall be given the opportunity to complete
their clinical rotation at the Ambulatory Facility, such completion not to exceed twelve (12) months.
b. Termination for Breach. Any party may terminate this Agreement upon
breach by the other party of any material provision of this Agreement, provided such breach is not
cured within fifteen (15) days after receipt by the breaching party of written notice of such breach
from the non-breaching party.
c. Immediate Termination. This Agreement shall automatically terminate if
either Home Hospital or Ambulatory Facility fails to maintain in good standing its licensure,
certification or accreditation governing the operation of its facility, or in the event that the Program
loses its accreditation. Such party shall immediately inform the other party in writing of any such
failure.
d. Termination for Changes in Law. In the event that any governmental or
nongovernmental agency, or any court or administrative tribunal passes, issues or promulgates any
new, or change to any existing, law, rule, regulation, standard, interpretation, order, decision or
judgment (individually or collectively, “Legal Event”), which a party (the “Noticing Party”)
reasonably believes (i) materially and adversely affects either party’s licensure, accreditation,
certification, or ability to refer, to accept any referral, to present a bill or claim, or to receive
payment or reimbursement from any governmental or non-governmental payor, or (ii) indicates a
Legal Event with which the Noticing Party desires further compliance, then, in either event, the
Noticing Party may give the other party thirty (30) days prior written notice of its intent to amend
or terminate this Agreement. Notwithstanding the foregoing, the Noticing Party may propose an
amendment to the Agreement to take into account the Legal Event, and, if accepted by the other
party prior to the end of the thirty (30) day notice period, the Agreement shall be amended as of the
date of such acceptance and if not amended shall automatically terminate
e. Effect of Termination. As of the effective date of termination of this
Agreement, neither party shall have any further rights or obligations hereunder except: (a) as
otherwise provided herein; (b) for rights and obligations accruing prior to such effective date of
termination; and (c) arising as a result of any breach of this Agreement.
16. REPRESENTATIONS AND WARRANTIES OF AMBULATORY FACILITY. Ambulatory
Facility represents and warrants to Home Hospital as follows: (a) each Ambulatory Facility
physician is a participating physician in Medicare and State’s Medicaid program; (b) any
compensation paid or to be paid by Ambulatory Facility to any physician is and will, at all times
during the term of the Agreement, be fair market value for services actually provided by such

physician, not taking into account the value or volume of referrals or other business generated by
such physician for Home Hospital. Ambulatory Facility represents to Home Hospital that
Ambulatory Facility has and will at all times maintain a written agreement with each physician
receiving compensation from Ambulatory Facility who is not an employee of Ambulatory Facility
(e.g., each non-employed independent contractor), which written agreement is or will be signed by
the parties, and does or will specify the services covered by the arrangement. Ambulatory Facility
further represents that with respect to employees of Ambulatory Facility with whom Ambulatory
Facility does not have a written employment agreement, the employment arrangement is or will be
for identifiable services and is or will be commercially reasonable even if no referrals are made to
Ambulatory Facility by the employee; and (c) Ambulatory Facility shall comply with all relevant
claims submission and billing laws and regulations.
17. DISCLOSURE OF TERMS OF AGREEMENT. Ambulatory Facility shall not refer to the
existence of this Agreement in any press release, advertising, marketing, publicity or other
materials, without the prior written consent of Home Hospital. Neither party shall use the name,
trade name, trademarks, service marks or logos of the other party or any of its affiliates in any press
release, advertising, marketing, publicity or other materials, without the prior written consent of the
other party. Ambulatory Facility shall not represent, directly or indirectly, that any product or
service of Ambulatory Facility has been approved or endorsed by Home Hospital or any of its
affiliates, without the prior written consent of Home Hospital.
18. ENTIRE AGREEMENT; MODIFICATION; GOVERNING LAW, COUNTERPARTS;
NOTICES, WAIVER; ASSIGNMENT. This Agreement contains the entire understanding of the parties
with respect to the subject matter hereof and supersedes all prior agreements, oral or written, and
all other communications between the parties relating to such subject matter. This Agreement may
not be amended or modified except by mutual written agreement. This Agreement shall be
construed in accordance with the laws of the State of Arizona, which provision shall survive the
expiration or other termination of this Agreement. This Agreement may be executed in one or more
counterparts, all of which together shall constitute only one Agreement. All notices hereunder shall
be in writing, delivered personally, by certified or registered mail, return receipt requested, or by
overnight courier, and shall be deemed to have been duly given when delivered personally or when
deposited in the United States mail, postage prepaid, or deposited with the overnight courier,
addressed at the place identified on the signature page below. A waiver by either party of a breach
or failure to perform hereunder shall not constitute a waiver of any subsequent breach or failure.
Neither party shall assign or transfer, in whole or in part, this Agreement or any of its rights, duties
or obligations under this Agreement without the prior written consent of the other party, and any
assignment or transfer by such party without such consent shall be null and void. This Agreement
is subject to the provisions of A.R.S. § 38-511. Exclusive venue and jurisdiction for any actions or
proceedings related to or stemming from this Agreement will be in the state or federal courts sitting
in Phoenix, Arizona.
19. REFERRALS. The parties acknowledge that none of the benefits granted Ambulatory
Facility hereunder are conditioned on any requirement that Ambulatory Facility, any Ambulatory
Facility physician or any physician affiliated with Ambulatory Facility make referrals to, be in a
position to make or influence referrals to, or otherwise generate business for Home Hospital. The
parties further acknowledge that neither any Ambulatory Facility physician nor any physician

