VANGUARD DBAABRAZO STUDENTAGMT.PDF

AGREEMENT FOR AMBULATORY CLINICAL ROTATIONS
THIS AGREEMENT FOR AMBULATORY CLINICAL ROTATIONS ("Agreement") is made and entered
into the later of September 1, 2019 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, whose principal office is located at 3250 W. Lower
Buckeye Rd., Ste. 2100, Phoenix, AZ 85009, and its PUBLIC HEALTH DEPARTMENT, whose principal
office is located at 4041 N. Central Ave., Ste. 1400, Phoenix, AZ 85012 (the "Participating Site").
RECITALS:
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 additiona,1 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. Participating Site agrees to provide such additional experience and training at its
Participating Site 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 Participating Site
NOW, THEREFORE, in consideration of the mutual promises contained herein, the parties hereby
agree as follows:
1. PARTICIPATING SITE ROTATIONS. Throughout the term of this Agreement, Participating
Site 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 years 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 Participating Site (the "Program Coordinator") who shall serve as
principal liaison between the Home Hospital and Participating Site for all matters concerning the Program.
Home Hospital shall submit to Participating Site the names and educational background of the Residents at
least two weeks prior to their scheduled rotations at Participating Site. Participating Site is defined to include
any portion of the clinical rotation occurring at another facility at which Participating Site provides
professional services.
2. RESPONSIBILITIES OF PARTICIPATING SITE. Participating Site shall be responsible for
the following: (a) provide an appropriate orientation to Participating Site; (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 Participating Site while on rotation to
D-1

Participating Site; (c) provide teaching faculty at Participating Site who shall be responsible for supervision
of clinical services rendered by Residents at Participating Site. 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 Participating Site; (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 Participating Site 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
Participating Site, 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 Participating
Site 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
Participating Site abide by the policies, rules and regulations and bylaws of Participating Site; Participating
Site may, after consultation with the Director of Medical Education, remove from the rotation and from
Participating Site any Resident who materially fails to follow such policies, rules and regulations; (d) require
each Resident to carry an identification card issued by Participating Site and to conspicuously display his/her
name badge when engaging in activities at Participating Site; (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 Participating Site with academic goals and objectives as
provided in the Program Letter of Agreement attached hereto as Exhibit D.
4. RESIDENT DISCIPLINE. An individual Resident's disciplinary problems shall be evaluated
jointly by Home Hospital and Participating Site in conference. Any corrective action shall be undertaken
consistent with the policies of the Program. Participating Site 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 Participating Site, be discussed in advance with the
Director of Medical Education.
5. HEALTH OF PARTICIPANTS. Each Resident assigned to Participating Site shall be required
to provide to Participating Site satisfactory evidence that each Resident is free from contagious disease and
does not otherwise present a health hazard to Participating Site patients, employees, volunteers or guests
prior to his or her participation at Participating Site. 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 Participating Site. In no event shall Participating Site 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
D-2

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 Participating Site under this Agreement,
the Residents assigned to Participating Site 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
Participating Site. For supervisory teaching activities rendered by Participating Site pursuant to this
Agreement, Home Hospital shall pay Participating Site as its sole compensation hereunder, a monthly fee of
Three Hundred Three and 00/100 Dollars ($303.00) for a one-half (1/2) month rotation and Five Hundred
Eighty-Five and 00/100 Dollars ($585.00) for a full month rotation. Rotations scheduled for less than a one-
half (1/2) month block shall be compensated at Twenty-One and 67/100 Dollars ($21.67) per one-half (1/2)
day and Forty-Three and 33/100 Dollars ($43.33) for each full day. Participating Site shall invoice Hospital
for completed services provided hereunder on a monthly basis. Each such invoice shall be in a form and
contain the information requested by Home Hospital. Home Hospital shall pay each invoice within thirty
(30) days after receipt thereof by Home Hospital of written documentation of the performance of the
services; provided, however, that no payment shall be made under this Subsection until the CEO or his/her
designee has approved the documentation attached hereto as Exhibit E. Notwithstanding the foregoing, no
compensation shall be payable to Participating Site in the event the documentation as reasonably required
by Hospital, including, without limitation, the IRS Form W-9 "Request for Taxpayer Identification Number
and Certification" and the documentation provided for under Exhibit E of this Agreement is not submitted.
It is acknowledged by the parties hereto that while the parties estimate the time required to perform duties
hereunder is approximately 120 minutes per one-half (1/2) day, or four and one-half (4 V2) hours per month
for a one-half (1/2) month rotation and eighty (80) hours per month for a full month rotation, the actual time
will vary from time to time, but as to the tasks to be performed and the time likely to be required to perform
such tasks, the above-stated fixed compensation fee is an estimate of fair market value. During the time
such Residents are on rotation in Participating Site under this Agreement, Home Hospital will incur the
salary, fringe benefits, and other direct costs with respect to each Resident.
Said documentation pursuant to Exhibit E shall be submitted to Home Hospital no later than
the last day of the first month following the month in which services were rendered ("Due Date"), to receive
payment. If the documentation is not received on or before the Due Date, Participating Site will forfeit
compensation for the Services rendered in that month.
8. INSURANCE.
a. Participating Site shall maintain, at Participating Site's sole expense, professional liability
insurance covering Participating Site 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. Participating Site
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. Participating Site 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 Participating Site's
request.
D-3