affiliated with Ambulatory Facility is restricted from establishing staff privileges at, referring any
patient to, utilizing the services of, or otherwise generating any business for any other facility of
Ambulatory Facility physician’s or any Ambulatory Facility-affiliated physician’s choosing.
20. ACCESS TO BOOKS AND RECORDS. If the value or cost of services rendered to
Ambulatory Facility pursuant to this Agreement is $10,000 or more over a 12-month period, in
accordance with section 1861(v)(1)(I) of the Social Security Act, Home Hospital agrees that at least
for four (4) years after the furnishing of such Services, Home Hospital shall, upon written request,
make available to the Secretary of the United States Department of Health and Human Services
(the “Secretary”), the Comptroller General of the United States, or their respective duly-authorized
representatives, such books, documents, and records as may be necessary to certify the nature and
extent of the cost of such Services.
21. ARBITRATION. Any dispute or controversy arising under, out of or in connection
with, or in relation to this Agreement, or any amendment hereof, or the breach hereof shall be
determined and settled by final and binding arbitration in the county in which the Home Hospital
is located in accordance with the Commercial Rules of Arbitration (“Rules”) of the Judicial
Arbitration and Mediation Services (“JAMS”) before one arbitrator applying the laws of the State.
The parties shall attempt to mutually select the arbitrator. In the event they are unable to mutually
agree, the arbitrator shall be selected by the procedures prescribed by the JAMS Rules. Any award
rendered by the arbitrator shall be final and binding upon each of the parties, and judgment thereof
may be entered in any court having jurisdiction thereof. The costs shall be borne equally by both
parties.
22. COMPLIANCE OBLIGATIONS. Ambulatory Facility represents it read, understands,
and shall abide by Tenet's Standards of Conduct. Ambulatory Facility shall comply with Tenet’s
Compliance Program and Tenet’s policies and procedures related to the Deficit Reduction Act of
2005, Anti-Kickback Statute and the Stark Law. Tenet’s Standards of Conduct, summary of
Compliance Program, and policies and procedures, including a summary of the Federal False
Claims Act and applicable state false claims laws (collectively “False Claims Laws”) with
descriptions of penalties and whistleblower protections pertaining to such laws, are available at:
http://www.tenethealth.com/about/ethics-compliance.
23. EXCLUSION LISTS SCREENING. Ambulatory Facility shall screen all of its current
and prospective owners, legal entities, officers, directors, employees, contractors, and agents
(“Screened Persons”) against (a) the United States Department of Health and Human
Services/Office of Inspector General List of Excluded Individuals/Entities (available through the
Internet at http://www.oig.hhs.gov), (b) the General Services Administration’s System for Award
Management (available through the Internet at http://www.sam.gov), and (c) any applicable state
healthcare exclusion list (collectively, the “Exclusion Lists”) to ensure that none of the Screened
Persons are currently excluded, debarred, suspended, or otherwise ineligible to participate in
Federal healthcare programs or in Federal procurement or nonprocurement programs, or (z) have
been convicted of a criminal offense that falls within the ambit of 42 U.S.C. § 1320a-7(a), but have
not yet been excluded, debarred, suspended, or otherwise declared ineligible (each, an “Ineligible
Person”). If, at any time during the term of this Agreement any Screened Person becomes an
Ineligible Person or proposed to be an Ineligible Person, Ambulatory Facility shall immediately

notify Home Hospital of the same. Screened Persons shall not include any employee, contractor or
agent who is not providing services under this Agreement.
24. SURVIVAL. The provisions of Sections 9, 10, 12, 13, 20 and 21 shall survive
expiration or termination of this Agreement regardless of the cause of such termination.
25. SIGNATURE AUTHORITY. Individuals executing this Agreement on behalf of the
parties represent and warrant that they have been authorized to do so.
26. COMPLIANCE REQUIREMENTS FOR A.R.S. § 41-4401, GOVERNMENT
PROCUREMENT; E-VERIFY REQUIREMENT:
a. Home Hospital warrants compliance with all federal immigration laws and
regulations relating to employees and warrants its compliance with A.R.S. § 23-214, Subsection A
(that subsection reads: “After December 31, 2007, every employer, after hiring an employee, shall
verify the employment eligibility of the employee through the E-Verify program and shall keep a
record of the verification for the duration of the employee’s employment or at least three years,
whichever is longer”).
b. A breach of warranty regarding compliance with immigration laws and
regulations shall be deemed a material breach of this Agreement and Home Hospital may be subject
to penalties up to and including termination of the contract.
c. Failure to comply with a State audit process to randomly verify the employment
records of contractors and subcontractors shall be deemed a material breach of this Agreement and
Home Hospital may be subject to penalties up to and including termination of the Agreement.
d. The State of Arizona retains the legal right to inspect the papers of any employee
who works on this Agreement to ensure that the contractor or subcontractor is complying with the
warranty under Paragraph a.
For questions about E-Verify Home Hospital should visit the following web site:
http://www.uscis.gov/portal/site/uscis.
VANGUARD HEALTH MANAGEMENT, INC.
D/B/A ABRAZO COMMUNITY HEALTH NETWORK:
BRIAN ELISCO
By: BRIAN ELISCO (Jun 2, 2021 06:45 PDT)
Name: Brian Elisco
Title: CEO and Authorized Signatory
Date: Jun 2, 2021
Address: 1445 Ross Avenue, Suite 1400
Dallas, TX 75202
MARICOPA COUNTY, BY AND FOR ITS CORRECTIONAL
HEALTH SERVICES DEPARTMENT AND ITS PUBLIC HEALTH
DEPARTMENT :
By: _______________________________________

Chairman, Maricopa County Board of Supervisors
Attest: ________________________________________
Clerk of the Board
Date: ________________________________________
Address: 301 W. Jefferson St.
Phoenix, AZ 85003
________________________________________________
Approved as to Form Date
Deputy County Attorney

Exhibit A
Scheduled Rotations
The Program Director of the Family Medicine Residency Program at Home Hospital shall provide
a rotation schedule one (1) month in advance of rotations.

EXHIBIT B
STATEMENT OF RESPONSIBILITY
For and in consideration of the benefit provided the undersigned in the form of experience in
evaluation and treatment of patients of MARICOPA COUNTY CORRECTIONAL HEALTH SERVICES
OR MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH (“Ambulatory Facility”), the
undersigned and his/her heirs, successors and/or assigns do hereby covenant and agree to assume
all risks of, and be solely responsible for, any injury or loss sustained by the undersigned while
participating in the Program at Ambulatory Facility unless such injury or loss arises solely out of
Ambulatory Facility’s gross negligence or willful misconduct.
Dated this day of , 20 .
Resident
Witness

EXHIBIT C
CONFIDENTIALITY STATEMENT
The undersigned hereby acknowledges his/her responsibility under applicable Federal law
and this Agreement to keep confidential any information regarding patients of MARICOPA COUNTY
CORRECTIONAL HEALTH SERVICES OR MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH
(“Ambulatory Facility”), as well as all confidential information of Ambulatory Facility. The
undersigned agrees, under penalty of law, not to reveal to any person or persons except authorized
clinical staff and associated personnel any specific information regarding any patient and further
agrees not to reveal to any third party any confidential information of Ambulatory Facility, except
as required by law or as authorized by Ambulatory Facility.
Dated this day of , 20 .
Resident
Witness