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 Participating Site 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 Participating Site'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,
D-4

both parties agree to comply with all state and federal employment laws, rules, regulations and executive
orders, including Arizona Executive Order 2009-09.
b. Participating Site 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 Participating Site, any Confidential Information of Home Hospital or its affiliates or Data
provided to or learned by Participating Site 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
Participating Site 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 Participating Site is authorized to provide under this Agreement, without prior
written consent of Home Hospital or its affiliates. Additionally, Participating Site 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 Participating Site or for any
commercial exploitation, unless otherwise agreed upon in writing by Home Hospital or its affiliates.
Moreover, Participating Site 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, 2021.
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 Participating
Site, 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 Participating Site 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-5

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 PARTICIPATING SITE. Participating Site
represents and warrants to Home Hospital as follows: (a) each Participating Site physician is a participating
physician in Medicare and State's Medicaid program; (b) any compensation paid or to be paid by
Participating Site 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. Participating Site represents to
Home Hospital that Participating Site has and will at all times maintain a written agreement with each
physician receiving compensation from Participating Site who is not an employee of Participating Site (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. Participating Site further represents that with
respect to employees of Participating Site with whom Participating Site 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 Participating Site by the employee; and (c) Participating Site shall
comply with all relevant claims submission and billing laws and regulations.
17. DISCLOSURE OF TERMS OF AGREEMENT. Participating Site 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. Participating Site shall not represent,
directly or indirectly, that any product or service of Participating Site 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
D-6

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 Participating Site
hereunder are conditioned on any requirement that Participating Site, any Participating Site physician or any
physician affiliated with Participating Site 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
Participating Site physician nor any physician affiliated with Participating Site 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 Participating Site physician's or any Participating Site-affiliated physician's choosing.
20. ACCESS TO BOOKS AND RECORDS. If the value or cost of services rendered to Participating
Site 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. Participating Site represents it read, understands, and shall
abide by Tenet's Standards of Conduct. Participating Site 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. Participating Site 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 1tjp://www.oig.lihs gov), (b)
the General Services Administration's System for Award Management (available through the Internet at
http://www.sam.g(w), 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-
D-7

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, Participating Site 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.
e. 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:
By:
Nam5/40-Molinaro
Title: Chief Executive Officer
Date: (f
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: 4041 N. Central Avenue, Suite 1400
Phoenix, AZ 85012
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 ("Participating Site"), 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
Participating Site unless such injury or loss arises solely out of Participating Site'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
("Participating Site"), as well as all confidential information of Participating Site. 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 Participating Site, except as required by law or as authorized by Participating
Site.
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
This PROGRAM LETTER OF AGREEMENT outlines MARICOPA COUNTY, BY AND FOR ITS
CORRECTIONAL HEALTH SERVICES DEPARTMENT, and its PUBLIC HEALTH DEPARTMENT, and
VANGUARD HEALTH MANAGEMENT, INC., a Delaware corporation, doing business as ABRAZO
COMMUNITY HEALTH NETWORK Family Medicine Residency Program.
1. ROTATION
This Letter of Agreement covers the family medicine with Obstetrics elective rotation of Abrazo
Community Health Network at the Department at the Maricopa County Correctional Health Services or
Maricopa County Department of Public Health.
2. ROTATION HOURS/LENGTH:
A resident will spend up to twenty (20) hours a week during a one (1) month rotation with his/her
assigned 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 Program Director, Merima Bucaj, DO will retain full control and responsibility for the overall
education and evaluation of the residents.
5. TEACHING FACULTY RESPONSIBILITIES:
a) The supervising Faculty agrees to participate voluntarily in the resident's educational
process without expectation of monetary compensation.
b) The supervising Faculty agrees to provide a written evaluation of the resident's
performance to the program director at the conclusion of each resident's rotation.
c) The supervising Faculty agrees to not compensate the medical student for any services
provided while on the rotation.
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 resident's assigned to this rotation.
D-1

b) The Abrazo Community Health Network Family Medicine Residency Program agrees to
provide a liaison to the 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 agreement is to be governed and construed in accordance with the laws of Arizona.
8. TERM OF AGREEMENT:
This 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 the Maricopa County Administration.
SIGNATURES
Participating Organization
Signatures of Maricopa County Date

ADDENDUM A
ACADEMIC GOALS AND OBJECTIVES
• Allow family medicine residents to rotate into the clinical practice
• Teach and supervise resident 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 the resident's fund of knowledge
o Evaluation of the resident's diagnostic process
o Evaluation of treatment options and follow up care
o Critique of the resident's case presentation
o Critique of the 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.

EXHIBIT E
MONTHLY CERTIFICATION OF SERVICES PROVIDED
Participating Site: MARICOPA COUNTY
Participating Site Physician
Date of Service Hours of Service Providing Service
By signing this document, Participating Site attests that the documentation above accurately reflects
the Services that Participating Site performed during this month.
Printed Name of the Authorized Participating Site Representative
Signature of the Authorized Participating Site Representative Date Signed
By signing this document, the Hospital Unit/Department Director acknowledges that the services
reflected above are consistent with the records of Services provided by Participating Site during the
month.
Hospital Unit/Department Director Date Signed