EXHIBIT D
PROGRAM LETTER OF AGREEMENT BETWEEN
ABRAZO COMMUNITY HEALTH NETWORK AND
MARICOPA COUNTY CORRECTIONAL HEALTH SERVICES OR MARICOPA
COUNTY DEPARTMENT OF PUBLIC HEALTH
1. ROTATION
This Letter of Agreement covers the Family Medicine rotation of Abrazo Community
Health Network at Maricopa County Correctional Health Services or Maricopa County
Department of Public Health.
2. ROTATION HOURS/LENGTH:
No Resident will exceed the eighty (80) hour weekly limit during the rotation with
assigned Ambulatory Facility Faculty and staff.
3. ROTATION GOALS AND OBJECTIVES:
The goals and objectives for this elective rotation are attached as Addendum A and are
hereby incorporated into this Letter of Agreement.
4. TEACHING FACULTY:
The Abrazo Community Health Network Family Medicine Residency Program
Director, Merima Bucaj, D.O. will retain full control and responsibility for the overall education
and evaluation of the Residents.
5. TEACHING FACULTY RESPONSIBILITIES:
a) The supervising Faculty of Ambulatory Facility agree to participate voluntarily in each
Resident’s educational process without expectation of monetary compensation unless
otherwise stated in a written arrangement between the Abrazo Community Health
Network Family Medicine Residency Program and Ambulatory Facility.
b) The supervising Faculty agrees to provide a written evaluation of each Resident’s
performance to the program director at the conclusion of each Resident’s rotation.
c) The supervising Faculty agrees to not compensate any Resident for any purpose.
6. ABRAZO COMMUNITY HEALTH FAMILY MEDICINE RESIDENCY PROGRAM
RESPONSIBILITY:
a) The Abrazo Community Health Network Family Medicine Residency Program agrees
to notify supervising Faculty in advance of Residents assigned to this rotation.

b) The Abrazo Community Health Network Family Medicine Residency Program agrees
to provide a liaison to each Resident and supervising Faculty, who will provide
coordination and oversight of the rotation.
7. GOVERNING POLICY/LAW:
a) Residents will continue to be subject to all established policies and procedures of the
Abrazo Community Health Network Family Medicine Residency Program, its
Department of Academic Affairs, and the specific student-training program.
b) This Letter of Agreement is to be governed and construed in accordance with the laws
of Arizona.
8. TERM OF AGREEMENT:
This Letter of Agreement shall become effective on the execution of the agreement and
shall remain in effect until it is either amended or terminated upon written notification by either
Abrazo Community Health Network Family Medicine Residency Program or an authorized
representative of Ambulatory Facility.
Abrazo Community Health Network Maricopa County
Family Medicine Residency Program
Merima Merima Bucaj, DO Bucaj, (Jun 2, 2021 07:43 DO PDT)
Name: Merima Bucaj, DO Name: ________________________
Title: Family Medicine Program Director Title: _______________________________
Date: _______________________________ Jun 2, 2021 Date:_______________________________
akil akil ____________________________________ loli (Jun loli 2, 2021 10:58 PDT)
Name: Akil Loli, MD
Title: Designated Institutional Official
Date: ________________________________ Jun 2, 2021

ADDENDUM A
ACADEMIC GOALS AND OBJECTIVES
▪ Allow Family Medicine Residents to rotate into the clinical practice.
▪ Teach and supervise Residents in all aspects of patient care.
o Preference is given to teaching that is 1:1, bedside, hands-on, and direct.
▪ Serve as a role model for professionalism.
▪ Serve as a role model for patient advocacy and customer service.
▪ Teach and role-model the “art” of medicine.
▪ Participate in the medical education and evaluation of residents using the core competencies
set forth by the ACGME (www.acgme.org):
o One-on-one discussion regarding the care of every patient seen.
o Review of patient’s History and Physical exam. This may include a face-to-face
discussion with the patient to confirm or elicit history. Faculty may need to repeat
parts of the physical exam to confirm findings.
o Direct supervision of all procedures.
o Evaluation of each Resident’s fund of knowledge.
o Evaluation of each Resident’s diagnostic process.
o Evaluation of treatment options and follow up care.
o Critique of each Resident’s case presentation.
o Critique of each Resident’s documentation in the medical record.
▪ Participate in ongoing development of curriculum in specific area of specialty. This
includes the documentation of goals, objectives for learning and communication with the
residency program director at least yearly regarding curricular issues. All curriculums must
be compliant with the ACGME program information and RRC requirements for Family
Medicine and is subject to approval of Program Director and Core Faculty.